Content Warning: This article talks about suicide and suicide prevention in general terms.
I would like to start off by thanking Stacey for her patience with me. We met a while ago, and I have not been able to make the time to actually write this up until now.
Stacey is a social worker and author who focuses on suicide prevention and has an amazing website full of resources for people living with suicidal ideation, people who love people living with suicidal ideation, and mental health professionals.
Stacey is the author of Helping the Suicidal Person: Tips and Techniques for Professionals, an excellent book for providers to address fear about working with suicidal clients regardless of their theoretical orientation, and she runs Speaking of Suicide, a Facebook community for people “touched in any way by suicide or suicidal thoughts.” Stacey “wrote the book I wanted to read” as a new practitioner, though her book is accessible to providers at all levels.
She shared with me that many existing books emphasize on immediate risk assessment and safety planning without focusing on “what to do to help people feel better.” She wanted to move the emphasis from practitioner liability to client need. She also wanted to share what she has learned in her career in suicide prevention.
Surprisingly, Stacey has seen some pushback in her work. She told me, “It shocked me how many people hate suicide prevention,” and she wrote an excellent blog piece about why she is so passionate about this topic. Even though the vast majority of suicide survivors say that they are glad they survived, people get upset that she wants to prevent someone from dying from suicide if that is what they “want” to do.
Unfortunately, in the field of psychology, we often emphasize clinician liability over client need. Stacey was at a training where she was told to send clients to the emergency room “the minute they mention suicidal thoughts.” When asked how we justify hospitalizing so quickly when hospitalizations can do more harm than good when they are not the right resource, the presenter said, “It doesn’t matter if it helps [the client] … it protects you.” Stacey cited multiple studies that show that “it’s indisputable that, for many people, hospitalization is traumatic.”
It is so important for clinicians to be well-versed in risk assessment and determining when hospitalization is needed. Stacey noted that she was taught, “If there is a suicide, then there was a failure” by the clinician. Although we want to prevent suicide, placing the emphasis on therapists “failing” our clients by not hospitalizing ends up doing more harm than good. Stacey cited an article by a psychiatrist that pointed out that we don’t call it a failure when an oncologist loses a patient to cancer.
This attitude does a disservice not only to clients, but to their loved ones: telling someone they “could have” prevented someone’s death. We can be there for someone, offer appropriate support, do our best, and still miss the mark. We unfortunately cannot magically know whether someone is going to act on suicidal thoughts, and Stacey has blogged about this topic. She asked, “How do we predict the future?” The fact is, we can’t. This is why we do our best to monitor, assess risk, and walk with our clients on their journey.
If you or someone you know is experiencing suicidal thoughts, help is available. The National Suicide Prevention Lifeline is available 24/7 in the United States for those in crisis. Call 1-800-273-8255 to speak to someone.