Keeping Teens Safe: What parents must know about suicidal Thoughts & self-Harm

We work every day with teens who think about hurting themselves or about dying.  Part of our job is to help parents understand this, and how to respond.  Here's the most important things for adults to know about suicidal thinking and self harm in teens.

Suicidal Thoughts: Many teens who struggle with anxiety, depression or difficult life challenges think about ending their life at some point.   Most commonly these thoughts will be something like “there is no point to life”, “I may as well be dead”, “I don’t want to live anymore”.  Some studies have suggested up to 30% of teens will think about suicide at this level.  Other, more distressed teens, will thoughts like these and ALSO will think about a specific method and time for them to kill themselves.  This is a higher level of suicidal ideation and is less common.

Self-Harm:  Other teens do not have suicidal thoughts but DO deliberately hurt themselves.  In other words, teens are not trying to die but instead are trying to manage or control their distress.  These teens might cut, hit or burn themselves.  Most teens who self-harm do NOT intend to kill themselves, but tragically some teens accidentally do so while they are self-harming. 

Some teens have both suicidal thoughts AND self-harm, other teens have just one or the other.

What can parents do?
 

1.Know common life triggers for depression, self-harm and suicidal ideation in teens.

It is important to be aware the common triggers for self harm or suicidal thinking in teenagers.  While this situations do not necessarily lead to self harm or suicidal thinking, they increase the risk of this happening.  These include:

  • Having been abused or assaulted
  • Having intense conflict with someone – parents or friends
  • Knowing another person who has suicided
  • Feeling exceedingly stressed about school work
  • Experiencing  anxiety and depression
  • Being isolated and feeling “on the outer”
  • Thinking about or identifying as being lesbian, gay, transgender or bisexual
  • Going through a relationship break up

Remember that going through a life event such as these does not necessarily mean a teen will becme suicidal or self harm.  But it is important to know that teens are at higher risk when these life events occur.

2. Know the warning signs for depression, self-harm and suicidal ideation in teens.  

It is useful to know the warning signs of depression, self harm and suicidal ideation in teens.  In other words, these are the signs within teenagers themselves which suggest they are struggling and are at higher risk of thinking about suicide or self harm.

  • Not wanting to be with friends
  • Drinking heavily alcohol or using drugs
  • Wanting to spend lots of time alone
  • Talking or Joking about suicide (Higher risk)
  • Crying more than usual
  • Writing stories and poems about suicide (Higher risk)
  • Fatigue and oversleeping
  • Not wanting to be with friends (Higher risk)
  • Not wanting to go to school, work, sport
  • Giving prized possessions away (Very High risk)
  • Not enjoying activities
  • Writing a suicide note (very High risk)
  • Increased irritability and aggression
  • Increasing panic, agitation or anxiety

Remember that one warning sign by itself, doesn’t necessarily mean a teen is depressed, self harming or suicidal.  These warning signs are more serious when more than one happens at the same time.

3. It is vital to regularly check in on the safety of your teen when difficult life situations or warning signs occur.

If you know your teen has some of the life triggers as listed above OR you suspect your teen is very sad for another reason, it is very important to ask your teen about how they are feeling. 

Starter questions:

  • How are you coping with life?
  • How have you been feeling?
  • You seem really sad – do you know what has been making you feel so bad lately do you know?
  • Is it things to do with school, friends, relationships or family which make you feel the worst? 
  • What is the worst thing about all of that?  
  •  What are you most worried about?  
  • What is the worst thing that will/could happen do you think?

Questions about self-harm

  • I know there are a few teens when they are feeling bad, who hurt themselves or cut themselves? Have you ever deliberately hurt or cut yourself?
  • What did you do?
  • When you hurt/cut yourself, do you think you just wanted to die, or was it for another reason, like to try to make yourself feel better in some way?
  • Have you thought about hurting yourself again?  Do you think you will?  How do you think you might try to hurt yourself again?  When do you think you might do that?

Questions about suicidality

  • Have you ever felt so bad that you have felt like ending your life?
  • Have you thought about what you would actually do to kill yourself? 
  • How would you do that?
  • Have you thought about a time or a date that you would kill yourself?
  • What stops you, if anything, from doing that?
  • Is there anything that might happen that would make you definitely follow that plan?
  • Have you ever actually tried to end your life previously?  What did you do?

4. Act immediately if you think there is an immediate threat that a teenager might hurt themselves:

Do not leave your teenager alone.  Take them directly to the Emergency Department of your local hospital.  (Special note for SA based families:  There are mental health workers experienced with teens on duty at Flinders Medical Centre during 9am-4pm, and 24/7 on duty at the Women's and Children's Hospital ( 81617000).  You can also call the Women's and Children's Hospital Switchboard 24/7 and ask to speak to the Emergency Mental Health Nurse.)

5. If you think there is a higher than normal risk, but do not believe your teen will hurt themselves in the immediate future - still take these three actions

First, reduce the method and opportunities for teens to hurt themselves.  Remove access (as much as possible) to all medication (including over the counter pills such as paracetamol and aspirin), ropes, cords, belts , alcohol and drugs ,firearms and razors, knives and broken glass, as far as possible.  Also, do not allow the teenagers to spend time in their room with the door shut, at home alone or to drive if they are distressed

Second, Provide empathy and support, don’t get angry or be shocked. Don’t get hung up on “why” the teen feels this way or whether they “should” or “shouldn’t” feel this way.  Don’t spend too long trying to convince the teen that they shouldn’t be sad or upset. Instead, show empathy and care by saying things like: I’m so sorry you feel so bad, I wish I could make you feel better and is there anything I can do?

Third, provide your teenager with 24 hours access to yourself AND OTHER SUPPORTS:  Remind the teen they can talk to you anytime, and also provide your teenager to other supports.   Remind them of other adults they can talk to, either teachers, school counsellors, aunts and uncles and other supports.  Also email or write down for them the lifeline number (13 11 14) and the Kids Help Line (1800 55 1800) both of which are 24 hour a day phone numbers.  Also email or write down for them the following websites which have 24 hour live chat/email counselling Reachout.com.auHeadspace.org.au, and  kidshelpline.com.au (note - this is for kids AND teens AND young adults up to the age of 25)

Finally, Organise ongoing counselling for your teenager.  Start by contacting your GP.  If your teen already is accessing counselling, tell the counsellor about the suicidal ideation or self-harm.


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