Crisis Intervention And Suicide Prevention

  • What are the signs of a mental health crisis?
  • What are the signs of suicidality?
  • How can I help my child manage their mental health and develop coping skills?
  • What do I do if I think my child is suicidal?

Most teens don’t even think about, let alone attempt, suicide. Yet national suicide rates have been increasing over the past 10 years. Many teens who attempt or die from suicide do have a mental health condition, but most often this is not the sole factor.  The stress that comes from being an adolescent combined with many of life’s challenges can make it hard for some young people to cope.  Without the proper coping strategies, they may feel hopeless and turn to self-destructive behaviors as a solution. 

Why it Matters

Mental health issues can be brought on by changes in social life, transitions in family life, stressful or unsafe conditions at home or school; discrimination, social exclusion, unhealthy lifestyle, or exposure to violence and trauma. There are also psychological and personality characteristics that can make people vulnerable to mental illness, as well as biological factors, including genetics and chemical imbalances in the brain. The following is a list of risk factors that are often connected to mental health challenges and mental illness, and suicidality:

  • Poverty
  • Violence and home, school, or work
  • Verbal, emotional, or sexual abuse
  • Family history of suicide
  • Easy access to lethal means like firearms, medications, poison, cars, and ropes
  • Isolation due to living alone, living rurally, or feeling like no one understands you
  • Changes like moving or transitioning to a different job or school
  • Loss of a loved one or a significant relationship
  • Poor health, mentally or physically
  • Lack of social-emotional skills
  • One or more prior suicide attempts
  • Failure at work or school
  • Unrealistic expectations of oneself or inability to accept failure
  • Rejection by peers
  • Harassment due to race, ethnicity, sexual orientation, or gender identity
  • Bullying or being bullied at school/work
  • Suicide of someone with whom they identify with or feel close to
  • Substance abuse (which includes vaping and dabbing)
  • Unemployment
  • Homelessness
  • Incarceration
  • Natural disaster
  • Lack of support services

Protective Factors

The checklist below is a list of protective factors that may help protect against crisis and suicide.  Read through them and note which ones you feel describe your teen’s current situation.

Overall has positive physical, mental, and emotional health.
Lives in a safe home and community and attends a safe school.
Has positive, loving, and supportive relationships.
Has typical intellectual, social, and physical competence for their age
Uses Social-Emotional Skills (e.g., “ life skills,”  like self-awareness, relationship skills,  self-management, anger & stress management, responsible decision-making, problem-solving, communication skills)
Has a sense of autonomy, empowerment, and boundaries.
Believes their life has meaning and purpose.

Warnings Signs

This checklist is for parents who are concerned about whether or not their teen is suicidal.  It includes warning signs but is not meant to be a comprehensive checklist.  Read through them and identify any that your teen may exhibit and then seek support from the resources listed below. 

I have witnessed my teen:

Talking about

Wanting to die.
Great guilt or shame.
Being a burden to others.

Feeling

Empty, hopeless, trapped, or having no reason to live.
Extremely sad, more anxious, agitated, or full of rage.
Unbearable emotional or physical pain.

Changing behavior, such as

Making a plan or researching ways to die.
Withdrawing from friends, saying goodbye, giving away important items, or making a will.
Taking dangerous risks such as driving extremely fast.
Displaying extreme mood swings.
Eating or sleeping more or less.
Using drugs or alcohol more often.

Open communication will be an important tool in supporting  a teen you suspect may be suicidal.  Remember that this is not a time to ask a lot of questions or suggest that your teen “will get over it.”  Try to listen more and speak less. Following are ways that you can show you care, gather information and offer support:

The Steps Towards Helping a Suicidal Person

Show You Care   

  • Listen. 
  • Give the person your full attention. 
  • Be supportive and non-judgmental. 
  • Be honest and direct. 
  • Speak slowly and calmly. 
  •  Be positive and reassuring. 
  • Acknowledge the person’s pain. 

Ask About Suicidal Intent 

  • “Some people in your situation might not know what to do but there are healthy choices to deal with your pain.”  
  • “Are you thinking about suicide?” 
  • “Do you have thoughts of killing yourself?” 

Get Help: 

Offer to help but recognize your own limits.  Do not be the only person offering or providing help.

  • “You are not alone. Help is available.” 
  • “Who do you trust that you’d like to talk to?”  
  • “Let’s find someone together,” 
  • “Let’s call together and I’ll be right here with you.”  

Offer Hope

Help people understand that life in general and theirs, in particular, has purpose and meaning. 

  • “I’m sure there are other people who care about you.”
  • “Let’s try to identify some of them.” 
  • “Perhaps it’s hard to see it right now, but you do have a place in the big picture.” 

 “I can understand that you feel really bad right now, but there are other solutions that can help you feel better.”

How Should I Respond to Suicidal Behavior?

The Dos

  • Always offer hope 
  • Remain calm (even when feeling otherwise)
  • Identify and seek available resources
  • Understand that there are alternatives to suicide
  • Get safely through the crisis
  • Keep a suicidal person away from things they can use to harm themselves

The Don’ts

  • Leave a suicidal person alone
  • Act shocked
  • Interrupt or offer advice, or ask a lot of questions
  • Minimize or discount the problem
  • Argue about if suicide is right or wrong
  • Try to forcefully remove a weapon
  • Promise to keep a secret
  • Offer solutions-other than resources
  • Say anything that might cause shame or guilty feelings

Help Prevent Suicide

  • Address issues of anxiety and depression
  • Pay attention 
  • Discourage isolation
  • Encourage a healthy lifestyle
  • Support the treatment plan
  • Find and maintain close, trustworthy friends
  • Meditate
  • Identify personal strengths and positive attributes and share those with your teen
  • Help them learn to create a positive mindset and motivate positive actions
  • Keep a list of people they can talk to when they are struggling
  • Be substance-free.  Substances interfere with a healthy brain and healthy decisions

As a parent or caregiver, you have an important role in supporting your teen’s mental wellbeing. If you think your teen may have a mental health issue, reach out and get the support you need to help them feel better. 

  • If your teen’s mental state is at a crisis level (e.g., they have harmed [or threatened to harm] themselves or others), call 911 or go to your local emergency room.
  • Schedule an appointment with your primary care doctor: Let the doctor know your concerns and give your teen the opportunity to speak to the doctor in private. The doctor may recommend a follow-up appointment with a mental health professional.
  • Work with your teen’s guidance counselor, the school nurse,  and other school personnel to secure the necessary support. 
  • Ask the school psychologist, therapist, or other mental health professionals for advice on how to respond to your child and handle difficult behavior.
  • Contact other trusted adults in your teen’s life (relatives, clergy, teacher, sports coach) so they can help support them, too.
  • Consider family counseling with a licensed therapist. 
  • Reach out to your health insurance or state/county mental health authority for more support.
  • Enroll in parent support groups or training programs, especially those designed for parents of children with a mental illness.
  • If treatment has been recommended for your teen (e.g., therapy or medication) support them with managing and maintaining their treatment plan 
  • Set important phone numbers on your own and your teen’s phone, for example: 
    • The National Suicide Prevention Lifeline: 1-800-273-TALK (8255).
    • The Crisis Text Line: 741741 
    • Add your local Mental Health Agency’s crisis line into your phone
    • The non-emergency number for the local police department
    • The phone number for a trusted friend or relative

You will play an important role in ongoing support and monitoring of your teen’s mental health.  Continue to learn and stay up-to-date on mental health topics.  Be sure to take time for yourself when possible- your mental health and wellness will be important in helping your child/teen manage their mental wellbeing.  You must put your Oxygen mask on before you can help others. Below are some additional resources you might find helpful.

Social Emotional Learning

Responsible Decision Making

How can I help my child . . .

  • recognize and handle peer pressure
  • make safe, healthy, responsible choices
Social Emotional Learning

Self-Management

How can I help my child . . .

  • get/stay organized and manage their time responsibly?
  • take initiative and develop independence?, (communicate problems and ask for what they need, stay organized, and set and reach goals)
  • be responsible and reliable?
  • better manage stress and strong emotions?
Social Emotional Learning

Social Awareness

How can I help my child . . . 

  • recognize others’ emotions and develop empathy?
  • be aware of their own impact on others?
  • be open to and accepting of differences?