People are complicated. As a social worker, you are often working with individuals in immense emotional and often physical pain. One of the best aspects of being a social worker is when you help someone heal. Other times, a client can have difficulty moving out of their pain. It can be scary for a social worker (new or experienced) to have a client indicate they are going to irrevocably harm themselves. I know a lot of therapists who say they don’t take clients who are at high risk of suicide but anyone you work with may be at risk. It is essential, to be willing to be aware that suicide might be a risk.
- Talk about it! If a client brings up suicide – don’t be afraid to talk about it. If your client doesn’t bring it up and you are getting the feeling something is off – you can ask them if they are thinking of harming themselves. Speaking about suicide and asking questions will not cause someone to try to commit suicide but it may help them (and even save their life.) Ask questions. Do all the textbook steps of finding out if they have a plan, means and opportunity to kill themselves. Gather information.
- Use empathy and reflexive listening– Use non-judgmental words of empathy. “I can see how much pain you are in now.” “You are saying you feel like you have no options.” Since empathy and reflexive listening is social work 101 and probably comes very naturally to you – it is easy to forget the impact that listening and understanding someone’s story may have on a person.
- Be honest (Don’t lie!) – Don’t tell someone everything will be fine tomorrow because it might not be. Work with the situation. Feel free to find positives but make sure they are real.
- You can’t fix everything – As a social worker, you want to help. Unfortunately, there may be no easy or magic answer to an individual’s problems. There are times you may have to just sit and witness the client’s pain because there is nothing else you can do.
- Leave your Values at the door – All I mean is that suicide can provoke strong feelings in each of us. Maybe suicide is against your religious beliefs. There are always variables, but generally, telling your client he or she will go to hell if they commit suicide is not helpful. Think about what you are saying to the client who is suicidal, and ask yourself why you are saying it.
- Don’t Ignore it – Make sure to make some plan. Maybe ask permission to get a family member or friend involved. Make sure you have given the client tools before they leave if you are not getting them assessed to be hospitalized.
- Educate yourself – If you have the opportunity, take a graduate course in working with clients who are suicidal. Definitely, take continuing education courses on interventions. You want to learn not only how to deal with someone who is actively suicidal but also learn to be able to predict the risks. Risks would include past suicide attempts, isolation, and mental health diagnosis, lack of support systems, impulsivity, and hopelessness. There are many more signs that you can learn about and many ways to intervene early on.
- Err on the side of Caution – I am a staunch defender of self-determination. However, sometimes we have to make a decision to have someone get help. This is a hard step for me, I hate feeling like I’m making someone do something they don’t want. I once worked with a delightful woman who told me about her wishes to die. Even though her plans weren’t concrete she could not agree to any plan not to harm herself. I helped her get assessed and to the hospital and she was admitted. Later when she came back to therapy she said she was very angry with me and was coming back only because her daughter said she must. She also said she was doing better and no longer wanted to harm herself. It is OK if your clients are angry with you. It is OK if they don’t want to see you anymore because you assisted with getting them hospitalized. It is better to make a mistake by having them assessed or working out a plan than have them die because you didn’t want to upset them. Err on the side of caution.
- Self-Care and Supervision – Anytime a social worker interacts with a distressed client, it takes an emotional toll. Don’t forget to take time for yourself. Read a fun book alone or take your kids to a movie or go for a run or out with friends. Do something just for yourself. Also, make sure to speak to a supervisor or consult with another clinician. It is imperative we talk about our experiences with other clinicians for both feedback and validation.
As a social worker, there are many different kinds of messy, complex situations you may come across. You will learn to handle them and you will be a beacon to some of your clients.
World Suicide Prevention Day is September 10th. Consider taking some time and thinking of some way you can contribute to the prevention of suicide.
