Thinking about suicide isn’t enjoyable, for any of us. Two of the most difficult situations we can encounter are (a) to learn that a loved one is wrestling with suicidal thoughts, or (b) to remember a loved one who took their own life. We’ve put together this list of suicide prevention resources to help adults pinpoint potential suicide warning signs in youth with the hope of helping children build resilience and save themselves.
For those reasons, we want to be gentle in offering this blog post. Please feel free to skip it or to come back to it at a more comfortable time.
For those of us who have worked extensively with suicide-related situations, thinking about suicide is very, very important. Thinking ahead of time allows us to be thoughtful about what sparks suicidal thoughts, what contributes to their growth, and what can be done to prevent them and to recover from them.
I am one of those people who thinks about these situations a lot and studies those factors. This post will hopefully de-trigger the topic of suicide, share two big ideas about how suicidal thoughts work, and give all of us a few practical things we can do if we know someone who is thinking about taking their own life.
Consulting the Experts: Studies on Suicidal Ideation and Behavior
Let’s start with some context about suicide warnings in youth and name some of the major institutions studying suicide:
- American Foundation for Suicide Prevention
- Suicide Prevention Resource Center (SPRC)
- National Center for School Mental Health (NCSMH)
- Behavioral Tech
- School-Based Health Alliance – a group that recently hosted a webinar on monitoring and addressing suicide risk among school-aged children as we go back to school in person or virtually. You can watch that webinar here.
There are terrific resources available at each of these websites, especially for professional educators and mental health workers.
For those of us who may not be working with suicide-related situations professionally, there’s good news. You can take simple steps that will help you understand and respond to your loved ones or students who may be thinking about suicide.
First step: Take time to think about suicide yourself. By reading this post, you’re already doing this! We respond best when we know in advance how we might feel or react when someone tells us they are thinking about suicide. Knowing how we might feel helps us hold our feelings while staying open to our friend or loved one. Consider how you’re feeling right now reading along… that’s a clue about how you might feel if your child or loved one comes to you to share they’ve been thinking about suicide.
What causes suicidal thoughts?
Suicidal thoughts happen for a lot of reasons. Generally, suicide is about pain. Unbearable, emotional pain – and sometimes physical pain, too. To someone who is suffering in these ways, it may make sense to think about suicide. To paraphrase psychologist Dr. Marsha Linehan of the University of Washington and Behavioral Tech, LLC, when a person feels unbearable, overwhelming pain, it can be very calming and organizing to think about ending this pain. The problem is, thinking about, preparing for, or rehearsing suicidal thoughts and actions doesn’t actually address the reasons for the pain.
We tend to think about suicide when our pain overwhelms our ability to cope. Additional factors include knowing someone who took their own life. Those of us who do know someone who committed suicide are statistically more likely to think of this when in pain. To put this another way, we want to support most strongly the circle of first-degree connections to a person who committed suicide.
How do suicidal thoughts get worse?
Think of that little phrase, “our ability to cope.” It contains so many variables! Coping comes from our sense of belonging and connectedness, our sense of ourselves, and our abilities to tolerate pain and to balance pain with positive feelings. All of these ingredients go into the soup of resilience.
Let’s imagine you have a hard time coping with a stressor, whether you’re a child or an adult. If you speak up about this to someone you expect to support you, and they say, “That’s silly, you’re being extra, be quiet, pipe down, not right now…” That impacts your sense of belonging and connectedness.
If you start to hide or swallow your negative feelings around everyone, all the time, you may start to believe that you are “too much, too difficult, too sensitive.” That impacts your sense of yourself. And if you are stressed, you may naturally begin to avoid the stressful object or event – this impacts your brain’s ability to tolerate it.
Your brain begins to think, “I avoided this and I survived… I must keep on avoiding it!” And because our brains are biased towards negative events, you may begin focusing on what you cannot control (pain) instead of what you can control (beauty, creativity, self-regulation, reaching out, learning a new skill, etc.). All of the ways you can bring positive experiences into your life start to look smaller and smaller, but your pain starts to look bigger and bigger.
Youth Suicide Prevention: Action Steps
Let’s put this in a positive way, and apply it to what we know best: our children. What the research and our community healers tell us is that we can strengthen our families against the risk of suicide by improving one another’s sense of connection, a sense of personal identity, an ability to tolerate pain, and an ability to balance pain with positive feelings.
But where can you start? Try incorporating these suicide prevention practices into your family dynamics:
- Honor the negative. When someone comes to you with sadness, anger, loneliness, or pain, let that person know that their experience is important. Don’t be too quick to say, “but at least X, Y, or Z is positive.”
- Take time to connect – even if you don’t have a reason. Let the people in your life know that you value them, you like hearing their voice, you like seeing their face. This is especially important for our children to hear from us.
- Push for the positive. We know, we know… we just suggested not saying positive things. But it is important to push for positive experiences. Instead of saying, “at least it’s a beautiful day,” you can say, “I get that you’re feeling so hopeless. Can we take a walk? I’d like to spend time with you.” This affirms connection AND brings both of you into contact with the beautiful day.
- Be direct. Ask your loved one, “are you thinking about ending your life?” If the person is thinking this way, they may open up – just remember to hold your reaction at arm’s length. If the person is not thinking this way, you asking about it will not make them more likely to do so. If anything, most people feel cared about when someone has the courage to ask them something so personal.
- Take care of yourself. Spending time supporting people in pain can tax your own emotional reserves. Put these tips into practice to keep yourself strong, grounded, and safe – this is the number one task you can do to support the children and adults in your life who may not be feeling strong, grounded, or safe.
- Practice aftercare. If your loved one does attempt to end their life, you may want to double down on connection and quality time. Whether an adult or a child, that person will likely need to know that you are comfortable with them and want to stick around. They will also need to see that you can be around them without preaching, pushing, or “fixing.”
How to look for suicide warning signs in youth
The American Foundation for Suicide Prevention notes that someone may be at risk for suicide anytime we notice a change in that person’s behaviors, particularly after a loss or major change in life circumstances. Consider the following suicide warning signs in youth, with examples by age.
Does this child talk about ending their life, feeling trapped or hopeless, or being in pain?
- High school: does the child idolize cultural figures who have ended their life?
- Middle school: do they make jokes about suicide and personal pain?
- Elementary school: do their toys or dolls act out suicide or hopelessness in play?
Does this child behave in ways that are noticeably different from how they typically act?
- High school: are they searching online to learn more about suicide?
- Middle school: are they withdrawing from peers and social activities?
- Elementary school: are they giving up on activities they formerly enjoyed?
Does this child seem to feel badly most of the time?
- High school: do they act ashamed of themselves? Are they more irritable than you would expect an adolescent to be?
- Middle school: does this person suddenly seem more aggressive and angry towards peers?
- Elementary school: does this child have trouble getting out of bed, trouble eating, and seems lethargic?
What if my child is exhibiting warning signs of suicide?
If you’re seeing multiple warning signs, please lean in and spend time with that person. In addition, please reach out and get support for yourself. If your loved one is a child and is exhibiting the suicide warning signs in youth, please consult with other adults in the child’s life and a local therapist.
If you or a child in your care is expressing immediate or serious suicidal ideations, call the Suicide Prevention Lifeline at 1-800-273-8255.
ChildSavers also offers a 24/7 Immediate Response Helpline for families in Richmond, VA. Our Immediate Response therapists are available anytime for children’s mental health support, including youth suicide intervention, in the Richmond Metro area, at 804-305-2420.
Immediate Response clinicians are also available to assist with child-related situations involving:
- Exposure to violence in the home or community
- Accidents in a vehicle or home resulting in serious injury or loss
- Sexual, physical, psychological, or emotional abuse
- The loss of a loved one through death, separation/divorce, or incarceration
- Intense anxiety or depression as evidenced by isolation or verbal aggression
- Speaking about death daily
- Self-harms or threatens others
- Inappropriate touching of themselves or others
- Behavior changes such as bedwetting, neglect of hygiene, insomnia, or eating habits
- Running away or attempting to run away
After responding, the clinician schedules a follow-up with the family. The clinician will work with the family to assess the child’s continued needs and educate caregivers about trauma and mental health. The clinician will support caregivers through referrals to best-fit services to address the child’s continued mental health needs.
Children may qualify for ongoing mental health services through ChildSavers or other community partners. A child may receive therapy from ChildSavers Outpatient Mental Health Services. This care focuses on establishing safety, developing coping skills, identifying resources, and enhancing resiliency.
Bob Nickles is a Licensed Clinical Social Worker (LCSW) and actor. He was born in South Carolina and has been moving around ever since. Bob lives on the Northside of Richmond and hails most recently from St. Louis. ChildSavers welcomed Bob to the Mental Health team in 2015 and recently, he became the School-Based Services Program Manager for ChildSavers and Richmond Public Schools Resiliency Partnership. Bob is leading the delivery of clinical services within Richmond’s East End schools and supervises the school-based mental health team.
Prior to ChildSavers, Bob spent a portion of his life dedicated to suicide prevention, specializing in spotting and addressing suicide warning signs in youth and adults.