In a 2018 survey, about 16% of Kentucky students said they had considered ending their own life. During the pandemic, health care providers have seen an increase in psychiatric disorders and suicidal thoughts and behaviors in children as young as elementary school age.
The increased feelings of isolation, loneliness, fear and uncertainty can have a detrimental effect on a child’s mental health. Other factors such as grief and loss, the family’s financial status, and experiencing abuse can contribute to child and adolescent suicidal ideation.
Parents, teachers, and friends can help prevent suicide if they know what signs to look for and what questions to ask. Your child’s friends may have a better idea of what is going on with them than you, which is developmentally appropriate for adolescents. Get to know your child’s friends, give them your number and let them know they should contact you if they are worried.
What to look for
• Withdrawal from friend groups, including withdrawal from group chats
• Loss of interest and engagement in activities they enjoy
• Sleeping too much, too little, or difficulty sleeping
• Change in appetite: eating too much or too little
• Difficulty concentrating and finishing work
• Irritability, such as talking back and angering quickly
• Moving slowly and feeling like everything takes too much effort
• Seeming overly hyper and bubbly
• Panic attacks
• Expressions of hopelessness or helplessness
• Increase references to self-harm and/or death
• Saying goodbye to friends either directly or in a vague manner
Even if those signs are not present, you may have no idea what your child is thinking and feeling unless you ask. You cannot trigger someone to end their life by asking if they have thought about it. In fact, by allowing them to name and share their thoughts, you may reduce their distress and likelihood that they will feel that suicide is their only option.
Depression is not logical nor does it discriminate. Your child may indeed have little “reason” to be depressed or want to end their life. Leave judgment regarding depression and suicide at the door when talking to your child or adolescent.
Preparing to talk
• Be calm; if you are agitated, your child may interpret this as something negative about themselves. Have the conversation at a time when you and your child are at your best, such as after dinner. Do not force them to look at you. You may even want to sit next to them rather than across from them.
• Children and teens may find it easier to talk during an activity or while doing something else. Play a game of cards or allow them to fidget while they talk.
What to ask
Start by mentioning a news story. You can say “I saw this story about teen depression, and I was wondering…” You can also start by describing signs that you have seen that cause you concern.
• How many days in a week do you feel happy?
• Have you ever felt sad, depressed or hopeless most of the day?
• Have you ever thought that you might not want to be alive anymore?
• Have you ever thought about ending your life or killing yourself?
If you hear “no,” but it sounds hesitant or uncertain, label that and see how they respond. You can say “I heard you say ‘no,’ but you hesitated.” If they still say “no,” reassure them that you want to be supportive and that if they have thoughts like these, you will do your best to find them help and they won’t be in trouble. You can leave it there and maybe restart the conversation another time.
If your child feels sad or down and has thoughts of ending their life, immediately talk to your pediatrician or school mental health professional to identify appropriate community referrals. If you are concerned that your child may take their own life, take them to an emergency room for a behavioral health evaluation. You can also always call or text the National Suicide Prevention Lifeline anytime for support. Text “TALK” to 741741 or call 1-800-273-TALK(8255).
ALISSA BRIGGS, Ph.D., is a licensed psychologist in the division of adolescent medicine at UK HealthCare.