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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 middle schoolers don’t ever think about, let alone attempt, suicide. Yet national suicide rates have been increasing over the past 10 years. In 2019, the CDC reported that suicide was on the rise for students between 10-14 years old. In addition, children at this age have a harder time than older teens to communicate their feelings and will more often deny their pain and not seek help.

Many children 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

In the early years of middle school, depression and anxiety can take on the guise of typical tween  behavior like irritability, extreme annoyance or anger.  That makes it difficult for parents and caregivers to see the signs.  True 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

Check In:

This is a good time to start gathering your resources and arm yourself with information. Knowing where to find support and who you can turn to will help prepare you for the many changes and potential challenges that you and your tween will face. Take a look at this list of common topics related to middle schoolers. Which ones do you feel you know more about? Which topics do you want to learn more about? There are many more resources on this site to help guide you. Simple take a look and click on the link:

  • Social and emotional learning and development
  • Physical health
  • Mental health
  • Family relationships
  • School success
  • Sexuality and sex education

Protective Factors

The checklist below is a list of protective factors that may help protect against crisis and/or suicide.  Read through them and note which ones you feel describe your child’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 adults in their lives that they can trust to go to
  • 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
  • Has plenty of time for play and rest

Warnings Signs

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

I have witnessed my child:

Talk about

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


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

Change 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

Connect & Communicate:

Open communication will be an important tool in supporting a middle schooler you suspect may be suicidal. Remember that this is not a time to ask a lot of questions or suggest that your child “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?

Dos Don’ts
  • 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
  • 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
  • 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 
  • Give them plenty of time for unstructured play time
  • Give them permission to tell an adult if a friend seems unusually sad or angry

For direct information and support, use the hotlines provided below:

  • The National Suicide Prevention Lifeline: 1-800-273-TALK (8255).
  • The Crisis Text Line: 741741 


The following activities can help support positive physical and emotional well-being, which can be protective factors against crisis and suicide.

Meditate:  Find an app like Headspace or other online resources that your child can use to meditate.  Offer to do this activity with them to support a positive mindset.

Attributes List:  With your child or with the whole family, make a list together of all of the positive attributes that each member has.  Put them in a place where you can see them regularly.

Gratitude Journal:  Allow your child to choose a fun and colorful journal to write in.  Get them to make notes about what they are grateful for each day.  Here are some tips for how to do it:

Family Meetings:  Getting together as a family each week to talk about goals, achievements and struggles can be a way for you to get a sense of how your child is doing.  Not only that, but it can help them feel a sense of belonging and love. Keep the meetings positive and upbeat and a place for them to feel safe to share. You can Google “family meeting ideas” or use this printable here:

List of Trusted Adults:  Sit down with your teen and help them make a list of all the people in their lives that they trust and who they could go to if they were in crisis. Discuss what they feel makes this person trustworthy and make sure they know how to access that person if they are in need.

Find Coping Strategies:  It might be helpful for you to share some of the coping strategies you use when you feel overwhelmed or sad.  Read through other coping skills with your child and have them identify the ones that they use or would be interested in using when they feel down or anxious.  You can start with these two resources:

Contact & Collaborate:

As a parent or caregiver, you have an important role in supporting your child’s mental well being. If you think your middle schooler may have a mental health issue, reach out and get the support you need to help them feel better. 
  • If your child’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 child 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 child’s guidance counselor, the school nurse,  and other school personnel to secure necessary support. 
  • Ask the school psychologist, therapist or other mental health professional for advice on how to respond to your child and handle difficult behavior.
  • Contact other trusted adults in your child’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  child’s  phone, for example: 
    • The National Suicide Prevention Lifeline: 1-800-273-TALK (8255).
    • The Crisis Text Line: 741741 
    • Add your local Mental Health Agencies’ crisis line into your phone
    • The non-emergency number for the local police department
    • The phone number for a trusted friend or relative

Continue Learning:

You will play an important role in ongoing support and monitoring of your middle schooler’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 middle schooler 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.

Mental Parent and Caregivers (website)

National Institute of Health Children and Mental Health (website)

National Alliance for Mental Illness: (website) Learning to Help Your Child and Your Family

Child Mind Institute (website): Articles on all topics related to suicide

Parents Navigating the Teen Years (podcast):  What Parents Can Do About Teen Suicide Prevention

The Impactful Parent (podcast):  Suicide Prevention

Voices of Compassion (podcast):  Teen Suidcide:  What Parents Need to Know

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