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SUICIDE PREVENTION

Suicide Prevention

What can you do as a parent if you’re concerned about your child contemplating suicide?

As a parent or guardian, try to be open in your communication with your child or children: let them know that you love them, support them, and are there to talk and listen. Try not to let them spend too much time alone. Pay attention to changes in behaviors or signs of withdrawal from regular activities. Safely secure all medications, substances or weapons at home.

If your child says they are anxious, depressed, want to hurt themselves or don’t want to be alive, do not downplay how they are feeling. It is important to take the warning signs seriously. If you are concerned and your child already has a mental health provider, contact that person for what you should do next. If your child doesn’t have one or if you are unable to reach that person, you should take your child for a full mental health evaluation.

Mental Health and Teens: Watch for Danger Signs

Adolescence isn’t an easy time for parents, either. As children move through the various tumultuous transitions that accompany adolescence — physical, emotional, hormonal, sexual, social, intellectual — the pressures and problems they encounter can all too easily seem overwhelming. For many teenagers, these and other pressures can lead to one or more of a variety of mental health disorders; all are matters of concern, and some are life-threatening. 

Key Tips for Parents:

  • Keep communication constant, open, and honest: Your children should not only know that they can talk to you about anything, you have to be committed to broaching topics of concern and do so openly. Talk about your own experiences and fears when you were an adolescent. Let them know that they are not alone; nor are their anxieties unique.
  • Understand that mental health disorders are treatable: Arm yourself with information about the most common mental health disorders among adolescents; speak with your child’s pediatrician, your local health department, your religious leader, and your child’s school representatives about what sorts of information are available from them.
  • Be attentive to your teen’s behavior: Adolescence is, indeed, a time of transition and change, but severe, dramatic, or abrupt changes in behavior can be strong indicators of serious mental health issues.

Mental Health “Red Flags” Parents Should Be Alert For:

  • Excessive sleeping, beyond usual teenage fatigue, which could indicate depression or substance abuse; difficulty in sleeping, insomnia, and other sleep disorders
  • Loss of self-esteem
  • Abandonment or loss of interest in favorite pastimes
  • Unexpected and dramatic decline in academic performance
  • Weight loss and loss of appetite, which could indicate an eating disorder
  • Personality shifts and changes, such as aggressiveness and excess anger that are sharply out of character and could indicate psychological, drug, or sexual problems 

Key Mental Health Issues:

Depression

While all of us are subject to “the blues,” clinical depression is a serious medical condition requiring immediate treatment. Watch for:

  • Changes in sleep patterns
  • Unexpected weeping or excessive moodiness
  • Eating habits that result in noticeable weight loss or gain
  • Expressions of hopelessness or worthlessness
  • Paranoia and excessive secrecy
  • Self-mutilation, or mention of hurting himself or herself
  • Obsessive body-image concerns
  • Excessive isolation
  • Abandonment of friends and social groups

Eating disorders

Body image concerns can become obsessions, resulting in startling weight loss, severely affecting the adolescent’s health:

  • Anorexia: Avoidance of food and noticeable changes in eating habits should trigger concern.
  • Bulimia: Purging (forced vomiting) after eating — be alert for both dramatic weight loss without changes in eating habits (which could, of course, indicate other health issues that require a doctor’s attention) and also for immediate trips to the bathroom or other private spot after a meal.

Drug abuse

In addition to peer pressure, mental health issues can lead adolescents not just to experiment with alcohol and drugs, but also to use substances for “self-medication.” And in addition to being aware of the behavioral and physical signs of alcohol and drug abuse — drug and alcohol paraphernalia or evidence, hangovers, slurred speech, etc. — parents should also:

  • Be alert for prescription drug misuse and abuse: According to the AAP, prescription drug misuse by adolescents is second only to marijuana and alcohol misuse. The most commonly abused prescription drugs include Vicodin and Xanax.
  • Know that over-the-counter-medications can be abused as well: Teenagers also frequently abuse OTC cough and cold medications.

Concern about your adolescent’s mental health should first be addressed with your child — fostering open communication goes a long way toward fostering sound adolescent mental health habits.

If your concerns are serious, discuss them with your pediatrician. Because so many mental health issues display physical manifestations — weight loss being the most dramatic but not the only one — your pediatrician can offer both initial medical assessment and also refer you to appropriate mental health organizations and professionals for counseling and treatment if called for.

Additional Information from HealthyChildren.org 

How to Communicate With and Listen to Your Teen

Many parents have questions that start with, “What do I say when…?” However, parents need to understand that it is “less important what you say, and more important that you listen.”

  1. Turn off the “parent alarm.” Listen without judgment and reaction. When your son says, “Mom, I met this girl” and you react by saying, “You’re too young to date,” that instinctual alarm prevented you from being able to hold a meaningful discussion on healthy sexuality.
  2. Don’t catastrophize. When teens come to their parents with concerns, they need a calming, rational presence that will create a safe space for them to figure things out. When parents make it seem worse than they had imagined, they leave more anxious and won’t return.
  3. Don’t over empathize. Adolescents need a sounding board. Sometimes they exaggerate; sometimes they express fleeting feelings. When you over empathize, it can heighten their emotions and make you look naïve or overly involved. Imagine your empathizing by condemning their friend who your daughter had a fight with. You’ll look “wrong” the next day when your daughter is best friends again with the girl she hated yesterday.

Your Values & Opinions

Teens are happy to hear their parents’ values and opinions, but these opinions should not be shared in a way that feels judgmental or condescending and should try to avoid personal territory that will position a teen to need to become defensive of friends or self. 

Avoid “The Lecture”

Parents who lecture are not heard. The lecture is often condescending or hostile, and is delivered with an abstract string of possibilities loosely tied together. Young adolescents are still not thinking abstractly, and all teens who are upset or in crisis mode will not absorb lessons delivered abstractly. Parents may increase their yield if they are able to convey their wisdom in a more concrete manner that adolescents can follow.

Additional Information:

  • Communicating with Your Teen: Avoiding the ‘Should Do’ (Video)
  • Fair and Reasonable Limits for Teens
  • How To Resolve Conflicts With Your Teen

Author Edited by Kenneth R. Ginsburg, MD, MS Ed, FAAP, FSAHM and Sara B. Kinsman, MD, PhD

Know the 12 Suicide WARNING SIGNS


  • Feeling like a burden
  • Being isolated
  • Increased anxiety
  • Feeling trapped or in unbearable pain
  • Increased substance use
  • Looking for a way to access lethal means
  • Increased anger or rage
  • Extreme mood swings
  • Expressing hopelessness
  • Sleeping too little or too much
  • Talking or posting about wanting to die
  • Making plans for suicide

5 Steps to help someone at risk

  1. Ask.
  2. Keep them safe.
  3. Be there.
  4. Help them connect.
  5. Follow up.

Find out how this can save a life by visiting: www.BeThe1To.com

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CDC

10 Things Parents Can Do to Prevent Suicide

1. Don’t let your teen’s depression or anxiety snowball.

Maybe your child is merely having a bad day, but maybe it’s something more if this mood has been going on for a couple of weeks.

 > Fact: 9 in 10 teens who take their own lives met criteria for a diagnosis of psychiatric or mental health condition or disorder—more than half of them with a mood disorder such as depression or anxiety.

Depressed people often retreat into themselves, when secretly they’re crying out to be rescued. Many times they’re too embarrassed to reveal their unhappiness to others, including Mom and Dad. Boys in particular may try to hide their emotions, in the misguided belief that displaying the feeling is a fifty-foot-high neon sign of weakness.

Let’s not wait for children or youth to come to us with their problems or concerns. Knock on the door, park yourself on the bed, and say, “You seem sad. Would you like to talk about it? Maybe I can help.”

2. Listen—even when your teen is not talking.

Not all, but most kids who are thinking about suicide (this is called suicidal ideation) tip off their troubled state of mind through troubled behaviors and actions. Studies have found that one trait common to families affected by a son’s or daughter’s suicide is poor communication between parents and child. However, there are usually three or more issues or factors going on all at once in a child’s life at the time when he or she is thinking about taking his or her life.

These include but are not limited to:

 > Major loss (i.e., break up or death)
 > Substance use
 > Peer or social pressure
 > Access to weapons
 > Public humiliation
 > Severe chronic pain
 > Chronic medical condition
 > Impulsiveness/aggressiveness
 > Family history of suicide

If your instinct tells you that a teenager might be a danger to himself, heed your instincts and don’t allow him to be left alone. In this situation, it is better to overreact than to underreact.

3. Never shrug off threats of suicide as typical teenage melodrama.

Any written or verbal statement of “I want to die” or “I don’t care anymore” should be treated seriously. Often, children who attempt suicide had been telling their parents repeatedly that they intended to kill themselves. Most research supports that people who openly threaten suicide don’t really intend to take their own lives; and that the threat is a desperate plea for help. While that is true much of the time, what mother or father would want to risk being wrong?

Any of these other red flags warrants your immediate attention and action by seeking professional help right away:

 > “Nothing matters.”
 > “I wonder how many people would come to my funeral?”
 > “Sometimes I wish I could just go to sleep and never wake up.”
 > “Everyone would be better off without me.”
 > “You won’t have to worry about me much longer.”

When a teenager starts dropping comments like the ones above or comes right out and admits to feeling suicidal, try not to react with shock (“What are you, crazy?!”) or scorn (“That’s a ridiculous thing to say!”). Above all, don’t tell him or her, “You don’t mean that!.” Be willing to listen nonjudgmentally to what he or she is really saying, which is: “I need your love and attention because I’m in tremendous pain, and I can’t seem to stop it on my own.”

To see your child so troubled is hard for any parent. Nevertheless, the immediate focus has to be on consoling; you’ll tend to your feelings later. In a calm voice, you might say, “I see. You must really, really be hurting inside.”​

4. Seek professional help right away.

If your teenager’s behavior has you concerned, don’t wait to contact your pediatrician. Contact a local mental health provider who works with children to have your child or youth evaluated as soon as possible so that your son or daughter can start therapy or counseling if he or she is not in danger of self-harm.  However, call your local mental health crisis support team or go to your local emergency room if you think your child is actively suicidal and in danger of self-harm.

5. Share your feelings.

Let your teen know he or she is not alone and that everyone feels sad or depressed or anxious now and then, including moms and dads. Without minimizing his anguish, be reassuring that these bad times won’t last forever. Things truly will get better and you will help get your child through counseling and other treatment to help make things better for him or her.

6. Encourage your teen not isolate himself or herself from family and friends.

It’s usually better to be around other people than to be alone. But don’t push if he says no.

7. Recommend exercise.

Physical activity as simple as walking or as vigorous as pumping iron can put the brakes on mild to moderate depression.

There are several theories why:

 > Working out causes a gland in the brain to release endorphins, a substance believed to improve mood and ease pain. Endorphins also lower the amount of cortisol in the circulation. Cortisol, a hormone, has been linked to depression.
 > Exercise distracts people from their problems and makes them feel better about themselves.
 > Experts recommend working out for thirty to forty minutes a day, two to five times per week.
 > Any form of exercise will do; what matters most is that children and youth enjoy the activity and continue to do it on a regular basis.

8. Urge your teen not to demand too much of himself or herself.

Until therapy begins to take effect, this is probably not the time to assume responsibilities that could prove overwhelming. Suggest that he or she divide large tasks into smaller, more manageable ones whenever possible and participate in favorite, low-stress activities. The goal is to rebuild confidence and self-esteem.

9. Remind your teen who is undergoing treatment not to expect immediate results.

Talk therapy and/or medication usually take time to improve mood. Your child shouldn’t become discouraged if he or she doesn’t feel better right away.

10. If you keep guns at home, store them safely or move all firearms elsewhere until the crisis has passed.

 > Fact: Suicide by firearm among American youth topped a 12-year high in 2013, with most of the deaths involving a gun belonging to a family member, according to a report from the Brady Center to Prevent Gun Violence. Any of these deaths may have been prevented if a gun wasn’t available.

If you suspect your child might be suicidal, it is extremely important to keep all firearms, alcohol, and medications under lock and key.

First seen on healthychildren.org

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