Suicidal Crisis: “The Single Most Important Factor in Why Our Clients Survive”

In 2012 I experienced a suicidal crisis after a traumatic event. I was placed under a mental health crisis team but found their approach and methods didn’t work for me. This experience led to my feeling that there was a need for an alternative type of crisis care for some of us.  

The following year I set up a Suicide Crisis Centre, which has attracted attention in recent years because of our ‘zero suicide’ achievement. We know that our methods, approach and ethos – carefully tailored to each individual’s unique needs – have contributed significantly to our clients’ survival. 

In this blog piece, I want to focus on one aspect of our approach. When I was placed under the psychiatric crisis team, the clinical distance of staff left me detached and disconnected from them. I understand why clinical distance exists within services. However, when someone is approaching the point of suicide, they will often (consciously or unconsciously) disconnect from people around them, as part of their preparation for ending their life. In that detached place, they can be very much at risk. We need to work proactively to build a strong connection with them, to keep them connected to us – and to keep them connected to life, because they are trying to disconnect from life itself. 

Almost all our team members are qualified BACP-accredited counsellors, because counselling skills are so effective when supporting clients in crisis. Building empathy is such a vital part in building the strong connection with our clients. But crisis support is different from counselling. The relationship is slightly different.

Our clients in crisis know that we care about them, and that we care about their survival. Some professionals ask me: “Isn’t there a risk that they misunderstand the relationship and mistake it for friendship?” But caring openly for clients is not incompatible with a professional relationship. There are still many boundaries which indicate to clients that this is a professional relationship. For example, there are boundaries of time: we see most of our clients for an hour a day. And all contact is via a central phone system – clients don’t have individual work numbers for our team.  

One of our clients used to say that he carried us with him “in his pocket”. He felt that we were always with him. We cannot be with our clients every second of every day but we know that the sense of being cared for, the value placed on their life and the knowledge that the team who cares is but a phone call away – all that helps them to survive even when we are not with them. When he left our services, the client wrote a poignant phrase on our charity’s social media page: 

“You remain in my pocket for life, supporting, guiding and aiding my recovery.” 

This illustrates how a strong connection can help sustain a person even when you are absent, and indeed even after they have left your services.  

There are other specific techniques that we use to help our clients in crisis, but the relationship that we build with them is central to everything. It is likely to be the single most important factor in why our clients survive.  

Despite our ‘zero suicide’ achievement, we have never had a ‘zero suicide’ ambition. Indeed, we never use the phrase within our charity, because we worry that it might put too much pressure on our team. From the very first day of providing services, our approach has simply been this:  

We do everything we can, for each individual, to help them survive. 

Some organisations – both statutory and charitable – respect the right of the individual to take their own life. Some charities describe this as ‘self-determination’. Psychiatric services sometimes express it as: ‘You have the (mental) capacity to make the decision to end your life’.   

We take a different approach, however. In my experience of supporting clients in crisis over many years, their ability to make decisions is almost always being impacted by high levels of distress, by mental illness (such as depression) or by post-traumatic symptoms. They are almost always thinking in a profoundly different way from how they usually would.    

For that reason, we work tenaciously to help our clients survive.    

Joy Hibbins will be delivering a CPD seminar, Supporting Clients in Suicidal Crisis, hosted by Sussex Counselling & Psychotherapy, on 19th February 2022. Click here for more information about the Suicide Crisis Centre.