Heather Trepal, the 68th president of the American Counseling Association

In graduate school, I completed my practicum at a children’s counseling center. The evening I was to meet with my very first client, I entered the room but didn’t immediately see him. I looked around and saw that he had crawled under the couch. I knelt down and introduced myself. I then asked how he was doing. He answered, “I want to kill myself.” He was 8 years old. He was experiencing unspeakable pain because of a difficult family situation and was trying to deal with things to the best of his ability. The only solution he could imagine for himself was to no longer be alive.

After consulting with my supervisor, I went home to my apartment and spent a sleepless night tossing and turning with worry. This was my first client ever. Had we asked the right suicide assessment questions? Had we made the right decisions regarding intervention? How was the client’s family reacting? And, most importantly, was the client going to be OK? Thankfully, with the help of my supervisor, we were able to provide the client and his family with the assessment and intervention that he needed in that moment. I worked with the client and his family for six more months. I still think of him often.

This month’s Counseling Today cover story is about suicide. If you were in a room full of people and asked those whose lives had been touched in some way by suicide to stand up, I’m sure that many, if not most, would do so. That’s because suicide does not discriminate. It touches the young (like my first client), the very old, and everyone in between.

Shortly before the ACA Conference commenced this past spring, news broke of the suicide of Jeremy Richman, a neurobiologist and co-founder of the Avielle Foundation (aviellefoundation.org). The news of Jeremy’s death deeply affected the ACA community. Many remember the outstanding keynote he gave on brain health and compassion at the ACA 2016 Conference in Montréal. Jeremy’s daughter, Avielle Rose Richman, was killed in the 2012 mass shooting at Sandy Hook Elementary School, and Jeremy’s passion for exploring ways to eradicate violence through compassionate connection was compelling. Jeremy’s dream for a safer world for all continues through the ongoing work of the Avielle Foundation.

Suicide is a national public health challenge. Visit the American Foundation for Suicide Prevention website at afsp.org to view some state-by-state statistics. Some states have enacted legislation that addresses both mental health education and suicide prevention. As counselors are aware, suicide is a complex issue, and that means ongoing advocacy for our clients, students and communities is sorely needed. Given our training and experience in human growth and development, as well as in prevention, counselors play an important role as advocates. We can work with other mental health and medical professionals on suicide prevention education.

Suicide is such an important topic for students, professional counselors in every setting, and counseling supervisors. If we continue to engage in conversations on this topic, perhaps we can lessen the associated shame and stigma surrounding it. I am glad that we, as a profession, continue to discuss the topic of suicide and can learn about the best approaches for assessment, intervention and prevention from one another.


Finally, my deepest condolences are with the families, friends, and extended communities of those affected by the recent shootings in Southaven, Mississippi; Gilroy, California; El Paso, Texas; and Dayton, Ohio. These horrific acts of gun violence will continue to impact these communities. ACA offers a number of resources for the public and for counselors working with communities affected by trauma (see counseling.org/knowledge-center/mental-health-resources/gun-violence-trauma-resources). We must continue working together to support one another as we respond to these events.