On the Pulse

How to Start a Conversation About Suicide with Children and Teens, According to Experts

9.22.22 | Ashley Speller

A father comforts a teen sonEvery year, people around the country observe September as Suicide Prevention Awareness Month to shine a light on mental health care and bring awareness to suicide, a topic many find difficult to discuss.

Dr. Alysha Thompson, the clinical director and psychologist on the Psychiatry and Behavioral Medicine Unit (PBMU) at Seattle Children’s, shares ways that parents and caretakers can support children and teens, and enable families to engage in meaningful and supportive discussions about suicide together.

The Seattle Children’s PBMU team regularly sees children and teens with a range of emotional, behavioral or neurodevelopmental concerns and is dedicated to making a positive impact in mental health outcomes. Their work is urgent as suicide has been the second leading cause of death in the U.S. for people between the ages of 1-44 since 2012.

It’s key that family and friends know how to spot warning signs for suicide, learn what to do in a crisis and how to get help. Most youth suicides occur at home and the numbers continue to be staggering. As data compiled by NAMI shows, approximately 18% of high school students and 45% of LGBTQ youth across the nation report serious thoughts of suicide each year. In Washington, over 75% of gun deaths in Washington are due to suicide. Additionally, in the Washington, Alaska, Montana and Idaho (WAMI) region, suicide rates are consistently higher than the national rates. Suicide is a complex issue and there is no single cause but there are steps all of us can take to help prevent suicide.

Support Your Child or Teen

Dr. Thompson suggests talking to your child and asking about suicide.

“Check in with your child or teen. Ask how they’re feeling and how things are going in life. Listen to their words and also pay attention to their behavior,” she said.

Dr. Thompson also explained that it’s key to listen more than you talk to ensure that you are truly hearing what your child is saying.

“It’s important to ask directly if your child or teen has had thoughts about suicide. Asking does not increase the risk of suicide and in fact can be the difference between life and death. It offers relief to someone who may be struggling and helps them feel noticed and heard,” she added.

If your child does say that they are thinking about suicide, Dr. Thompson says it’s critical to stay calm and follow some key steps.

First, call the 988 Suicide & Crisis Lifeline, formerly known as the National Suicide Prevention Lifeline. This is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States.  Services are available in Spanish, along with interpretation services in over 250 languages and individuals can call for themselves or in support of another person.

Additionally, reduce the risk of suicide by removing pills and firearms from your household or by placing them in a lockbox, safe or other secure location. Keep firearms locked up, unloaded, and the ammunition stored and locked separately.

Ensure that you do not leave your child or teen alone if they are in immediate danger or harming themselves. Take them to the closest emergency department (ED). If you cannot safely transport them, call 911. Tell the dispatcher that you have a mental health emergency and need your child taken to the ED. You can also call your county crisis line for help with problem-solving.

Know When and Where to Seek Help

If you believe that your child or teen is struggling, Dr. Thompson suggests getting connected to an outpatient therapist.

“Start by asking your child’s doctor for a referral or check if your insurance plan has a list of therapists, psychologists, or psychiatrists who are in your insurance network,” she explained.

You can attend or view a recording of Seattle Children’s new class on Finding Mental Health Care in Washington: Where to Start. You can also contact Washington’s Mental Health Referral Service for Children and Teens, a free service funded by Washington State and operated by Seattle Children’s, which finds providers in the local area who fit your child’s mental health needs.

“Start looking for help when you first notice that your child or teen is struggling, this may help prevent a crisis,” she said.

Remove Access and Educate Yourself and Others

One of the best ways to prevent suicide is to ensure the removal of things that could possibly be used for self-harm. Firearms and substances like medicines are common methods for a suicide attempt, with firearms being the most fatal. Locking up all medications, including over-the-counter medicine and vitamins, and removing weapons from the home are an important step everyone can take, even if you don’t believe a child or teen is at risk of hurting themselves. Washington Firearm Safe Storage Map outlines places for temporary, voluntary storage of firearms outside of the home if needed.

“You never know what they may be struggling with, and unfortunately we hear all too often of youth who were struggling without anyone knowing,” Dr. Thompson noted.

Learn about youth mental health issues and stay informed on how to support youth who might be struggling. Share with others how important it is to keep the lines of communication between adults and teens open.

There are plenty of virtual opportunities available to explore, including Seattle Children’s Youth Mental Health First Aid, a free two-part class that provides tools and education to help people recognize signs of mental health challenges, and support and respond to youth in distress.

Provide Validation and Reduce the Stigma

Lastly, don’t forget to validate your child’s emotions and experiences.

“It’s hard to be a teenager,” Dr. Thompson said. “Talk about mental health in your home, in your community and with your peers.  It’s OK not to be OK, and it is OK to ask for help.”