Many parents are aware of the importance of having conversations with their kids about topics like sex, alcohol and drugs or safe driving. Most of us find our way through these sometimes awkward but important conversations with our kids because we believe in the importance in trying to educate and protect them. Yet, there is a topic that many parents often are not discussing with their adolescents and young adults that can be equally important in our efforts to keep them safe and create open dialogue about difficult topics.
Suicide is the second leading cause of death among young people ages 10-24 (https://www.nimh.nih.gov/health/statistics/suicide.shtml). With suicide rates in our country increasing over the past few decades, (https://www.cdc.gov/vitalsigns/suicide/index.html) including among adolescents and young adults, we must add suicide to our list of key topics we have conversations about with our kids.
Parents may shy away from conversations about suicide for many reasons. It may be horrifying to think of their child wanting to end their life, they might be uncomfortable with the subject, their parents likely didn’t talk to them about suicide or emotional wellness, or they aren’t sure how to start the conversation and what to say. People tend to think of suicide as something that could not ever touch their lives or their loved ones until it does. A recent study indicated that 50% of parents whose adolescent was thinking of killing themselves were unaware of this (http://pediatrics.aappublications.org/content/143/2/e20181771). Suicide can happen to any teen or young adult in any family.
Parents can be proactive and have caring conversations with their kids so that suicide isn’t something taboo to discuss. Silence is suicide’s best friend. Breaking the silence can help stop suicide. As with drugs and alcohol or other potential hazards, to best protect our loved ones we have to be willing to talk with them about suicide and empower them.
What parents convey in a conversation about suicide is just as important as bringing up the topic. As parents, we set the tone. To have a meaningful and potentially lifesaving conversation about suicide parents need to:
1) Stay calm and use direct language. It is okay to use the word ‘suicide’ and to directly ask if your child has ever had thoughts of suicide. Asking about suicide does not give them the idea or increase risk of suicide. Instead research suggests it may reduce suicidal thinking and risk (https://www.ncbi.nlm.nih.gov/pubmed/24998511). Remember your child may be hyperaware of your emotional reactions and could misinterpret them so stay calm! Some parents have shared that practicing this conversation by saying their thoughts out loud before they talked to their child was helpful and allowed them to feel more confident in their approach. It can also help to have a point of reference to start the conversation such as “I was reading an article recently about suicide and would like for us to talk about it.”
2) Do not stigmatize the issue. I have often heard teens say that if their parent talked to them about suicide at all, a leading and biased statement like "You're not thinking of doing something crazy like killing yourself are you?" or “You would never consider suicide, right?” led them to be less likely to open up to their parents about this issue. Avoid stigmatizing and judgmental statements in general about suicide, such as disparaging statements about celebrities or community members who die by suicide for example. Kids hear these comments and may store them away as "my parents think only crazy or weak people are suicidal." A teen once told me that she didn’t tell her parents about her suicidal thoughts which led to a suicide attempt because when she watched a news story with her parent about a celebrity who died by suicide, the parent commented that the person must have been selfish and weak to have ended their life. The teen then felt ashamed of her own suicidal urges and worried about how her parents may view her in light of them.
3) Emphasize that there are always other options instead of suicide and convey that you are available for support. Give your child the message that talking about this and seeking support if they are feeling suicidal or having any mental health problem is a sign of strength and help is available.
4) Avoid glamorizing or glorifying suicide in any way as this can increase the risk. Be clear that this is not a desirable way to cope or to address problems.
5) Periodically check in with your adolescent or young adult about suicide and their emotional well-being. Some research suggests that teens at risk for suicide can benefit from an ongoing connection with a caring adult (https://www.vox.com/science-and-health/2019/2/28/18234667/teen-suicide-prevention). Just like with sex or substance use, this should not be a onetime only conversation. This keeps the lines of communication open and further reduces the taboo. Look for natural opportunities to continue the conversation as needed. Educate yourself about the warning signs of suicide (https://afsp.org/about-suicide/risk-factors-and-warning-signs/) and talk to your child if you feel they may be struggling with suicide or a mental health condition. Trust your instincts.
6) If your child indicates that they are having thoughts of ending their life, stay calm and express that you care about them and want to help them find a way to feel better. Any indication of suicidal thoughts or actions should always be taken seriously. Attributing suicidal urges to attention seeking or to mimicking the behaviors of others for example can lead to invalidating the person and to not taking appropriate action towards keeping them safe. We can’t afford to be wrong about someone’s motivation for expressing that they are suicidal so we always should treat this as a real and serious concern. Dr. Stacy Freedenthal, a professor of social work at the University of Denver, has additional suggestions on things to say to someone who is suicidal (https://www.speakingofsuicide.com/2017/10/03/10-things-to-say/) and things to avoid saying (https://www.speakingofsuicide.com/2015/03/03/what-not-to-say/) in order to help the person feel safe sharing with you.
Further steps to take to support your child and keep them safe (https://afsp.org/find-support/when-someone-is-at-risk/) include removing or securing anything that could be used to harm one’s self, going to the emergency room, contacting the Suicide Prevention Lifeline (https://suicidepreventionlifeline.org/) for support, and connecting them with a mental health professional, particularly one who specializes in suicide prevention or uses Dialectical Behavior Therapy or Cognitive Behavioral Therapy for Suicide Prevention. Parents can also encourage the use of a safety plan (https://www.usatoday.com/story/news/investigations/2018/11/28/suicide-prevention-if-youve-had-suicidal-thoughts-do-safety-plan/2018051002/). There’s even a free app for creating a safety plan which makes it convenient to always have on hand to use if a crisis occurs (http://my3app.org/safety-planning/).
While suicide among youth is a relatively rare event, it is critical that we talk about suicide with our children. Most adolescents and young adults who encounter life stressors or mental health concerns won’t consider suicide and even more won’t attempt or die by suicide. Yet, as parents we can have open, honest, caring conversations about suicide so that our children know that if they ever find themselves or someone they love thinking about ending their life, we are there to listen and help them find a way to live through it. These conversations could be the lifeline your child needs now or in the future. If your child is struggling with suicide, know that with support and intervention, many people who experience a suicidal crisis can go on to live positive and happy lives and find healthy ways to cope (https://www.usatoday.com/story/news/investigations/2018/11/28/suicide-prevention-if-youve-had-suicidal-thoughts-do-safety-plan/2018051002/).
If you or someone you care about has thoughts of suicide, support is available 24/7 through the National Suicide Prevention Lifeline at 800-273-TALK (8255) or by text at 741-741. Additional resources and information are available through the American Foundation for Suicide Prevention, the Suicide Prevention Resource Center and the American Association of Suicidology.
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