The Hazards and Joys of work in Mental Health


One of the riskiest and most challenging aspects of working in mental health is that of suicide.  For those who are depressed, bipolar, and psychotic that risk is very high.  We do everything in our power to prevent such tragedies.

In the last two weeks at work I have witnessed two contrasting stories on the topic.  Firstly, a client committed suicide that was on the caseload of one of the case manager.  This client’s life was very hard, she suffered from extreme highs and lows and she had numerous previous attempts where she had escaped death. The case manager noted that on the weekend that it happened there was a hang-up message from that client.  So close to asking for help.  This was very hard for the case manager and for all those who had worked with the client over the many years.

The second story is one of miraculous grace.  A client of a different case manager told me that one of her clients told her that over the week-end her client had prepared to commit suicide and was ready to do it and at that very moment her phone rang and the client picked it up.  It was his daughter who he had not heard from in 10 years calling to say that she wanted to come and visit him shortly.  This stopped the man in his tracks and he sought out help.

I have never experienced the loss a client by suicide, but I understand that most people who work in mental health do so at some point in their career.  I know that likely I would struggle emotionally and feel guilt and wonder what I could have done.  I know it would be an incredibly painful experience.  Trusting in God, as a loving father, I know he loves that deeply wounded and through the second story see that he does miraculously use us weak human beings for his means of grace in this world.

I was interviewing and listening to a new client the other day as she told me her story of death of all of those close to her, parents who were not available or in jail, and chronic physical problems. I  also read the chart to see also that she had experienced abuse in foster case.  It is so easy to understand how people become so hopeless when they experience life as unhappy and without joy as this woman described.  I just wanted this client to experience the love of Jesus.  The story of the phone call reminds me that God moves in mysterious ways gently and unexpectedly through each person’s life.

My lenten discipline for this season is to endeavour to pray for each client before seeing them and ask that God would give me openness, patience, love and grace.


Entering the world of work

This past week I had two interviews, received all of my grades, and was offered and accepted my first job with an MSW. I will be working as a mental health therapist at my former practicum site.

One of the questions that the interviewer asked me was what I felt about safety: both mine and clients’.  At first I thought of this question mainly in terms of my own personal safety; I felt relatively little unease or concern regarding that.  However the interviewer’s wanted to know how I would deal with clients safety,  more specifically how I would deal with the responsibility and the emotional challenges of the dealing with suicide and client self-harm.  As I was studying for this interview I had been madly reading everything I could on suicide risk assessment. As I did so the responsibility of my future role started to weigh on me.  I began to become worried that I would miss something important and then I would lose someone.  It is important to have that sense of responsibility but what the examiner’s wanted to know more than anything (as they could see I had read up and knew suicide risk assessment fairly well) was whether I could handle someone whom I had done everything possible to help and protect them…dying.  The interviewer candidly related how she had experienced this in her career in mental health.  I related how important self-care and seeking good family and social support would be for this job.  However, I have to admit that the thought of someone committing suicide on my caseload scares me- as it probably should- and I think it would be an incredibly difficult thing to deal with as a social worker.  Nonetheless I am determined to plunge into this work and field with courage, skill, and openness to learning.

My question to you, fellow professionals (social workers, counsellors, etc): how have you dealt with risk/difficult situations (whether it be the difficult call to remove a child or not, or to hospitalize someone, or have someone on your caseload die). How have you learned to cope keep strong even with the huge responsibility you carry?

Let me know- help me be prepared for the disappointments and challenges ahead.

Also: how has your faith helped you through such challenges?