My Child Has Expressed Suicidal Thoughts: What Do I Do?

Trigger warning: Suicide. If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

While it can be extremely scary if your child has expressed suicidal thoughts, their choice to share these thoughts with you is brave—and can actually be the first step in healing. “We want people to talk about suicide because if they talk about it, we have a better chance of helping them,” Charlie Health Clinical Director, Sam Adams, said in a piece where our clinicians shared what everyone should know about suicide. “Suicide prevention starts with talking about suicide,” she added (a point that’s readily substantiated by research).

Although talking about suicidal thoughts with your child (or any young person) may be daunting, it can also be life-saving. And talking openly about suicide and suicidal thoughts is becoming more pressing because, unfortunately, suicide is on the rise among young people nationwide. Below we explain what to do if your child expresses suicidal thoughts, including guidance on how to talk about suicide, how to know if your child is having suicidal thoughts, and how to help a teen who is thinking or talking about suicide.

How can I help a teen who is thinking or talking about suicide?

One of the most critical steps in supporting a teen who is thinking or talking about suicide is creating a safe space for open dialogue. However, this kind of conversation can be daunting, which is why the Charlie Health Clinical Team developed a comprehensive resource on “How To Talk About Suicide.” Below, we review the key steps in this guide, which is aimed at empowering families to talk openly about suicide and suicidal ideation and provide life-saving support during a moment of crisis. 

That being said, if someone with suicidal thoughts is in danger of harming themselves, they should receive professional mental health treatment immediately. You can contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988. Some people may choose to call 911 or go to an emergency room for immediate care. 

Here are some tips on supporting a teen who is thinking or talking about suicide.

Choose the right time and place

Find a private setting where you can talk without interruptions, and you both have enough time for a meaningful conversation. This will help create a safe space for them to open up.

Express concern and care calmly and clearly

Start the conversation using non-judgemental language and ask directly about suicidal ideation. Use a non-confrontational approach that expresses concern and asks about suicidal ideation directly. It’s important to use the word suicide so that the person knows what you’re asking about. Here are some examples of what you can say:

• “I’ve noticed that you’ve had a lot on your mind, and I’m here to listen and support you. I want to ask you a difficult question because your safety is important to me. Have you had thoughts of suicide?”
• “I want to make sure you feel safe and supported. With that in mind, I’m wondering: have you made any plans for suicide?”
• “You’ve been talking about some difficult emotions, and I’m feeling concerned for you. Have you ever thought about how you would end your life? If so, do you have a plan?”

Practice active listening

Continue discussing their feelings by actively listening. Ask open-ended questions and normalize their feelings, even if their responses are distressing. Open-ended questions encourage the person you’re with to express their thoughts and feelings freely. You can ask questions like, “Can you tell me more about that?” Also, normalizing their feelings allows the person to know that it’s okay to feel overwhelmed, sad, or anxious at times and that seeking help is a sign of strength, not weakness. You can say something like, “Many people struggle with these thoughts and feelings. You are not alone.”

While being a supportive listener, avoid promises of secrecy. In case of immediate danger, you may need to involve professionals to ensure their safety. 

Encourage professional help

Waiting to offer solutions or advice is important, as people sometimes just need to be heard. However, later on, offer to help them find a therapist or crisis helpline. You can also reassure them of your support and companionship on their journey. As mentioned, if the person you’re talking with is in immediate danger, do not leave them alone; seek help immediately.

Follow-up

After the initial conversation, follow up with them regularly to check on their well-being. Ongoing support is crucial for someone struggling with suicidal thoughts.

Take care of yourself

Supporting someone in distress can feel overwhelming, especially when that person is a loved one. Remember that just showing up and not being afraid to talk about hard things makes a big difference when someone feels hopeless and alone. It’s also important to take care of yourself and turn to self-care activities or professional support that renew your energy and help you stay grounded.

How to know if your child is having suicidal thoughts

The best way to know if your child is having suicidal thoughts is to ask them (as outlined above), but there are some signs and behavior changes of emotional distress that suggest they may be struggling with thoughts of suicide. It’s important to take these signs seriously and seek help if you observe them. Here are some potential warning signs that may indicate your child is in emotional distress and possibly having suicidal thoughts: 

• Expressing feelings of hopelessness, wanting to die, or being a burden to others
• Withdrawing from social activities, friends, and family members
• Sudden and dramatic mood changes
• Loss of interest in activities they once enjoyed 
• Self-harming behaviors 
• Giving away possessions or making plans for what would happen if they were gone
• Reckless behaviors, including unsafe substance use 
• A prior history of mental health issues, self-harm, or suicidal thoughts or attempts

How can I help a teen who is thinking or talking about suicide?

In many (non-life-threatening) instances, talking about suicide is the first step in helping a teen who is thinking of talking about suicide, but the second step is to get that young person the professional help they need. 

It’s proven that there’s a spectrum of risks associated with suicidal ideation; some people with thoughts of suicide do not want to complete suicide, but others need to go to the hospital for intensive emergency care. Here’s a list of different kinds of treatment that may be available for a teen who is thinking or talking about suicide. Decisions about mental health treatment, though, should always be made with the support of a licensed mental health professional. 

Individual therapy

Also known as outpatient therapy, individual therapy is usually conducted once weekly and can offer support for a young person who has expressed suicidal thoughts and needs a safe and confidential space to talk about their thoughts and feelings. Individual therapy provides personalized support, can help a young person develop a safety plan for times of crisis, and uses evidence-based techniques like cognitive-behavioral therapy (CBT).

Family therapy

When facilitated by a qualified mental health professional, family therapy can help a teen who is thinking about suicide get support from their caregivers. It can also improve family dynamics and communication, which can contribute to a more stable and understanding environment for the young person.

Group therapy 

Group therapy provides a supportive environment for teens to share their experiences with peers who may be facing similar challenges. It can also reduce feelings of isolation, which are often seen in people who are having suicidal thoughts. 

Medication management 

In some cases, medication may be prescribed by a psychiatrist to manage underlying mental health conditions, such as depression or anxiety, which can contribute to suicidal thoughts.

Intensive outpatient program (IOP)

For a young person who is more at risk for suicide, an intensive outpatient program (IOP) can be a chance for them to process suicidal thoughts in a structured and intensive mental health environment while maintaining some level of their usual routines. IOP usually combines all of the interventions mentioned above: individual therapy, family therapy, group therapy, and medication management as needed. 

Partial hospitalization program (PHP)

A more intensive option than IOP, a partial hospitalization program (PHP) allows young people more at risk for suicide to spend most of their day in an intensive mental health environment while living at home. Like IOP, PHP typically combines all of the therapeutic interventions mentioned above. 

Residential treatment 

Considered the most intensive form of mental health treatment for suicidal thoughts, a residential treatment option offers 24/7 support. This form of treatment can benefit young people at risk for suicide because it gives them round-the-clock access to mental health professionals who can provide immediate support and intervention during times of crisis, reducing the risk of self-harm or suicide.

Emergency support 

As mentioned, if someone is at imminent risk of harming themselves, it’s important to get them support immediately. People can contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988. Some people may also choose to call 911 or go to an emergency room for crisis care. 

How Charlie Health can help young people struggling with suicidal thoughts 

If you or a loved one are struggling with thoughts of suicide, Charlie Health is here to help. Our virtual Intensive Outpatient Program (IOP) combines peer groups, individual therapy, and family therapy for teens and young adults who need more than once-weekly mental health treatment—including those struggling with suicidal ideation and those who have survived suicide attempts. Our virtual IOP has been shown to reduce suicidal ideation by more than 70%. Charlie Health’s compassionate mental health professionals are here to listen to your story, understand your needs, and match you with an appropriate treatment plan. Fill out our short form to get started today.