Dear Amber Fuller, LMFT,
I am a mental health provider for a local agency that works with individuals with severe and persistent mental illness and who also struggle with having low-income. I have a client who I’ve worked with for the last two years and about two weeks ago I got the worst phone call of my life. It was my client’s dad who stated to me that my client had overdosed on a cocktail of meds the night before, went into cardiac arrest, and passed away about 24 hours after having overdosed. In trying to stay strong for my client’s father I consoled him and pointed him in the direction of some resources. I then had to read through each page on client suicide in the agency’s policy and procedure manual all the while having to complete about 4 hours worth of paperwork while all of my other tasks for other clients stacked up. In the process of doing this I saw the “big wigs” laugh, make jokes, be incredibly loud and noisy, and not appear as though they were doing work and each of them knew what had just happened with my client. Thankfully, I have a supervisor who has been extremely supportive through this process and has encouraged me through it. I finally fell apart about 3 days ago. I can’t shake the feeling that I’m responsible for my client’s death and that if I had just done something more, something different, something else, my client would still be here today. I can’t sleep and find myself feeling terrified that something awful is going to happen with my other clients. In the paperwork that I have to complete, I sense the filtering down from the top of the hiearchy, the anxiety of making sure suicide doesn’t happen and I feel as though I carry all of that weight on my shoulders. I’ve found myself feeling terrifed, guilty, not worthy to work with my clients, incompetent, and angry with the “big wigs”. I love the work that I do but I just don’t know if I can handle the stress and pressure that I take home with me from work. How do I survive this overbearing feeling of responsibility and grief? I’m desperate!
-Guilty Mental Health Provider
Dear Traumatized Mental Health Provider,
Early in my mental health days I started off teaming with individuals with severe and persistent mental illness. It was a very rewarding job and I felt so much purpose in seeing how much resources can make a difference in the life of somebody who feels like everyday is a struggle to survive. I got to see the in’s and out’s of mental illness and was privelged to have people allow me to see the very depths of the most vulnerable places of their souls.
In this vocation I found that the most anxiety provoking idea was the thought of losing a client to suicide. I also found that others within the profession became concerned about this as well. As a mental health provider, we do what we can do and then some to help people see hope and to help them feel supported. The very idea of losing a client to suicide makes most of us feel a little ill in our stomachs. I, like you, experienced the loss of a client to suicide and felt responsible for it for a good 2 months. It was two of the worst months of my life. The what if’s really took me by suprise and I can’t imagine going back to that place.
I want to reassure you that it can, will, and does get better. You were created for this job, don’t quit. You care so much because you care and your very purpose is in the work that you do.
How did I find myself being able to sleep again? I found myself being very intentional in researching suicide, specifically suicide of clients. The key factor, however, was understanding responsibility. I came to grips with the idea that there was absolutely nothing I could have done to change my client’s mind. I saw my client the day before they committed suicide and they presented at baseline stating they were feeling good and that everything was going smoothly in their life only to get the life changing phone call the following day. All of the what if’s that came from having seen them the day before was overwhelming, however, there was nothing I could have done differently. If I had been there with that client in their moment of attempt I still would have had no control over their actions, thoughts or feelings…yeah, I could have helped alleviate some parts of the situation, but the very fact that all I could do is alleviate implies that I’m not the one responsible for the actual action. Our thoughts, feelings, and actions can only be controled by one person, the individual…and as much as we’d like to think that we have control over other people’s thoughts feelings and actions, we just don’t, and in this situation, it can help alleviate the overwhelming anxiety in knowing that we only control our own. Your client made the choice that they made, and even if they were ill and possibly on civil committment, it still was not a choice that you made for them. You are only responsible for your choices and can’t be blamed for somebody else’s. Also, statistically, client’s who are successful in completing suicide don’t tell others that they plan to do it. This would be like planning a surprise birthday party for a friend who hates suprises and then telling them that you’re doing it all the while knowing that if they found out they won’t come to their party. When a client is serious about their plan, often then know that somebody will do something about it thus putting barriers up that make their plan harder. There’s likely no way you would have ever known. Please give yourself the same grace you give your clients. Check into whether or not your workplace offers EAP coverage and go speak with somebody about the situation (at Fuller Living we specialize in this and would love to schedule with you!)…grieve your client, and reflect on their purpose in your life and the good you offered to them. Give yourself time to heal and be kind to yourself. Find coworkers who have been where you’re at and find support in that painful yet comforting bond that you have with each other. Lastly, seek legal advice. I know that it’s very common to think of legal ramifications in this situation and to ask all of the what if’s. Calm your anxiety by speaking with an attorney about possibilities and likelihood of those possibilities. Also, know that 95% of the things we worry about never happen. I remember worrying about legal ramifications until the brother of my client called me one day out of the blue (I had a release on file, of course) and told me how much of a difference I made in their family’s life. It reminded me that the world is really big, and our client’s worlds are bigger than sometims we think, and that we assume all responsibilty forgetting about their very own ability to be resourceful in building relationships and asking for help. Most agencies have legal aid as a benefit to working for the company. Speak with your HR rep to find out if yours has this benefit.
Your value, worth, and purpose have not changed and never will so live in your purpose and focus on being responsible with things you can actually control…like your strengths, and making a difference with them!
(If you or somebody you know is struggling with the death of a client or a loved one by suicide please know that there is support. Contact us to schedule an appointment, there is hope and healing after trauma)
A very helpful read for this time in your life: