Suicide Prevention for Children and Young Adults

Suicide is a leading cause of death among young people, but it is preventable with the right knowledge, support, and interventions. If a child or young adult expresses suicidal thoughts or exhibits warning signs, take it seriously and respond immediately. The most important steps are to ensure their safety, remove access to dangerous items, listen to their concerns, and connect them to crisis support and professional help right away. Call or text 988 to reach the Suicide & Crisis Lifeline 24/7.

After the crisis, ongoing support is essential to their recovery and well-being. Encourage open communication, help develop a personalized safety plan, connect them to mental health professionals, stay involved in their care, and surround them with a strong support system of caring adults, family members, and friends. Remember, your love and commitment to getting them help can make all the difference.

• If a child expresses suicidal thoughts, stay with them, remove access to lethal means, listen without judgment, help connect them to support, and seek immediate help
• Continue supporting their recovery with open communication, safety planning, professional care, and a strong support system
• Key crisis resources: 988 Suicide & Crisis Lifeline, Crisis Text Line (text “START” to 741-741), local emergency rooms, and mental health professionals

Suicide Prevention Resources

There are many helpful resources and crisis lines available to support young people who are struggling, including:

Resource	Contact Information
988 Suicide & Crisis Lifeline	Call or text 988
Crisis Text Line	Text “START” to 741-741
Local Emergency Room
Mental Health Professional

Supporting a child through a mental health crisis is challenging, but you don’t have to face it alone. This guide provides information on recognizing warning signs, responding effectively in a crisis, accessing professional help, and providing ongoing support and recovery resources. You’ll also find self-care tips for parents and caregivers. Reach out, get informed, and know that help and hope are available.

Suicide Warning Signs and Risk Factors

Parents, caregivers, and educators must be aware of the warning signs and risk factors associated with suicidal thoughts and behaviors in children and adolescents. Early recognition and intervention can make a significant difference in preventing suicide attempts and saving lives.[1]

Warning Signs 

Warning signs are observable behaviors or expressions that indicate an individual may be at immediate risk for suicide. These can include:[2]

• Talking about wanting to die or kill themselves
• Expressing feelings of hopelessness, worthlessness, or guilt
• Withdrawing from friends and family
• Displaying extreme mood swings or sudden changes in behavior
• Giving away prized possessions or saying goodbye to loved ones
• Engaging in reckless or self-destructive behaviors
• Showing a loss of interest in activities they once enjoyed
• Experiencing a decline in academic performance
• Exhibiting unexplained crying or emotional outbursts
• Saying they feel like a burden to others
• Showing a preoccupation with death or suicide through clothing, media, or artwork
• Neglecting personal appearance or hygiene
• Signs of self-harm, such as cutting or burning

It’s important to note that warning signs can be subtle, especially in younger children who may not have the vocabulary to express their feelings directly.[3] Any talk of suicide or self-harm should be taken seriously and requires immediate attention.[4]

Risk Factors

Risk factors are characteristics or conditions that increase the likelihood of suicidal thoughts or behaviors. While the presence of risk factors does not necessarily mean an individual will attempt suicide, it’s essential to be aware of these factors to identify those who may be more vulnerable.[1]

Some notable risk factors for suicide in children and teens include:[5],[6],[7]

• Mental health conditions such as depression, anxiety, or substance abuse
• Family history of suicide or mental illness
• Exposure to trauma, abuse, or neglect
• Chronic medical conditions or disabilities
• Social isolation or bullying
• Access to lethal means, such as firearms or medications
• Stressful life events, such as relationship problems or academic difficulties

Risk Factors	Warning Signs
Mental health conditions	Talking about wanting to die or kill themselves
Family history of suicide or mental illness	Expressing feelings of hopelessness or guilt
Exposure to trauma, abuse, or neglect	Withdrawing from friends and family
Chronic medical conditions or disabilities	Displaying extreme mood swings or behavior changes
Social isolation or bullying	Giving away prized possessions or saying goodbye
Access to lethal means	Engaging in reckless or self-destructive behaviors
Stressful life events	Showing a preoccupation with death or suicide

Risk factors can vary across different stages of development.[7] For example, young children may be particularly vulnerable to risks associated with abuse or lack of parental support, while adolescents may be more sensitive to peer victimization and academic pressures.

The Role of Social Determinants

In addition to individual risk factors, social determinants of health can significantly influence the risk of suicidal thoughts and behaviors in children and young adults.[8] These may include:[8],[9]

• Poverty and economic disadvantage
• Unequal access to resources and healthcare
• Discrimination and stigma
• Neighborhood and school environment

Research has shown that youth living in impoverished communities or attending disadvantaged schools are at higher risk for suicide attempts and suicidal ideation.[8],[9]

Addressing these social inequities is a critical component of comprehensive suicide prevention efforts.

Protective Factors

Protective factors play a vital role in reducing the risk of suicide among children and young adults. These factors include both personal traits and external support systems that build resilience and offset risk factors. By recognizing and fostering these protective elements, we can establish a nurturing environment that equips young people with the tools to handle difficult situations more successfully.

Some important protective factors in preventing suicide in young people include:

• Strong beliefs and values
• Positive coping strategies and problem-solving skills like effective emotional regulation
• High self-esteem and a sense of self-efficacy
• A supportive family environment
• School and community connectedness and belonging
• Close social networks and supportive friendships
• Access to quality and appropriate mental health resources

The Importance of Parental Involvement and Support

Parents play a key role in safeguarding children and young adults from thoughts and actions related to self-harm.[10][11] Building and maintaining a strong, supportive bond with your child helps them handle the difficulties of growing up and creates a secure environment where they can share their emotions. [12]

Some ways parents can support their children’s mental health include:

• Encouraging open and honest communication
• Validating their emotions and experiences
• Helping them develop healthy coping skills
• Monitoring for signs of distress or changes in behavior
• Seeking professional help when needed

Research shows that bullying and harassment can increase the risk of self-harm thoughts and actions in young people. Our study aimed to find factors that help protect against these risks. We found that when parents actively participate in their child’s education, both at school and individually, it reduces the likelihood of harmful thoughts and behaviors. This suggests that parental involvement in education acts as a safeguard for youth mental health.

Cixin Wang, Assistant Professor, Department of Counseling, Higher Education, and Special Education

How to Respond to a Child’s Suicidal Ideation

If you suspect that a child or young adult is at risk for suicide, it’s important to take action and seek help immediately by:

• Seek immediate help from a local emergency room or call 988 for the Suicide & Crisis Lifeline
• Remain with the person and keep them company at all times
• Removing access to lethal means, such as firearms or medications
• Providing a safe and supportive environment
• Encouraging them to express their feelings and listen without judgment
• Reassuring them that help is available and that you will support them through the process

Remember, threats of suicide should always be taken seriously and responded to immediately. Suicide prevention is a community effort. By working together to recognize warning signs, address risk factors, and provide support, we can help protect the lives of children and young adults in our communities.

Talking to Children and Young Adults About Suicide

Talking about suicide with kids and teens can be tough, but having this important conversation can save lives. It helps young people recognize and respond to thoughts of self-harm, and encourages them to seek help when needed.[13] Children of all ages may learn about tragic events, so it’s valuable to discuss these topics with them, no matter how young they are. [14]

Starting the Conversation

When initiating a conversation about mental health with children, consider discussing emotions as a starting point. Ask them if they feel sad, mad, or nervous, and help them label and express their feelings.[14] 

For older children who are more aware of their thoughts and feelings, ask about their perceptions and other symptoms like sleep problems, mood changes, and feelings of hopelessness or being overwhelmed.[15]

Remember to listen actively, use encouraging gestures, and ask open-ended questions to show that you care and are engaged in the conversation.[16]

Key Points to Remember

• Ask Direct Questions: Don’t be afraid to ask directly about suicidal thoughts. Asking can protect them by giving them permission to share their feelings.
• Use Their Language: Tailor your questions to the child’s vocabulary but keep them slightly vague to encourage more honest answers.
• Validate Their Feelings: Use active listening techniques. For example, you might say, “That sounds really difficult,” to show empathy and understanding.

Seeking Help and Support

If your child is struggling with suicidal thoughts, get them help as soon as possible. Follow-up care may include individual therapy, family therapy, and medication. Encourage open communication about suicidal thoughts to make it easier for them to ask for help.[4]

If your child isn’t talking, changes in their behavior can sometimes help you understand what they might be feeling:

• Expressing strong feelings of hopelessness, worthlessness, sadness, guilt, or shame
• Withdrawing and spending lots of time alone
• Not wanting to be around friends and family

Building a Support Network

Encourage your child to reach out to friends and trusted adults in their life for support. They can also call the 988 Suicide & Crisis Lifeline any time for confidential help. Consider creating a safety plan together to guide them through difficult moments and keep them safe.[19]

Strong relationships between educators and families can also strengthen children’s emotional health by showing them that they can trust the adults in their lives. Work on creating a respectful and reciprocal relationship where families feel valued and supported.[20]

Discussing mental health, including thoughts of self-harm, shows we value emotional well-being.[13] Open, honest talks with your child about tough subjects can help them understand and find the support they need.

Creating a Safety Plan

A safety plan is a personalized set of coping strategies and resources that can help reduce the risk of suicidal thoughts and actions in children and young adults.[21] It is developed collaboratively between the individual and their support system, which may include family members, friends, and mental health professionals.

The safety plan should include the following key components:

1. Identifying Warning Signs and Triggers

Spotting early signs that a child or young adult might be thinking about suicide helps prevent tragedy. Create a personalized list of warning signs and triggers for the individual, which may include:

• Expressing feelings of hopelessness, worthlessness, or guilt
• Withdrawing from friends and family
• Talking or writing about death or suicide
• Changes in mood, sleep patterns, or appetite

It is also important to identify the specific situations or stressors that may trigger suicidal thoughts, such as relationship problems, academic stress, or bullying.[22]

2. Listing Coping Strategies and Distractions

The safety plan should include a list of healthy coping strategies and distractions that the individual can use when experiencing suicidal thoughts, such as:

• Engaging in favorite hobbies or activities
• Practicing relaxation techniques, such as deep breathing or meditation
• Journaling or creative writing
• Spending time with supportive friends or family members

3. Naming Trusted Contacts for Support

Identifying a network of trusted individuals who can provide emotional support is a key component of the safety plan. These may include family members, close friends, teachers, or mental health professionals.[15] The plan should include their contact information and instructions on how to reach out when needed.

4. Providing Emergency Contact Information

The safety plan should also include emergency contact information, such as:

• National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
• Crisis Text Line: Text “HOME” to 741741
• Call the 988 Suicide & Crisis Lifeline
• Call 911 

It is important to emphasize that seeking help is a sign of strength and that support is always available.

5. Removing Access to Lethal Means

Restricting access to lethal means, such as firearms or medications, is a necessary step in reducing the risk of suicide.[21] Here’s how:

• Safely storing firearms in a locked cabinet or with a trusted friend or family member
• Properly disposing of unused medications
• Installing barriers on windows or balconies to prevent falls 
• Removing access to sharp objects, rope, or anything else that could be dangerous

Section	Details
Warning Signs	Feeling hopeless or trapped, isolating from others, talking about death or suicide
Coping Strategies	-Listen to favorite music, take a walk in nature, call a friend or family member
Trusted Contacts	– Parent: (555) 123-4567- Sibling: (555) 987-6543- Therapist: (555) 555-5555
Emergency Contacts	– National Suicide Prevention Lifeline: 1-800-273-TALK (8255)- Crisis Text Line: Text “HOME” to 741741- Local Emergency Services: 911
Lethal Means Restriction	– Remove firearms from the home- Lock up medications- Install window guards or barriers, remove sharp objects, rope, and other dangerous means

Creating a safety plan is a collaborative process that involves open communication and trust between the child or young adult and their support system. By working together to develop a personalized plan, individuals at risk for suicide can feel more empowered and prepared to manage their thoughts and emotions during difficult times.

Evidence-Based Interventions and Prevention Strategies

Protecting children and young adults from self-harm requires a wide-ranging, layered approach using proven methods and plans. These fall into three main groups: whole-community efforts, programs for higher-risk groups, and personalized support. [23]

Population-Based Strategies

Population-based strategies aim to reach a broad audience and promote mental health resilience. These include:[23],[24]

• Mental health promotion and education campaigns to increase awareness and reduce stigma
• School-based awareness programs, which have been shown to reduce suicide attempts and suicidal ideation
• Careful media coverage guidelines to prevent sensationalism and copycat behavior
• Restricting access to lethal means, such as controlling analgesics and securing suicide “hot spots”

Targeting High-Risk Subgroups

Some groups face a greater risk of suicidal behavior, including LGBTQ+ youth, people with a family history of suicide, and those living with mental health conditions. Strategies to support these high-risk groups include: [25],[26],[27],[28]

• Gatekeeper training for teachers, parents, and community members to recognize warning signs and connect at-risk individuals to help
• School-based peer support programs and skill-building groups
• Enhanced crisis services and referral resources
• Screening programs to identify and assist high-risk individuals

Individual-Focused Approaches

For individuals identified as being at high risk for suicide, targeted interventions are essential. Strategies include:[23],[24],[29],[30]

• Improving access to and quality of mental health treatment, particularly for depression
• Providing follow-up care and support after a suicide attempt or crisis
• Teaching coping and problem-solving skills to at-risk youth and their families
• Offering evidence-based psychotherapies, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), which have been shown to reduce suicidal ideation and attempts

School-based mental health services can play a key role in providing accessible, intensive treatment for students struggling with mental health issues, such as:[31]

• Individual, family, and group therapy
• Specialized treatment for conditions like anxiety, depression, and trauma
• Interpersonal therapy, which has been shown to effectively treat adolescent depression when delivered in school-based health centers

By putting in place a comprehensive set of proven methods ranging from broad prevention efforts to focused treatment in schools, health centers, and local areas, we can join forces to lower the risk of suicide and protect young people. Continuing studies and reviews of programs can help improve and expand the approaches that work best.

The Role of Schools in Suicide Prevention

With students spending a significant portion of their day in school, educators and staff are uniquely positioned to recognize suicide warning signs, provide support, and connect at-risk youth with mental health resources.[32]

Fostering a Supportive School Environment

Creating a supportive and welcoming school environment helps promote mental health and reduce the risk of self-harm. Consider these strategies: [29],[32],[33],[34]

• Encourage open dialogue about mental health to reduce stigma
• Promote connectedness between students, teachers, and peers
• Establish clear policies addressing suicide prevention, intervention, and postvention
• Provide opportunities for student participation and engagement in school activities

Implementing Evidence-Based Prevention Programs

Schools can implement evidence-based suicide prevention programs to educate students, staff, and families about mental health and suicide risk. These may include:[28],[35],[36]

• Curriculum-based learning that explicitly teaches about mental health issues and develops students’ mental health literacy
• School-based peer support programs that train students to recognize warning signs in their peers and refer them to appropriate resources
• Antistigma curriculum interventions that improve knowledge, attitudes, and help-seeking behaviors

Training School Personnel

Regular training for teachers and school staff can help them build the skills and confidence needed to identify and assist vulnerable youth, such as:[32]

• Recognizing warning signs of suicide risk
• Responding effectively to students in distress
• Making appropriate referrals to mental health professionals

Teachers are important in preventing suicide, but they don’t need to handle all prevention tasks alone. Well-trained and supervised individuals, like school staff or community health workers, can effectively carry out proven mental health approaches. [37]

Collaborating with Mental Health Professionals

Schools should work closely with mental health professionals to provide comprehensive support for students at risk of suicide.

• Employing or partnering with community-based mental health providers to offer onsite individual, family, and group treatment[31]
• Leveraging technology, such as validated electronic screening tools and telehealth, to expand schools’ capacities[37]
• Developing emergency plans and protocols for students at high risk of suicide[4]

Engaging Families in Suicide Prevention Efforts

Engaging families is a critical component of school-based suicide prevention. Here’s how:[35],[38],[39]

• Educating parents and caregivers about mental health, suicide risk factors, and warning signs
• Establishing open communication channels between educators and families to share information about students’ well-being
• Providing resources and support for families affected by suicide or mental health concerns

Schools can improve student wellbeing and safety by putting in place wide-ranging prevention programs. These efforts can help promote mental health and identify students who may need extra support. Mental health professionals, prevention specialists, and researchers play a key role in backing school programs and pushing for the funding and resources to make them effective. [37]

Resources and Helplines

If you or someone you know is struggling with mental health issues or having thoughts of suicide, it’s important to reach out for help. There are many resources and helplines available that provide confidential support and guidance.

National Suicide Prevention Lifeline

The National Suicide Prevention Lifeline offers round-the-clock, cost-free, private help for those facing emotional challenges. They also provide crisis prevention resources for individuals and their families. [40]

• Call: 988
• Chat: 988lifeline.

Crisis Text Line

The Crisis Text Line is a free, 24/7 text-based crisis support service. It provides a safe space to talk about what you’re going through and get connected to resources that can help.[21]

• Text “START” to 741-741

Additional Resources

There are many other resources available to help you or someone you care about who may be struggling:

Resource	Description
FindSupport.gov	A website that provides information on how to get support for mental health, drug, and alcohol issues.[41]
Building Connections	A befriending service for children and young people struggling with loneliness, helping them build confidence and resilience.[42]
Child and Adolescent Mental Health Services (CAMHS)	A free NHS service for children and young people under 18 who need professional help for mental health issues.[42]
Samaritans	A 24/7 helpline (116 123) for anyone who needs someone to listen without judgment or pressure.[18]

Self-Care for Those Supporting Young People

When helping a young person with mental health challenges, remember to look after your own well-being too. Consider these self-care strategies:

• Prioritize Your Own Mental Health:
  • Seek therapy or counseling for yourself to manage stress and emotions.
  • Join a support group for parents or caregivers in similar situations.
• Establish Boundaries:
  • Set healthy boundaries to avoid burnout.
  • Balance caregiving responsibilities with personal time.
• Practice Mindfulness and Relaxation:
  • Engage in mindfulness exercises like meditation or deep breathing.
  • Take time for relaxation activities such as reading, gardening, or listening to music.
• Stay Physically Active:
  • Incorporate regular exercise into your routine.
  • Activities like walking, yoga, or swimming can help reduce stress.
• Maintain a Healthy Diet:
  • Eat balanced meals and stay hydrated.
  • Avoid excessive caffeine and alcohol consumption.
• Get Enough Sleep:
  • Aim for 7-9 hours of sleep per night.
  • Create a relaxing bedtime routine to improve sleep quality.
• Take Breaks:
  • Schedule regular breaks throughout the day to rest and recharge.
  • Take short vacations or day trips when possible.
• Connect with Others:
  • Reach out to friends and family for support and companionship.
  • Share your experiences and feelings with trusted individuals.
• Educate Yourself:
  • Learn about mental health issues and effective coping strategies.
  • Stay informed about resources and support systems available for both you and your child.
• Engage in Hobbies and Interests:
  • Dedicate time to hobbies or activities that bring you joy and relaxation.
  • Pursue creative outlets like painting, writing, or crafting.
• Create a Support Network:
  • Build a network of supportive individuals who can offer assistance and understanding.
  • Rely on trusted friends, family members, or community resources.
• Practice Self-Compassion:
  • Be kind to yourself and acknowledge the challenges you face.
  • Celebrate small victories and progress, both for yourself and your child.
• Monitor Your Stress Levels:
  • Recognize signs of stress and take proactive steps to manage it.
  • Use stress-reducing techniques like journaling or talking to a trusted friend.
• Stay Organized:
  • Keep track of appointments, medications, and important information.
  • Use planners or digital tools to stay organized and reduce overwhelm.
• Focus on Positivity:
  • Maintain a positive outlook and focus on the strengths and resilience of both you and your child.
  • Practice gratitude by acknowledging the positive aspects of your life.
• Set Realistic Expectations:
  • Understand that progress may be slow and setbacks are normal.
  • Be patient with yourself and your child, and adjust expectations as needed.

Taking care of yourself is essential when supporting a child with suicidal ideation. By implementing these self-care tips, you can maintain your well-being and be better equipped to provide the support your child needs.