One of many parents’ worst fears is learning that their child is struggling and no longer feels like they can keep going. Whether your child tells you directly that they have thoughts of suicide, or you find out in another way, it is heartbreaking and instantly makes us panic. I want to focus this blog on how to support your teen and yourself through this difficult time.
I have been working with teens affected by suicidal ideation for many years. It has become a daily conversation I have with youth, parents, and colleagues. Having these conversations never becomes easier, but I think there is a lot of information that families can be aware of to help them navigate this difficult time.
It’s more normal than you think: The first thing I want to normalize is how common suicidal thoughts are to people in general. Most people have had one thought throughout their lifetime of not wanting to be around or how much easier it would be if they died. If your child has been one of those people, it does not necessarily mean that anything major is going on.
Understanding Risk Assessment: Many mental health professionals are trained in suicidal risk assessment. This is what is used when determining the level of risk involved in someone’s suicidal thoughts. This will also be done if you visit an Emergency Room. the professional will most likely be assessing three things:
- Frequency and Intensity of Thoughts: The first thing they will acknowledge is that this person is having these thoughts and try to figure out how often they are occurring. Someone who has these thoughts daily may be struggling more than someone who has them monthly. Within this they will also assess the intensity of the thoughts. If we think about a radio dial, we can turn the volume to the loudest (10/10) or so low we cannot hear it (0/10). Someone whose thoughts are intensely loud, would be more concerning than someone who has these thoughts as a background thought. Many people’s thoughts can change in intensity throughout the day.
- Does this person have a plan: The second thing we investigate is has this person actually thought of how they would end their life. Many people have suicidal thoughts and have never explored how they could make this happen, while others may have one or multiple ways they have thought of doing this.
- Does this person intend to act on their plans: The last thing we explore is whether this person has intent of carrying out this plan. Some people have plans and thoughts but would never act on these thoughts. The person may think a lot about how this would affect others, they may carry spiritual beliefs about what happens if they acted on it, or they may be too scared to do something. Someone who has intent may have started to act on their plan (collecting medication, writing letters, researching, etc.)
These three factors can help professionals determine the severity of your loved one’s risk to themselves and guide the next steps in intervention.
Passive versus Active Thoughts: This information ties back to the last point. Passive thoughts are typically categorized by having thoughts, and sometimes plans, but no intent, versus active thoughts involve someone having all three categories: thoughts, a plan and intent to act on it. Most of the time for someone to be admitted to a hospital, they must have active suicidal ideation at the time of visiting the hospital. This is an important distinction when considering the level of intervention that needs to happen.
Knowing what not to say: Many people struggle to know what to say to people expressing these thoughts. I wanted to take a moment to discuss some phrases that are not helpfu.
- The first is “that is so selfish.” People who are having these thoughts are in severe emotional and/or physical pain. Their thoughts of suicide act as a way for them to finally be relieved from their pains. By calling the act selfish, it could make that person feel more isolated in their feelings. .
- The second is “think about your loved ones.” I understand why people are using this in this context, however when people have active thoughts, one predictor is them feeling like a burden to their loved ones. They could be told a million times they are not, but their brain is so focused on how much they feel they are costing their families. By mentioning their loved ones, it could be a reinforcer of how much they feel like a burden.
- The final is “think about all the reasons to live.” Most people do not reach the decision of suicide lightly. Many people go back and forth for a long time before deciding this would be their only option. It’s important to first validate someone’s pain, before encouraging them to “look on the bright side.”
Difference in suicidal ideation and self-harm: Many people associate these two things as being the same. We see many people who have both, and some who only have one. The important distinction is that self-harm is a form of coping through pain (possibly in the only way they know how), versus suicidal ideation is extreme hopelessness and not being able to cope. If someone is engaging is self-harm it does not necessarily mean they are suicidal.
What can you do?
The first most important thing you can do is try to have open conversations with your loved one about their feelings. Talking about suicide does not increase someone’s chance of acting on it, especially if the conversation is done is a supportive way. By being open to discussing suicide you are showing your youth that you care about how they are doing. In most cases it’s important to listen first and provide supportive statements, before moving into problem solving. Supportive statements could be “I love you,” “I am here for you through this,” and “we are going to come up with a plant together to get you support.”
Take safety precautions. For some youth who have more active or intense suicidal thoughts, we must make environmental changes in the home. This could be locking up sharp objects, medication or vitamins and rope objects. It could also mean increasing supervision of the youth so they are not left alone for long periods (again this will depend on the severity of the situation). We know that people who are desperate will find anything they can to try and end their life, but by doing this we are removing many lethal ways they can harm themselves. I also have many youths say, “I wanted to do something but couldn’t because I didn’t have anything to use, or that someone was with me.”
Explore resources in your area. Many municipalities have community agencies or family health teams that can provide counselling. If you youth is willing to talk to someone, it can be a huge benefit to get them connected. Counselling for suicidal thoughts usually involves figuring out what is driving the thoughts and helping the youth work through these problems and feelings. Many private therapists also have experience working with people who have suicidal thoughts.
Access crisis services. If you are unsure of how to respond to these thoughts, it’s always possible to call a crisis or suicide hotline and ask the professionals for their opinions. Sometimes these workers will be able to talk to your youth and offer guidance. The second would be bringing your youth to your local emergency department if you suspect they are in imminent danger to themselves or others. The last resource would be calling police if your youth is unwilling to go with you voluntarily. This can be a hard decision to make as a parent; however, sometimes this is what a child needs versus what they want. The police may be able to de-escalate the situation before bringing to hospital, but they can assess once they arrive.
Please know that this is a difficult time for all involved and it’s important to also seek support for yourself. This could be accessing counselling for yourself or reaching out to parent supports. Two of these supports are linked below:
Parents for Children’s Mental Health: https://www.family.cmho.org/