Talking about Suicide with Children
Learn some key elements when addressing the subject of suicide with children and why it’s important to bring up the topic.
By Dr. Cheryl Andaya, Child Psychologist
Talking About Suicide with Children
Is it okay to talk about suicide with my child?
Talking to children about suicide, is this necessary? This question gets asked every so often in my office by nervous parents who suspect their child may be depressed. The short answer, YES. It is definitely okay to talk about suicide with children.As far as age-wise, I started talking about a tough day and how I had to go to the ER because of a suicidal patient. My kids overheard and asked about suicide. My 6-year-old was puzzled but I just told him this:
Talking to children about suicide - when they're young...
If you ever feel so sad or have thoughts about death or dying, please come to me so I can be there for you.
It’s sweet, simple and to the point. That is usually enough for a 6-year-old.
My preadolescent kid, however, needed more discussion, especially because he’s the type to be on the quieter, let me think about this, type (analyzer, like his mom). As a mom, I also get worried about suicide. I get particularly worried as my older son enters that age where fitting in and peers become a driving force in the way they see themselves. Children these days feel immense pressure to fit in and lead perfect lives as they are bombarded by perfect (staged) pictures in social media…everyone’s highlight reel. Self-esteem is impacted.
Parents often don’t know if or how to approach their child. However, it can be more uncomfortable for a child to bring up the subject, feelings aren’t always easy to talk about. It’s important to let your child know that you are there for them. Let them know you are there to listen and that it’s okay to ask for help.
Suicide of Celebrities Promoting Suicide?
The news regarding the suicidal deaths of Robin Williams, Kate Spade and, shortly after, Anthony Bourdain, shocked many. Suicide is not often reported on the news, unlike homicide. There is a phenomenon called, contagion suicide or suicide copycat, where studies found that “exposure to suicide or suicidal behaviors within one’s family, one’s peer group, or through media reports of suicide and can result in an increase in suicide and suicidal behaviors” (U.S. Department of Health & Human Services). It is likely this may have occurred in the case of Anthony Bourdain who committed suicide shortly after Kate Spade. This phenomenon is also why we (behavioral health workers) talk to children about suicide, particularly if there has been suicide in the family or with friends to determine if there may be increased risk of suicide.
One of the risk factors of suicide is if a close family member or close friend had committed suicide recently. If this has happened, please seeking professional help to address and hopefully decrease that risk. Like any other disease, if you are aware of your risk, you can help do something about it.
Second Leading Cause of Death for Youngsters 10 to 24
Suicide is the second leading cause of death for young people between the ages of 10 to 24 (Lifeline, n.d.). What?!!!!! 10 year-olds?! Seriously?! I am always amazed at how young some of these children are. Yep, I’ve had 10-year-olds and even younger children, tell me they’ve thought about suicide or have made suicidal comments.
I remember when my kid was in the 2nd grade and he told me about hearing a classmate tell another student to go kill himself as they were arguing in the cafeteria. This might have been said in jest or in frustration but I was completely shocked to hear about it. The sad thing about suicide and young ones this age is that they hear about suicide, and, because of their developmental age and limited understanding, they act on impulse.
In 2016, nearly 45,000 persons died by suicide in the United States (Stone, et al., 2018). According to the Center for Disease Control and Prevention (CDC), there has been a 30% increase in suicides in the United States since 1999 (Stone, et al., 2018). As a mental health professional, it is frustrating! No family should have to go through that pain and no individual should feel like death is the answer.
Mental Health Stigma Sucks!
Despite the increase in awareness, advocacy by celebrities, and promotion through media, access to mental health is STILL blocked by stigma. There is still shame in reaching out for help. I was at a Mental Health America – Hawaii training and the speaker talked about a great app put out by the organization. It’s basically an app that screens for mental health conditions. The highest users of the app? Those ages 11-17!!!!
Still, despite the growing concern, there is still shame and hesitance with asking someone if they have had thoughts about suicide. As a psychologist, I’ve heard the tragic stories of families who found a loved one had committed suicide and had no idea their child was in pain. The pain, agony, guilt, self-blame, anger, sadness, grief, and confusion families feel in the wake of suicide is tremendous! Mothers cried, “Why didn’t they tell me?” Other parents are burdened with guilt saying they should’ve known.
Children's perspective...don't worry mom and dad
I had patients tell me they’ve thought of suicide but they have never told their parents about it because they didn’t know how or they didn’t want their parents to worry. Children often say their parents have enough to worry about. As parents, we need to let them know that no other worry is greater than their well-being!
When I talk to parents, they have no idea about the struggles their child has been facing because their children don’t want them to worry. They see the poor grades and think their child is just lazy or they see their smiling child and think all is well. Hearing about the celebrities taking their own lives, people wondered how these seemingly successful individuals could have been suffering inside when they seemed to have it all. Masks of smiles are worn to convince you they are doing okay; then they huddle up in their beds and cry when they are alone.
Is it Mental Illness?
There is also the belief that only those with a history of mental illness are prone to suicide. However, a study found that more than half of those who committed suicide did not have a known mental health condition, rather there were other life stressors at play which included relationship problems/loss, life stressors, and recent/impending crises (Stone, et al., 2018). Some children just don’t know who to turn to, or they believe that no one cares.
Masking the Pain
I had a few patients who described the loneliness they felt despite having friends and loved ones around. They smile for everyone and seem like the perfect students. It’s difficult for them to talk about their hurt with others. Tears in my office are shed as they describe how overwhelming it was trying to be perfect and be the happy friend. Their masks fool everyone. One patient seemed to cry uncontrollably at times but admitted that crying and “letting it out” helped. Thoughts of suicide emerge because they felt so tired pretending to be happy and so overwhelmed with trying to meet the expectations of others. I wrote a post recently about grades and self-esteem (here) and the pressure some children put on themselves.
I know I’ve put pressure on my children as well (BE GONE TIGER MOM!!!! 🤜🏼🦁 – note: in no way do I condone abuse of animals); I’m so guilty of it. Knowing this, I have to remind myself to back-off, check in with my keiki (children) and see how they are doing. I freqeuntly ask myself: Am I asking too much? Does my child have the emotional resources and support to keep going? Are they feeling pressured? Do they know they can come to me at any time?
Some children just don’t know who to turn to, or they believe that no one cares…so if you see your child OR ANY CHILD hurting be that listening ear. Let them know someone cares.
Start Open Communication Early
Starting the habit of open communication at an early age is important. From a young age, I frequently asked my children how they were doing.
We have our quiet times (usually before bed) and I use that to remind them they can always talk to me about whatever. I say it, and I mean it. They can ask me or tell me anything at this time and my job is not to freak out, no judgement. It’s the quiet time. It’s their time.
Parent: Eh, how YOU doin’? (why did I just read that in the Joey Tribbiani voice? 🤔)
More Like this:
Parent: Hey kiddo, how are things going?
(Occasionally I will ask) If you could change something about your life right now, what would it be? (or) If you had 3 wishes, what would it be? (therapy staple question)
Parent: How are things going in school?
Me: (digging deeper if you need to) What is something that frustrated you in school today? What was something you slayed? (see how I try to be sooo cool and hip there? 😃🙄 Keep asking different questions.)
After our talk, I say: You know you can always come to me about anything at any time. I love you. (Awww, isn’t that sappy. Don’t worry, they get used to it…and I’m not always that sappy. trust!)
Signs There Might be a Problem (and Not Just Teen Angst)
As a psychologist, I often have parents tell me they’ve noticed their child becoming distant, irritable, and isolating themselves. They attribute this to teen years and those lovely hormonal changes so they leave them alone. Yes, it could just be hormones but it doesn’t hurt to talk to them about the changes you see. Go ahead and ask them about their feelings. Teens are often torn between wanting to be independent and wanting to be a child.
I have also prepped my son about the hormonal changes and the moods he will likely experience. His school has told them the same (love when the school and paretning efforts are on the same page). In fact, my preadolescent son told me one day, “Mom, we talked about puberty today and the takeaway message I had was that I need to talk about my feelings so I don’t get trapped with the moods and hormones.” (say what?!?!!! I was FREAKIN’ AMAZED! raise the roof!!!!) YES!!!! I told him he will have hard days but hard days pass and turn into better days.
Even if your child seems completely fine, check in with them and make sure they are really doing okay and not just appearing okay. Don’t wait for your child to initiate the talk. They may not know what to say or how you would react. Ask deeper questions about their friendships, school, and the demands they are placing on themselves. Let them know they don’t have to be perfect. If they can’t talk to you, ask if they’d be willing to talk to someone else. Give them an outlet: a trusted adult, an aunt or uncle, or (even better) a mental health professional.
Asking About Suicide Helps
Parents are concerned that by asking about suicide, they will be giving their child ideas or encouraging it. It’s okay to ask about suicide and talk to children about suicide. Lemme say it again, IT’S OKAY TO ASK ABOUT SUICIDE! Studies show that talking to someone about suicide does not increase the chances of that person committing suicide. On the contrary, there is the opposite effect. Talking to children about suicide REDUCES suicidal ideation (thinking about suicide) (Dazzi, Gribble, Wessely, & Fear, 2014). If your child was thinking about suicide, this gives them the opportunity to seek support. If they weren’t thinking about suicide, it doesn’t hurt to discuss it in case it comes up in the future or if they come across a friend who needs help.
Pointers you want to cover when addressing the issue of suicide:
Take threats of suicide seriously.
If your child admitted to having thoughts of suicide, DO NOT PANIC! Have him/her talk about it. Ask these questions:
- How often are you thinking about it?
- When did it start?
- Have you ever done anything to hurt yourself?
- Do you feel like hurting yourself now? If they feel they can’t keep themselves safe, and you feel they are in danger of hurting themselves, take them to the Emergency Room to be assessed for safety by a professional.
If you are worried that your child may be experiencing suicidal ideation or depression, get some help. Talk to a professional. Contact a crisis line. I’ve had parents think that the problem would just go away but later discovered that their child has been cutting themselves. Once a child becomes accustomed to using this as a coping method, it can be hard for them to stop.
One parent sobbed in my office when her child rolled up her sleeves and exposed multiple lines of healed and raw scars. Her mother had suspected the cutting because her child was wearing long-sleeves in summer but she had no idea how bad it was.
Other tips when discussing suicide:
Do not keep it a secret! If your child or a loved one comes forward and tells you they have been thinking about suicide, and then asks you not to say anything to anyone, PLEASE, PLEASE, PLEASE do not keep it a secret! They may get angry if you tell but if you let them know you are coming from a place of caring, they will understand. Some people don’t know how to react or what to say when someone tells them about suicide. Other times, misinformation may be shared, which is why it is so important to seek professional help.
Recent overwhelming stressors. Loss of a loved one, loss of a job, poor grades, ending of a romantic relationship, parent-child conflict, bullying, abuse, or any other traumatic event can all contribute to suicidal ideation. If these things happen, make sure your child has emotional support and permission to grieve or process their feelings.
Changes in behavior. This includes sudden changes in friends (negative peer influences), mood swings, isolating themselves, changes in appetite or sleep, drop in grades, and loss of interest in things they used to enjoy. When combined, they may signal a problem. It doesn’t hurt to check in with your child to make sure everything is okay. If they don’t talk to you, ask their friends, their teachers, coaches, or other people your child sees on a daily basis to see if they have noticed changes.
I will be discussing this topic more in my webinar on parenting where you can learn specific ways to talk about the subject. Be sure to subscribe so you will be alerted when it’s out.
If your child admitted to suicidal thoughts, seek professional help. If they admitted to hurting themselves now, contact the crisis line (available 24/7) (1-800-273-8255) or 911. Don’t just hope it will go away on its own.
If you need further advice, please don’t hesitate to reach out. suicidepreventionlifeline.org
Still not sure how to talk to your child? Or worried that your child is at risk? Get parent coaching and learn specific ways to approach the subject through the assistance of a licensed Clinical Psychologist who has worked with children and families who have faced suicide.
Dazzi, T., Gribble, R., Wessely, S., & Fear, N. (2014, December). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine, 44(16), 3361-3363.
Lifeline, S. P. (n.d.). Youth. Retrieved from Suicide Prevention Lifeline: https://suicidepreventionlifeline.org/help-yourself/youth/
Stone, D., Simon, T., Fowler, K., Kegler, S., Yuan, K., Holland, K., . . . Crosby, A. (2018, June 8). Vital Signs: Trends in States Suicide Rates – United States, 1999-2016 and Circumstances Contributing to Suicide – 27 States, 2015. Centers for Disease Control and Prevention, 67(22), 617-624. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a1.htm?s_cid=mm6722a1_w
U.S. Department of Health & Human Services. (n.d.). What does “suicide contagion” mean, and what can be done to prevent it? Retrieved from hhs.gov: https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-does-suicide-contagion-mean/index.html
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Need a parenting coach/tutor? Rely on someone with years of education and clinical experience working with families. I’m a mother and a licensed Clinical Psychologist who works with children and their families as well as individuals reaching for their goals. Born and raised in Hawaii, I embrace diversity and help individuals find their strengths.