Children and Youth with Thoughts of Suicide: Guide for Parents and Caregivers
Suicide is the act of ending one's life. It is unfortunate, but modern society tends to be stressful and disconnecting, and as a result, some children and youth may think about ending their lives. People may suicidal when they feel disconnected from people or activities that give a sense of belonging, purpose, hope and meaning.
Stresses can contribute, such as:
- School stress such as problems with friends, schoolwork, teachers, bullies.
- Home stress, such as conflict or disagreements with family members.
- Work stresses such as problems with co-workers, bosses, workload.
- Modern society, with the way that screens, technology and other factors tend to disconnect people from human connection, sleep and other essentials;
- Other problems such as depression, anxiety, substance use.
The good news is that there are many ways to help young people who are feeling suicidal, by helping them reconnect to people and activities that give belonging, purpose, hope and meaning.
The following is a list of signs that may indicate someone is thinking about suicide. Its normal for many people to have one or two of these signs from time to time, but having many of these would be a reason to seek help:
- Your child expresses feelings of worthlessness, such as, "I'm no good to anybody."
- Your child talks about suicide and about what it would be like if things end such as "When I'm gone ..." or ask questions such as, "What would it be like if I wasn't around?"
- Your child becomes preoccupied with giving away or distributing his/her possessions.
- Your child shows hopelessness about the future, saying things such as, "What's the use?"
- Talk to your loved one openly about suicide.
- You might:
- Express your concerns:"You don't seem yourself lately -- I'm worried about you. How's it going?"
- If your loved one denies any issues, but you are worried, you might follow up with more direct questions
- "Everyone has stresses. I want you know, that if you are having stresses, we're here to help you with those stresses. How are things with school? Friends? Home?"
- "Does it ever get so stressful that you think life isn't worth living?"
- "Do you get thoughts of doing something to end your life?"
- "Do you have any plans to end your life?"
- Don't be afraid to ask. Asking does not make people suicidal.
- Don't try to make your loved one feel guilty.
- Don't make it about you.
- Do listen without interrupting.
- Do thank your loved one for sharing with you, e.g. "I didn't know you feeling so bad... Thanks for telling me."
- Do empathize, which means that you agree and acknowledge how bad they are feeling, e.g. "Yeah, I can see that would be very difficult."
- Do give hope. "This is going to get better. Things were better in the past; we'll get it back to how it was when things were better."
- Do tell the person they are not alone. "We're in this one together; we're going to help you get over this."
- Do offer your support, e.g. "How can I support you? How can I help you get over this?"
- Do help with problem-solving. People often think about suicide when they are overwhelmed by stress. And even if those stresses don't directly cause a person to feel suicidal, the stress nonetheless doesn't help. Things you might say to help problem-solving include:
- "Sometimes people think of hurting themselves when they're under stress or trying to deal with some problem"
- "What's the stress that your dealing with?"
- "Is there some particular problem that you're trying to deal with?"
- "I'm here for you and want to help you work through this..."
- Don't say things such as "You shouldn't be feeling this way" or "You should count yourself lucky"
- Don't invalidate or judge the other person for how they are feeling, even if you yourself wouldn't feel the same way. Don't say things such as... "How can you possibly feel this way? After all that we've done for you? Is this the way you repay us? How can you do this to us?" Such blame will most likely make your child feel worse, making it less likely that s/he will confide in you. And worse, in some cases such statements will only confirm to the child that s/he is a burden, increasing the risk of suicide.
Is your child saying that they get thoughts that life isn't worth living, but doesn't have any immediate plans? (i.e. passive suicidal ideation)
- If so, then seek professional help:
- Contact a local mental health agency to set up an appointment.
- Call a telephone crisis or distress line, and ask where to find mental health help and supports.
- Visit a mental health walk-in clinic.
- Set up an appointment to see the family physician or pediatrician.
Is your child expressing that they have made plans to end their life, and they are going to carry this out in the near future? (i.e. active suicidal ideation) Or do you have worries that your child is in immediate danger?
- If so, then
- Make sure someone stays with your child at all times for the time being; call family, friends or neighbours if you need to.
- Seek immediate professional help:
- Call a telephone crisis or distress line.
- Visit a mental health walk-in clinic.
- Bring your loved one to the local Emergency Department.
- Call 911 for police or ambulance, if you feel immediate intervention is required to keep your child safe.
Whenever someone has thoughts about suicide, whether those thoughts are active or not, make your home a safer place by removing potential sources of harm:
1. Remove firearms and weapons
- Make sure that there are no firearms, ammunition nor weapons in the home. Remove any fire arms from the home by giving to a trusted friend/neighbour, or by taking them to the local police station if no other options can be found.
2. Remove alcohol
- Since alcohol affects rational thinking and lowers inhibitions, alcohol can be a risk factor for suicide. Hence, remove alcohol from the home or keep in small amounts only.
- Prescription medications should be locked up. People who are depressed often overdose on the very medications that they are prescribed for depression. Fortunately, in general, newer medications prescribed for depression (such as Fluoxetine/ProzacTM Fluvoxamine/LuvxTM, Sertraline/ZoloftTM, Paroxetine/PaxilTM, Citalopram/CelexaTM) are significantly safer than the older medications, even in overdose. Nonetheless, it is still best to lock them up anyways.
- Make sure that when prescriptions are filled, that you have safe amounts of medication on hand, which makes it harder to overdose. Ask the physician or pharmacist to dispense safe amounts.
- Supervise your child when s/he takes medication(s).
- Dispose of all unused or out-of-date medications, by taking them to the local pharmacy for disposal.
- Lock up or get rid of over-the-counter medications such as acetaminophen (TylenolTM), acetylsalicylic acid (AspirinTM, or ASA). These medications can be dangerous in overdose, so it is safest to remove them from the home.
4. Remove any other means of suicide
- Remove or lock up cords, ropes, sharp knives, or other obvious means of self-harm.
5. Car keys
- Remove access to car keys as a car can be used to harm oneself
6. Lock up things in the car
- If you don't have other options to lock up things, then firearms or medications can be locked in a car (preferably in the trunk)
7. Use your security system
- If you have a security system, you can activate it when you need to in order to alert you if your loved one attempts to leave the home.
When things are calm, it can be helpful to think about what types of stresses may trigger your loved one, and how one might support your loved one through distraction or coping strategies.
Here is an example of a Safety Plan that can be printed out and filled out.
Sometimes people feel more overwhelmed and unsafe during certain high risk periods. It might be holidays, anniversaries (of a loss or breakup), or times when close supports are away,
- Do be extra cautious and check in regularly with your loved one.
- Do take your loved one with you if you have to go out. If your loved one refuses to come and you can't persuade them, then ask a friend or neighbour to check in if you have to go out.
- Don't leave him/her alone for long periods.
Sometimes despite our best efforts, people may still end up attempting to end their lives, such as:
- Overdosing on medications: Signs that someone might have overdosed include being very drowsy, or confused for no obvious reason.
- Attempting to hang themselves.
Hopefully this will never happen to you, but should it happen:
- Call 911 (or an ambulance) immediately.
- Remove them from any danger, e.g. remove any ropes if they have attempted hanging.
- If you know first aid, administer it immediately.
- Phone someone to go with you to the hospital; or to stay with you at home.
In case you ever need to go to hospital, it is good to make a list of key information ahead of time; it is not good to be looking for phone numbers and information while rushing to go to the hospital.
Person(s) (and their phone numbers) that I can call day or night for support
Names and Numbers for my loved one's health care professionals (such as doctors, therapists, others...)
Hospital (name and phone number) that my loved one uses
Medications that my loved one uses, including dosages
Pharmacy and phone number that my loved one uses
Helpful people that my child trusts in the event of an emergency (names and phone numbers) (For example, these would be helpful people that could help persuade him/her to get help, accompany you to the hospital, etc.)
Are there young children that cannot be left alone at home? What child care could I use to take of those young children in case I had to accompany my child to the hospital?
Name of Power of Attorney (if applicable) (consider a power of attorney if your child is aged 16 and above)
Additional Comments for Action Plan
Sometimes it is necessary to go to the hospital with your loved one, such as following a crisis at home, such as an episode where your child has tried to harm themselves, or is saying they are going to end their life immediately.
Consider the following:
- If possible, try to have other family and friends accompany you as well. This way, one adult can focus on driving, and the other adult(s) can sit with your loved ones, ideally in the back of the car.
My loved one is refusing to go. What now?
- If you physically cannot force your child (e.g. adolescent) to go, see if there is another friend, family member or relative that can help convince him/her to go to the hospital.
- Consider giving choices such as "Will you go to the hospital with me, or would you prefer that John comes along too?"
At the emergency department:
- Speak directly with the doctor, social worker or nurse. Let them know about your concerns.
- Is the hospital wanting to discharge your loved one home?
- Most of the time nowadays, people are not admitted to hospital, even for suicidal ideation, but rather a follow-up and treatment plan is set up. However, if the hospital is wanting to discharge your loved one, and you feel strongly that your loved one should be admitted, you can tell them that you do not feel that it is safe to take the person home. Recognize that mental health professionals in an emergency room deal with mental health crises regularly, so they may have a higher tolerance for mental health distress than you. Nonetheless, you can still ask the professional to explain to you why he or she feels that the decision is a safe one, and for advice on how to deal with things should your relative go home.
Supporting a loved one with suicidal ideation can be extremely stressful.
Do make sure you have your own support network, such as family and friends, a support group, or counselor/therapist for yourself.
Depression & Bipolar Disorder: Family Psychoeducational Group Manual - Therapist Guide, by Christina Bartha, Kate Kitchen, Carol Parker and Cathy Thomson. Available from the Centre for Addiction and Mental Health at http://www.camh.net/Publications/CAMH_Publications/
Written by the eMentalHealth Team.
Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.
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Date of Last Revision: Jan 25, 2020