{"id":23963,"date":"2026-10-06T00:00:15","date_gmt":"2026-10-06T06:00:15","guid":{"rendered":"https:\/\/www.unk.com\/blog\/?p=23963"},"modified":"2026-10-05T02:51:40","modified_gmt":"2026-10-05T08:51:40","slug":"what-to-do-now-if-your-client-is-suicidal","status":"publish","type":"post","link":"https:\/\/www.unk.com\/blog\/what-to-do-now-if-your-client-is-suicidal\/","title":{"rendered":"What to Do Now if Your Client is Suicidal"},"content":{"rendered":"

Feeling a clear and imminent threat that your client may kill themselves can be terrifying.<\/p>\n

Of course, I don’t want to worry you! It may be that you never see a suicidal client.<\/p>\n

But I want to give you some clear and simple practical<\/em> steps to take should you begin to suspect that a client has real intention to end their own life.<\/p>\n

Agitation is concerning<\/h3>\n

In a recent blog post<\/a> I described how language patterns can change in the pre-suicidal (and also how shifting language patterns may predict relationship breakdown<\/a>). I also listed suicide risk factors. Most of these were fairly obvious, such as expressing a desire to die or at least that life feels too painful to bear, and a history of self-harm.1<\/sup><\/p>\n

But, pointedly, catastrophic impulsivity<\/a> driven by nervous agitation was a greater predictor of suicide attempts than low mood.<\/p>\n

\r\n \t\t\t\r\n \t\t\tCatastrophic impulsivity driven by nervous agitation is a greater predictor of suicide attempts than low mood.\r\n \t\t\t<\/span>\r\n \t\t\tClick to Tweet<\/span><\/path><\/svg><\/i>\r\n \t\t<\/div>\n

Research suggests that when agitation is present, the risk of suicide attempts may increase by up to 50%.2,3<\/sup><\/p>\n

It may seem strange to think that a proportion of suicides may have been simply impulsive acts rather than long-planned ones, but this might account for at least some people’s deaths by their own hand.<\/p>\n

A client who is exhibiting all the depressive thinking biases<\/a> and who seems to be energized by agitation (perhaps pacing up and down, wringing their hands, compulsively tapping a foot or fingers) may be particularly at risk of doing something in the moment.<\/p>\n

People need motivation to act<\/a> in order to kill themselves which, paradoxically<\/a>, deep depression robs them of.<\/p>\n

Your duty of care<\/h3>\n

Now, the vast majority of people who come to see you will probably not<\/em> be suicidal. Seeking help implies at least some<\/em> hope that things can get better<\/a>.<\/p>\n

But if you’re genuinely concerned that a client may attempt suicide, this must be treated as a high-risk, potentially life-threatening situation, and there are well-established clinical and ethical steps to follow. The priority is always safety over confidentiality.<\/p>\n

You can tell your client you have a duty of care, not just as a professional but from one human being to another.<\/p>\n

But how exactly should you proceed?<\/p>\n

<\/div>\n

One: Conduct an immediate risk assessment<\/h3>\n

We don’t want to assume someone is a great suicidal risk when they’re not. And ultimately we have to take people’s word at face value.<\/p>\n

If someone says they don’t always want to be here but that they would never take their own life, we can<\/em> believe that.<\/p>\n

Yes, some people may hide their true feelings in order to make a more successful attempt, but we can only work with what we have.<\/p>\n\n

Having said that, some clinical guidelines (from, for example, the National Institute for Health and Care Excellence [NICE] and Zero Suicide in the UK) emphasize using a validated tool such as the Columbia Suicide Severity Rating Scale (C-SSRS)<\/a> or the PHQ-9 item 9<\/a> to assess suicide risk rather than unstructured exploration alone.<\/p>\n

If you are uncomfortable doing this kind of risk assessment you could recommend or request another professional do this as fast as possible. Or at least explore that possibility.<\/p>\n

We can gently and calmly explore:<\/p>\n