Now that our kids are settled back in school, we need to think about a difficult and growing problem among our students; suicide. A recent report published by the Centers for Disease Control and Prevention (CDC) indicated that the suicide rate in the U.S. has increased by 30 percent since 1999, and it’s an increase across all genders, ages, race, and ethnic groups. While many approaches to suicide prevention focus on mental health, authors of the report indicate that 54 percent of those who committed suicide did not have known mental health conditions. Instead, they were dealing with relationship problems, life stressors, or a recent or impending crisis.  Deborah Stone, the lead author of this study, states that these results suggest the need for a much more comprehensive approach to suicide prevention.

The hard truth is that for those between the age of 10-24, suicide is the second leading cause of death. Thankfully, suicide is preventable. Youth who are having thoughts of suicide often give warning signs such as making direct verbal or written threats, showing a preoccupation with death, or changes in behavior, thoughts, or feelings.  It is critical that parents take these warning signs seriously, do not agree to keep these thoughts a secret, and get help. Most importantly, parent or caregiver relationships have been found to be the most significant protective factor in preventing adolescent suicide, even when compared peers.

Fostering resiliency is the first step in suicide prevention. Resilience is the process of adapting to adversity, trauma, or stress. Resilience is an important part of healthy development for kids, enabling them to emerge from challenging or stressful circumstances with a positive sense of themselves and their future.  Developing resilience begins with healthy and supportive relationships with caring adults such as parents or caregivers and teachers.  These relationships can be a source of strength when children are learning to overcome any sort of obstacle, challenge, or stress.  Resilient youth have a sense of control over their futures, initiate problem solving, and reach out for help. 

When talking about mental health and suicide, it’s sometimes difficult to recognize the difference between “normal” childhood experience and behavior and something that’s a serious concern. But resilience plays an important role between the two. Dr. Sami Timimi, a child and adolescent psychiatrist, argues that resiliency in youth has been undermined by what he calls the “Scientism” of child and adolescent depression. For example, children begin to use clinical language like “I feel depressed” instead of simply saying “I feel sad.” This medicalization of childhood can lead to normal challenges or uncertainties of growing up being viewed as something being “wrong” with the child.  

I recently worked with a concerned parent who call me for advice. This parent took their child to a therapist because the parent noted that their child seemed sad.  After the therapist administered a depression scale, the child was diagnosed with depression and referred to a psychiatrist for medication.  This parent called me for advice because they were concerned about this recommendation.  Together we looked at what was going on in the child’s life overall, and we discovered that the child was being bullied at school. Naturally, this led to feelings of sadness, and subsequently withdrawn behavior, particularly during lunch time.  Once we knew the source of the problem, we addressed the bullying at school and helped the child to feel safe again.  The child did not need medication, as it was a psychosocial problem that was addressed, and the symptoms resolved.  In the process, the child’s resiliency was strengthened as they learned to reach out to adults for help, developed their own coping skills, and increased their sense of empowerment. The parent was a source of support and an advocate for their child in managing this significant stressor.  

Remember, you are the expert on your child. Trust your instincts and reach out for support if needed.  Essential Questions for Concerned Parents can help you make sense of some of the concerns you might have for your child, guide you in considering the severity of the issues, possible causes, and considerations for when you should reach out for help. 

Here are some additional tips for what parents and caregivers can do:

1. Build resilience in your children by supporting them through failures and setbacks, helping them to see these as opportunities for learning and growth.
2. Praise your children for their hard work and perseverance, not just “easy” successes and good grades. 
3. Model for your children what it looks like to take care of yourself and maintain a hopeful outlook.  How do you manage your own challenges and stress?  Do you have positive coping methods? Are you able to keep things in perspective and manage your own challenging emotions?  We may feel overextended and like we don’t have time for ourselves, but self-care is key in both having more to give to your family and children, and also sends a message about how to manage life’s stresses.  What you do can be more powerful than what you say. 
4. Support your child through events that might be stressful or traumatic by helping your child to get in touch with their body’s experience.  We know that when traumatic events occur, “the body remembers.”  The event is stored in the body and the ability to self-regulate emotions can be enhanced by being in touch with the body. Build sensory awareness with your child by developing “sensation” vocabulary with words like “jittery,” “goose-bumpy,” “tickly,” “calm,” “shaky,” or “tingly.”  This can be a fun activity by making a “sensation treasure chest” by filling an empty box with 10-12 objects of different textures, weights, and sizes.  With their eyes closed, have your child pick and object and guess what it is based on how it feels.  Ask your child how the object feels on their skin (tickly, cool, heavy, etc.).  Developing this awareness can be helpful in regaining equilibrium after an upset does occur.
5. Don’t be afraid to talk about suicide with your child.  Talking about suicide will not “put the idea in their head.” Instead it will help your child learn that there is space to talk about any feelings they may have, no matter how distressing, and that they can reach out to you.
6. If your child expresses suicidal thoughts, remain calm, focus on their well-being, do not judge, reassure them that they will not always feel this way, provide constant supervision, remove any means of self-harm, and most importantly, get help as soon as possible by accessing school or community resources, taking them to the nearest emergency room, or calling 911.
7. If you have concerns about your child’s emotional well-being and feel that you and/or your child need additional support, seek out family therapy.  While there are many approaches to family therapy, Attachment-Based Family Therapy is a family based therapy designed to reduce depression and suicide risk in adolescents. The focus is on drawing out emotions rather than a focus on how the adolescent or the child is thinking (cognition).  The goal is to help an adolescent feel more secure, safe, and protected while supporting parents or caregivers to feel more connected and increase their sense of competence.  The attachment pattern shifts when the adolescent feels heard and validated while the parent feels satisfied meeting their child’s needs.  Other family-based therapies that include components aimed at improving the relationships and attachments between the caregiver and the child have also been shown to be effective in reducing suicidality among adolescents.
8. Stay involved and engaged in your child’s treatment if your child is receiving individual therapy.  Parental involvement has been shown to increase the success of individual therapy.  Learning about emotional regulation so that you can support your child’s social emotional skill development at home and how to communicate with your child when they are experiencing emotional distress can be a buffer to suicidal ideation.  In addition, monitoring your child’s whereabouts and learning about their peers can help prevent the use of alcohol or other substances, which are often interrelated with suicidal thoughts or depression in adolescents.

Resources:

• If you are concerned about yourself or someone you know, call 1-800-273-8255 or visit https://suicidepreventionlifeline.org/
• Essential Questions for Concerned Parents 
• The Parent Resource Program
• Suicide Prevention and Intervention Resources
• Parenting resources and tools as well as resources for dealing with trauma
• 13 Reasons Why Support for Educators and Families
• 13 Reasons Why Season 2: An opportunity to engage in vital conversations related to suicide and violence prevention.