“How to Human” with Dr. Diana Morelen: What parents should know about teens and suicidal thoughts

Scared Mother

Dear Scared Mother,

My mama heart aches knowing that your mama heart is suffering. When we love people, we hurt when they hurt. I hope you are leaning into your support systems as you navigate how to help your daughter.

Please know you, your daughter, and your family are not alone. Suicidal thoughts are relatively common with about 1 in 5 teens reporting having had suicidal thoughts. Some folks think that we shouldn’t talk to teens about suicide; however, the research suggests that talking about suicide and mental health reduces the risk of suicidal behaviors because it allows youth to know that they’re allowed to express their thoughts, feelings, and concerns. The fact that your daughter told you shows me that she felt safe enough to come to you. It’s that connection and sense of safety that will be a crucial ingredient in promoting safety and wellness moving forward.

Before I go on, let me offer a few tangible resources:

• 988 is the national mental health crisis line or text TALK to 741741

• If you or anyone you know is having serious concerns about hurting or killing themselves, it’s best to go to a local crisis stabilization unit or emergency room.

• In Johnson City, Frontier Mental Health has Turning Point, a 24/7 walk-in mental health support center (1-877-928-9062)

• The American Foundation for Suicide Prevention offers free resources, including guides for parents: https://afsp.org/teens-and-suicide-what-parents-should-know

Here are a few steps to help parents lower risk for suicide and promote mental health for their kiddos:

1. Create a family culture that normalizes feelings and struggles with mental health: One way we can all help is by normalizing that it’s okay to not feel okay. As a culture, we have room to grow in our ability to talk about hard things. In families, it’s important to find ways to create a family climate that allows for discussion of stressors and negative emotions (such as sadness, anxiety). The more we can create family routines around checking in about mood, feelings, and well-being, the easier it is to know when someone in the family might be struggling mentally. The majority of youth who experience suicidal thoughts are also experiencing anxiety, depression, or other mental health problems.

2. Watch, listen, and wonder: Be curious about your child’s inner and outer world. Notice changes to mood and behavior. Some (but not all) possible warning signs of mental distress include changes to sleep, changes to appetite, changes to mood, increased irritability, feeling panicky or on edge, increased isolation or withdrawal, and/or changes to social activity. Be intentional to ask your child how they’re doing and feeling regularly, not just when things seem strained.

3. Ask, listen, validate. Ask: If you’re worried that your teen is experiencing suicidal thoughts and/or mental distress, let them know you’ve noticed that something seems wrong and ask them how they’re doing/feeling. It’s okay to directly ask teens if they’ve had or are having thoughts about suicide. There’s no one right way to ask, but here is some possible language: “I’ve noticed some differences in you lately and I’m wondering how you’re doing” … “Have you had any thoughts about hurting yourself or killing yourself?”

Listen: Really listen to what your child shares. Don’t try to fix or problem-solve in that moment. Try to stay calm and curious. Don’t interrupt.

Validate: Let your child know that their feelings are valid (normal, okay, understandable). Instead of saying, “Oh don’t say that” or “You shouldn’t feel bad,” or “but you have so much to be grateful for…” try saying “I can see this is really bothering you,” or “I hear how sad you’ve been feeling” or “I’m so glad you told me.”

4. Get familiar with some of the risk factors for suicide (for a full list check out asfp.org): mental health struggles, substance use, serious physical health concerns, stress, being bullied, major stressful life events (e.g., loss of a loved one, divorce, rejection, major transitions), exposure to another person’s suicide, family history of suicide, and/or history of abuse, neglect, or trauma.

5. Get familiar with some of the protective factors against suicide: mental health treatment, feeling connected to family and community, problem solving and coping skills, activities or groups that promote a sense of purpose and self-esteem.

6. Keep your house safe: Access to firearms and access to medications are two of the biggest risk factors for suicide attempts. If you have firearms in your home, please ensure they are properly locked and that no children/teens can access them (check out Moms Demand Action Guide to Secure Gun Storage Devices online for more info). The same is true for potentially lethal, toxic, or dangerous medication (many local anti-drug coalitions will provide free medicine lock boxes).

For parents like you who have a child who expresses suicidal thoughts, my additional tips are:

1. If you’re worried about safety, go to your local crisis stabilization unit or emergency room for a safety evaluation.

2. Connect with an evidence-based therapist ASAP (check out effectivechildtherapy.org for more info on how to find an evidence-based provider).

3. Continue to treat your child as normally as possible. Don’t tiptoe around the topic of suicidal thoughts or mental health as though it’s some dark and scary thing to keep secret. Try to approach this like you would if your child were experiencing a physical health concern and needed treatment. If your child had strep or chronic ear infections, you’d probably tell your friends and neighbors so they could help, pray, support, etc. I encourage you to approach mental health challenges the same way. Name it. Normalize it. It’s nothing to be embarrassed or ashamed about. Mental and physical health are interwoven, and mental and physical health challenges are quite normal. The more we can normalize that mental distress is a common experience, the more easily we can get the help we need and reduce stigma and shame around mental distress.

4. Work with mental health providers to develop a formal safety plan for your home and your teen.

Please remember. You are not alone. This is not your fault. This is not your daughter’s fault. Suffering is a normal part of life, and your daughter had the brave vulnerability to come to you and let you know that she was suffering. There is hope. We’re not meant to do this alone, please connect with the supports that you need (friends, family, church, therapy) to take care of yourself as you are committed to the ongoing work of taking care of your daughter. I hold much compassion and hope for your family. Take care.

Dr. Diana Morelen is a licensed clinical psychologist, associate professor in the Department of Psychology at East Tennessee State University, and an associate director for the ETSU Ballad Health Strong BRAIN Institute. Her passion for learning and exploring started as a child of the Chesapeake Bay and her steady curiosity now finds itself rooted in the Blue Ridge mountains of Southern Appalachia, where she calls Johnson City home.