When Children are Suicidal

It’s a tough statistic to swallow, but suicide is currently the second leading cause of death in children between the ages of 10 and 24 years of age.  While we tend to think about depression or suicidal ideation occurring in adults, children are susceptible to stress and are susceptible to thoughts about wanting to hurt themselves or kill themselves.

This a pretty sobering thought.

What is Suicidal Ideation?

Suicidal ideation refers to a child having thoughts of wanting to die.  They may have identified how they plan to end their life and have a desire to act on these thoughts.  Suicidal ideation can lead to suicide attempts.

What are the warning signs?

Often, children will disclose that they are having thoughts of ending their lives.  They may say things like, “I wish I was dead,” “My life is hopeless”, or “I’m just going to kill myself.”  It’s important to take these comments seriously, and follow up with direct questions.  Ask your child:

• How long have you been feeling this way?
• What would you do to kill yourself?
• Have you ever tried to hurt yourself?
• If you could change one thing about your life, what would it be?

and play close attention to the answers.  Be direct and open, but stay calm.

Look for changes in your child’s behaviors.  Are they withdrawn, irritable, socially isolated, or more moody than usual?

What are the risk factors?

• Existing mental health concerns: Depression carries a strong link with suicidal thoughts and behaviors, and other mood, anxiety and trauma-related disorders can also increase risk.
• Acute stressors: Suicide is not caused by one event or stressor; however, break-ups, bullying and fights with caregivers can layer with other stressors, generate intense emotions and put kids and teens at an escalated risk.
• Community factors: Youth with marginalizing experiences based on factors such as race or ethnicity, gender identity, sexual identity, socioeconomic factors or stigma associated with help-seeking can be at increased risk of suicide.

What action can I take?

First, it’s important to let your child know that you take them seriously and that they are safe sharing their emotions with you. Let them know that you care about them and love them, and will do everything you can to help them.

• If you believe that your child is imminently at risk of attempting suicide, call 988 or take them to the emergency room.  You can also call your counties crisis response team.  Telephone numbers listed by county are at the end of this entry.
• If your child is not in crisis, contact the child’s pediatrician to be seen urgently.
• Schedule an appointment with a therapist who works with children and can assess and treat your child.  Ask your pediatrician for a recommendation, or call your insurance company.
• Create a safety plan with your child so that they can identify feelings of crisis, come up with ways to cope, and come up with people that they can reach out to for help if they feel depressed or suicidal.

One great Safety Plan for children was created by Lindsay Brayman.  It is free to download on her website.

Working on a safety plan with your child is a great way to build trust and show your support.  This gives children the knowledge that they can ask for help and use coping skills to help themselves.

Keep your child’s safety plan where they can easily find it, like on the refrigerator or on the wall in their room.  Don’t stop talking to them about it and assessing their moods, comments, and behaviors.

Increase your safety at home

• Lock up firearms and make sure they are unloaded.
• Lock up prescription medications, pain relievers, and any other medicines in the home.
• Limit access to sharp objects, ropes, or cords.
• Supervise your child more closely.
• Do a “room sweep” for items that they could use to harm themselves.

Put on your own oxygen mask

You can’t take care of your child if your own physical and emotional needs are going unmet.  In times of crisis, it might be hard to think about what you need, but the stress of raising children with mental health challenges can contribute to difficulties with your own mental health.

• Get professional help:  See a therapist or talk to your religious leader.  It’s important for you to share your feelings too.
• Consider respite care:   If a trusted friend or family member can take your child for a night or weekend, take them up on their offer so that you can recharge and feel ready to tackle the issues again.
• Let go of guilt:  Your child’s struggles are not a reflection of your parenting abilities.  Mental health issues are complex and are often a mix of genetic and environmental factors.  Parenting is hard enough without beating yourself up.
• Manage anxiety and stress:  Go for a walk, talk to a friend, and take care of your relationships, especially your marriage.  Recall fun times as a family, write down one good thing that happens each day, and try to get enough sleep.

Guiding your child by showing them acceptance, support, and helping them access services that will teach then the tools that they need to cope will provide them with self-awareness and self-acceptance.  There is hope!

For more information on helping your child with suicidal ideation, I recommend the book Messy Hope by Lori Wildenburg.

Children’s Mental Health Crisis Response Phone Numbers