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In this blog post, APA President-elect Nadine Kaslow and her colleagues offer parents advice on how to prevent teen suicide.
By Nadine J. Kaslow, PhD, Parents Can Make a Difference Polina Kitsis, Mili Anne Thomas, MA, and 1. Know your facts Dorian A. Lamis, PhD
Every day, about 12 youth die by suicide. For every adolescent death by suicide you hear about, about 25 suicide attempts are made. These are staggering statistics. We know that families, schools, peer groups, and communities are dramatically impacted when young people engage in suicidal behavior. We want to help you prevent these tragedies.

Parents can help prevent suicide by recognizing warning signs, identifying risk factors (characteristics that may lead a young person to engage in suicidal behaviors), promoting protective factors (characteristics that help people deal with stress and reduce their chances of engaging in suicidal behaviors), and knowing how to talk to their children and seek mental health services. You can empower yourself and your teen by following these 7 steps.

Information is power and too much misinformation about suicide can have tragic consequences. Separating myth from fact can empower you to help your teen in distress.

Myth - Suicide in youth is not a problem

Truth - Suicide is a major problem affecting youth; it is the 3rd leading cause of death among 10-24 year olds

Myth - Asking about suicide causes suicidal behavior
2. Recognize the warning signs
Truth - Addressing the topic of suicide in a caring, empathetic, and nonjudgmental way shows that you are taking your child seriously and responding to their emotional pain

Myth - Only a professional can identity a child at risk for suicidal behavior
3. Know the risk factors
Truth - Parents and other caregivers often are the first to recognize warning signs and most able to intervene in a loving way

Studies who that 4 out of 5 teen suicide attempts are preceded by clear warning signs, so make sure to know them. A warning sign does not mean your child will attempt suicide, but do not ignore warning signs. Respond to your child immediately, thoughtfully and with loving concern. Don't dismiss a threat as a cry for attention!
4. Know the protective factors

Changes in personality: sadness, withdrawal, irritability, anxiety, exhaustion, indecision

Changes in behavior: deterioration in social relationships and school and/or work performance, reduced involvement in positive activities

Sleep disturbance: insomnia, oversleeping; nightmares

Changes in eating Habits: loss of appetite, weight loss, or overeating

Fear of losing control: erratic behavior, harming self or others

Recognize certain situations and conditions that are associated with an increased risk of suicide.
5. Take preventive measures

Previous suicide attempt(s)

Mental health disorders (depression, anxiety)

Alcohol and other substance abuse

Feelings of hopelessness, helplessness, guilt, loneliness, worthlessness, low self-esteem

Loss of interest in friends, hobbies, or activities previously enjoyed

Aggressive behavior

Bullying or being a bully at school or in social settings

Disruptive behavior, including disciplinary problems at school or at home

High risk behaviors (drinking and driving, poor decision-making)

Recent/serious loss (death, divorce, separation, broken romantic relationship,)

Family history of suicide

Family violence (domestic violence, child abuse or neglect)

Sexual orientation and identity confusion (lack of support or bullying during the coming out process)

Access to lethal means like firearms, pills, knives or illegal drugs

Stigma associated with seeking mental health services

Barriers to accessing mental health services (lack of bilingual service providers, unreliable transportation, financial costs)

These factors have been shown to have protective effects against teen suicide:
6. Talk to your teen about suicide

Skills in problem solving, conflict resolution, and handling problems in a nonviolent way

Strong connections to family, friends, and community support

Restricted from lethal means of suicide

Cultural and religious beliefs that discourage suicide and support self-preservation

Easy access to services

Support through ongoing medical and mental health care relationships

You are not powerless; you can guard your teen against the possibility of suicide.
7. Last but not least, seek mental health services

Interact with your teen positively (give consistent feedback, compliments for good work.)

Increase his/her involvement in positive activities (promote involvement in clubs/sports)

Appropriately monitor your teen's whereabouts and communications (texting, Facebook, Twitter) with the goal of promoting safety

Be aware of your teen's social environment (friends, teammates, coaches) and communicate regularly with other parents in your community.

Communicate regularly with your teen's teachers to ensure safety at school

Limit your teen's access to alcohol, prescription pills, illegal drugs, knives and guns

Talk with your teen about your concerns; ask him/her directly about suicidal thoughts

Explain the value of therapy and medication to manage symptoms.

Address your concerns with other adults in your child's life (teachers, coaches, family)

Discuss your concerns with his/her pediatrician to seek mental health referrals

Talking to your teen about a topic like suicide can seem almost impossible. Have this important discussion with your teen by using these tips.

Talk in a calm, non-accusatory manner

Express loving concern

Convey how important he/she is to you

Focus on your concern for your teen's well-being and health

Make "I" statements to convey you understand the stressors he/she may be experiencing

Encourage professional help-seeking behaviors (locate appropriate resources)

Reassure your adolescent that seeking services can change his/her outlook

Mental health professionals can be essential partners in teen suicide prevention.

a) Take appropriate action to protect your child

If you feel that something is "just not right"

If you notice warning signs

If you recognize your child has many of the risk factors and few of the protective factors listed above

National Resources
b) Find a mental health provider who has experience with youth suicide

Choose a mental health provider with whom your child and you are comfortable

Participate actively in your child's therapy

c) If danger is imminent, call 911 or take your child to the nearest emergency room

1-800-273-TALK (8255) - National Suicide Prevention Lifeline

American Association of Suicidology: http://www.suicidology.org

Light for Life Program: http://www.yellowribbon.org/

National Institute of Mental Health Suicide Prevention Resources http://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml

National Mental Health Association: www.nmha.org

S.O.S High School Suicide Prevention Program: http://www.mentalhealthscreening.org/highschool

Suicide Awareness/Voices of Education (SAVE): www.save.org

Suicide Prevention Therapist Finder (SPTF): http://www.HelpPRO.com/SPTF

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7 Essential Steps Parents Can Take to Prevent Teen Suicide

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In this blog post, APA President-elect Nadine Kaslow and her colleagues offer parents advice on how to prevent teen suicide. By Nadine J. Kaslow, PhD, Polina Kitsis, Mili Anne Thomas, MA, and Dorian A. Lamis, PhD Parents Can Make a Difference Every day, about 12 youth die by suicide.

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Suicide in Children and Teens

No. 10; Updated October 2017

Suicides among young people continue to be a serious problem. Suicide is the second leading cause of death for children, adolescents, and young adults age 5-to-24-year-olds.

The majority of children and adolescents who attempt suicide have a significant mental health disorder, usually depression.

Among younger children, suicide attempts are often impulsive. They may be associated with feelings of sadness, confusion, anger, or problems with attention and hyperactivity.

Among teenagers, suicide attempts may be associated with feelings of stress, self-doubt, pressure to succeed, financial uncertainty, disappointment, and loss. For some teens, suicide may appear to be a solution to their problems.

Depression and suicidal feelings are treatable mental disorders. The child or adolescent needs to have his or her illness recognized and diagnosed, and appropriately treated with a comprehensive treatment plan.

Thoughts about suicide and suicide attempts are often associated with depression. In addition to depression, other risk factors include:

family history of suicide attempts

exposure to violence

impulsivity

aggressive or disruptive behavior

access to firearms

bullying

feelings of hopelessness or helplessness

acute loss or rejection

Children and adolescents thinking about suicide may make openly suicidal statements or comments such as, "I wish I was dead," or "I won't be a problem for you much longer." Other warning signs associated with suicide can include:

changes in eating or sleeping habits

frequent or pervasive sadness

withdrawal from friends, family, and regular activities

frequent complaints about physical symptoms often related to emotions, such as stomachaches, headaches, fatigue, etc.

decline in the quality of schoolwork

preoccupation with death and dying

Young people who are thinking about suicide may also stop planning for or talking about the future. They may begin to give away important possessions.

People often feel uncomfortable talking about suicide. However, asking your child or adolescent whether he or she is depressed or thinking about suicide can be helpful. Specific examples of such questions include:

Are you feeling sad or depressed?

Are you thinking about hurting or killing yourself?

Have you ever thought about hurting or killing yourself?

Rather than putting thoughts in your child's head, these questions can provide assurance that somebody cares and will give your child the chance to talk about problems.

Parents, teachers, and friends should always err on the side of caution and safety. Any child or adolescent with suicidal thoughts or plans should be evaluated immediately by a trained and qualified mental health professional.

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Suicide in Children and Teens No. 10; Updated October 2017 Suicides among young people continue to be a serious problem. Suicide is the second leading cause of death for children, adolescents, and young adults age 5-to-24-year-olds. The majority of children and adolescents who attempt suicide have a significant mental health disorder, usually depression.

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What is teen suicide?

What causes a teen to attempt suicide?

Which teens are at risk for suicide?

What are the warning signs of teen suicide?

How is a teen diagnosed as being suicidal?

How is a teen treated for suicidal behavior?

How can I help prevent my teen from attempting suicide?

When should I call my teen's healthcare provider?

Key points about teen suicide

Next steps

Tips to help you get the most from a visit to your child's healthcare provider:

Know the reason for the visit and what you want to happen.

Before your visit, write down questions you want answered.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

Ask if your child's condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child's provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Suicide is when a teen causes his or her own death on purpose.

Suicidal ideation is when a teen has thoughts of wanting to die.

Suicidal behavior is when a teen is focused on doing things that cause his or her own death.

Normal developmental changes combined with stressful life events may cause a teen to think about suicide.

Many of the warning signs of suicide are also symptoms of depression.

Any teen who expresses suicidal thoughts should be evaluated right away.

Call your teen's healthcare provider right away if your teen:

Feels extreme depression, fear, anxiety, or anger toward him or herself or others

Feels out of control

Hears voices that others don't hear

Sees things that others don't see

Can't sleep or eat for 3 days in a row

Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

Call 911 if your teen has suicidal thoughts, a suicide plan, and the means to carry out the plan.
Learning the warning signs of teen suicide can prevent an attempt. Keeping open communication with your teen and his or her friends gives you an opportunity to help when needed. Also take these steps:

Keep medicines and guns away from children and teens.

Get your teen help for any mental or substance abuse problems.

Support your teen. Listen, try not to offer undue criticism, and stay connected.

Become informed about teen suicide. Resources include the public library, local support group, and the Internet.

Know the warning signs for depression:

Feelings of sadness, hopelessness, or loneliness

Declining school performance

Loss of interest in social and sports activities

Sleeping too little or too much

Changes in weight or appetite

Nervousness, agitation, or irritability

Teens can take these steps to help prevent suicide if they see warning signs in a friend:

Take their friend's behavior and talk of suicide seriously.

Encourage their friend to seek expert help. Go with the friend, if needed.

Talk with an adult they trust about their friend.

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment starts with a detailed evaluation of events in your teen's life during the 2 to 3 days before the suicidal behaviors. Treatment may include:

Individual therapy

Family therapy. Parents play a vital role in treatment.

An extended hospital stay, if needed. This gives the child a supervised and safe environment.

Threats of suicide are a cry for help. Always take such statements, thoughts, behaviors, or plans very seriously. Any teen who expresses thoughts of suicide should be evaluated right away. Talk with your teen's healthcare provider.

Any teen who has tried to commit suicide needs a physical checkup first to rule out life-threatening health problems. He or she should then get a mental health evaluation and treatment until he or she is stable. This often will take place at an inpatient facility to make sure of the child's safety.

Many of the warning signs of suicide are also symptoms of depression. They are:

Changes in eating and sleeping habits

Loss of interest in usual activities

Withdrawal from friends and family members

Acting-out behaviors and running away

Alcohol and drug use

Neglecting one's personal appearance

Unnecessary risk-taking

Obsession with death and dying

More physical complaints often linked to emotional distress, such as stomachaches, headaches, and extreme tiredness (fatigue)

Loss of interest in school or schoolwork

Feeling bored

Problems focusing

Feeling he or she wants to die

Lack of response to praise

Another warning sign is making plans or efforts toward committing suicide:

Says "I want to kill myself," or "I'm going to commit suicide."

Gives verbal hints, such as "I won't be a problem much longer," or "If anything happens to me, I want you to know ...."

Gives away favorite possessions or throws away important belongings

Becomes suddenly cheerful after a period of depression

May express weird thoughts

Writes 1 or more suicide notes

These signs may look like other health problems. Make sure your teen sees his or her healthcare provider for a diagnosis.

A teen's risk for suicide varies with age, gender, and cultural and social influences. Risk factors may change over time. They are:

One or more mental or substance abuse problems

Impulsive behaviors

Undesirable life events or recent losses, such as the death of a parent

Family history of mental or substance abuse problems

Family history of suicide

Family violence, including physical, sexual, or verbal or emotional abuse

Past suicide attempt

Gun in the home

Imprisonment

Exposure to the suicidal behavior of others, such as from family or peers, in the news, or in fiction stories

The teen years are a stressful time. They are filled with major changes. These include body changes, changes in thoughts, and changes in feelings. Strong feelings of stress, confusion, fear, and doubt may influence a teen's problem-solving and decision-making. He or she may also feel a pressure to succeed.

For some teens, normal developmental changes can be very unsettling when combined with other events, such as:

Changes in their families, such as divorce or moving to a new town

Changes in friendships

Problems in school

Other losses

These problems may seem too hard or embarrassing to overcome. For some, suicide may seem like a solution.

Suicide is when a teen causes his or her own death on purpose. Before attempting to take his or her own life, a teen may have thoughts of wanting to die. This is called suicidal ideation. He or she may also have suicidal behavior. That's when a teen is focused on doing things that cause his or her own death.

Suicide is the third leading cause of death in young people ages 15 to 24. The CDC reports that:

Boys are 4 times more likely to die from suicide than girls.

Girls are more likely to attempt suicide than boys.

Guns are used in more than half of youth suicides.

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Suicide is when a teen causes his or her own death on purpose. Before attempting to take his or her own life, a teen may have thoughts of wanting to die. This is called suicidal ideation. He or she may also have suicidal behavior.

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I think this article gives a lot of good information on what suicide is and what should be done if your teen is thinking of suicide but I think it s

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Children and adolescents thinking about suicide may make openly suicidal statements or comments such as, "I wish I was dead," or "I won't be a problem for you much longer." Other warning signs associated with suicide can include
changes in eating or sleeping habits

frequent or pervasive sadness

withdrawal from friends, family, and regular activities

frequent complaints about physical symptoms often related to emotions, such as stomachaches, headaches, fatigue, etc.

decline in the quality of schoolwork

preoccupation with death and dying

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For some teens, normal developmental changes can be very unsettling when combined with other events, such as:

Changes in their families, such as divorce or moving to a new town

Changes in friendships

Problems in school

Other losses

These problems may seem too hard or embarrassing to overcome. For some, suicide may seem like a solution.

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Myth – Asking about suicide causes suicidal behavior

Truth – Addressing the topic of suicide in a caring, empathetic, and nonjudgmental way shows that you are taking your child seriously and responding to their emotional pain