Talking with Your Teen about Suicide

September is National Suicide Prevention Awareness Month — which makes now a good time to have a conversation about suicide with your preteen or teenager.

If you’re like most parents, you probably think that suicide isn’t something you need to worry about, that if it were a concern for your child you would know it. You could be wrong on both counts. Consider these facts:

• Suicide is the second-leading cause of death among young people between the ages of 10 and 24.[1]
• One in every 6 high-school students has considered suicide in the past year, and 1 in 14 has made a suicide attempt.[2]
• Parents are sometimes surprised by a child’s suicide, not having realized how unhappy their child was.

Stacy McAllister, MD, a psychiatrist in the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children’s Hospital of Philadelphia (CHOP), helps put the issue in perspective for parents. “You regularly talk to your children about safety issues, like wearing seat belts and not using drugs,” she explains. “Suicide is no different.”

You should not be afraid to talk to your child about suicide. Having that conversation doesn’t increase their risk of suicide or plant the idea in their head. In fact, opening a dialogue can help your child feel connected and supported. It might be the first step toward helping your child get what could be life-saving help.

How do you have this conversation? Dr. McAllister offers some suggestions:

• Choose a time when you and your child will be able to talk and listen without distraction. That might be while you are in the car together, or at night when your child has wound down after homework and chats with friends.
• It can help to refer to a news item or something you have read (this article, for example) to start the conversation. “I just read a surprising statistic about the number of teenagers who have considered suicide.” If there has been a publicized suicide or suicide attempt in your community, you might start by referring to that.
• If you feel uncomfortable bringing the subject up, admit to that. It’s probably hard for your child to talk about it, too.
• Ask for your child’s response with direct questions. “Is suicide something you have ever thought about?” “Have any of your friends ever talked about suicide?” “Do you have any questions or worries about suicide?”
• Pause to give your child time to answer. Listen to what your child says without interrupting.
• Be mindful of your responses. Don’t overreact or criticize what your child says, which could shut the conversation down and might make your child afraid to confide in you. Don’t underreact or dismiss your child’s feelings, either. That could make your child feel unheard and ignored.
• If your child says something that worries you, or you don’t know how to respond in the moment, ask for time to think about it and permission to continue the conversation later. Then follow through and talk again within the next couple of days.
• If your child has trouble opening up to you, ask if there is another adult they trust enough to confide in — perhaps a relative, someone at school, or someone in your faith community. If not, offer to help find a therapist who can listen and help.
• If your child admits to being miserable and to having current thoughts of suicide, seek help immediately. In this case, it’s not an overreaction to bring your child to a hospital emergency room.

“Even if your child doesn’t say much the first time you introduce the topic,” says Dr. McAllister, “you have opened the door for future conversations. It is important for your child to know that they can come to you if they have worries or questions as they grow through the teenage years.”

In addition to talking together and listening to your child, pay attention to your child’s behavior. Warning signs include:

• Excessive anger or irritability, or feelings of anxiety or sadness
• Changes in your child’s personality, or in sleep or appetite
• Loss of interest in spending time with friends
• Statements that show feelings of hopelessness (“I wish I were dead”)
• Plans for giving away favorite belongings

If you feel like there has been a major shift in your child’s mood or behavior, and you are feeling worried, do not hesitate to seek help. Bring your child for an evaluation by a mental health professional.

For more information, see the resources for parents and teens on the website of the Society for the Prevention of Teen Suicide.

Contributed by: Stacy McAllister, MD