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Teen suicide prevention: Identifying the warning signs and getting help for a suicidal child
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By Cesar & Carolann De Leon


There are few situations as devastating  for a parent as discovering that your child is experiencing a degree of pain so seemingly unbearable that suicide appears to offer relief. It is unrealistic to believe that the ministry profession inoculates the pastoralfamily from the emotional brokenness that touches all of humanity. When a ministry parent carries misinformation, misunderstanding, and/or shame about their child’s emotional crisis, they may inadvertently miss the subtle and overt signs that their child’s depression has crossed into the territory of suicidal ideation and suicide planning. Your commitment to become informed and act upon the learned information may save their life.
 
Conversation Starters:
1. Identify the actions that Sam’s parents took in this video.

2. Was there anything they could have done better?


FACT or MYTH:
➢ In the US, suicide is the third-leading cause of death for ages 15-24 according to the Centers for Disease Control and Prevention (CDC) after accidents and homicide. FACT
 
➢ In Canada, suicide is the second-leading cause of death for ages 10-24 according to the Canadian Mental Health Association. FACT
 
➢ Talking to a depressed person about suicide will give him or her the idea.
Fact: Encouraging someone to speak about suicidal feelings can reduce the risk.
MYTH
 
➢ Suicidal people are determined to die.
Suicidal youth are in pain; they don’t necessarily want to die, they want their pain to stop.
MYTH
 
➢ Four out of five teens who attempt suicide give clear-cut signs. FACT
 
➢ The reasons behind a teen's suicide thoughts or plans can be complex. FACT

Which teens are at risk for suicide?
The teen years are fraught with growing pressure to perform well academically, fit in socially, and behave in a responsible manner. Teens often experience and report high levels of stress and worry. Additionally, the hormone surges and increasing significance on peer relationships may contribute to a teen’s growing need for independence, often resulting in increased conflicts with the rules and expectations of the adults in their lives.
 Michelle New offers the following teen suicide factors that increase the risk of teen suicide:
  • a psychological disorder, especially depression, bipolar disorder, and alcohol/ drug use
  • feelings of distress, irritability, agitation, or violence
  • feelings of hopelessness and worthlessness that often accompany depression
  • a previous suicide attempt
  • the recent suicide of someone close
  • a family history of depression or suicide
  • emotional, physical, or sexual abuse
  • being the target of traditional bullying or cyber-bullying
  • lack of a support network, poor relationships with parents or peers, and feelings of social isolation
  • dealing with sexual identity issues in a hostile home/school environment[2]
Teen suicide warning signs
Stressful life events—such as problems at school, a breakup with a boyfriend or girlfriend, relocating to a new community, the death of a loved one, major family conflict, or a divorce—usually precede a teen suicide.[3]
 

Teens who are thinking about suicide might:
  • talk about suicide or death in general
  • give hints that they might not be around anymore
  • talk about feeling hopeless or feeling guilty
  • pull away from friends or family and isolate themselves
  • write songs, poems, or letters about death, separation, and loss
  • start giving away treasured possessions to siblings or friends
  • lose the desire to take part in favorite activities
  • have trouble concentrating or thinking clearly
  • express intense anger and become violent
  • experience changes in eating or sleeping habits
  • engage in risk-taking behaviors
  • lose interest in school or sports
Following is a short list of some things a parent should do if they have reason to suspect their child is suicidal:
  • Be willing to ask tough questions and listen empathetically
  • If your child or teen attends a school, inquire about available mental health services and request a mental health evaluation and ongoing counseling support.
  • If the school does not offer any mental health evaluations, request some referrals and get professional mental health support.
  • Alert key adults in your child’s life—family, friends, teachers, coaches, youth pastor—that your child or teen is going through an emotionally difficult time and is in need of additional understanding and support.
  • Trust your instincts. If you think the situation may be serious, seek immediate help by calling your local hospital’s emergency room.[4]
 
Talking about suicide with my child
Parents are typically afraid that just asking their child about suicide may encourage him or her into a suicide attempt. Listening actively to your child will encourage him or her to share. Correcting, ridiculing, judging, or sermonizing may block open communication. Asking your “at risk” teen about having suicidal thoughts or having a suicidal plan may be the most loving act a parent can do. Keep in mind that it may make them feel angry or offended though. It is ok if they get mad at you for asking.[5]
 
Evaluating for immediate danger
If your teen tells you that he or she is thinking about death or suicide, it's important to evaluate the immediate danger he or she is in. Those at the highest risk for committing suicide in the near future have a specific suicide PLAN, the MEANS to carry out the plan, a TIME SET for doing it, and an INTENTION to do it. The following questions can help you assess the immediate risk for suicide:
  • Do you have a suicide plan? (PLAN)
  • Do you have what you need to carry out your plan (pills, gun, etc.)? (MEANS)
  • Do you know when you would do it? (TIME SET)
  • Do you intend to commit suicide? (INTENTION)
The following is a guideline to help you assess the level of Suicide Risk:
Low—Some suicidal thought. No suicide plan. Says will not commit suicide.
Moderate—Suicidal thoughts. There is a vague plan that is very lethal. Says will not commit suicide.
High—Suicidal thoughts. There is a specific plan that is highly lethal. Says will not commit suicide.
Severe—Suicidal thoughts. There is a specific plan that is highly lethal. Says they will commit suicide.[6] Remember, if a suicide attempt seems imminent, call 1-800-273-TALK, a local crisis center, 911, or take your child to an emergency room. Remove guns, drugs, knives, and other potentially lethal objects from the vicinity and do not, under any circumstances, leave a suicidal teen alone.
 
10 parenting actions for suicide prevention
  1. Take every warning that a child is going to harm themselves seriously. Ignoring these “cries for help” may increase the chance of a threat follow-through.
  2. If your teen refuses to talk to you, ensure that a neutral person such as a school counselor, teacher, or youth pastor addresses this life-threatening issue.
  3. If your child confesses to having suicide thoughts but has no suicide plan or means, you must seek professional help. Call your local hospital’s Emergency Room or 1-800- SUICIDE.[7]
  4. Make and keep a mental health appointment even if your teen says he or she is no longer having suicide thoughts, is feeling better, and does not want to go anymore. Discuss your teen’s refusal. Together, formulate a plan to get your “at risk” teen the professional help they need.
  5. Follow-up on their mental health treatment plan. If the doctor prescribes medication, ensure your teen takes it as directed. Assess for possible side effects and notify the physician if your child seems to be getting worse.
  6. Be proactive in regularly re-evaluating for recurring suicide ideas or plans. Keep an open dialogue and let them know you must ask the same difficult questions regularly to ensure that they will not harm themselves, even if it angers them.
  7. Adopt positive lifestyle changes for the whole family. A healthy plant-based diet, regular physical exercise, encouraging your teen to get more nighttime sleep,[8] and getting out in the sun for at least 30 minutes each day will be of great benefit.
  8. Make a safety plan. Help your teen develop a set of steps he or she promises to follow during a suicidal crisis. It should identify triggers that may lead to a suicidal crisis, such as an anniversary of a loss, alcohol consumption, or high stress, and provide easy steps for them to follow.
  9. Continue your loving parental support over the long haul. After the immediate suicidal crisis has passed, continue to be intentional about being emotionally attuned to your teen. Talk, text, or call your teen regularly. Ask open-ended questions, become a great listener, and plan regular “dates” with your teen.
  10. Encourage your teen to reach out and become involved in local academic and/or church youth groups, sports, music, or other group activities in his or her area of interest as he or she begins to feel stronger. Studies have shown that children and teens that hold spiritual beliefs and are involved in spiritual activities like attending church have less depression and less suicidal ideation than teens who do not.[9]
As you are helping your suicidal loved one, do not forget to take care of yourself. You are role modeling good “self-care” for your teen as you seek to find help from someone you can trust—a friend, family member, clergyman, or counselor—to talk to about your feelings and get support for yourself. Often, when a child sees his or her parent seeking outside support, they are more inclined to view seeking outside help as “ok” and are more willing to accept outside help as well. Interestingly, your teen’s crisis may offer an opportunity for you, your spouse, and even your other children to strengthen the emotional bonds as you go through the healing process of discovering some of the contributing family issues as well as helpful solutions to this crisis. It is our desire that, by God’s grace, and with the support of caring mental health professionals, this can become an opportunity for your teen and your whole family system to build more open communication, stronger emotional connections, and more effective life coping skills; as he or she prepares to launch into adulthood.
 
[1] Roy Benaroch, “Teen Depression: Symptoms and Tips for Parents. Are There Warning Signs of Teen Suicide?,” retrieved from www.webmd.com/parenting/teen-abuse-cough-medicine-9/depression?page=2 on May 21, 2014.
[2] Ibid.
[3] The following video was created by the Mayo Clinic. For help regarding suicide, call 1-800-273-TALK or visit www.suicidepreventionlifeline.org.
[4] D. Shern, “Child and Adolescent Suicide,” retrieved from www.mentalhealthamerica.net/conditions/child-and-adolescent-suicide on May 21, 2014.
[5] For additional tips on how to start a conversation about suicide, a list of helpful things to say, or helpful questions to ask, visit www.helpguide.org/topics/suicide_prevention.htm.
[6] Melinda Smith, Jeanne Segal, and Lawrence Robinson, “Suicide Prevention: How to Help Someone who is Suicidal,” retrieved from www.helpguide.org/mental/suicide_prevention.htm on May 21, 2014.
[7] For a list of suicide hotlines in the United States by State, visit www.suicide.org/suicide-hotlines.html.
[8] James Gangwisch at the Columbia University Department of Psychiatry found that teens that went to bed later and got inadequate amounts of sleep had higher rates of depression and suicidal thoughts. “Study links teen depression to bedtimes,” retrieved from asp.cumc.columbia.edu/psych/articles/Article_Display.asp?ID=182 on May 21, 2014.
[9] Joseph Mercola, “These Types of Children Have an Increased Risk of Suicidal Thoughts,” retrieved from articles.mercola.com/sites/articles/archive/2011/02/03/signs-your-teen-may-be-contemplating-suicide.aspx on May 21, 2014.

Cesar De Leon Ph.D., LMFT is ministerial and evangelism director for Central California Conference and Carolann De Leon R.N., M.S., is volunteer assistant ministerial director of the Central California Conference of Seventh-day Adventists. They are co-founders of Tu Familia Primero ministry.