But what help is there? The Samaritans are a volunteer organisation for the UK and Ireland who are available 24 hours a day with confidential listeners working by telephone, text or online.
Outside this area it is worth contacting www.befrienders.org.
Samaritans say their phones ring every 5 seconds - so there are a lot of people in desperate circumstances who need help.
However, what about private counselling? If a client in a face to face session said they have suicidal feelings, as a counsellor you would allow them to express those feelings and support them in whatever way was appropriate. Many counsellors take details of GPs and next of kin for precisely this scenario and include in their contract the fact that this is something they will be unable to keep confidential as, morally (if not legally) they feel the need to intervene.
So what is different about working with clients online? Many websites for online counsellors will state that they cannot or will not work with clients who have thoughts of suicide. That's fine of course, we are ethically obliged to work within our level of competency. But just a couple of thoughts occur to me.
Firstly the Samaritans, while trained listeners and part of a large organisation - and truly admirable, are not qualified counsellors with degrees and extra professional development under their belts.
Secondly, why is it different to listen to someone face to face express these thoughts and feelings to hearing the same things online? In neither case are you going to immediately rush out to 'save' your client, which would be undermining them and their personal choice and control, but in both would seek to hear what they had to say, support and probably find extra support for when they were no longer talking to you. (My next blog will address assessing and responding to suicide risk)
But my main point is that, by saying you will not take a client who expresses suicidal feelings (worse - what if they are already a client? - Are you going to leave them with feelings of abandonment as you refer them rapidly to someone else?) you are denying them the opportunity to speak truthfully and from the heart. You are keeping a barrier between you that they are unable to cross if they wish to work with you.
How many of us, at any point in our lives, has not thought - 'it would be just so much easier, less painful if .... Or 'I just can't do this any more - there is no point, no hope .....'?
Then what if you came up against someone you really wanted to talk to, to help you, and they referred you elsewhere because 'they didn't work with suicide'. Is it really suicide? Is it just someone needing to say the words, try it out, see if it is a reality for themselves? Or just ask you for help.
As the BACP information sheet P7 (Reeves and Seber, 2010) points out - there is not only no evidence that asking a client if they have suicidal thoughts will put the idea into their heads, but there is a great deal of evidence to say that allowing a client the opportunity - allowing them permission and the space - to express these thoughts and feelings is an honest and respectful way of helping them to keep themselves safe. Many people feel suicidal but have no intention of acting on those feelings. However, allowing yourself to be with them in their despair in the moment allows them to reflect further on the meaning of their feelings and take control for themselves.
There is also plenty of evidence to suggest that the possible anonymity of Online Counselling allows the client to say things they would not usually say - and certainly not face to face. This is precisely then the time that, when a relationship has started to develop, the subject of suicidal thoughts might come up - and we have to be prepared to deal with that and be the empathic, honest and non judgemental ear they need us to be.
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