By: Eric J. Sigel, MD, FAAP & Maria H. Rahmandar, MD, FAAP
As children grow and become more independent, it can be more challenging for parents to know what they are thinking and feeling. When do the normal ups and downs of adolescence become something to worry about?
Parents and family members can help teens cope when life feels too difficult to bear. Learn about factors that can increase your child's
risk for suicide and explore these 12 suggestions below. These steps can help you feel better prepared to offer the caring, non-judgmental support your child needs.
1. If you see signs that your child's mental health is under threat, tune in.
Maybe your child is just having a bad day. When signs of mental health troubles last for weeks, though, don't assume it's just a passing mood.
Studies show that 9 of 10 teens who died by suicide were struggling with mental health conditions such as depression. But keep in mind:
Teens who haven't been diagnosed with any mental health condition may still be at risk. In part, this is because it can be hard to pinpoint mental health issues at early ages.
Occasionally teens who attempt suicide do not have underlying mental health issues. But they may give signs that they're considering ending their own lives.
Your goal should be to remain calm, alert and ready to speak with your teen. Don't wait for them to come to you. You might start by saying, "You seem sad. I'm open to talking about this, because I love you and I care what happens to you."
Here are more tips for
opening mental health conversations with your child.
2. Listen—even when your child is not talking.
Don't be surprised if your teen turns away when you first raise the subject of mental health or suicide. Keep in mind that, even if your child is silent at first, actions may speak even more loudly than words.
Watch for major changes in your child's sleep patterns, appetite and social activities. Self-isolation, especially for kids who usually enjoy hanging out with friends or participating in activities, can signal serious difficulties.
If your child is struggling more than usual with schoolwork, chores and other responsibilities, these are additional signs you shouldn't ignore.
3. Realize that your child might be facing suicide risks you haven't considered yet.
Many parents wonder: Could my child really be at risk for suicide? Unfortunately, the answer is yes. Young people of all races, ethnicities, gender identities, sexual orientations, income levels and community backgrounds die by suicide every year.
In fact, suicide is the second leading cause of death among young people 10 to 24 years old.
Here are some suicide risk factors to be aware of:
Loss of a loved one to death, divorce, deployment, deportation or incarceration
Bullying (in person or online)
Discrimination, rejection or hostility due to gender identity or sexual orientation
Racism, discrimination and related inequities and stressors
Stigma (the belief that it's wrong or shameful to talk about mental health or suicide)
Witnessing or suffering violence or domestic abuse
Financial instability that causes worry and insecurity
Suicide in their school or friend group
Major life-changing events, such as a breakup with a dating partner, a change in social connections, academic disappointment or a major health issue
Get more perspective on your child's specific risks
4. Do not dismiss what you're seeing as "teenage drama."
Never assume your child is exaggerating or playing games if they say or write:
"I want to die."
"I don't care anymore."
"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."
Many adolescents who attempt suicide will tell their parents ahead of time (though others do not). These words indicate an urgent need for help.
Don't risk being wrong about this. Take every statement about suicide seriously.
5. Respond with empathy and understanding.
When your child talks or writes about suicide, you may feel shocked, hurt or angry. You may even want to deny what you're seeing or argue with your child. These feelings are natural and valid. But it's essential to focus on your child's needs first and foremost.
Your goal is to create a safe space where your teen can trust you to listen and express concern, but without judgment or blame.
Instead of reacting this way:
"That's a ridiculous thing to say."
"You have a great life – why would you end it?"
"You don't mean that."
"I can't believe what I'm hearing!"
Manage your own feelings so you can respond with empathy:
"I'm sorry you are feeling this way—can you share a bit more?"
"It sounds like you're in tremendous pain and you can't see a way out."
"Maybe you're wondering how life got this complicated and difficult."
"Right now, you're not sure of the answers to the problems you're facing."
"You must really, really be hurting inside to consider ending your life."
6. Get help right away.
Risk for suicidal behavior is complex and not straightforward. Certainly, if you are concerned about depression, self-harm or vague references to suicide thoughts, seek care from your primary care provider as soon as possible. You can consider reaching out to a school therapist, local mental health provider or even a national suicide hotline for guidance.
If you have any concern that your teen is at more immediate risk for attempting suicide, take them to the emergency department of your local hospital or call 911. Fast action is crucial when things have reached a crisis point.
Health care providers can help you and your teen create
a safety plan that covers:
Warning signs or triggers your teen feels will lead to suicidal thoughts
Possible steps to help them cope when they feel triggered
Sources of support: family, friends, teachers, mentors and others
Emergency contacts and steps to take if things get worse
7. Remove or secure guns you have at home. Do the same with other lethal means.
Half of youth suicides occur with firearms—and suicide attempts with firearms are almost always fatal. Teens and adolescents almost always use a gun found in their house.
- By far, the safest option is to remove all guns and ammunition from your home while your teen is struggling with thoughts of suicide. Many families turn guns over to relatives (as long as your child does not go to that relative's house), other trusted individuals, law enforcement or gun shops to help safeguard their teen during a vulnerable time.
- Safe home storage is the second-best option. Locking and unloading all guns, with ammunition stored and locked in a separate space, does reduce the risk of tragedy. But it only helps if your teen doesn't know the combination to the lock or where the key is hidden. Disassembling guns and storing the components separately and locked is another option.
Medications & other risks
Of course, guns are not the only means of suicide your child might seek out. Prescription medications and over-the-counter drugs can pose hazards during a suicidal crisis.
Keep medications locked away and, whenever possible, reduce the volume of medications on hand. Also consider buying over-the-counter medications in blister packs instead of bottles. This can help slow down access to pills.
Hanging/suffocation is another leading way adolescents die by suicide. Though it is challenging to completely eliminate this possibility, secure any ropes, belts, cords or plastic bags so teens do not have access.
Other potentially lethal tools and substances you should consider locking away include:
Household cleaners and other poisonous products
Canned dusting products
Knives, razors, or other weapons
The work of removing or locking up these objects and substances may seem daunting. But remember that your child's safety is at stake.
Suicide attempts are often impulsive
, and a moment of crisis can escalate very quickly. Making sure your teen cannot lay hands on lethal means at the wrong time is critical.
8. As your child enters treatment, focus on creating hope.
Your child's care team will likely recommend a combination of steps to reduce mental health symptoms and thoughts of suicide. Medications, talk therapy and stress-reducing techniques such as yoga, meditation or journaling may be part of the plan.
Provide realistic reassurance for your child along the way. Remind them (and yourself) that difficult times don't last forever. People do feel better when they receive effective treatment and support.
If your child expresses feelings of stigma or shame, you can remind them that 1 in 5 people have mental health symptoms at some point in their lives. Mental health is part of total health—and seeking help is a sign of self-respect and maturity.
9. Encourage them to see family and friends, and keep an eye on social media.
Your child may feel reluctant to spend time with other people. However, you can explain that social support, when they are ready, may help them feel better.
Although more quiet time might be needed at first, gentle encouragement to hang out with family, friends and neighbors will be helpful. Avoid power struggles around specific events or invitations, since your goal is to respect your child's needs and minimize stress.
Social media may be the primary way some adolescents engage with their friends. It can be a point of connection and support, but at the same time, social media can be a source of bullying and triggers. Encourage an open dialogue around social media use and ask how your adolescent feels after using social media. Consider making a Family Media Plan.
10. Encourage sleep and exercise.
Sleep changes can be warning signs before suicidal thoughts. In addition, sleep is important for baseline mental health. Encourage healthy sleep habits.
Physical activity eases mental health symptoms and supports your child's wellness plan. Whether it's getting
outside to take a daily walk, a gym workout, an online exercise class or something else, exercise will:
Elevate your teen's mood by stimulating the production of endorphins (natural substances in the brain and body that help balance out stress and manage pain).
Support higher levels of serotonin, another brain-body substance that leads to positive moods and restful sleep.
Offer to go with them on a walk, a bike ride, or to the gym. Experts recommend 60 minutes of physical activity per day for adolescents. Easing back into any form of exercise is fine. What matters most is that your teen enjoys this activity and feels motivated to do it regularly.
11. Encourage balance, moderation and self-care.
Teens in crisis need to go easy on themselves. This means adopting a realistic pace and avoiding experiences that could prove overwhelming.
Reassure your teen that self-care is never a sign of weakness. Everything we do in life is affected by our health. So, giving ourselves time to heal is essential. Big tasks can be divided into smaller, more manageable ones, and gradually, as your child's confidence and strength grows, they'll feel ready to take on more.
12. Remind each other that this will take time.
You and your child will benefit from knowing that progress will come at its own pace. Setbacks may happen—they're part of the healing process, too.
Encourage your child to be patient and self-forgiving. They've been through a lot, but with the right care and support, you will both see improvement.
If your child is considering suicide, call or text 988 or chat on 988lifeline.org right away. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones.
Ask your teen's care team for other resources you should know about.
The National Alliance on Mental Illness and the American Foundation for Suicide Prevention have great information.
Parents of LGBTQ2S+ children can visit
the Trevor Project website for focused resources. Parents and teens facing racial stress can benefit from
these strategies and tools offered by the American Psychological Association.
You can also visit the American Academy of Pediatrics
Blueprint for Youth Suicide Prevention for information about ways to prevent suicide in your community or school.
About Dr. Sigel
Eric J. Sigel, MD, FAAP, specializes in Adolescent Medicine at Children's Hospital Colorado. Dr. Sigel is a member of the American Academy of Pediatrics (AAP) Committee on Adolescence, Council on Injury, Violence and Poison Prevention and Violence Prevention Subcommittee.
About Dr. Rahmandar
Maria Rahmandar, MD, FAAP, is a board-certified pediatrician and adolescent medicine physician. She serves as the Medical Director for the
Substance Use & Prevention Program at Lurie Children's Hospital of Chicago and is an Associate Professor at Northwestern University Feinberg School of Medicine. Within the AAP, Dr. Rahmandar sits on the Council on Adolescents and Young Adults and co-facilitates learning collaboratives on suicide and mental health.