Unfortunately, suicidal ideation is a very real concern among tweens and teens. No matter the situation, how you handle it is crucial to ensure the safety and well-being of your child. In this Scary Mommy article, Mindpath Health’s Rashmi Parmar, MD, discusses what to do if your child is struggling with suicidal thoughts or feelings. 

Your Teen Expressed Suicidal Thoughts — Here's What to Do_Rashmi Parmar, MD_Mindpath Health

The realization that your child might be in a genuine mental health crisis is a situation no parent ever wants to face. Cases of depression, anxiety, eating disorders, and other mental health conditions have spiked among tweens and teens in recent years, making it increasingly possible that your child could be struggling. Even more alarming: a recent report by the Centers for Disease Control and Prevention (CDC) showed a 4% increase in suicides in the U.S. in 2021, with an 8% increase in suicide rates among males ages 15-24. 

Perhaps you stumbled upon a troublesome text or a worrisome social media post, or maybe your child has flat-out told you they are struggling. Maybe you’ve noticed things are amiss, or perhaps you had no idea something might be going on behind the scenes. No matter the situation, how you handle it is crucial to ensure the safety and well-being of your child, who likely needs your support now more than ever. 

Signs your child might be struggling 

Unfortunately, suicidal ideation is a very real concern among tweens and teens. Tracy Livecchi, LCSW, notes that any suicide concerns— even seemingly off-hand jokes or one-off comments) —should be taken seriously, as these thoughts and feelings “often come from experiences of rejection, shame, hurt, isolation, and hopelessness.” 

Here are some of the warning signs your child might be struggling: 

  • An abrupt change in behavior, especially if related to a stressful or painful event 
  • Change in appetite, rapid loss or increase in weight 
  • Change in sleeping habits 
  • Decline in grades/academic performance 
  • Feeling hopeless, low, or irritable 
  • Isolating and spending less time with friends and family 
  • Loss of interest in things they previously enjoyed 
  • Rebellious behavior/suddenly acting out 
  • Taking an interest in firearms or prescription pills 

Rashmi Parmar, MD, a psychiatrist with Mindpath Health, notes some other ways tweens and teens might express suicidal thoughts or intent: 

  • Making vague comments during conversations or on social media, including phrases like: “don’t want to wake up ever,” “wish to be gone forever,” “want to not exist or disappear” 
  • Making joking comments about dying or killing oneself 
  • Writing goodbye notes or saying goodbye out of context to close friends and family 
  • Drawing pictures depicting suicidal themes 
  • Secretive behaviors around family in context of planning or execution of suicidal thoughts, such as researching possible ways of suicide on the internet, hoarding medication bottles, etc. 
  • Taking inventory of personal things and giving away prized possessions for no clear reasons 
  • Change to a reckless or careless attitude about things 
  • Lack of self-care or attention to personal hygiene 

“It is important to understand that some of these warning signs and expressed thoughts may be related to a different underlying problem or stressor in the child’s life and may not necessarily mean that the child is suicidal,” Dr. Parmar says. “However, it is better to err on the side of caution and explore these feelings with the child rather than assuming anything.” 

Here’s what to do — and not do

Your approach and reaction is important, no matter how panicked or worried you might feel about your child’s well-being.  

Staying calm is crucial, says Parmar. “You may naturally feel a range of emotions (like sadness, guilt, anger, etc.). Try not to blame yourself because it will cloud your thinking and will interfere with your ability to act appropriately.” 

After you approach them gently, Parmar recommends listening openly, “allowing them enough time and space to open up about their thoughts and feelings. Give them breaks from the discussion if the situation becomes too overwhelming.” 

Some things you can say in the moment, per Parmar: 

  • “Thank you for sharing your feelings with me, I am glad we started this conversation.” 
  • “I am here for you no matter what. I love you and care about you.” 
  • “I want to help you feel better in whatever way I can.” 
  • “We will figure this out together.” 
  • “Let’s work together to seek the help you need. I’ll be with you every step of the way.” 

Ultimately, “Your goal should be to find out how serious these thoughts are and possible ways you can protect your child against them,” says Parmar. You can ask questions like: 

  • “How long have you been feeling this way?” 
  • “How often do you get them?” 
  • “What are some of the triggers for these kinds of thoughts?” 

“Research has shown that asking about these thoughts directly is not necessarily going to plant ideas in their mind, which is what most parents fear,” says Dr. Parmar. Possible questions include: 

  • “Does it ever get so tough that you think about ending your life?” 
  • “Have you ever come close to acting on these thoughts?” 
  • “Have you ever felt scared of having these thoughts?” 
  • “Does anything seem to help make them go away?” 

If your child is in imminent danger

“If you sense that they are at an immediate risk for attempting suicide, get them help right away by taking them to the local hospital emergency room or by calling 911 or 988,” the new mental health emergency hotline number, says Levicchi. “Even if you don’t sense an immediate crisis, you need to take action by reaching out to their pediatrician and/or a local mental health professional who specializes in seeing tweens and teens.” 

For serious, immediate emergencies, “You will need to assess the situation by having a direct conversation with your child and come up with a safety plan that is agreeable to both of you,” says Parmar. “Identify a few trusted adults for the child to connect with when feeling unsafe. Know where your child is at all times. Let your location and contact details always be known to your child in case they need you during an emergency. Remove access to any potentially dangerous objects at home, like knives, scissors, razors, belts, cleaning products, or medication bottles. If you keep firearms at home, make sure they’re kept locked and out of the child’s reach and store the ammunition separately as well.” 

Read the full Scary Mommy article with sources. 

Rashmi P Parmar, M.D.

Manteca, CA

Dr. Parmar is a double board-certified psychiatrist in Adult and Child Psychiatry. She earned her medical degree at Terna Medical College & Hospital in Mumbai, India. Thereafter, she completed general psychiatry training at Texas Tech University Health Sciences Center program, TX, followed by the Child & Adolescent Psychiatry fellowship training at Hofstra Northwell Health program, NY. Her training has equipped ... Read Full Bio »

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