The statistics on teen suicide are incredibly sobering. According to the CDC, an average of 8 percent of American teens will attempt suicide every year. It’s the second leading cause of death for children and youths aged 10 to 24. In fact, more teenagers die each year from suicide than from cancer, heart disease, AIDS, birth defects, pneumonia and influenza combined. And yet the stigma surrounding suicide in particular and mental health in general is so huge that these issues rarely get the coverage they deserve, a fact that can lead parents of youth struggling with mental health crises feeling like they have little in the way of support or resources.
How should parents react if their teen discloses that they are suicidal? In what ways can parents reassure their kids that they are taking them seriously? What can parents do to manage their own feelings about the situation without adding to their child’s distress?
Dr. Damon Constantinides, a psychotherapist at Relationship and Sex Therapy Associates in Philadelphia, who specializes in anxiety, identity and sexuality, offers some advice for parents whose teenagers who are experiencing suicidal feelings.
Actively listen to your child and validate what they feel. Having your child recognize that you are hearing and understanding what they’re telling you is incredibly important. You can practice active listening by using body language that shows you’re paying attention, occasionally summarizing the speaker’s comments, and asking questions to clarify points.
“When a teenager or child talks to a parent about mental health concerns or thoughts about suicide the best thing to do is to listen,” says Constantinides. “It says a lot about the strength of the relationship between the parent and child that they feel like they can talk to them in the first place. Listening without judgement creates an opportunity to learn more about what’s going on. We tend to think as listening as being a passive action. However, truly listening to a person is an act of validating their experience and feelings.”
Try not to freak out. “The first time a teen says something to a parent it is in some ways a test to determine what their parent can ‘handle,’ ” says Constantinides. Hearing that your child is thinking about killing themselves is scary, and it’s hard for parents not to let their own feelings take over when their child discloses that they are suicidal. Unfortunately, reacting in a way that overwhelms your child could scare them into silence, which makes figuring out how to help them even more challenging
So how should parents react?
“Staying calm, listening, asking questions, taking them seriously, affirming their feelings (saying, for example, ‘Yes, that must feel terrible’) are all ways to let a teen know that their parent that can handle talking about hard things,” says Constantinides. “Thinking about [discussions like this] ahead of time and making hard conversations a regular part of parent/teen communication will make it easier to navigate if the teen does talk about suicide.”
Ask your child clarifying questions to get a better idea of what the situation is. Says Constantinides, “When someone comes to us with a problem, we often want to tell them how to solve it. But you have to know what the problem is first. What do you mean when you say suicide? How often do you feel this way? Suicidality is scary because saying that you want to kill yourself can mean so many things – for example it can be a way to explain how bad things feel, it can be a way to talk about needing something you’re not getting, it can be a way to saying you don’t want to feel anything, or it could mean that you’ve already planned how to take your life. Thoughts about suicide should always be taken seriously.”
Let your teen have plenty of input on what their treatment plan looks like. “Teenagers should have as much input in an action plan as possible,” advises Constantinides. “When we’re teenagers we stand at a crossroads of having no actual control of our lives and wanting nothing more than to have control of our lives. This is normal adolescent development. A teen is more likely to follow a plan if they helped make it. Not only because it’s more likely to meet their needs if they participated, but also because they own it, it’s theirs.”
Figure out a communication system that works for you. Once you, your teen and your family doctor have figured out a treatment plan, make sure that you have a workable way to exchange information about it. Some teens will be fine with talking, whereas others will find that idea overwhelming. Remember that communication can happen in lots of different ways; it may take a few tries before you discover what works for your family. “If talking is too hard, what is another way that you can communicate? I’ve worked with youth who have thoughts of suicide and don’t like talking to their parents, so they come up with a plan. This might be a code word, or writing it down on a marker board in the kitchen. And when the teen does communicate in this alternative way, what’s the plan? Is it that they need to email their therapist? Or schedule a visit? Having a therapist that the teen likes can be a way to help them find other coping skills for dealing with stress, depression, or anxiety. It’s important that it’s someone that the parent and teen like.”
Know the risk factors. There are a lot of variables that can increase the risk that a teen will attempt suicide, such as race, sexuality, gender identity, and socio-economic class. But according to Constantinides, the top thing that puts teens at higher risk for attempting suicide is not having the support of their parents. “A teenager’s job is to push against their parents, and the job of a parent of a teenager is to hold tight and be present,” he says. “It’s not an easy dance.” He adds that other risk factors include “lack of friends and community (often due to bullying), access to means, and other mental health issues such as depression and anxiety. I always assess to see if the teen has a plan and if they have access to acting out that plan. Those two things tell me a lot about how that teen is thinking about suicide.”
Know the warning signs. Hormonal changes mean that adolescence is often accompanied by mood swings and a certain amount of sullen, withdrawn behavior. How can parents differentiate between normal teen moodiness and signs of something more? Says Constantinides, “One thing to look for is, does your child still enjoying the things that they used to enjoy? Or, are there any things your child enjoys? Apathy and hopelessness are two signs of depression.”
Know what to ask. This can be tricky, because asking the wrong questions can shut down the discussion entirely. Parents need to find a balance between making sure their child is safe and not making them feel as if they’re being interrogated.
“Parents can ask about their child’s feelings, although not all teens can clearly identify or talk about their feelings. Parents can also point out things about the child’s behavior that are different and say that they’re concerned,” he says. “Long before parents are having these conversations with their teen they can be setting the groundwork for them. If parents and teens talk often about feelings, values, and ideas then having a conversation about mental health is a natural extension.”
He adds that parents shouldn’t be concerned that serious talks about mental health will somehow suggest suicide to teens. “Adults are often worried that if they talk about suicide it will put the idea into their kid’s head. This just isn’t how it works. If you can talk openly and honestly about suicide with your child then they know that you’re not going to freak out if they come to you about it.”
Be a safe place for your teenager. This is a parent’s most important job, one that becomes even more crucial (not to mention challenging) when kids become teenagers. Even as teens break rules and push boundaries, what they need to know most of all is that their parents will love them no matter what they do or who they are.
“Being a teenager is both exciting and terrifying, teens are figuring out who they are and how they feel about everything in the world, including their parents,” says Constantinides. “And although teens feel like they want to be on their own and not have any rules, what they need most is boundaries and stability. Parents get to be the safe, affirming and accepting place that teens come home to after they’ve tried something new and different.”
Find support for yourself. You need to be safe and healthy in order to help your child, so self-care should be a priority. Try to figure out a support network of friends and family who can step in and take over when you need a break. Not only will this be helpful to you, but your teen will almost certainly appreciate having someone to talk to who’s not their parent.
“Hearing that someone we love, especially a child, is struggling in a way that we can’t help can be terrifying,” Constantinides says. “Parents need to make sure that they have their own places to get support. Having a friend or family member that you can freak out to allows you to be able to concentrate on your child and what’s going on for them.”
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