September 12, 2018

Youth suicide prevention

Following recent tragedies in our community, Dr. Brooke Kwiecinski of UW Health answers some questions parents and others may have about youth suicide prevention.

What's the best way for parents to talk to kids about suicide in a way that is free from clichés or platitudes?

The most important thing is to foster communication with your child, regardless if it feels cliché. It's OK to ask them if they feel depressed or have had thoughts of death or dying. Being present, actively attending and asking about your child's feelings and thoughts in a non-judgmental manner gives your child the space to share. If it doesn't work the first time, don't give up. Be gentle but persistent in your efforts to show care and concern, which will reassure him or her that your unconditional support is there when the child is ready.

How can parents tell the difference between suicide risk and normal sadness and angst that all kids face?

While suicide is complex and most often has multiple causes, mental disorders — most commonly depression symptoms — are found in 90 percent of people who have died by suicide. Depression can be difficult to detect in kids and can look different from persistent sadness that can be seen in depressed adults. Kids with depression often appear angry or irritable. While occasional moodiness is typical of "teen angst" other signs and symptoms of depression include changes in eating habits or sleep; physical complaints (headaches, stomachaches, fatigue) without identified cause; declining school performance; loss of interest in pleasurable activities; withdrawal from family, friends or activities; and/or a preoccupation with death and dying. Feelings of despair and hopelessness are common. If you are unsure if this is depression, pay attention to how long your child has not been herself or himself and the impact of these symptoms on her or his ability to function at school, at work or in relationships.

What are the real risk factors and warning signs of suicide or that a child or teenager needs help?

In addition to the signs and symptoms of depression, in older kids, some of the warning signs of suicide can include agitation, a change in personality or an increase in risky behavior, such as reckless driving or drug or alcohol use. Other risk factors for suicide include other mental health disorders (anxiety, substance use disorders), access to firearms, a family history of suicide attempts and any recent stressor triggering feelings of loss or rejection. Kids who are thinking about suicide might stop planning for the future or give away important possessions. They could make overt statements about suicide or harm themselves. Any child or adolescent with suicidal thoughts, plans or warning signs should be evaluated by a qualified mental health professional. The more of the above signs and symptoms that the child has, the greater the potential risk of suicide.

What is the best way to get help for a child or teen?

The good news is that once they are recognized, depression and other mental health disorders that put people at risk for suicide are treatable. Multiple evidence-based psychotherapies and medications have proven to be effective in children and adolescents and adults. If there are no acute concerns for safety, you might start with your primary care physician, who can refer your child to a qualified mental health professional. If there are urgent concerns, do not leave your child alone. Have firearms, alcohol, drugs or sharp objects removed. Seek help in an emergency room, from a medical or mental health professional, or call 911. If you or someone else is in a crisis, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting TALK to 741741.