When a child is struggling emotionally, parents often recognize that something has changed before they understand why. Their child may seem unusually quiet, irritable, exhausted or disconnected. Friends and activities that once mattered may suddenly hold little interest. A parent may know that a conversation is needed but worry about saying the wrong thing—or making the situation worse by mentioning suicide.
Asking directly about suicide does not increase suicidal thoughts or place the idea in a child’s mind. A calm, straightforward question can give a struggling child permission to express something they have been unable or afraid to say.
In recognition of World Suicide Prevention Day on September 10, Sandy Springs Pediatrics is sharing factual, practical information to help parents recognize possible suicide warning signs in children and teens, begin a supportive conversation and know when to seek professional help.
Youth Suicide Rarely Has One Cause
Suicide is complex and generally cannot be attributed to one event, diagnosis or family circumstance. According to the American Academy of Pediatrics, youth suicide risk may involve a combination of individual, relationship, community and societal factors.
Mental health conditions, a previous suicide attempt, social isolation, substance use, bullying, family or peer conflict, traumatic experiences, barriers to healthcare and access to lethal means can all contribute to risk. However, the presence of one or more risk factors does not mean that a child will attempt suicide.
Protective factors matter as well. Supportive relationships with caregivers, strong connections to friends and community, access to pediatric and mental healthcare, coping and problem-solving skills, and limited access to lethal means may all help protect young people.
Suicide Warning Signs in Children and Teens
Not every child experiencing suicidal thoughts will display obvious warning signs, and not every concerning behavior means a child is considering suicide. Parents should pay particular attention to emotional or behavioral changes that are new, increasing or connected to a painful event, loss or major transition.
Possible youth suicide warning signs include:
- Talking about wanting to die, having no reason to live or feeling like a burden
- Expressing hopelessness, unbearable pain, guilt, shame or feeling trapped
- Withdrawing from family, friends or previously enjoyed activities
- Showing significant changes in sleep, eating habits, mood or school performance
- Becoming unusually anxious, agitated, angry or irritable
- Giving away meaningful possessions or saying goodbye in an unusual way
- Taking dangerous or uncharacteristic risks
- Increasing alcohol or drug use
- Researching or making a plan for suicide
Statements such as “Everyone would be better off without me,” “I wish I could disappear” or “Nothing is ever going to get better” should not be dismissed as attention-seeking or typical adolescent behavior. Any mention of suicide, self-harm or not wanting to be alive should be taken seriously.
How to Talk to Your Child About Mental Health
A child or teenager may not volunteer what they are feeling. Some young people worry about frightening or disappointing their parents, being judged, losing their privacy or creating additional problems. Others may not know how to describe the intensity of what they are experiencing.
Parents can begin by calmly naming what they have observed:
“I’ve noticed that you haven’t seemed like yourself lately. I’m not here to judge or lecture you. I want to understand what you’re going through.”
Choose a quiet setting, limit distractions and allow time for an answer. Try not to immediately correct, reassure or solve the problem. Statements such as “You have so much to be grateful for” or “Things aren’t that bad” may be intended as encouragement, but they can leave a child feeling misunderstood.
More supportive responses include:
“Thank you for telling me.”
“I’m glad you told me.”
“You don’t have to handle this alone.”
“We are going to find help together.”
How to Ask Your Child About Suicide
If a parent is concerned about suicide, it is appropriate to use clear, direct language:
“Have things felt so overwhelming that you’ve thought about hurting yourself?”
“Have you wished you could go to sleep and not wake up?”
“Have you been thinking about suicide?”
The American Academy of Pediatrics states that the best way to support someone who may be thinking about suicide is to ask directly and listen to the answer. Using the word “suicide” helps ensure that both the question and the child’s response are understood.
If a child says no but the parent remains concerned, the conversation should not end there. A pediatrician or qualified mental health professional can assess the child’s symptoms and behavior and determine whether additional evaluation or support is appropriate.
What to Do If Your Child Says Yes
A disclosure of suicidal thoughts does not always mean that a suicide attempt is imminent, but it always requires attention and further assessment.
Remain calm and stay with your child. Listen without expressing anger, disbelief or disappointment. Do not promise to keep suicidal thoughts secret. Protecting the child’s safety may require involving another trusted adult, a pediatrician, a mental health professional or emergency services.
Ask whether the child is in immediate danger, has made a plan or has access to anything that could be used for self-harm. Secure firearms, medications and other potentially dangerous items. Firearms should be stored unloaded and locked, with ammunition locked separately. When there is a safety concern, medications should be secured and dispensed by an adult.
Parents can call or text the 988 Suicide & Crisis Lifeline for immediate guidance, even if the child does not want to make the call. If a suicide attempt is underway, the child has taken something, has access to a weapon or cannot be kept safe, call 911 or go to the nearest emergency department.
Pediatric Mental Health Screening and Support
A pediatrician can be an important first point of contact when parents notice emotional, behavioral or social changes. Comprehensive pediatric care includes both physical and mental health.
The American Academy of Pediatrics recommends universal suicide-risk screening for patients ages 12 and older. Children ages 8 through 11 should be screened when there is a clinical concern, while younger children should be assessed if warning signs are present.
During a pediatric mental health screening, an adolescent may speak privately with a healthcare provider. Confidential time can make it easier for a young person to answer sensitive questions honestly. When a safety risk is identified, parents or caregivers must be involved so that appropriate steps can be taken to protect the child.
Families do not need to wait until a situation becomes a crisis. Persistent sadness, anxiety, withdrawal, sleep changes, declining school performance, self-harm or other significant behavioral changes are appropriate reasons to speak with a pediatrician.
Supporting Child and Teen Mental Health in Sandy Springs
Parents are not expected to have every answer. What matters is noticing meaningful changes, taking a child’s words seriously and being willing to ask a difficult question.
A child may not be ready to explain everything during the first conversation. Continuing to check in calmly, directly and without judgment communicates that difficult feelings can be discussed and that help is available.
Sandy Springs Pediatrics provides pediatric care for children and adolescents in Sandy Springs and surrounding Atlanta communities. If you are concerned about your child’s mood, behavior or mental health, please contact our office. Our pediatric providers can evaluate your concerns, discuss appropriate mental health screening and help your family identify the next steps in care.
If you or someone you know is experiencing suicidal thoughts or emotional distress, call or text 988 to reach the Suicide & Crisis Lifeline at any time. If there is immediate danger, call 911 or go to the nearest emergency department.