Suicide Prevention in Youths

Youth of all ages, but especially younger children, may find it difficult to recognize and verbalize when they are experiencing stress. For children, stress can manifest itself through changes in behavior. Common changes can include:

• Acting irritable
• Moody
• Withdrawing from activities that used to give them pleasure,
• Routinely expressing worries
• Complaining more than usual about school
• Crying
• Displaying surprising fearful reactions
• Clinging to a parent or teacher
• Sleeping too much or too little
• Eating too much or too little.

With teens, while spending more time with and confiding in peers is a normal part of growing up, significantly avoiding parents, abandoning long-time friendships for a new set of peers or expressing excessive hostility toward family members, may indicate that the teen is experiencing significant stress. While negative behavior is not always linked to excessive stress, negative changes in behavior are almost always a clear indication that something is wrong. Adults will want to pay attention to these behaviors and determine an appropriate response or intervention.

Stress can also appear in physical symptoms such as stomach aches and headaches. If a child makes excessive trips to the school nurse or complains of frequent stomachaches or headaches (when they have been given a clean bill of health by their physician), or if these complaints increase in certain situations (e.g., before a big test) that child may be experiencing significant stress.

Sometimes a child or teen may seem like his or her usual self at home but be acting out in unusual ways in other settings. It is important for parents to network with one another so that they can come to know how child or teen is doing in the world around them. In addition to communicating with other parents, being in contact with teachers, school administrators and leaders of extracurricular activities can help parents tap into their child or teen’s thoughts, feelings and behaviors, and be aware of any sources of concern.

Because children are often not familiar with the word stress and its meaning, they may express feelings of distress through other words such as “worried,” “confused,” “annoyed” and “angry.” Children and teens may also express feelings of stress by saying negative things about themselves, others, or the world around them (e.g. “No one likes me,” “I’m stupid,” “Nothing is fun.”). It is important for parents to listen for these words and statements and try to figure out why your child or teen is saying them and whether they seem to indicate a source or sources of stress.

Parents, children, and teens do not need to tackle overwhelming stress on their own. If a parent is concerned that his or her child or teen is experiencing significant symptoms of stress on a regular basis, including, but not limited to those described above, it can be helpful to work with a licensed mental health professional, such as a psychologist. Psychologists have special training to help people identify problems and develop effective strategies to resolve overwhelming feelings of stress.

• Mental illness (e.g. depression, conduct disorder) or substance abuse
• Family stress/dysfunction
• Environmental risks, including presence of a firearm in the home
• Situational crises (e.g., traumatic death of a loved one, physical or sexual abuse, family violence, bullying)

Pre-teens who drink alcohol are substantially more likely to be involved in violent behavior as adolescents and young adults. In fact, research has shown that high-risk teens who drink alcohol underage are three times more likely than their non-drinking peers to attempt suicide, and those who begin drinking before age 13 are more likely to also be victims of dating and peer violence.

• Suicidal threats in the form of direct statements such as, "I am going to kill myself".
• Suicidal threats in the form of indirect statements such as, "I wish I could fall asleep and never wake up again”.
  • Talking about feeling hopeless or having no reason to live.
  • Talking about feeling trapped or in unbearable pain.
  • Talking about being a burden to others.
• Increasing the use of alcohol or drugs.
• Suicide notes and plans, including messages and posts, shared online.
• Prior suicidal behavior.
• Making final arrangements (e.g., making funeral arrangements, writing a will, giving away prized possessions).
• Preoccupation with death.
• Changes in behavior, appearance, thoughts and/or feelings.
  • Acting anxious or agitated; behaving recklessly.
  • Sleeping too little or too much.
  • Withdrawing or isolating themselves.
  • Showing rage or talking about seeking revenge.
  • Extreme mood swings.

• Remain calm
• Ask the teen directly if he or she is thinking about suicide
• Focus on your concern for their well-being and avoid accusations
• Listen attentively
• Reassure them that there is help and they will not feel like this forever
• Do not judge them or their thoughts
• Offer to stay with them. Do not leave the teen alone
• Offer to go with them to get help or contact a crisis line
• Remove means for self-harm
• Never keep what you’ve heard a secret
• Seek help from school or community mental health resources as soon as possible