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Helping children & youth who are feeling suicidal

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Many young people have thoughts about ending their lives. A recent study by CHEO staff found that 1 out of 3 teen girls, and 1 out of 7 teen boys reported thoughts of suicide in the past. This fact sheet will help you support youth who are having thoughts of ending their lives.

Typical stresses include:

Relationships

  • Feeling disconnected from family or close friends;
  • Conflict with others (parents, brothers, sisters, friends, peers, co-workers, employers);
  • Bullying (in person or online);
  • Parent’s separation or divorce.

School

  • Problems with schoolwork, peers, bullying, peer pressure, teachers.

Mental health problems

  • Depression, anxiety, eating disorders, or addictions. These could be problems that youth, parents or other family members are experiencing.

Keeping ‘secrets’ from others

  • Youth who are gay, lesbian, bisexual or transgendered may feel pressured to hide their sexual orientation or gender identity from others, causing immense stress. This is usually out of fear, because they worry about being rejected should they be ‘outed’. Other secrets include sexual abuse, which children and youth often hide from parents. 

Children and youth can feel suicidal when they feel:

  • Disconnected from others;
  • Helpless to deal with their stress;
  • Hopeless that their stress or situation will not improve.

You can help a young person who is feeling suicidal by helping them to:

  • Feel more connected with others again;
  • Gain a sense of control over their lives (to overcome helplessness);
  • See that things will get better (hope!).

When people have overcome their feelings of suicide, there is one protective factor that stands out – a supportive relationship with at least one significant other...  Be that person who matters!

What are some warning signs for suicide?

Children and youth may be thinking about suicide if they:

  • Talk about suicide and about what it would be like if they were gone. For example, they may say things like, “When I’m gone ...” or ask questions like, “What would it be like if I wasn’t around?”
  • Express feelings of worthlessness, for example, “I’m no good to anybody .”
  • Seem hopeless about the future, saying things like, “What’s the use?”
  • Become pre-occupied with giving away their belongings.

What should we do if we think our child or teen is having thoughts of suicide?

It is not easy to talk about suicide. You may be worried about ‘planting’ ideas of suicide in your child’s mind. But don't be afraid to ask about suicide. Studies show that you cannot ‘plant’ ideas of suicide in someone’s head. Hopefully your child will never feel this way, but if she does, the fact that you have raised the topic will make it easier for your child to confide in you...

Talk about it.

  • Start gently, by first asking how your child or teen is feeling. (How are you feeling?)
  • Start slowly, by asking some general questions... 

Listen.

  • It’s important to give your child or teen a chance to respond to your first question.

Express your concerns

  • (“I love you and I’m worried about you.”)

Remark on what you’re noticing

  • (“It seems like things have been stressful for you lately.”)

Bring up suicide

  • (“Does it ever get so stressful that you think life isn’t worth living?”)

Ask more if needed

  • (“Do you get thoughts of doing something to end your life?”)

My child says that he is feeling suicidal, and has plans to end his life.

Trust your instincts!

Even if your child says “no” when you directly ask about thoughts of suicide, trust your instincts. If you are worried your child or teen is in immediate danger for suicide, then get help.

If y our child is expressing that she cannot stop thinking about suicide and has imminent plans to hurt herself, seek professional help right away: 

  • Don’t leave your child alone:
    make sure that there is someone with your child, whether it is you or a close friend or family member.
  • Call a telephone crisis line
    for example, the Child, Youth and Family Crisis Line for Eastern Ontario, 613-260-2360 or toll-free, 1-877-377-7775. Call 911 if your child or teen is going to carry out a plan to kill themselves, or has made an attempt.
  • Get support for yourself during this time of crisis
    If you have contacted professional help, then consider calling a close family member or friend to support you as you get help for your child.

PLEO (Parent’s Lifelines of Eastern Ontario), a support group for parents of children and youth with mental health difficulties. 613-321-3211 toll free: 1-855-775-7005

For more information about help in your community, see the ‘Getting help’ section at the end of this fact sheet.

Helping children and youth feel that life is worth living

No matter what stress youth are feeling, you can help youth who are feeling suicidal by helping them to:

  • Feel more connected with others again;
  • Gain a sense of control over their lives (to overcome helplessness);
  • See that things will get better (hope!).
  • Strengthen your relationship with your child
    A strong parent-child relationship is the single most important factor that helps any young person with stress.

“But my child doesn’t want to spend time with me! He’d rather spend time with his friends!” Friends and peers are very important to teens. Although it is healthy for teens to have friends and social activities, this shouldn't completely replace parents and family. Friends can never give the same love and support that parents can. And teens really do need this special love and support that only parents can give. The good news is that there are ways to strengthen your relationship with your child. It may not be easy at first, but it is well worth the effort. Your child really does need you.

  • Spend regular time with your child, ideally one on one
    Invite your child to go on ‘dates’ with you outside of your home. Or find things you can do at home together: cooking, baking, a home project, tossing a ball around outside. Try to find at least one time every day, where you can spend quality time with your child. This gives your child the chance to share feelings or confide in you about what's really going on. Remember that quality time is not asking about homework, chores, or anything that your child might see as criticism. Quality time is about creating a warm atmosphere where your child feels willing to share feelings. It's a chance for you to validate those feelings.
  • Listen and validate
    When your child tells you how she is feeling, thank your child or teen for sharing with you. “I didn’t know you were feeling so bad... Thanks for telling me.”
  • Show empathy
    This means accepting how bad your child or teen is feeling. “Yeah, I can see that would be very difficult.” What not to say:
    • “You shouldn’t be feeling this way”
    • “It’s not that bad”
    • “You should count yourself lucky”
    • “How can you be feeling so bad when we’ve given you so much? What do you expect from us?”
    These comments can make children and youth feel guilty and ashamed, and they might not open up to you any more. Blaming children and youth only makes them feel worse, and may confirm to them that they are a burden for you. This could increase the risk of suicide.
  • Avoid jumping in with advice or criticism
    Because as parents we have more life experience than our children, we think we are being helpful when we offer advice or criticism. Even though we mean well, children and youth need to feel 'heard', understood and accepted. Giving advice or criticizing can seem to a child that we are not really hearing them, and really don't understand what she is going through.
  • Give hope
    You might say: “This is going to get better.” If things were better in the past, you might say, “I will be with you and we’ll work on this and get through it as we did before.” Help your child remember how he has overcome other challenges and remind him how he used his strengths to get through that difficult time. Assure your child or teen that she is not alone. You might say: “We’re in this one together; we’re going to help you get over this.”
  • Offer support, but ask your child how he wants to be supported
    Ask questions like: “How can I support you? How can I help you with this?” Don’t give advice if your child doesn't ask for it. Youth will ask for advice if they want it. If you are unsure, ask: “How can I support you? Do you want me to just listen, or do you want my advice?” 
  • Whenever you say goodbye, talk about the next reunion
    If your child is leaving for school, then you might say, “Have a great day at school! I’ll see you after school, and I look forward to our walk together!”
  • Help with problem-solving
    Children and youth can think about suicide when they are overwhelmed by stress. Even if those stresses don’t directly cause suicidal feelings, stress certainly doesn’t help. You can help with problem solving by saying something like:
    “Sometimes people think of hurting themselves when they’re under stress or trying to deal with some problem. I’m here for you and I want to help you work through this. Is there something that is stressing you out right now?”, or “Is there a problem you’re trying to work out?”
    If y our child or teen is unsure about what is bothering him, you might just ask about the usual stresses like school, friendships, peer pressure, bullying, relationships ( girlfriends or boyfriends), teachers or schoolwork.
  • Get professional help
    You can be a great support, but remember- you are not a therapist. And even if you are a trained therapist, your role is to be your child’s parent or caregiver, not a therapist. For all these reasons and more, if your child is feeling that life isn’t worth living, speak to a professional. Make sure you have the support you need too; either through your network of friends or family, or by finding a therapist. It can be extremely stressful caring for a child who is depressed or suicidal. It's important for you to have support at this difficult time, so that you continue to have the energy to care for your child.

Helping your child or teen stay safe at home

When a child or teen has thoughts of suicide (whether these thoughts are active or not) it’ s important to make your home a safer place.

  • Make sure your teen has developed a safety plan with their mental health care provider.
    We use this resource at CHEO: Safety plan for youth
  • Be mindful of ‘triggers’ and high risk periods
    Identify situations and times that may be especially difficult for your child or teen, and make appropriate plans. During high risk periods (like holidays, anniversaries, or times when close supports are away), be extra careful and:
    • Check in often with your child or teen.
    • Do not leave your child or teen alone for long periods. If you have to go out, take your child or teen with you. If you absolutely cannot get your youth to come along, then have someone stay with your child.
  • Remove firearms and weapons
    Make sure that there are no firearms, ammunition nor weapons in your home. Or make sure they are stored in a securely locked firearms cabinet, and keep the keys with a neighbour, your work - place, or some other place where your child cannot easily find them. In a crisis, you can also call your local police station to see if they would store them for you temporarily.
  • Remove alcohol
    Alcohol is a risk factor for suicide. Alcohol affects rational thinking and can make children and youth more impulsive. Remove alcohol from your home, or only keep small amounts. 
  • Medications
    • Lock up all medications, even non-prescription ones. Acetaminophen (Tylenol™), acetylsalicylic acid (ASA or Aspirin™) can be very dangerous overdoses.
    • People who are depressed often overdose on their depression medications. Fortunately, many newer medications for depression (Fluoxetine/Prozac™ Fluvoxamine/Luvox™, Sertraline/Zoloft™, Paroxetine/Paxil™, Citalopram/Celexa™) are much safer than the older medications, even in overdose. Even so, it’s still important to keep these medications under lock and key.
    • Ask your doctor to prescribe only safe amounts of medications. When you fill prescriptions, ask the pharmacist to dispense safe amounts. This makes it more difficult for your child or teen to overdose.
    • Supervise children and youth when they take medication. Medication times can be a good time to check in with your child or teen. But discuss this with your child or teen first.
    • Take all unused or out-of-date medications to your local pharmacy for disposal.

 (Enlarge image)

Imagen of a house with message of what to remove and/or lock up

  • Remove any other means of suicide
    Remove or lock up cords, ropes, sharp knives, or other obvious means of self-harm.
  • Hide car keys
    Keep car keys hidden so youth can’t use your car to hurt themselves.
  • Lock up things in the car
    If you don’t have other ways to lock things up, you can lock firearms or medications in your car (the trunk is best).

Going to the hospital: things to consider

There are some important things to know when you bring your child or teen to the hospital (because of suicidal or violent episodes):

  • Going voluntarily is best
    It’s best if you can get your child or teen to agree to go the hospital voluntarily. If you can’t get your child or teen to agree to go to the hospital, ask someone your child or teen trusts to try to convince her (include this person’s name and number in your emergency action plan).
    Try to offer a choice, like “Will you go to the hospital with me, or would you prefer to go with (other trusted relative or friend)?” This helps children and teens feel like they are part of the plan, and not so helpless.
  • Age of consent
    Youth (generally 12 and older) may ask to speak with health professionals in the emergency department without parents in the room. If this happens, you can still ask to speak directly with the professionals looking after your teen afterward. Ask about the plan, and what you can do to help support your teen.
  • Possible outcomes
    Most youth who visit an emergency department for a mental health problem are not admitted to hospital. You need to be prepared for this. Most of the time, youth are assessed and a community plan of care is developed.

For more information, check our resource: Children and youth in crisis: What to expect in the Emergency Department (CHEO)

What if the hospital discharges my child or teen, but I think she should be admitted?

Mental health care providers today usually don’t see admission to hospital as the best way to treat mental health problems. At CHEO, we usually only admit patients to resolve an immediate crisis. Because of this, ED staff may not feel that an admission is the best treatment plan. It is still important to share your hopes for your child or teen’ s treatment, as well as your concerns, with ED staff. 

If your child is at immediate risk for suicide, or you are afraid for your child’s immediate safety:

  • Call 911 for emergency services (for example, if your child or teen’ s life is in immediate danger).
  • For children and youth up to age 18, you can take your child to the Emergency Department at CHEO
  • For youth aged 16 and older, you can take them to any hospital

If you discover your child or teen after a suicide attempt:

  • Call 911 (or an ambulance) right away.
  • Give first aid if you’ve been trained.
  • Phone someone to go with you to the hospital; or to stay with you at home.
  • After you come home from the hospital, do not try to handle things alone. Make sure you have relatives or friends to talk to. Think about contacting a support group, counselor or therapist for yourself as well.

Emergency Action Plan

A crisis is not the time to be running around searching for phone numbers. Make an emergency action plan ahead of time. It will be easier knowing exactly what to do and how to get help in an emergency.

Names and numbers:

  • People I can call day or night for support
  • Health care professionals (Doctors or other therapists)
  • Hospital (the one your child or teen uses)
  • Helpful people that my child trusts in the event of an emergency (These would be helpful people that could support, or give advice to your child) 
  • Emergency child care (in case you have to leave other children at home to go with your child to the hospital)
  • Name of Power of Attorney (if applicable) (consider a power of attorney if your child is aged 16 and above)
  • Pharmacy (where you get medications from)
  • Medications (including dosages)

Finding help in Ottawa

In a crisis?
Child, Youth and Family Crisis Line for Eastern Ontario, 613-260-2360 or toll-free, 1-877-377-7775

Looking for mental health help?
eMental Health is a bilingual directory of mental health services and resources for Ottawa, Eastern Ontario and Canada.

Finding help in Eastern Ontario

In a crisis?
Child, Youth and Family Crisis Line for Eastern Ontario, 613-260-2360 or toll-free, 1-877-377-7775

Looking for mental health help?
eMental Health is a bilingual directory of mental health services and resources for Ottawa, Eastern Ontario and Canada.

  • Renfrew County: Phoenix Centre for Children, Youth and Families, with offices in Renfrew and Pembroke. 613-735-2374 or toll-free 1-800-465-1870
  • Leeds and Grenville County: Children’s Mental Health of Leeds and Grenville, with offices in Brockville, Elgin, Gananoque and Prescott. 613-498-4844
  • Lanark County: Open Doors for Lanark Children and Youth, with offices in Carleton Place, Smiths Falls and Perth. 613-283-8260
  • Stormont, Dundas, Glengarry and Akwesasne (Cornwall Island): Single Point Access-for all child, youth, family and mental health services. Services in French and English. Main office, Cornwall, Ontario 613-938-9909 Toll free 1-888-286-KIDS (5437). Satellite office in Winchester.
  • Cornwall and area: Child and Youth Counselling Services (CYCS)- (Cornwall Community Hospital) provides assessment, therapy, and counseling. Services provided in English. Office in Cornwall 613-932-1558, limited outreach services in Winchester office.
  • To find a psychologist anywhere in Ontario: College of Psychologists of Ontario, 1-800-489-8388

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