Suicide might not feel like a family-friendly dinner conversation topic, but perhaps it should be. According to the latest data from the National Institute of Mental Health (NIMH) and the Centers for Disease Control and Prevention (CDC), suicide was the second leading cause of death among individuals between the ages of 10 and 24. Suicide does affect children and adolescents, and avoiding the topic won’t help them learn how to get help if they need it.

One of the misconceptions about the discussion of suicide is that talking about it causes kids and teens to think about it. The truth is that parents can never know for certain whether or not a child experiences suicidal thinking if they are too afraid to ask the question.

Suicidal behavior in children is complicated. It can be impulsive and associated with feelings of confusion, sadness, or anger. The so-called “red flags” people are cautioned to look for can be subtle in young children. While a young adult might say something like, “You’ll be better off when I’m gone,” for example, a child might say some something like, “No one cares if I’m here.”

Studies on suicide and suicidal ideation among elementary school age children are limited and tend to have small sample sizes. This makes it difficult to draw direct correlations between specific triggers and suicidal behavior. One study published in Pediatrics, however, compared characteristics and precipitating factors for suicide between elementary school children (5-11 years old) and early adolescents (12-14 years old). Results indicated that children who died by suicide more often experienced relationship issues with family and friends (compared to relationship issues with boyfriends or girlfriends for adolescents.) Both groups were likely to suffer from mental health disorders. While adolescents were more likely to experience depression or dysthymia, children were more likely to experience attention deficit disorder, with or without hyperactivity.

Subtle Warning Signs in Children

While the warning signs in children can be subtle, learning potential red flags plays a crucial role in intervention.

Changes in baseline behavior:
Trust your gut. If you notice behavioral changes that aren’t a one-time issue, take note. While suicidal behavior is often associated with symptoms of depression, you might also notice the following changes in your child:

  • Changes in sleeping habits (too much, too little, insomnia, or night wakings)
  • Changes in eating habits (overeating or eating too little)
  • Withdrawing from family and friends (social isolation)
  • Psychosomatic symptoms: headaches, stomachaches, other aches and pains that can’t be explained

Changes at school:
It’s perfectly normal for kids to experience ups and downs during the learning process, but a pattern of negative change can be a red flag that a child needs help. Make a note of the following:

  • Drop in academic performance
  • Decreased interaction with teachers and kids at school
  • Lack of interest in school
  • School refusal
  • Loss of interest in normal daily activities (playing, sports, extracurricular activities)

Preoccupation with death:
It’s natural for kids to think about death at times, particularly when they are coping with loss or hear about tragic events in the news. Preoccupation with death, researching ways to die, and/or talking about their own death can be red flags. Watch for the following warning signs that involve thoughts about death:

  • Frequent questions about or looking up ways to die
  • Statements about dying or what will happen if the child dies (ex: “You won’t miss me when I die, I wish I was dead, I won’t bother you anymore when I’m gone.”)

Take all suicidal statements seriously by seeking an evaluation for your child.

Feelings of hopelessness:
Children who have suicidal thoughts might communicate feelings of hopelessness for the future. They might also make statements about helplessness. These kinds of statements indicate that the child feels as if there is nothing to be done to improve their outcome, and no one who can help.

Child-sized will:
Some children give away their favorite possessions or tell parents, siblings, or friends who should get their favorite possessions. While talk of divvying up possessions might seem like fantasy play to parents, it can signal thoughts of suicide when combined with other changes in demeanor.

Writing or drawing about death or suicide:
Young children often struggle to verbalize intense emotions, but they are likely to write or draw about them. Poems, stories, or artwork that depicts suicide or frequent writings and drawings about death should be evaluated.

Significant changes in mood:
Kids experience changes in mood as they grow and work through stressors, but significant changes in mood signal a problem. You know your child best. If your child suddenly shifts from calm and relatively happy to aggressive, completely withdrawn, or very anxious, it’s important to get help.

In addition to the warning signs that a child might experience suicidal ideation, there are also certain factors that can elevate the risk.

  • Previous suicide attempt (regardless of how serious)
  • Experiencing a loss (this can include grief and the loss of a relationship due to divorce or family discord)
  • Chronic bullying
  • Family history of suicide or suicide attempts
  • Violence or witnessing violence
  • Access to firearms
  • Impulsivity
  • Acute rejection
  • Feelings of hopelessness
  • Feeling like a burden

Any signs of suicidal ideation or behavior should be taken seriously. Parents should ask specific questions about suicidal thoughts, “Are you thinking about hurting or killing yourself?” Parents should also talk openly about depression by asking questions like, “Are you feeling depressed or very sad lately?” These questions show your child that you understand and that you care. Conveying empathy in a time of emotional crisis is crucial.

Regardless of how your child answers these questions, it’s essential to seek an evaluation by a licensed mental health practitioner who specializes in working with children. If you’re not sure where to access help, schedule an immediate appointment with your child’s pediatrician, and indicate that you have concerns about your child’s mental health and potentially suicidal behavior.

With proper support in place, children can work through the feelings and triggers that result in suicidal thinking and learn effective coping skills to deal with difficult life situations.

Last Updated: Oct 23, 2018