As a therapist, you are bound to work with a suicidal client at one point in your career. Working with clients suffering from depression means you will innately come across an individual battling suicidal thoughts. It is estimated that 60% of people who commit suicide have major depressive disorder, linking the two closely.
While sessions are a critical time to work with clients on assessing their risk for suicide and teaching them skills for managing their depression, it is not always clear how to help individuals once the hour is up.
While the session is over, the client leaves your office with their feelings and continues to carry them until the next time they see you. The idea is that they will take the skills and interventions you work on with them and apply them outside of the session, but there may be other ways in which you can help them as well. Keep reading to learn more about suicide prevention strategies for therapists.
Steps to Help Suicidal Clients During and After a Session:
Assess for Risk Factors
If a client is showing signs of depression or suicidal ideation, it is vital that you assess their risk for suicide. Look at their individual, relationship, societal and community risk factors to determine if they are at a higher risk for suicide. Risk factors can include many things, such as previous attempts, history of mental illness, history of substance abuse, family history of suicide, lack of community, direct access to means, and more.
Screen for Suicide Risk
Once you have determined a client’s risk factors, ask them screening questions to determine if they are at imminent risk for suicide or not. Depending on what level of risk the client is at for suicide, their safety may be in question, and a clinician may need to be alerted. If the client is at a lower risk for suicide but still needs resources, then continued sessions and additional help may be the right route.
Make sure to follow your state’s laws and regulations regarding patients at high risk of suicide.
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What About When the Session Ends?
After the session ends, the best thing a provider can do is give patients an arsenal of resources. This bank of tools, interventions, and resources are all bases of strength that a client can pull from when managing suicidal ideations. These resources might vary from community to community, but some of the most common include:
A safety plan, also known as a safety contract, is a plan in which the client and provider share a common goal, keeping them alive. While this plan is created during a session, a patient uses it after a visit to stay safe. If the patient finds themselves having suicidal thoughts, this action plan gives them steps they can take to cope rather than lean into those thoughts. A safety plan might include steps such as:
- Contact Someone – Have them reach out to a friend, family member, mentor, crisis hotline, or another resource so that they are not alone.
- Skills and Interventions – Activities and strategies that the client can practice, such as coping skills, mindfulness, meditation, and other methods of calming themselves.
- Plan for Safety – If a client finds themselves feeling suicidal, they should take themselves to a safe environment. The provider and their client should discuss what this means. The patient should remove their access to means and take themselves to a safe location or somewhere that makes them feel safe.
Utilizing telehealth capabilities can help you bridge the gap between sessions with at-risk clients. If a client needs more frequent sessions or is experiencing a mental health emergency, you can host secure, HIPAA-certified virtual sessions with them using software like ShareNote Community. Private messaging in the secured client portal will help you to check in with clients and help them stick to their safety plan when they are feeling suicidal.
Inform them of the nearest hospital to their home and work address should they need to go there. If you are not available to answer the phone during a crisis, a patient should always know that there is somewhere they can go so they do not have to be alone and will be able to receive help.
Always looking around your community for local resources for patients dealing with suicidal thoughts. While there might not be specific groups dedicated to this, there may be community events, groups, or services that might benefit your client differently by helping to alleviate their symptoms.
On July 16th, 2022, the Suicide & Crisis Lifeline went live. Previously, the National Suicide Prevention number was 1-800-273-8255. Now, the number has been shortened to 988. This number directs individuals dealing with mental health crises to a mental health professional working at the crisis center closest to the caller. The individual can also text this number if they aren’t up to calling or chatting with a professional by visiting 988lifeline.org.
When working with a client at risk for suicide, it is important to prepare yourself and your client with a plan to follow in case of emergencies. By implementing these suicide prevention strategies, you can better support your clients battling suicidal thoughts outside of their sessions.
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