As someone who struggled with suicidal ideation as a teen, I remember how it felt like a dirty little secret—and how little support I had. I can’t imagine how different my experience would have been if I’d had a safe and nonjudgmental environment to discuss it out in the open, especially with adults. With teen suicide rates rising, it’s more important than ever that parents know the facts, are familiar with the warning signs, and are equipped with the tools not only to intervene when necessary but to have ongoing conversations with their kids about mental health.
According to an October 2019 Centers for Disease Control and Prevention (CDC) report, the suicide rate in kids, teens, and young adults increased by 56 percent from 2007 to 2017. People between the ages of 10 and 24 are dying by suicide at a rate of 10.6 deaths per 100,000 individuals, up from 6.8 deaths per 100,000 people in 2007. Things become even more upsetting when you focus on certain age ranges, like kids between the ages of 15 to 19, who experienced a 76 percent increase in suicide between 2007 and 2017. In 2017, suicide was the second-leading cause of death for people in this age range.
In an ideal world, no parent would ever have to think about watching their kid for warning signs of suicide. But the reality is, we need to be talking openly about suicide and suicidal ideation to reduce stigma and to keep children, adolescents, and young adults safe.
This can be particularly important when it comes to teenagers since a lot of parents mistake warning signs of suicide for the regular ups and downs of adolescence. To help make this easier, SELF talked to three experts on teen suicide about what they want parents to know.
1. Asking about suicide doesn’t increase the risk of suicide.
Before we get into anything else, all three of the experts SELF talked to emphasized the importance of dispelling this harmful myth. “Parents are fearful that if they ask about suicide, they’re going to cause their kid to be suicidal, and that’s simply not the case,” Jill Emanuele, Ph.D., senior director of the Mood Disorders Center at the Child Mind Institute, tells SELF.
Depending on your situation, it might feel like a scary or even overdramatic topic to raise, but it’s better to be safe than sorry. “You have no risk in asking your child if they’re thinking about hurting themselves,” James Mazza, Ph.D., professor in the School Psychology Program at the University of Washington, tells SELF. “Your kid may say, ‘Oh, I’d never do that. Don’t be dramatic.’ But you can say, ‘I know, but sometimes people feel that way, and I don’t want to be the parent who didn’t ask.’”
We’ll get into how and when to have these conversations later in the article, but if you take anything away from this story, let it be this.
2. Experts don’t know exactly why the rate of teen suicide is rising.
There’s no question that existing as a teen today is a very different experience than it was in previous generations. There’s the whole social media thing, which studies have shown can negatively impact mental health (though others have shown no connection or even a positive one). Academic pressure may be at an all-time high, too, thanks to decreasing acceptance rates and increasing tuition prices that drive a more competitive academic environment than ever. Emanuele also points out that there are theories that teens are a lot more isolated than they used to be, whether due to technology or a shift in culture.
It’s also worth mentioning that there’s a possibility the rate isn’t going up as much as it seems. It may be that as it grows more culturally acceptable to talk about mental health—although stigma hasn’t disappeared by any means—more people are reporting suicide deaths than before. (Stigma surrounding suicide typically leads to underreporting, according to the American Foundation for Suicide Prevention.) If that’s the case, experts could have access to data that more accurately reflects how high the suicide rate has always been, says Emanuele.
All that said, there is currently no research that ties anything directly to the rising teen suicide rate. But it’s helpful to keep these things in mind as you make an effort to understand what your teen might be going through.
3. Some teens don’t show outward signs when they’re suicidal, so you should also be aware of the risk factors.
While knowing the signs is extremely important, they’re not a definitive litmus test for how your child is doing. “The challenge is that there are a lot of people who are struggling and suffering in silence,” says Emanuele.
Some risk factors to keep in mind, according to the CDC:
- A family history of suicide
- A family history of child maltreatment
- At least one previous suicide attempt
- A history of mental illness, especially clinical depression
- A history of substance abuse
- Local suicide epidemics
- A significant physical illness
- Barriers to mental health support and treatment
- Easy access to methods of suicide
We also know that LGBTQ youth are at higher risk of suicide than their straight and cis counterparts. Bullying, too, is a risk factor worth paying attention to from both sides. According to Emanuele, being a victim of bullying is a risk factor, but there’s also some evidence that kids who are bullies may be at increased risk for suicidal behavior. Researchers have also theorized about a relationship between perfectionism and suicide risk.
4. There are many observable warning signs of suicide.
An easy way to remember the warning signs of suicide is with the acronym FACTS, which stands for Feelings, Actions, Changes, Threats, and Situations, Susan Tellone, R.N., clinical director of the Society for the Prevention of Teen Suicide (SPTS), tells SELF. It breaks down like this:
- Feelings such as expressing emotions like hopelessness about the future and depression
- Actions such as acting out and displaying impulsive or aggressive tendencies; giving away possessions
- Changes such as withdrawing from friends, sleeping and eating more or less, or acting in worrisome ways that aren’t typical for them
- Threats such as talking about, writing about, or making plans for suicide
- Situations such as going through loss, change, trouble at home, breakups, stressful situations at school, or other significant events that may trigger suicidal feelings
Of course, it’s worth mentioning that there is a lot of overlap between signs of suicide risk and symptoms of mental illnesses like major depressive disorder. According to Emanuele, not everyone who is at risk for suicide is dealing with a depressive disorder, and not everyone with a depressive disorder is at risk for suicide. There’s still a lot that experts don’t know about suicide and suicide risk, but regardless, the signs above are indicative of a larger problem you should be paying attention to. Even if a depressed teen isn’t suicidal, they still need your help.
5. There are important differences between “normal” teen moodiness and red flags.
You might be wondering, “Wait, some of those signs sound like normal teenage behavior. What teen doesn’t deal with stressful situations or occasionally get depressed or angry?” It’s true that teens will sometimes deal with sadness, stress, anger, and basically every other unpleasant kind of mood. But sometimes those emotions can signal larger issues.
Specifically, it’s really important to pay attention to the duration of these signs, according to Emanuele. If you’re noticing worrisome symptoms or behaviors that are persistent and don’t go away after two weeks, that can be a red flag.
In fact, Tellone advises staying away from splitting hairs about whether something is “typical” teen behavior or something more serious. Attributing things to teen moodiness might lead to you miss some pretty important signs that your child isn’t doing well—or it might lead to assuming it’s not important enough to ask about. Even if it is typical teen behavior now, you want to open up the support channels and show your child that they can come to you if it ever becomes more than that.
6. One of the most important steps you can take is talking to your child regularly.
“You’d be surprised by how many people just don’t talk to their kids,” says Emanuele.
The good thing is that it’s never too late to start. “The first couple of times [are] going to be awkward,” says Mazza. “You can even say, ‘Hey, we haven’t been chatting much and part of that is my fault for not putting in the effort. So I want to ask how you’re doing. The message is, I care about you and I don’t know what’s going on in your life. Can you please share with me?”
Adolescents also tend to respond better to routine than you might think, says Tellone, so if you’re having a hard time connecting with them, it could be worth scheduling regular time to catch up. (Maybe over something fun, like a pizza or game night.) Not only will that help you check in regularly, but knowing that time for connection is on the calendar can also make it easier for your kid to bring up hard topics.
7. If you’re worried about your child’s mental health, you can take action.
Remember when I said that the most important thing you can do when you’re worried your child is at risk for suicide is to talk to them about it? Here’s how.
First, prepare yourself emotionally and mentally to have this conversation.
According to Tellone, parents should do some honest self-reflection before bringing up suicide and mental health. Personal, religious, or moral biases against suicide or a strong fear of the topic can get in the way of coming at it from a place of compassion instead of judgment or alarm. Awareness of how these beliefs and attitudes might come through is a good place to start.
Second, ask yourself, “Am I prepared to hear the answer to this question?” Finding out that your child has been thinking about hurting themselves can be terrifying and might lead you to say things that aren’t exactly helpful. The other items on this list will help you develop a plan for responding.
Ask directly about self-harm and their emotions.
I know we went over this earlier, but it bears repeating: Don’t beat around the bush. “If you’re starting to get concerned, it’s important that you come right out with the question,” Tellone says. “For example, ‘Are you feeling so sad that you’re thinking about hurting yourself?’ or, ‘Are you feeling so sad that life is getting hard to live?’” The exact way you ask can differ depending on your relationship, but doing this in an empathetic, loving way is most important.
Keep checking in if your child isn’t forthcoming the first time.
Even if you do everything you should to engage your kid, there’s a not-insignificant chance that they’ll still brush you off. “Keep asking,” says Emanuele. “Don’t just say, ‘Well, they said they were fine!’ and move on. You stick with it.”
Listen more than you talk.
As parents, it’s natural to want to jump into Advice Mode or Encouragement Mode when your child is sharing something hard. Resist those urges. “When your child starts to talk, listen,” says Emanuele. “This is not a time for you to lecture. This is not a time for you to give information. Don’t interrupt. Don’t try to problem-solve. Validate them. Show them that you understand where they’re coming from, even if you’re freaking out inside.”
Along those lines, here are more “don’ts” to keep in mind, especially if the conversation turns explicitly to suicide and suicidal ideation:
- Don’t provide cliches or passive optimism. Saying vague things like, “Don’t worry, it gets better” or, “You’ll be over it eventually” negates and belittles their experience.
- Don’t say you know what they’re going through, because honestly, you don’t. Instead, express empathy with something like, “It sounds like you’re in so much pain right now. I can’t imagine how hard that is.”
- Don’t debate whether suicide is right, wrong, or selfish. Don’t even make comments remotely to that effect. Remember those biases we want to check at the door?
- Don’t talk about the value of life or list the reasons you think they shouldn’t feel this way. You might want to remind them of reasons they have for living, which is a compassionate instinct, but in the moment, it will likely sound like, “How can you feel this way when you have all this good stuff going for you?” That’s not how suicidal ideation works.
Ask other people in your child’s life for information.
If you have a gut feeling that something is wrong but your child won’t talk to you, Emanuele suggests checking in with the other adults in their life (like teachers and coaches) to see if they’ve noticed anything. You can also use this opportunity to mention your concerns and ask them to keep an eye out moving forward.
“Suicidal ideation happens when a child feels like they have a problem and they do not feel that they have the skills or the support to solve the problem,” says Tellone. After listening thoroughly, your job as a parent is to convey that options for feeling better are out there and you’ll support your kid along the way.
A big part of that is going over the possibility of seeking professional help. For someone dealing with suicidal ideation, therapy and/or medication can be crucial, but you don’t want your teen to feel like you’re forcing them into it. Go over the options together and let them have a say in the matter. For example, maybe they’d rather utilize a teletherapy service like BetterHelp or Talkspace instead of going into the office.
Safeguard your home.
If you haven’t taken the steps to do this and you’re concerned about your child’s mental health, now is certainly the time. But because easy access to lethal means of suicide is a risk factor in and of itself, it’s a good idea to make sure your home is safeguarded no matter what, not just when you’re worried.
Tellone recommends removing any firearms from your home completely. “I’ve heard too many stories from parents about how their gun was locked up and their children got to it anyway,” she says. “Kids will find a way.”
The same goes for any medication that someone might be able to use to overdose. Pay attention to the seemingly harmless medications you buy in bulk, too, such as over-the-counter pain relievers.
Only you know what might be dangerous in your home, but take the time to think about it and do what you can to keep your child safe.
Contact a crisis resource if need be.
If you’re worried that your child is at risk of hurting themselves, resources like the National Suicide Prevention Lifeline (1-800-273-8255) and the Crisis Text Line (text HOME to 741-741) can help diffuse the situation and offer advice. You can call or text yourself, encourage them to call or text, or do it together.
8. Keep in mind that this isn’t about you.
It’s common for parents of children who deal with suicidal ideation to question what they could’ve done better or differently or wonder what else is going on with their child that they don’t know about. You might find yourself asking, “What did I do? Is this my fault?”
According to Emanuele, this line of thinking is too simplified. “There are a lot of factors that go into why people start to think about ending their life, and it may not just be one thing,” she says.
Even if your kid does tell you that you’ve screwed up somehow or that you’ve influenced how they currently feel, it’s crucial to remember that you’re allowed to make mistakes. “Parents aren’t perfect,” says Emanuele. “But self-blame is actually distracting from the problem at hand. Your kid needs help, and that’s your focus.”
That said, it’s still important that you have your own outlets to explore those feelings. It’s not a conversation you should be having with your teen, at least not at this stage when your focus should be on getting them the help they need. “If you need help dealing with the distress you’re feeling, get therapy yourself or turn to family or friends for support,” says Emanuele. (As long as you trust that said family and friends won’t go rogue and talk to your child in a stigmatizing or unhelpful way.) “Have others support you in supporting your child.”
9. Lastly, here are some resources for your child and yourself.
It’s good to equip your kid with tools that can help, especially if you’re worried that they won’t tell you when they need help. But don’t be afraid to utilize resources, too. While your child might be the one who is suffering, it’s important to look after your own mental health—both for your own sake and so you can be an effective support system for them.
Some of these tools are to help you find resources like therapists, support groups, or peer support, while others might help you manage what you may be feeling:
- Psychology Today therapist finder allows you to sort by distance, specialty, and insurance, among other filters. (You can also read SELF’s guide to finding an affordable therapist here.)
- 7Cups is an online emotional health service with self-help guides, self-care ideas, and one-on-one chatting with trained listeners.
- The Trevor Project is home to various mental health resources for LGBTQ young people.
- NAMI HelpLine can connect you and/or your teen with a volunteer who can answer questions about mental health issues.
- PsyberGuide helps people find the best software and apps for managing mental health.
- MentalHealth.gov offers information on how to get help, support someone you love, or start a dialogue about mental health in your community (also available in Spanish).
If you’re thinking about suicide or just need someone to talk to right now, you can get support by calling the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or by texting HOME to 741-741, the Crisis Text Line. And here is a list of international suicide helplines if you’re outside the United States.