One of the most challenging things to discuss among mental health and well-being professionals is the death of a client. Death is a painful and complex subject at any time, but the death of a client carries with it a specifically challenging weight for those of us who work in the fields of counseling, psychology, and mental or general health. This is especially true if the death was by suicide. Learning that a client has taken their own life is always hard and often comes with a lasting and heavy emotional toll, both personally and professionally. Although client suicide is a harrowing and complex topic, it is important to discuss how we manage this on a personal level.
According to a recent study, up to 80% of mental health care practitioners have lost one or more clients to suicide; depending on the work setting, client suicide can be a regular occurrence.[1] It is, therefore, vital that we can openly discuss client suicide, understand what it means for us as professionals and as people, and learn where to seek help when we need it.
Understanding Client Suicide
Psychologists, counsellors, and clinicians work across such a wide range of environments that it’s difficult to obtain accurate statistics on the prevalence of client suicide, as it varies considerably from place to place and person to person. A study conducted in Australia, however, suggested that one-third of mental health practitioners have experienced one or more completed client suicides, while two-thirds had experienced attempted suicide.[2]
Part of what makes it such a difficult issue to deal with is that suicide itself is so complex. Research shows that suicide is very often impulsive, which makes it extremely challenging to predict. While certain mental health conditions, such as borderline personality disorder and bipolar disorder, place individuals at a much higher risk for suicidal ideation and attempts, there is no way to be sure whether or not suicide will become an issue. Similarly, while individuals who have a history of trauma, and particularly abuse, are statistically at a much higher risk of suicide, each person’s situation is different and unpredictable.[3]
As it is so difficult to foresee accurately, client suicide represents a frightening possibility that can have a lasting effect on us as professionals: 97% of mental health practitioners report client suicide to be their greatest fear, and 50% of those who experience client suicide go on to show post-traumatic stress symptoms.[1]
The immediate and long-term effects of client suicide can vary, but they are frequently very intense. After experiencing client suicide for the first time, psychologist Dr Laura Sobik stated that it caused her to feel “shattered” both personally and professionally. She said, “I didn’t realize just how painful it would be.”[4]
Although the experience of every mental health practitioner is unique, some of the known effects of client suicide are:[5]
- Shock
- Confusion
- Denial
- Difficulty sleeping
- Anger at the client or society
- Guilt or feelings of responsibility
- Feelings of shame or inadequacy
- Helplessness
Helping Heal Yourself
Beginning the process of healing after a client’s suicide is not always easy, but an excellent first step is practicing what we preach and reaching out for help. Use the resources available, speak with other mental health practitioners, share your experiences with others, and check in when necessary. As Sobik said of her experiences dealing with a first client suicide, “the most healing part for me was talking to others who had been through a similar situation, and were now on the other side…. The more we talk about these events, the more helpful it is for us as clinicians and as humans going through such a sad and difficult thing.”
There are also dedicated organizations that provide support for mental health practitioners who have experienced client suicide: the Clinician Survivor Task Force of the American Association of Suicidology (AAS) is a group of professionals dedicated to understanding and preventing suicide, and the Coalition of Clinician-Survivors (CCS) exists to support mental health professionals and other caregivers who have experienced both personal and professional losses from suicide.
As with any loss, taking the time to grieve properly is critical. At the end of the day, as mental health professionals, a client is a person with whom we have a relationship; their death is going to have a significant emotional impact, and we owe it to ourselves to treat that with as much care and compassion as we would any other experience of grief. Avoiding extreme reactions – withdrawing from our roles as healers completely or doubling our efforts to be a super carer, for example – can help us process our feelings of pain, sadness, anger, and hurt. Research has also suggested that mindset and belief play an essential role in coping with client suicide in the long term: mental health professionals who cultivate an understanding of their client’s agency and right to make autonomous decisions alongside their grief at the loss of life report fewer symptoms of post-traumatic stress disorder over time.
No matter the circumstances, death is difficult to face. For mental health practitioners who experience client suicide, the difficulty and pain of the loss can feel overwhelming. But as healers, we have the tools to help and need to remember to take our own advice: don’t suffer alone, seek support through knowledge, share your burden with others, and take the time to grieve and feel through your complex emotions.
[1] Van der Hallen, R. (2023). Suicide Exposure and the Impact of Client Suicide: A Structural Equation Modeling Approach. Archives of Suicide Research, 27(2), 426–438. https://doi.org/10.1080/13811118.2021.2020190
[2] Trimble, L., Jackson, K., & Harvey, D. (2000). Client suicidal behaviour: Impact, interventions, and implications for psychologists. Australian Psychologist, 35(3), 227–232. https://doi.org/10.1080/00050060008257483
[3] De Berardis D, Martinotti G, Di Giannantonio M. (2018) Editorial: Understanding the Complex Phenomenon of Suicide: From Research to Clinical Practice. Front Psychiatry. Mar 1;9:61. doi: 10.3389/fpsyt.2018.00061. PMID: 29545757; PMCID: PMC5839093.
[4] DeAngelis, T. (2008) Coping with a client’s suicide. gradPSYCH Magazine, 11. https://www.apa.org/gradpsych/2008/11/suicide[5] Tchounwou, P.B. et al. (2022) Attitudes toward Suicide and the Impact of Client Suicide: A Structural Equation Modeling Approach. International Journal of Environmental Research and Public Health 19(9): 5481. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9102844
