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What should I do if my child or teen is thinking about suicide?

May Lau, MD, MPH, FAAP

Answer

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All young people go through times of deep sadness, confusion and doubt. But if your child's moods and behaviors have taken a serious turn lately, you might be wondering if they are thinking about suicide.

Here are questions I often hear from parents, caregivers and other adults who are concerned about suicidal ideation. The answers may help you center your own thoughts about what you're seeing in your own child—and know when to seek help.

Parents, share this video American Academy of Pediatrics "Asking for a Friend" video, "When Should You Worry About Suicidal Thoughts?" with your teen:

Is my child really at risk for suicide?

The idea that young people would consider ending their own lives can be overwhelming, but the evidence is all around us.

One survey shows that 57% of teen females and 29% of teen males live with sad, hopeless feelings that won't go away. (These rates are dramatically higher than they were just 10 years ago.)

Depression, anxiety, attention-deficit/hyperactivity disorder (ADHD) and substance use—all issues linked with suicidal thoughts and actions—are common in young people. Suicide risks are especially high among Black children and teens and those who identify as LGBTQ.

Your child is an individual, not a trend. But it's important to realize they are growing up in a time when around 30% of teen females and 14% of teen males say they have given serious thought to ending their own lives, and around 40% act on those thoughts.

How can I tell if my child is having suicidal thoughts?

Even the most caring, dialed-in grownups can't read a child's mind. In fact, one study shows that nearly half of all parents whose adolescent children were thinking about suicide didn't know it was happening. These findings suggest that if we're worried, we should come out and ask your adolescent.

Doesn't talking about suicide make it more likely to happen?

Many people believe this, but research tells us the opposite is true. Asking honest, loving questions is more likely to save a life than prompt a suicide attempt. In fact, suicide prevention experts say that creating a sense of connection may keep suicidal thoughts from spiraling into actions.

Are there signs of suicidal ideation I should watch for?

Though young people may hide or deny their feelings, research shows that nearly 80% who attempt suicide will say something beforehand. That's why listening and observing is key.

You may notice your child is sleeping more or avoiding people and activities they once loved. They may say they've given up on solving particular problems, or suggest that life has no real meaning.

Self-harm, drug and alcohol use or symptoms of depression and anxiety are all causes for concern. You might also see worsening grades or creative work—writing, drawings, music, videos or other forms of self-expression—that reflect suicidal ideation.

How can I ask my child about suicidal thoughts?

Find a time when you're not rushing anywhere and can talk in private. Think about when you're driving or watching a TV show together, for example.

Begin with love and concern. You might say, "I care so much about you, and even though I know you are a strong person, I can't help but notice you're hurting lately. That makes some people think about suicide. Does this ever cross your mind?"

Expect some discomfort, resistance or even anger when you pose the question. Emphasize that it's safe to tell you anything, even if they're unsure what their thoughts mean.

Listen without judging. If you feel tempted to argue with their feelings, remember that you need their trust. Extreme pain changes the way we view life—which means your child's perceptions are their reality, at least for now.

What should I do next?

Tell them you love them, support them and will get them help.

If your child has a suicide plan or can't stop thinking about ending their life, call 988 right away. Crisis counselors are there 24/7 to link you with emergency services in your area. The 988 crisis centers have access to interpreters that speak over 240 languages. There is also the chat function at 988lifeline.org/chat and text.

Even if you believe your child isn't in crisis, take all thoughts of suicide seriously. This means calling your pediatrician. Your child's doctor has experience in helping families deal with mental health concerns, which are just as urgent as physical health issues. Your pediatrician can help you create a safety plan that spells out what you and your child will do if suicidal thoughts don't stop (or get worse).

Having a plan helps everyone in your home feel more prepared and aligned. It also helps reassure your child that, even when they're at their worst, you will give them your best—because that's what caring, responsible grownups do.

The actions you take now can help your child navigate suicidal thoughts now while modeling healthy self-care that will benefit them throughout life.

More information

May Lau, MD, MPH, FAAP

​​May Lau, MD, MPH, FAAP is an Associate Professor in the Department of Pediatrics at the University of Texas Southwestern Medical Center and the medical director of the Adolescent and Young Adult Program at Children’s Medical Center Dallas. As a fellow of the Society of Adolescent Health and Medicine and the American Academy of Pediatrics (AAP), Dr. Lau’s leadership roles include serving as a past co-chair of the AAP Texas Pediatric Society Committee on Adolescent and Sports Medicine and being elected to serve on the AAP Section on Adolescent Health Executive Committee.

Last Updated
7/16/2024
Source
American Academy of Pediatrics Section on Behavioral and Developmental Pediatrics (Copyright © 2023)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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