#JamesDonaldson On #MentalHealth – How to Talk to Kids About Suicide

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Parents and other adults can do a lot to make kids feel safe discussing mental health, so they know it’s okay to speak up if their thoughts ever turn to suicide. Here are eight tips.

By Lisa Rapaport

Medically Reviewed by Allison Young, MD of American College of Lifestyle Medicine

talking to kids about mental health and suicide
Normalizing conversations about mental health and feelings can help create a safe space for questions about suicide when they come up

Joanna Quigley, MD, is a mother of three school-age kids. She hasn’t talked to her kindergartener about suicide risk, but she has discussed it with her older children, who are in third and sixth grade.

One of her kids asked what suicide meant after hearing about a famous person who died this way. Dr. Quigley says that she paused to collect her thoughts before replying.

“It’s when someone takes their own life, because they are suffering in a way they don’t feel they can get out of,” she says of the explanation she shared with her children.

She also told her kids that “if they ever felt this way, or knew someone who did, they can always tell me or their dad or the adults in our lives — and no one would be mad.”

Done the right way, these discussions can help kids and teens feel comfortable talking about their mental health and help them realize that it’s okay to ask for help, says Quigley, who is an associate professor of psychiatry and pediatrics and the medical director of child and adolescent ambulatory psychiatry at Michigan Medicine in Ann Arbor.

“It’s such an important thing to talk about,” she says. Though she acknowledges it can be a tough topic to broach.

Something important for parents (and other adults who work with or care for kids) to know is that talking about suicide or naming it doesn’t raise the risk of a child thinking about it or hurting themselves. “If they are thinking about it or considering it already, naming it likely offers relief that this is something that you can say out loud or talk about — and that may open doors for them to say or ask more,” Quigley says.

Suicide deaths are rare among young people but still a leading cause of death among children, teens, and young adults, according to a May report from the Centers for Disease Control and Prevention (CDC).

Several recent studies have also documented an uptick in suicidal thoughts and behaviors among children and teens.

One study published in May 2023 in JAMA documented a fivefold increase in suicide-related visits among youths from 2011 to 2020, even as the overall number of emergency room visits remained little changed. A separate study published in July 2023 found a surge in suicide-related emergency room visits and hospitalizations among children and adolescents from 2016 to 2021.

More broadly, recent reports suggest that kids and teens are struggling with mental health in higher numbers than previously (per a 2022 CDC report, a 2023 CDC report, and others).

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
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Having discussions about suicide and mental health helps create a path for kids to ask for help if they need it, Quigley says.

Here are eight tips from Quigley and others for how to have these conversations.

1. Don’t Wait Until High School to Talk About Suicide Risk

The reality is that most kids know or have heard about someone who has thought about suicide or self-harm by the time they’re in middle school, Quigley says. They’re having these conversations with peers, she says.

“They are really hard concepts to understand and to process at any age but particularly at such a young age,” Quigley says. So making kids aware that you know this might be happening and it’s something you can help them understand and cope with can be really meaningful.

This is the first step to begin helping them have tools to take care of themselves, she adds.

There isn’t good research to say for sure the exact age that parents might want to broach this topic, says Geoffrey Ream, PhD, a professor at the Adelphi University School of Social Work in Garden City, New York, who studies youth suicide. Dr. Ream first had questions about suicide at age 10, when he read an article about it in a doctor’s waiting room.

“At the time, the grown-ups had made it clear that this was something that a kid should not think or talk about,” Ream recalls. This message is harmful because even though suicide is rare before adolescence, risk factors like depression and anxiety can start much earlier and parents should avoid making kids feel like it’s forbidden to discuss these emotions, Ream adds.

2. Normalize Conversations About Other Mental Health Topics, Too

Quigley says that normalizing conversations about mental health in general in kids’ day-to-day lives is a great place to start. It’s worked with her two older kids, and she advises other parents to try it, too.

“I recently took the oldest to their annual pediatrician visit, and I let her know that there might be questions at the visit about depression or anxiety,” Quigley says. “That opened up a conversation between the two of us in which she asked about what it means to be depressed, or the ways she knows anxiety has shown up for friends.”

During that conversation, Quigley was able to ask if her daughter was worried about any of her friends. “I let her know that if her feelings ever got hard to deal with or scared her, that she could always tell me, that it would not upset me, and that she could also tell her dad, or her teachers, or her grandparents.”

It can help, too, if parents and primary caregivers routinely ask kids how they’re feeling, so that talking about mental health can become just as normal to kids as sharing when they have a cold or a physical injury, Quigley says. This way, kids get used to talking about their moods and get the message that it’s okay to share when they’re struggling with how they feel.

3. Create a Safe Space for the Conversation

Kids will feel more comfortable opening up when parents and other adults intentionally create a safe space to talk, says Michael Lindsey, PhD, MPH, a professor and dean of the Silver School of Social Work at New York University who specializes in child and adolescent mental health.

This needs to be “a no-judgment zone where they are free to share their thoughts and feelings without repercussions,” Dr. Lindsey says. “Maybe it’s after dinner or during a time when the family normally relaxes.”

And if adults are worried that a child may be too sensitive to handle the conversation, it helps to start with some leading questions, Ream says: “I’d start by asking what the kid knows and believes already, because they’ve probably already had some exposure and developed some opinions about it.”

4. Let Kids Know That Help Is Available

Parents and other adults caring for kids need make sure that kids absorb some key messages about suicide, doctors and researchers say. Lindsey and John Ayers, PhD, the vice chief of innovation and a mental health researcher at the University of California San Diego School of Medicine, say these three points are most important to communicate:

  • It’s okay to tell the truth. Adults need to let kids know that it’s okay — and safe — for kids to tell them if they have feelings that their life isn’t worth living or thoughts about hurting themselves, Lindsey says.
  • Having suicidal thoughts doesn’t make you a bad person. Children need to know that having suicidal thoughts doesn’t make them a bad person, Lindsey adds.
  • Help is available. Adults need to stress that help is out there, Dr. Ayers says. “Encourage kids to speak up if they or a friend is struggling,” Ayers says. “Suicidal thoughts are often linked to treatable mental health issues.”

5. Avoid Tough Love Talk That Causes Stigma

Parents and other adults caring for kids should avoid unintentionally stigmatizing mental health problems or treatments that might help, Lindsey says. This means be conscious of word choices all the time, not just when you’re trying to talk to kids about suicide.

“Tough love talk can reinforce stigma, as can expressing a distrust of professional help,” Lindsey says. “Telling a boy to `man up’ or telling a girl to `keep things within the family’ can shut down important conversations before they even begin.”

Some parents might also want to prioritize prayer over getting professional help, Lindsey adds. “I always say that professional help can help you to know what to pray for with God,” she says.

6. Recognize if You’re the Best Person to Have This Talk With Your Kid

Parents and other adults should talk to kids about suicide risk only when they can remain calm and maintain a neutral facial expression regardless of what kids say, advises Benjamin Shain, MD, PhD, the head of child and adolescent psychiatry at NorthShore University HealthSystem in Chicago.

“When I ask about this during appointments with my patients, I don’t have any reaction if they do say they’re thinking about suicide,” Dr. Shain says. “I don’t see how every parent can do that.”

If a parent doesn’t feel ready or emotionally stable enough to have a conversation about suicide with their child, enlist the help of your child’s pediatrician, Shain says. Having a strong emotional reaction to what kids say about suicide can inadvertently make them feel like they’re better off keeping any thoughts about suicide to themselves, he explains. And that can be really detrimental to kids’ mental health.

7. Let Pediatricians Help

Parents or other primary caregivers who don’t feel emotionally prepared to talk about suicide with their kids or who aren’t sure their child can handle the conversation should really lean on the child’s pediatrician, Shain says.

“Pediatricians have the training to do this,” Shain says. They’ll be able to monitor if your child’s answers change over time and be able to respond to that in the right way.

Parents can also turn to school social workers or psychologists, Lindsey says. A child’s pediatrician may be able to refer children to a mental health professional if needed.

8. Seek Help if You Need It

Any time that kids have suicidal thoughts or talk about self-harm and parents or other caregivers aren’t sure what to do, they can call or text the national Suicide and Crisis Lifeline at 988, clinicians and researchers advise. Other expert-recommended resources include:

  • SAMHSA The Substance Abuse and Mental Health Services Administration (SAMHSA) has tips for parents on what symptoms to look for and how to talk to kids about suicide.
  • The Steve Fund This nonprofit is focused on supporting mental health for youth of color and has resources for parents on how they can help.
  • The Trevor Project This nonprofit is dedicated to suicide prevention among LGBTQ+ youth and offers guidance on how to prevent suicide and how to talk about it.
  • The Child Mind Institute This children’s mental health nonprofit has lots of tip sheets on how to talk to kids and teens about suicide risk, and how to help them when they or someone close to them has suicidal thoughts.

If you or a loved one is considering suicide, dial 988 to reach the Suicide and Crisis Lifeline, which is available 24 hours a day, seven days a week.

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