September is Suicide Prevention Month, and preventing suicide is a collaborative effort. The more parents, caregivers and caring adults who are committed to ending suicide, the better. It’s a staggering statistic: In the United States, suicide has become the second leading cause of death for ages 10-14 and the third leading cause of death for ages 15-24. Knowing how to approach the topic of suicide with an adolescent or teen in your care can empower you to save a life.

If you or someone you know is considering suicide, call or text the Suicide & Crisis Lifeline at 988 or get help online. If action has been taken or someone is experiencing a life-threatening emergency, call 911 or go to the nearest emergency department.

Know the Warning Signs

Suicide prevention is possible, but it requires loved ones to be attentive and aware of the possible warning signs. The following behaviors in youth may be indicative of a mental health crisis and suicidal ideation:

• Talking about feelings of hopelessness or a desire to die
• Struggling with unexplainable or unbearable emotional pain
• Exhibiting signs of anxiety or depression
• Extreme mood swings or increased anger
• Substance abuse
• Significant increase or decrease in sleep
• Withdrawing from family, friends or previously enjoyed activities
• Giving away possessions
• Lack of interest in the future
• Acquiring a means of self-harm or suicide (such as a weapon or medication)
• Taking unnecessary risks, such as driving recklessly

When to Talk About Suicide

What should you do if your child or teen shows none of these signs? Is this conversation really necessary if they seem happy and content? YES. You need to talk about suicide no matter what.

With more than 20% of teens having seriously considered suicide, it’s likely your teen will have a classmate at risk in the future. They need to know you’re a safe and trustworthy adult if they’re worried about a friend. 

Furthermore, your teen may not be struggling today — but they might struggle in the future. So when you begin the conversation now, you show them that they can come to you as a trusted resource when they need support. Even if they don’t need you as a lifeline today, they may need you tomorrow. 

How to Talk About Suicide with a Teen or Adolescent

If you have begun to notice warning signs of poor mental health in your adolescent or teen, time is of the essence. Here is what you can do to talk about suicide and get them the help they may need:

1. Start the Conversation

Begin the conversation in a safe, private setting. This can be a difficult conversation, and youth may feel insecure or embarrassed to open up about how they feel. Make sure you have the conversation in a place where they feel comfortable and don’t have to worry about being overheard.

Here are some helpful phrases you can use to begin the conversation:

• “I feel like you haven’t been yourself lately, and I want to check in. Can we talk?”
• “I want to respect your privacy, but I’m worried about you. Do you mind if I ask you how you’re doing?”
• “I care about you, and I can tell something is wrong. Can you talk to me about it?”
• “I know you’ve been having a difficult time recently. Can you tell me what has been going on?”

However you choose to broach the topic, make sure you establish that you care for them and are concerned, but avoid making them feel guilty or projecting your emotions onto them. You want to open the door for them to talk to you in a safe space, creating a pressure-free setting for them to talk about what they’re facing.

2. Ask Direct Questions

Dancing around the topic won’t help you understand what’s going on. And it won’t help your child or teen be honest and open. While not being demanding, you should still ask direct and specific questions to help them process and open up about what they’re going through. Here are some questions you can ask:

• How are you coping with [traumatic event or experience]?
• Do you ever feel like giving up?
• Have you ever considered suicide?
• Are you thinking about suicide right now?
• Have you ever thought about how or when you would do it?
• Do you have access to a means of suicide?
• Have you ever considered hurting yourself? Have you ever acted on those thoughts?
• Are you thinking about hurting yourself right now?
• Are you thinking about dying?
• How long have you felt this way?
• Have you thought about getting help?
• Can you think of anything I can do to help you?

Talking about suicide (even using the word “suicide”) will not increase the risk, and it can help de-escalate how a person is feeling when they know they have a trustworthy person to talk to.

3. Listen Calmly

Be a supportive, open listener as they answer your questions. Manage your own emotions as much as you can. Avoid phrases that could undermine or counter how they feel, like “You don’t really want to do that,” or phrases that make them feel guilty, like “You can’t do that to me/your family.” If you are feeling hurt or overwhelmed by what you’re hearing, it’s okay. As much as you can, get support for yourself as well (resources listed in Step 3).

Some supportive phrases to use include:

• “You’re not alone with this.”
• “I’m here for you. You can talk to me.”
• “Thank you for trusting me. We’ll get through it together.”
• “I may not understand exactly how you feel, but I care about you and want to help.”
• “I know it doesn’t seem like it right now, but you won’t always feel this way. Things can get better, and I want to help.”

While it’s important to acknowledge their feelings and be empathetic, don’t promise a person struggling with suicidal thoughts that you won’t tell anyone. Let them know you understand their desire for privacy, but you may need to talk to someone if you are concerned for their safety.

4. Create a Safe Environment

If the child or teen you are talking to is in a crisis, do not leave them alone. Get them to a safe place where they cannot harm themselves and seek professional help immediately. If you are a parent or caregiver, make sure your home is safe by removing or locking up any items that could be used for self-harm, including weapons, knives, medications, alcohol and any other substances that could be abused.

5. Provide Resources for Professional Support

You may not be the right person to provide the support a youth needs in a situation like this, but there are resources available to help. Don’t wait to seek professional help. There are many paths you can take to help the youth who is struggling. Here are a few resources available to youth in Kentucky who may be struggling:

• Call or text the Mental Health & Crisis Lifeline at 988 (available 24/7)
• Contact the National Alliance on Mental Illness (NAMI) Teen & Young Adult Helpline by texting “Friend” to 62640, calling 800-950-6264 or chatting online for peer support and referrals. (Resource available Monday through Friday, from 10 am to 10 pm Eastern time)
• Go to your local hospital or the nearest emergency department and ask for a consultation
• Contact the 24-hour Crisis Number for your county
• Find a Mental Health Provider near you
• Contact KVC Kentucky about our Behavioral Health Services

The right resource depends on the urgency of the situation. If it is a life-threatening emergency, call 911. If it is a behavioral health crisis, call 988 or your local county crisis number. Other resources can be helpful in less urgent situations or to have on hand for the future.

For therapy and behavioral health services catered to adolescents and teens in Kentucky, including virtual therapy services, call our office at (859) 254-1035 or fill out this referral form.