Online counselling is pretty popular. I get lots of young people (14-25), lots of women who are single parents or recently separated or want to talk about their relationship issues, and lots of people who are quite depressed or anxious or who have experienced trauma or abuse or are thinking about suicide or are self harming. These categories make up about 95% of new clients at any time.
After a couple of bad experiences I no longer directly work with people who are self harming or thinking about suicide – it is too risky. I refer them to a specialist service. To be extra careful I also refer people who score highly on depression or anxiety or whose main issue is some other mental health concern. Many mental health issues are empirically shown to just not be suitable for online counselling anyway.
Sometimes, though, a high risk client will slip through to me. They won’t be too clear on their initial submission and will only disclose the real issue once they’re in the counselling session. When that happens I can’t just kick them out – especially if they are at a high level of risk. When that happens I spend the session working through the anxiety they (often) have about accessing face to face support and try to link them in with it.
Sometimes they won’t have it. They don’t want support workers involved in their actual life. They don’t want hospital staff or the department of child safety or the police knocking on their door. I can understand that, for sure.
But it is really, really stressful when someone on the computer at the other end of the internet is telling you they are in a very high risk situation and simply won’t let you help them be safe.
They won’t let me help them. and then I just have to wonder.. forever.