How do you know when your suicidal thoughts are enough to seek a higher level of care?

I'm going through a really hard time right now. I'm in therapy, but cancelled my next appointment and can't bring myself to reach out. I feel stuck and alone. I've definitely been struggling on and off with suicidal thoughts, but I'm unsure how to tell if they're serious enough. I've thought about methods, thought about counting my pills, thought about if they're enough to kill me, thought about writing suicide notes and what I would write. Mostly I just want the pain to stop.