Awareness Over Prevention: Changing the Conversation on Suicide
Suzz Sandalwood | Reframing suicide work: from unrealistic prevention models to compassionate awareness-based practice.
Written by Suzz Sandalwood | Seeking Veritas Columnist | | Sankarsingh-Gonsalves Productions
“Stories like this can live in the body alongside every other complicated grief that clinicians carry quietly, while the world assumes we just move on.”
She was my client and she died
She sat across from me at the women’s shelter where I was working many years ago. We had been doing a lot of hard work together around self-esteem, addictions, her worth as a human being. That day, she seemed in good spirits. I even wrote that in the log. It was the last time I saw her alive. The next morning, I got the call. My supervisor wanted details, wanted me to recount exactly what she said, what I saw, what I missed. I could feel myself sinking deeper into my chair with every question. The “what did you miss?” undertone hung in the air like thick smoke.
When her parents came the following day, they brought her seven-year-old daughter. My supervisor asked me to take the child into the playroom. I sat on the floor with toys and my insides felt like they were shredding. She looked straight at me and said, matter-of-fact: “My mom died.” All I could manage was, “I know. I’m so sorry.” I held it together for her, but inside I was also holding the little girl in me, who grew up with her own mother’s suicide attempts. The girl I once was that watched wrists slit open in front of her and was told it was her fault. Who pulled pills out of her mother’s mouth while calling 911… again. Who eventually hung up on her mother to protect herself, only to carry the guilt when her mother died a few days later.
That client’s death has never left my mind fully. I didn’t have the workplace agency support I needed, and I took a leave from the field for a while. Stories like this can live in the body alongside every other complicated grief that clinicians carry quietly, while the world assumes we just “move on.”
“Suicide is not a faucet that can be shut off with the right combination of hashtags and hotline numbers.”
The impossible weight of “prevention”
In the field of mental health we know it’s not a matter of if, but when a client will die by suicide. Still, when it happens, the language of “prevention” makes it almost unbearable. Prevention implies control. It suggests that if someone dies by suicide, someone else failed; failed to intervene, failed to notice, failed to stop it. The word itself turns grief into guilt and makes clinicians feel like accomplices to tragedy. The family feels it too. Parents and partners comb through memories, convinced they should have caught some invisible signal. Prevention tells them they missed something obvious. They didn’t.
This is why our cultural obsession with “suicide prevention” is not just misguided, it’s cruel. Suicide is not a faucet that can be shut off with the right combination of hashtags and hotline numbers. It emerges from the interplay of trauma, biology, inequity, neurochemistry, and despair. Sometimes, despite every intervention, people die. That does not mean anyone failed. It means we are human, and humans are vulnerable.
Language that wounds
Public campaigns love the neatness of “prevention.” It’s clean. It’s hopeful. It photographs well. But inside the therapy office, in the homes of grieving families, in the hearts of those who’ve lost someone, “prevention” becomes a painful word. It carves blame where there should be compassion. It silences mental health workers who can’t risk admitting their grief for fear of professional scrutiny. It keeps families locked in shame. And worst of all, it keeps the conversation about suicide trapped in an impossible binary: you either stopped it, or you failed. That is not the reality. That is not the ethics of care. That is not the truth of grief.
“Awareness invites responsibility without implying fault.”
Awareness as an ethical alternative
What we need is not prevention. We need awareness. Awareness doesn’t pretend to be omnipotent. It doesn’t set clinicians and families up to fail. It doesn’t overpromise. Awareness makes room for compassion instead of control. It says you may not be able to stop every suicide, but you can notice. You can listen without turning away. You can ask the hard questions and sit in the answers. You can dismantle stigma so that people don’t suffer in silence.
Awareness invites responsibility without implying fault. It shifts the focus from unrealistic guarantees to meaningful conditions, access to care, safety, belonging, literacy about mental health and despair. It says our job is to make life more livable, to build spaces where people are seen and not judged for their pain.
Clinical honesty matters
Clinically, this shift matters. Suicide prevention rhetoric often leaves practitioners terrified of liability, desperate to predict the unpredictable, and ashamed when the inevitable happens. It sets up systems that prioritize paperwork and protocols over presence and relationship. Awareness changes that frame. Awareness honors the therapeutic relationship without pretending it guarantees immortality. It gives clinicians permission to grieve, to be human, to acknowledge limits without collapsing under them. It builds systems of support instead of systems of blame and it tells the truth, some clients will die. Not because we didn’t care, not because we weren’t skilled, but because pain is sometimes unbearable, and humans are not machines we can recalibrate at will.
To insist on “prevention” is to participate in a lie. It’s comforting for the public, but corrosive for those on the frontlines. It suggests a kind of mastery we do not have and should not claim. Awareness is harder. It requires us to face uncertainty, to accept limits, to sit in discomfort. But it is also more ethical, more clinical, and more humane. It gives space for survivors to grieve without guilt. It lets clinicians acknowledge heartbreak without shame. And it allows us to build communities grounded in honesty rather than illusion. We cannot prevent every suicide. But we can be aware, deeply aware, in ways that make life a little less lonely, despair a little less silent, and grief a little less cruel.
and now you know…….
About the Author: Suzz Sandalwood RSW/MSW is a Registered Social Worker, Psychotherapist, Advanced Certified Clinical Trauma and Addiction Specialist, Certified Grief Counsellor and is a former writer for Psych Central. She has extensive professional and personal experience in first responder, addiction, and grief communities | Connect with the author: https://suzzsandalwood.com
Wow. Reading this article was hard. I am a person who experienced the suicide of a good friend. I was only a teen when a friend of mind killed himself. In Trinidad, at the time, there was a horrific stigma around suicide. It was as cowardly and selfish. Not knowing any better I reacted negatively to my friend's passing. I even refused to go to the funereal - only doing so because my parents insisted. It was only later in life that I really began to understand the forces that are at play when this happens. That "world closing in" darkness that seems to snub out any light. The "no other path but this" view of reality that squeezes at the heart. The "finally this will give me (or my loved ones) freedom" from this constant throbbing pain.
Indeed this was a hard article to read, but it is a necessary one. Thanks for writing this.