To anyone who is a therapist, have you ever worked with a client, and later found out they killed themselves? How did you feel prior to learning this? Did anything about you change?

1. Not a therapist, but I work at the NSPL and spoke to a teen today who is pretty set on suicide. Has a plan, not willing to safety plan or have rescue sent. We talked about goals and dreams and he has so much to look forward to, but he just wasn't able to see through to the positive. By the end of the call I was just happy he had reached out and told someone his story. I have no way to follow up on him - I don't even know what state he lives in. But I think the most we can hope for as mental health workers is making even just a little bit of a difference.
   — stephope


2. I have been a case manager for over 10 years. This means I work under a therapist and can do things like teach anger management, communication skills, or help clients develop recovery plans. I have lost two clients to suicide. While each one made me sad, neither was shocking, nor did I feel like I had failed them. Both clients had attempted numerous times and I had hospitalized them. I had worked hard, spending multiple hours a week with each of them. I feel like some people are going to continue until they manage to complete an attempt. The best thing that I can do is help the ones that want the help. In cases where they don't, all I can do is help where I can and be there for the family after the fact.
   — missamel


3. I'm a grad student studying counseling and I had to interview a licensed counselor for an assignment. The woman I interviewed made a point of telling me that a client completing suicide isn't a reflection on the counselor.
   — Tisroc






4. I’m training to be a mental health nurse I had nursed a man with depression and suicidality and he was much improved got discharged. I was driving to work and it came on the news. My first thought my head was “for fucks sake” I was totally pissed off and angry. It was like aw fuck, I thought we had sorted that! Then that gave way to sadness then acceptance.
   — mrssac


5. No matter the medical profession, sooner or later you will lose a patient. And that does not mean that you failed at your job neither in general nor in that case in particular. Remember, even the best therapist can't see inside the patients head. If the patient decided to commit suicide and doesn't tell you when you ask there is nothing you can do about it. Nothing. Nobody can read minds, and therapists are not better in detecting lies than the average person. Who by the way is pretty bad at detecting lies while simultaneously vastly overestimating their skill to do so
   — malefiz123


6. I was very proud of the relationship I had built with my client, and we had done some excellent work together. She had experienced suicidal ideation in the past, so we’d done a lot of work around safety planning and I was aware that her “plan” was to overdose on illicit drugs. The worst part of her death was not knowing if her overdose was intentional or accidental... There was no note. At the end of the day I was devastated to see a young life cut short, and it was hard to grieve without knowing whether she had committed suicide. But I never felt as though I carried responsibility because I was confident in the work I had done with her.
   — singtothenight






7. Former therapist. I counseled a family- dad and two older kids. The dad shot the son to death, then committed suicide. The daughter got away. I wasn’t surprised in the least. About 3 weeks before the incident, I had some concerns about this family. Aside from the reasons they were appointed by a court to seek counseling, there were new-not necessarily red flags- but I can’t really put a finger on it. On a Tuesday afternoon I reported to my supervisors that I had these concerns, knew my session notes were on point, and by the end of the day I had requested them to be reassigned. We were incredibly short staffed, and this family was such a case that required at the very least an LPC, and thus could not assign them to one of my assistants or “case managers” to work with. Ultimately, I didn’t change or do anything differently as I knew that 1- I would not see them again 2- I was going to leave. It was one of the instances that solidified my decision to turn in my resignation by that Thursday morning. That afternoon I was told I had to still see this family until I left two weeks later, the thought of that was just so daunting. I walked out that day and never went back. Former co worker told me what happened less than a month later. All I could think was “of course he (the dad) did that...”
   — Lollyn


8. Thank you everyone for sharing their stories. It was nice hearing people’s insight and experiences.
   — AnActualGarnish


9. I’m a registered nurse, working in mental health for 16 years. The last 5 has been doing crisis in the ER. I have know a number of people who have completed suicide, or died accidentally related to substance use. Each one feels different, but is certainly felt and reflected on. There is an intimacy in what we do & how involved we get with everyone we connect with. Although I recognize that many of these situations are beyond my control, I think of these people often, and try to learn from each situation so that hopefully I can offer more to the next person.
   — Stellabella27






10. Professor and licensed therapist here. Never had a client kill themselves, but did have a client attempt to in the bathroom. I was running a group and one of the nurses came plowing through the door screaming for help. I ditched the group (probably wasn’t suppose to but oh well) and ran following said nurse down the hall. She was screaming that someone was in the bathroom of their room (inpatient locked psych unit) and they weren’t responding and the door wasn’t open. I ended up booting the door open and got it open just enough for the nurse to slide in. On the other side of the door was said patient with a towel or a sheet (I can’t remember specifics) around his neck and his face was some shit I’ve never seen before. Nurse pulls dude off the door enough so that I could get in, we drag him into the main hall, and start doing CPR. Still remember client file said HIV+ but in the moment it seems like I forgot that information (been tested since clean). I was doing rescue breaths, she was compressing the chest. Eventually dude came back and started breathing on his own. Next thing I know a team of icu nurses and docs come busting in the door and take over. They send him down to icu and he ended up having permanent brain damage due to lack of oxygen. What’s interesting is he went from the depressed, drug addictive, unwilling for treatment person to someone with the brain capacity of a 5 year old. He was back in the psych unit but on the SPMI floor but actually seemed happy. In regards to your question of how I felt? Meh, they had a “debriefing” meeting after my shift and it was like 12:30am and I was suppose to be off at 11. I wanted nothing to do with that meeting and had friends hitting me up to go out for the night. It didn’t really mess with me that much, but I definitely tell that story in class to our counseling students so they can be prepared for anything that comes their way.
    — itsdatoneguy


11. I'm not a therapist, but did run groups for seriously mentally ill patients in a prison. The thing is, from my experience, that if someone is determined to kill themselves it gets done and there is just not a lot you can do. Conversely, you have people who say that they are going to do it all the time that never will. I honestly believe others play a very small role.
    — pawnofanexpandinguni