I’ve gotten a call from frantic parents asking the above question more often than you would think. Suicide is the second-highest cause of death among teenagers. The good news is that the rate of suicide has gone down in recent years. The bad news is that it is still the second-highest cause of death among teens.
Popular TV Shows and movies glamourize suicide as an appropriate option to managing distress. When the Netflix show “13 Reasons Why” came out, there was a surge in self-harm and suicidal behaviors among teens.
Asking your child if they are suicidal will not make them suicidal or have thoughts about suicide if they didn’t have those thoughts before. Unfortunately, children who are already suicidal will see these TV characters, identify with them, and copy what they do. If they have close friends or family who die by suicide or are exposed to messages in the media about suicide it also will increase their risk of suicide.
Why is this? Partially because teenagers are more prone to be impulsive. They react often without thinking through the consequences. Survivors of suicide often report that as soon they have made the attempt they have immediate regrets and do not want to die.
On the other hand, I’ve experienced some parents who will take more of a lase flair attitude towards their child’s expression of suicidal ideation and chalk it up to their child “is just doing it to get attention.”
Yes, of course, they are trying to get your attention. They are in pain. Chances are high that this child has been trying to get your attention in more appropriate ways and when that didn’t work their behavior spiraled out of control.
Children who engage in self-harm, like cutting, have an ambivalent relationship with their self-harm behaviors. They will try to hide it by wearing long sleeves and pants, cut in areas where it can’t be seen like their thighs or stomachs. There is a shame and a fear of getting caught because then they can’t cut anymore and they have yet to learn another way to deal with their emotions.
At the same time, they are wishing that someone would ask them about their scars or catch them cutting so that they can be made to stop. They may feel relief from their pain by cutting, but it also scares them. They may not want to die, but just want their emotional pain to stop.
Most people (not just children) have difficulty recognizing that emotional pain is temporary. When you are stuck in your negative thoughts that everything is hopeless, it can be hard to see the positive aspects of your life. It can be hard to let go of your image of yourself as unhappy.
So what can you do?
First, there are some questions you can ask your child using the Columbia Protocol to understand if they are actively thinking about killing themselves. If they are, the next step can be a visit to the ER for further evaluation. It’s not about if you believe them or not. It is important early on to establish that any threats of suicide will be taken seriously because they have to be. This is your child’s life.
If your child is being seen by a therapist already then notify the therapist and follow their recommendations. For my clients, I would need to speak with the child the same day and determine what the next steps would be. If I couldn’t meet with the child then I would send the family to the ER.
Second, remove access to any objects that can be used for harm such as guns, pills, rope, and razors. Reducing access to means of dangerous objects can create a barrier during which time the emotional crisis will pass and your child will calm down.
Third, get connected to service providers in your community. If your child is considered high risk and requires hospitalization when they are released they will need continued care. Often hospitals know providers who can support your child or they will have an outpatient program that your child can attend.
You want to find a mental health provider who is trained in treating and assessing suicide. There are a few evidence-based models of treatment. The most common are Collaborative Assessment and Management of Suicide (CAMS), Dialectical Behavioral Therapy (DBT), and Cognitive Behavioral Therapy (CBT).
Treatment should include a Safety/Crisis Plan which is a plan to help your child regulate their emotions and avoid self-harm or suicide by using coping skills, distractions, and reaching out to people. You and your child should also be provided with emergency phone numbers like the National Suicide Prevention Lifeline: 1-800-273-TALK (8255).
Treatment can feel very overwhelming for parents and it can be helpful to have your own support system. You can also call the National Suicide Prevention Lifeline to get support in your role of parenting a child who is experiencing suicidal thoughts.
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