Listen carefully, ask questions, and don't minimize your child's concerns. (Photo: triloks via Getty Images)
No parent is prepared to hear the words, “I wish I were dead,” or “I don’t want to be alive anymore.” When a child says something so shocking, it can be tempting to believe they don’t really understand what they’re saying, or they couldn’t possibly be serious.
But if your child expresses thoughts of suicide, the most important thing you can do is to listen and take them seriously.
Suicide is the second-leading cause of death for youth ages 10-14, according to the Centers for Disease Control and Prevention.
The pandemic has taken an enormous toll on the mental health of children and teens. The proportion of youth visits to the emergency room that were for mental health rose 31% between 2019 and 2020. For teen girls ages 12-17, ER visits for suspected suicide attempts rose 50.6% from February and March 2019 to the same period in 2021.
If your child comes to you with thoughts of suicide, experts recommend you take these steps.
First, take a breath.
Experts say if your child says something that makes you believe they are thinking about suicide, the first thing you need to do is pause and take a deep breath.
“It’s important to take that pause,” said Ann-Louise Lockhart, a pediatric psychologist who practices in Texas. “If your 12-year-old feels comfortable sharing that with you, that is an honor and it’s so important to be present. As a parent, we don’t want to shut down the lines of communication by reacting too strongly or being dismissive.”
Before you react, use this moment to take stock of your own emotions.
Dr. Shairi Turner, a pediatrician and the chief health officer at Crisis Text Line, said, “Check in with your own emotions and remember that your child made the decision to come to you with this information because you are a trusted caregiver. Also, remember they are talking to you and are safe for this immediate moment.”
Turner also recommends saying something like, “It took a lot of courage for you to tell me you are having these thoughts. I’m here with you and want to keep you safe.”
Ask questions to assess their level of risk.
Try to figure out if they are saying this in reaction to something that has just happened or if they have been having these thoughts for some time. It’s possible they are having what Lockhart calls “morbid thoughts” — thoughts about death without the desire to die.
Turner suggests using open-ended questions, such as: “Can you tell me more about that? I want to be sure I understand,” or “When you say ____, can you tell me what that means to you?”
With a young child, it may also make sense to ask what they think death means, or where they think they would go if they were to die.
If they do express wanting to die, ask them the following questions to try to assess the severity of the thoughts.
Have you had these thoughts before?
How often do you have these thoughts?
How long have you had these thoughts?
When you have these thoughts, have you also thought about a plan?
It’s very important that you ask your child if they have a plan to hurt themselves, and, if they do, that you contact their pediatrician or mental health provider right away.
Ideally, even before a crisis arises, your child should know they can talk to you about death and dying, or tell you they are having upsetting thoughts.
“Many times, children are afraid or concerned about a parent’s reaction or that this will be an unbearable situation for the parent,” Turner said. “Let them know these thoughts can come out of the blue and you won’t be shocked. Instead, let them know that you want to hear about what is going on in their mind so that the child does not have to face these thoughts alone.”
Avoid saying anything that might shut them down.
Stay away from phrases like, “Don’t say that!” or “Why would you say that?” said Lockhart. You don’t want them to feel judged or ashamed for coming to you with these thoughts.
“Try to avoid minimizing their concerns. What may seem minor to you can feel overwhelming to a young person,” Turner said.
She also suggested avoiding platitudes like, “Everything will be fine” or “You’ll figure it out.” Your child is in distress and they are seeking help.
Based on the severity of your child’s thoughts, you may also want to reach out for assistance.
“If your child’s responses to your questions involve thoughts about death that have been ongoing, frequent, recurring and intrusive, then seeking out professional help is indicated,” Lockhart said.
Both Lockhart and Turner recommended reaching out to anyone in your network who could be of assistance in finding mental health care for your child. This should include your pediatrician and your child’s guidance counselor, as well as other community members who might be able to make recommendations.
If your child made a plan for suicide, you should get help immediately, taking your child to the emergency room if necessary. The same applies if they have access to weapons or pills, or cannot “agree to stay safe for now,” said Turner. If they are “debilitated and cannot be calmed by your efforts,” the ER may also be necessary.
Even if your child does not have a plan to hurt themselves, you want to act quickly.
“Although suicidal thoughts and statements can come and go, once your child has come to you, it is likely they have been experiencing those thoughts for a while,” Lockhart said.
It is very important to remember that talking to your child about suicidal thoughts does not make them more likely to attempt suicide.
“Data tells us that asking about feelings of death or dying does not cause a child to try to take their life and actually creates a safe space for your child to honestly share how they are feeling,” Turner said.
Let your child know you are there for them no matter what they are thinking or feeling. Make sure they are also aware of other resources in the community they can access.
Turner suggests you put the Crisis Text Line, 741741, into your child’s phone so they can access it at any time by themselves. They can also call the mental health emergency number, 988.
“We are experiencing a global mental health epidemic, and, as a parent, you are not alone in the challenges of navigating this crisis,” Turner said.
If you or someone you know needs help, dial 988 or call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also get support via text by visiting suicidepreventionlifeline.org/chat. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.
This article originally appeared on HuffPost and has been updated.