My Experiences in Suicide Prevention

I first started in the field of suicide prevention in 1994, when I received 54 hours of training and worked as a suicide hotline counselor for a now-defunct agency in Dallas called Contact 214. I loved it. Having experienced a suicidal thoughts and behavior myself, I understood the need to be heard, listened to, and understood by another person. It thrilled me to be that person for someone in need.

Based partly on my experiences as a hotline counselor, I decided to get a master’s degree in social work. During my studies, and for a while afterward, I worked for the University of Texas’ counseling center’s 24-hour hotline. This was a paid position with weekly individual supervision, weekly group supervision, and many training opportunities. Although the counseling line handled the gamut of concerns, from test anxiety to roommate problems to serious mental illness, many of the calls drew on my skills in suicide risk assessment and intervention.

After I earned my MSW, I worked in various crisis and mental health settings where I frequently helped people at risk for suicide. First, I was a counselor for survivors of domestic violence, then for adult survivors of childhood sexual abuse, at SafePlace, an agency in Austin. Trauma increases the risk for suicide, and many of my clients struggled with urges to end their life.

I also worked as an intake counselor at a psychiatric hospital called Charter, and when the hospital folded I became an intake counselor for Austin-Travis County’s Psychiatric Emergency Services (PES). Most of the people I evaluated and counseled at Charter and PES presented with intense suicidal thoughts, sometimes accompanied by auditory hallucinations, self-harming behaviors, or major depression.

Up until that point, I was piecing together part-time jobs. In 2000, I took a full-time job as an emergency room social worker for Seton Medical Center in Austin, TX. In this role, I conducted assessments primarily for people with suicidal thoughts, substance use problems, or both. I also worked in the ICU with people who had made a suicide attempt.

In 2001, I started doctoral studies at the Brown School of Social Work at Washington University in St. Louis. My intention in pursuing a Ph.D. was to learn how to conduct research about various aspects of individuals’ suicidal experiences, especially including the decision to seek professional help (or not).

thumbnail of Freedenthal 2007 Race disparities in MH svcsAs a doctoral student, I joined a research study called AIM-HI (American Indian Multisector Help Inventory). The study followed American Indian youth living in an urban area or on a reservation over a period of years. In this role, I co-authored a journal article comparing suicide risk between the reservation and urban youth (the reservation youth were at much higher risk) and looking at American Indian youth’s reasons for not seeking help when suicidal (stigma was a huge factor).

My doctoral dissertation looked at adolescents’ use of mental health services in the same year that they experienced suicidal ideation or attempted suicide. I used data from the 2000 National Household Survey on Drug Abuse, which had 19,430 youth participants. The survey asked youth if they had thought about or attempted suicide in the previous year. As I reported in a journal article, White youth were almost twice as likely as Black and Hispanic youth to have used mental health services around the time they were suicidal.

Subsequently, as a faculty member at the University of Denver Graduate School of Social Work, I have worked on numerous projects related to helping people at risk for suicide. Perhaps my biggest accomplishment is my book Helping the Suicidal Person: Tips and Techniques for Professionals. I am also proud of the website I created,, which had almost 4 million visitors as of February 2019, and of a graduate course I created and now teach every year, Suicide Assessment and Interventions. You can see my vita here for a list of all my projects, articles, presentations, and other works.

I also have a small psychotherapy and consultation practice in Denver. My therapy clients have come to me with a wide array of challenges, but most have experienced suicidal thoughts, attempted suicide, or lost a loved one to suicide. I draw from cognitive behavior therapy, dialectical behavior therapy, and acceptance and commitment therapy in my work with clients at risk for suicide.

Although I conduct trainings and teach graduate courses on suicide assessment and intervention, I also continue to learn as much as I can about the topic. I regularly attend suicide-related conferences, read current literature about suicide assessment and intervention, and remain active in the suicide prevention community. No matter how much I do, no matter how much I know, there is always more to learn.

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