In the field of social work, we are confronted daily with the possibility of loss.  Loss of clients that are vulnerable and on the margins of society.  In clinical social work, the symptoms of depression and substance use compound that probability of loss.

Graduate school programs do not prepare you for the loss of a patient.  Field placements do not have “death by suicide” as part of a learning agreement.  There is not a class on how to manage that volume of loss in this profession.

I was informed that a Patient died by suicide.

There is not a textbook to tell you what to do first; there is not a plan for providers to help you navigate the thoughts and emotions that arise due to this magnitude of loss. As practitioners we learn to recognize, identify, safety plan, and provide outreach.  All of us have done that and we are blindly comforted with the fact that we know how to do those practices and that our patients contact us the next day.  What happens when all of that is done and the Patient decides that this world is all too much?

Our clinical training tells us that depression is a silent beast, lying in wait for episodic periods of darkness opening a deep hole and encouraging our loved ones and those we serve down the hole, all the while closing the opening to make it difficult for them to climb back out.

I am sad to say that I have experienced this loss before with other patients.  The loss does not get easier the longer I do this work; it teaches me that I am only a small part of this world and in doing this work I am an agent of change and the darkness is at times much stronger than I am.

As you work in your day, whether you are a social worker, teacher, counselor, doctor, take a moment to recognize that depression is bigger and that those we serve are doing the best they can on any given day.  I will miss my patient a lot; I hope they have found peace from their darkness. I am proud to say I had time to know them.