Suicide is the second leading cause of death for 10 to 24-year-olds. According to the 2017 Youth Risk Behavior Survey, 17.2 percent of high school students nationwide have thoughts about suicide. In the same survey, 8.6 percent of high school students reported that they have made a suicide attempt. Suicide rates have been increasing significantly over the past 15 years. Although females attempt suicide more frequently, males complete suicide at a higher rate due to increased likelihood of using lethal means. Some of the factors increasing suicide rates are media stories, TV shows about suicide (i.e., 13 Reasons Why) and higher levels of social media use. Unfortunately, not allowing your child exposure to social media is not the answer because no social media use is also related to higher risk of suicide. Communicating with your child about mental health and suicide can help prevent suicide. Below is a guide on risk and protective factors, talking to your teen about suicide and what to do if they are having suicidal thoughts.

Suicide risk factors

Risk factors are conditions that increase the chance of attempting or committing suicide. There is no single cause for suicide, so being aware of various risk factors is important when supporting your teen and keeping them safe.

  • Bullying (e.g., verbal, physical, social exclusion)
  • Loss (passing of family member, friend, pet)
  • Stressful life events (e.g., divorce, school changes, breakups)
  • Struggles with identity (e.g., gender, sexual orientation)
  • Substance use
  • Hopelessness
  • Stigma associated with asking for help
  • Lack of support systems
  • Access to lethal means (e.g., firearms, pills)
  • Family history of suicide

Two of the strongest predictors of suicide:

  • Mental health challenges (e.g., depression, trauma, anxiety)
  • Prior suicide attempt

Protective factors

Protective factors are conditions that are linked with a lower likelihood of risk and a greater likelihood of well-being. When thinking about your child’s mental health, the factors below will lower their risk of suicide.

  • Support systems (family, friends, community)
  • Strong problem-solving and coping skills
  • Availability/access to clinical care (e.g., therapy, medication, rehabilitation)
  • Restricted access to lethal means

Suicide warning signs

As a parent, it can feel scary to know that your teen may be thinking about suicide. While it is impossible to know for certain without your child telling you themselves, there are warning signs that you can look out for.

  • Talking about feeling hopeless, wanting to disappear or die, wanting to go to sleep and never wake up and/or having no reason to live
  • Extreme mood swings
  • Withdrawing or isolating themselves
  • Acting recklessly
  • Sleeping too much or too little
  • Expressing that they feel like a burden to others
  • Behaviors that indicate they may be planning to kill themselves (e.g., buying a gun, searching online about suicide attempts, giving away possessions, writing goodbye letters/texts)

How to talk to your teen about suicide

It can feel scary to talk to your child about suicide. Many parents express that they are nervous that if they talk about suicide with their teen, it will put the thought into their head. Fortunately, we know this is not true, and, by talking with your teen about suicide, you can help prevent suicide.

  • Educate yourself: You will feel more comfortable talking about suicide if you feel well equipped with knowledge about suicide. Use reputable resources such as journals (e.g., using google.scholar.com) and reliable websites (e.g., suicidepreventionlifeline.org).
  • Create a safe space: One-on-one time and moments that foster connection (e.g., parent-child outings) can be the best time to bring up depression and suicidal thoughts.
  • Ask open-ended questions: Open-ended questions are questions that you cannot answer with a simple “yes” or “no.” By asking open-ended questions, you are supporting your child in finding their own words to express how they feel.
    • Examples of open-ended questions: “Tell me about how you have been feeling lately,” and “Say more about how frustrating earlier today was for you.”
  • What to ask: Below are some examples of how you can ask your child about suicide.
    • How are you feeling?
    • How did __ (an event, person, situation) make you feel?
    • Have you or your friends ever talked about suicide?
    • Have you ever had thoughts about not wanting to live?
    • Do you ever wish you didn’t wake up?
    • In the past few weeks have you wished you were dead?
    • Have you ever tried to hurt or kill yourself?
  • Remember to combine these questions using normalizing and supportive tones. For example: “I know things have been feeling hard for you. I see that you are trying to work hard and get through the stress. When life becomes too stressful, sometimes we might have thoughts like we wish we weren’t here anymore, or we might think about death. That we just want the challenges to be over. Have you ever had thoughts like this?”
  • Keep the door open: Sometimes teens are not ready to talk at the exact moment their parent is ready. Remember, you prepared yourself for the conversation, but the conversation may be a surprise to your teen. If they say they are not ready or do not have anything to talk about, respond by letting them know that whenever they want to talk, you will be there to listen, not judge, and help support them.

How to respond if your teen endorses suicidal thoughts

  • It is common for parents to want to “fix” the things that feel hard in their teens’ life. This is a normal feeling. You want to be their protector! However, suicidal ideation is complex and cannot be turned off in a moment. Often, teens feel shame about having suicidal thoughts. If a parent responds by going into solution mode immediately, this can cause the teen to feel invalidated and unjustified in their feelings.
  • Listening, responding with empathy, validation and providing emotional support are the best first steps. Once this is expressed, you can start the discussion with your teen regarding getting help.
    • Examples of supportive statements: “I’m so sorry you have been feeling this way,” “I’m going to support you no matter what,” and “I know this can feel scary. I’m going to be here for you as long as you need.”
  • Most importantly, when talking to your child about suicide, remember to take what they are saying SERIOUSLY.
  • Get them help. Find community resources such as therapy. Dialectical Behavior Therapy (DBT) is an evidenced-based therapy for adolescents with suicidal ideation.
  • Keep the environment safe: lock up all prescriptions and over the counter medications and lock up sharp objects or weapons.
  • Create a safety plan about what to do if your child is having suicidal ideation.

When to go to the hospital for an evaluation in the emergency department or call 911

  • Your child is making preparatory action to kill themselves, writing a suicide note, telling a friend about suicide, gathering items to make an attempt, etc.
  • Your child has a plan or method to kill themselves.
  • Your child has taken action in an attempt to kill themselves, even if they did not follow through with the attempt.
  • Once you go to your nearest hospital, the team there will evaluate and will determine what level of care is needed.

Resources

  • National Suicide Prevention Lifeline (1-800-273-8255)
  • Crisis Text line (741741), Text Home to Chat with a Crisis Counselor
  • Trevor Project (1-866-488-7386), Crisis intervention for LGBTQ+ Youth 13-24
  • Montgomery County Crisis Center and Mobile Crisis (240-777-4000)
  • Prince George’s County Crisis Hotline (301-429-2185)
  • Washington, D.C., Child and Adolescent Mobile Psychiatric Services (CHAMPS, 202-481-1400)
  • National Alliance on Mental Illness (nami.org)

ABOUT THE EXPERTS

Eleni Rizakos Eleni Rizakos, PsyD, is a licensed clinical psychologist within the Neuroscience and Behavioral Medicine Division with a specialized focus in the Comprehensive Pediatric Epilepsy Program.
Deborah ZlotnikDeborah Zlotnik, PhD, specializes in dialectical behavior therapy, cognitive behavior therapy and trauma-focused cognitive behavior therapy.

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Posts from Eleni Rizakos, PsyD, and Deborah Zlotnik, PhD

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