Suicide is a scary topic for parents, no matter your child’s age. But it’s important to face it to help protect them, and don’t wait until they’re teenagers to talk about it.
“People have historically thought that kids under the age of 10 don’t have suicidal thoughts, that these are thoughts that develop in adolescence,” says Adam Bryant Miller, PhD, associate director of UNC’s Child and Adolescent Anxiety and Mood Disorders Program, whose research focuses on suicide risk.
Suicide is the second leading cause of death for 10- to 24-year-olds in the United States, but “in trying to prevent suicide, we’ve started looking earlier and have found early warning signs.”
Last year, Dr. Miller and his colleagues published findings from a study in which 5- to 10-year-olds were asked about their thoughts of suicide; out of 98 children who were recruited into a study for potential trauma exposure, 34 reported passive suicidal ideation (a wish that they’d never been born or that they’d go to sleep and not wake up) while 33 reported active suicidal ideation (an explicit thought about killing themselves).
Research is continuing to better understand suicide risk in younger children. What we do know is that it’s important to start talking about suicide prevention early so that your child knows you’re there to help them, Dr. Miller says.
Here’s what parents should know.
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Asking children about suicide is safe.
Sometimes, people are afraid to discuss suicide because they’re scared they’ll put the idea in someone’s head. Dr. Miller’s work has not found these questions cause distress or danger, and other research has found the same.
“Our data so far suggests that you can safely ask kids about suicidal thoughts without negative effects,” Dr. Miller says. “Asking doesn’t give them the idea or increase the likelihood of suicide, but it will help you know if they have these thoughts.”
Your child may not fully understand what suicide is yet, but Dr. Miller says most kids have a good understanding of death between the ages of 5 and 7.
“In typical development, children that age understand that death is universal, happens to everybody and can be caused by the failure of some system in the body,” Dr. Miller says. “Even if they don’t have a complete understanding of suicide, it doesn’t mean they’re not experiencing those thoughts about wanting to die or not wanting to be alive.”
Your child might be afraid to tell you about these thoughts, which is why it’s important to ask.
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It’s OK to be direct and straightforward.
If you see changes in the mood, interests and energy level of your child, ask them how they’re feeling and if you can help. But you don’t have to wait for a separate conversation about mental health or emotions to bring up suicide.
“Sometimes parents assume they should do more lead-in to the subject than they actually need,” Dr. Miller says. “You can be straightforward and say, ‘Sometimes kids have scary thoughts about wanting to be dead. Have you ever had thoughts like that?’ Kids are usually unfazed. They say yes or no and move on.”
You know your child best and know what vocabulary they have around death, so you can tailor your approach when you ask the question.
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Reassure your child that you can help (and have a plan ready).
Before you ask your child if they’ve experienced suicidal thoughts, have a plan for what you’ll do for each answer.
If your child hasn’t experienced those thoughts, tell them that there is help for kids and adults with these types of scary thoughts, and if they ever have them in the future, you’re there to support them.
More importantly, think through what you’ll say if your child says they are having these thoughts.
“Don’t invalidate them by saying, ‘You don’t mean that’ or, ‘You’re not serious about that,’” Dr. Miller says. “It’s scary, but be prepared to validate and express gratitude to your child for sharing their thoughts with you.”
Ask your child about when they had these thoughts and what was going on when they had them. Talk to your child’s doctor or a mental health professional about any concerns you have.
Dr. Miller recommends the online resource Effective Child Therapy (from the Society of Clinical Child and Adolescent Psychology) for finding evidence-based therapies for your child and the 988 Lifeline, where counselors are available to talk confidentially to the parents and loved ones of someone who is experiencing suicidal thoughts.
“The interventions for older youth—cognitive behavioral therapy, dialectical behavior therapy and other therapies—are likely helpful for little kids, too,” Dr. Miller says.
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Try to keep your own emotions regulated.
It’s incredibly difficult to hear your child has had thoughts of wanting to die, but try to keep your own emotional response in check so that you don’t scare your child.
“A ton of emotion could cause the child to shut down and think they’ve said something wrong,” Dr. Miller says. “Parents aren’t robots, though, so a middle ground is appropriate. You can tell your child that you’re sad and worried but that you want to help.”
If your child fears a huge response from you, they could stop sharing how they feel. Try to stay calm and show that you can handle tough conversations with them. If you think you’ll need more support with this conversation, talk to your child’s doctor about how to approach it.
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Know that you can still set boundaries when a child is struggling with mental health.
If you know your child is struggling, you may fear enforcing rules or assigning chores because you’re worried they’ll get more upset and want to hurt themselves.
“Kids need boundaries, consequences and limits to keep them safe,” Dr. Miller says. “Continue to parent and discipline your child the same way you normally would.”
Make sure your home is a safe place, especially if you’re concerned about your child harming themselves. Be sure that your child can’t access any knives or sharp objects and lock up household cleaners, alcohol and medications. If you have a gun in your home, be sure it’s locked in a place your child cannot access, with ammunition stored and locked separately.
For help figuring out how to reduce access to potentially dangerous items such as guns and knives in your home, Dr. Miller recommends the resource Lock to Live.
Also, “you might need to set some different ground rules if you’re concerned about their behavior,” Dr. Miller says. “Maybe there needs to be a temporary rule that if they’re in their room, the door can’t be closed.”
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Check in with your child regularly.
As with other important topics, this isn’t a conversation you can only have once.
“Families tend to come up with their own system for regular check-ins and having difficult conversations,” Dr. Miller says. “Some kids like to write a note or use code words if they’re having certain thoughts, but it’s also important for parents to continue asking in a straightforward way.”
When suicide is in the news because a prominent person died, discuss it with your child.
“Don’t think that if you don’t talk about it, your kid won’t hear about it,” Dr. Miller says. “They will hear about it, so you want to be the one having those conversations with them. Be upfront: that person’s brain was not working correctly, but we can help people like this.”
If you or someone you love is struggling with thoughts of suicide, call or text 988, the Suicide & Crisis Lifeline. Your doctor also can help. If you need a doctor, find one near you.