Keeping Teens Safe – Suicidal Thoughts and Self-Harm

Suicidal Thoughts: There are many teens who at some point during adolescence struggle with feeling depressed and hopeless about life, and who then think about ending their life.   Most commonly teens have occasional thoughts like “there is no point to life”, “I may as well be dead”, “I don’t want to live anymore” but do not have thoughts about specific plans or times to kill themselves.   Other, more distressed teens, have more frequent thoughts and ALSO have a specific method in mind for which they would kill themselves.  This is a high level of suicidal ideation.

Self-Harm: Many teens do not have suicidal thoughts but deliberately hurt themselves – not in an attempt to die, but because they are trying to distract themselves or control their distress.   They might cut, hit or burn themselves.  Most teens who self-harm do NOT intend to nor do they kill themselves, but tragically some teens do accidentally kill themselves 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?

Know common life triggers for depression, self-harm and suicidal ideation in teens, for example:

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

Know the warning signs for depression, self-harm and suicidal ideation in teens, for example:

  • 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.

Check in on the safety of your teen:  If you know your teen has one or more 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 has made it worse recently?  
  • 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?

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. 

If you think there is a higher than normal risk, but do not believe your teen will hurt themselves in the immediate future

First, remove 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.au, headspace.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