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Assessing Suicide Risk in Your Child

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As the fall arrives and brings with it shorter days, pressures mount on our children and so do parents’ concern for their children’s mental health, and sometimes their risk of suicide.  Most of us can weather the storms of pressure and stress, but for children it is sometimes harder. Add to that the social pressures of cyber bullying, and it is evident that being a kid is harder than it ever has been. Suicide is real, and it is on the rise. According to the Centers for Disease Control, suicide is now the cause of more deaths than car accidents. Here are 7 steps to assess suicide risk in your child and ensure safety.

1 – Beware of Loss or Perceived Loss

 The most salient risk factor for suicide in all ages appears to be the experiencing of a significant loss- a break up, a rejection, school problems, a devastating grade. Whenever your child has a loss, it is critical to pay close attention to their behavior and mood. For children and teens, it is very important to view these losses through the eyes of your child, and not only through your eyes. In other words, what feels like a catastrophic loss to a child may not feel like a loss to a parent. What’s critical is to assess how important the loss is to your child.

2 – Other Risk Factors of Significance

Other risk factors that  have been shown to increase the risk for suicide are:
Depression or Bipolar Disorder
History of suicidal behavior
Family history of suicidal behavior or losing a friend to suicide
Impulsivity and Substance Abuse substantially limit a person’s self control
Withdrawal
Moodiness or Odd Behavior
If your child has been exposed to or involved in any of these situations, their risk is higher, and seeking mental health help is warranted. Take steps to limit a child’s access to methods of self harm – keep all medicine and sharp objects out of reach and/or put away. Restrict any kind of access to weapons.

3 – Listen even if it’s Painful

Listen to your child, and hear their cries for help. Is s/he telling you they feel overwhelmed, unable to cope, devastated? Have your child’s friends alerted you they are worried about your child? Poor parent-child communication has been shown to increase a teen’s risk for suicide. Most people reach out for help when they feel suicidal. The most important thing you can do is listen to your child, and take his/her concerns very seriously. Try to see things through their eyes, offer to be with them, arrange for professional help, tell them how much you love them and how you will help them get through this – that it absolutely will get better. Instilling a sense a hope is a key intervention and helping your child see hope when they feel hopeless is one of the most powerful things you can offer, in addition to assuring them you will keep them safe.

4 -Don’t be Afraid to Ask about Suicidality

Don’t be afraid to ask your child whether they have thought about giving up or ending their life. Many people think asking such questions will put thoughts in the head of a depressed person, and could make them suicidal. In fact, asking about suicidal thoughts does the opposite, and helps a person who is suicidal feel understood, and helps a depressed person see that they could be feeling a lot worse.
Having thoughts of dying, or wishing life would just end so the pain would stop, does not necessarily mean a person is at risk of taking action to end their life. While your child may not need to be hospitalized to keep themselves safe, such thoughts are indeed a cry for help and your child needs professional help, and urgently. Even if your child bounces back to themselves, and denies thinking of death, arranging for him/her to see a professional is important for their health, and also sends the powerful message that you heard them, and take their feelings and safety seriously.

5 – Establishing Safety

In the interim, ask your child to agree to a Safety Plan, by having them promise to keep themselves safe if they  feels like harming themselves. It can be helpful to have your child, in your presence, write down the following statement:

If I start to feel like harming myself, I agree to keep myself safe and avoid such behaviors. I also agree to reach out to (list 1-3 people) for help. If none of them are available and I cannot keep myself safe, I agree to call (National Suicide Hotline). Signed, (Your Child)

A Safety Plan Template  can offer a more detailed format to collect a more defined plan of action. Make sure to share your safety plan with the professional who is helping you and your child.

6 – Does Your Child Have a Suicide Plan?

If you are scared your child may not be safe, it will help to assess their risk for action, and always err on the side of safety. Any action you take to keep your child safe sends the powerful message that they are loved and valuable – often the thing they long to feel. If your child admits having suicidal thoughts, ask how they would do it. And listen to how practical and thought-through their plan is. The more realistic and lethal the plan, the higher the risk. For instance, if your child says they really don’t know how they would do it, they just wish it would happen so they would be out of pain, they are telling you they don’t really have a plan. On the other hand, if your child tells you s/he has looked up on the internet the most painless way to do it, and has secured the supplies to do so, they are telling you clearly they have a plan. Having any sort of realistic plan is a dangerous sign, and warrants immediate action. A parent should reach out to professionals immediately to assess how to keep them safe. When in doubt, go directly to the ER.

7 – Take Action

If you believe your child is in danger, and they will not agree to go to the hospital, take bolder action to ensure their safety. Do not hesitate to call 911. Every state has a protocol for emergency intervention to keep a person safe, and calling 911 is a first step in every jurisdiction. The police will help your family get your child the help they need at a hospital where they will be safe and can get the medical attention they need. If your child is in trouble, you will never regret  overreacting – the only real risk is under reacting.

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Alicia H. Clark, PsyD

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