The study aimed to identify the level of suicidal ideation in early attrition clients and their reasons for the early termination of their therapy. The cross-sectional design involved early attrition clients (CA) who withdrew from therapy before their second session (n = 61), and continuing clients who (CC) progressed beyond their second session (n = 73). All completed the Suicidal Behaviours Questionnaire-Revised scale, and the CA group also completed the Reasons for Terminating Therapy Scale. Clients were significantly more likely to disengage if they were self-referred, had no health-care support or had lower suicidal ideation. The study identifies the significant role of suicidal ideation and referral source in therapy retention and the implications this has for therapists and counsellors.