Coping with Client Suicide

Clinical Update

By Zur Institute

View a complete list of Clinical Updates.

Every year, suicide claims more lives than war, murder and natural disasters combined. There is one death by suicide in the US every 12 minutes. On average, 20 veterans die by suicide each day. Every day there are approximately 11 youth suicides. Are you aware that it is estimated that in the US, roughly half of all psychiatrists and one in five psychologists experience a patient’s death from suicide? This appears to be one of the worst fears of many mental health professionals.

“Nothing in my training had prepared me for how to handle a completed suicide,” said one therapist whose client never even mentioned wanting to hurt himself.

She never saw it coming. Unfortunately, very limited training, if any, is available for graduate students, seasoned clinicians, or supervisors regarding how to handle this traumatic experience and knowing what to do when a client suicide occurs. There is also a stunning lack of research into mental health professionals’ reactions to a client’s suicide. A major reason is the clinician’s hesitation and reluctance to open up and talk about their experiences of a patient’s suicide.

Limited studies on the topic maintain that after a client’s suicide, many clinicians report feelings of self-blame, shame, fear of exposure, loss of hope and doubt, as well as overall emotional upheaval.

Clinicians question themselves: “How could I have missed it? What did I overlook? Do I have the skills to continue practicing? Why can’t I put this aside? Why can’t I hold it together?”

Furthermore, particularly in the US, many clinicians fear legal action against them, or the denial of the future coverage of their malpractice insurance. Without proper support and an accurate understanding of one’s rights and responsibilities, these experiences and beliefs can become overwhelming and silencing, thus reinforcing a professional stigma.

Experts in the field encourage clinicians to consider the following when facing the death of a client by suicide:

Talk to someone who can help
Talking with a supervisor, a mentor, a trusted colleague or even starting one’s own therapy are seen by far as the most important things one can do following a client’s suicide to work through the initial shock and the subsequent grieving process.

Allow yourself time to grieve (as long as it takes)
Grieving has its own trajectory. It is not a linear process. One should take time to work through these feelings. One should remember that grief may surface suddenly, months after the event.

Be aware of extreme reactions
One should be mindful of possible temptations to either isolate or to overcompensate by trying to become an “ideal” therapist with other clients. Instead, it is important to explore the feelings that emerge out of perceived professional inadequacy, for example, without feeling defensive.

Become familiar with the research
While research on the topic is scarce, what is available can help put things into perspective and normalize one’s process.

Learn from the experience
One can grow through this trauma. It can help develop a deeper sense of compassion for those who lost a loved one to suicide, as well as cultivate better ways of articulating what to expect and how to cope with these situations.

While it is important to prepare ahead of time for the possibility of facing a client’s suicide, it is vital to be well-informed and to develop the needed skills to act quickly and effectively when working with suicidal clients.