What should I do when I notice warning signs?

Many parents fear asking their child about suicide thinking that by asking they might give their teenager some ideas or perhaps plant a thought in their head that may be acted upon later. As result they never ask and end up surprised! Don’t be that kind of parent, ask your teenagers about suicide. Questions never killed anyone, if anything the question will let your teenager know you care. However, don’t forget that relationship is always the key to getting good information.

So if you want to get the truth from your child, you will need to approach them with great care and loads of respect. Chances are you will have earned the right to ask them about suicide because you have been working hard to connect with them over the past few weeks and months by meeting them right where they are and taking the time to really listen (without judgment and without pressure) to what has been going on in their life.

Things to think about when asking about suicide:

Take a deep breath and try to stay calm.

Of course there is a chance that when you ask them if they have ever thought about suicide that they will say yes. This “yes” may be one of the scariest “yes’s” you have ever heard and you will need to be prepared for the emotional impact this has on you. No parent ever wants to hear about their child having considered suicide, but don’t forget that you are not alone; many other parents have gone before you and survived.

Try your best to ask about the following 4 things (White, 1999):

Remember: You are not a mental health professional and no one expects you to be; however, having more information is going to be helpful when trying to help your teenager cope with this stuff both now and in the future.

IDEATION

Thinking about suicide and planning your death are two different things. Studies have found that 20-30% of teenagers will report experiencing thoughts of suicide at some point during their teenage years (Brener, Krug, Simon, 2000; Kandel, Raveies, & Davies, 1991). While these numbers are alarmingly high, it would seem that thoughts about suicide are fairly common during the teenage years, so you will need to be ready to deal with them.

INTENT

As stated above thinking about suicide and wanting to die are two different things, however they always need to be assessed together. When your teenager tells you that they have thought about suicide your next question needs to be about motivation; do they want to die?

MOTIVATION

By asking about their intentions you are attempting to figure out if they really want to die, are attempting to manipulate, are crying out for help, or have some other reason for wanting to die (White, 1999). Remember, that just because they maybe attention seeking or manipulating does not mean that they are not a serious risk! In most cases they will say “no” when asked about motivation, however its fairly common for someone who has experienced thoughts of suicide to be somewhat ambivalent about their desire to die; a part of them wants to die, yet another part of them doesn’t. Helping them resolve this conflict may be the key to keeping them safe.

Here are some questions you could ask to assess INTENT (White, 1999):

Why do you want to die?

What are the contents of your thoughts?

What does death mean to you?

How long have you been thinking about hurting yourself?

How frequent and persistent are the thoughts?

Are you pre-occupied or obsessed with the idea of killing yourself?

Can you control your thoughts?

PLAN

Having a plan is often the most important part of determining what is going on with your teen. Suicide can occur without a well thought out plan, however most individuals experiencing thoughts and intentions will often very quickly arrive at a plan. Some will spend days, even weeks, planning their attempt without telling a soul.

Questions to ask yourself in addressing your teenager’s plan (White, 1999):

How far has the adolescent developed the plan?

When is the proposed plan going to occur?

How specific is the plan? (place, time, method)

Is the plan effective and feasible?

Is the adolescent’s chosen method lethal?

Will he/she have access to the chosen means when he/she needs it?

Does he/she know how to use the means?

Has he/she rehearsed his plan?

Has he/she taken precautions to avoid rescue?

METHODS & MEANS

When asking about your teen’s plan you will want to try and figure out just how plausible their plan appears to be. While every suicidal thought, intent, and plan should be taken very seriously and properly addressed by a competent mental health professional, some plans need to be taken much more seriously than others. The more lethal the means the more dangerous your teenager might be.

The 4 most common means of teenage suicide are:

Guns: Firearms typically account for about 60% of all completed suicides in the United States and any suicidal thought or plan that incorporates their use needs to be taken very seriously!

Cars: While there does not appear to be any statistics regarding teenager’s use of cars as a means of suicide, it is safe to say that not every death by auto accident is an “accident.”

Drugs: Drug overdose is very common in western culture and many, if not most, of the suicide attempt victims I have worked with decided to kill themselves by taking a handful of pills, or combine pills with alcohol.

Combination of all three

When asking about methods and means you need to ask about two things:

Access: Does your teen have access to the tools they are planning to use? Consider guns, knives, explosives, belts, ropes, sheets, medications (prescription and over the counter), drugs and of course alcohol.

Knowledge: You will need to find out how much your teen knows about the means they have mentioned. Do they even know how to use a gun? Do they know how to hang themselves? Etc.

Remember: Any person who is experiencing thoughts of suicide needs to be assessed by a mental health professional as soon as possible!

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*** Any advice given on this website is offered in generic form. In other words, all of our site visitors have unique qualities that play a role in their personal mental health. We do not know you personally and can therefore not take into consideration these qualities when offering advice, and do not claim to do so. All information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing psychologist, mental health professional, teacher, or professor. ***

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Written by Joseph James, Psy.D.

REFERENCES

Brener, N. D., Krug, E. G., Simon, T. R. (2000). Trends in suicide ideation and suicide behavior among high school students in the United States, 1991-1997. Suicide & Life-Threatening Behavior, 30, 304-312.

Kandel, D. B., Raveis, V. H., & Davies, M. (1991). Suicidal ideation in adolescence: Depression, substance use, and other risk factors. Journal of Youth and Adolescence, 20, 289-309.

White, T. W. (1999). How to identify suicidal people: A systemic approach to risk assessment. The Charles Press Publishers, Inc., PA.