Q&A: Keeping suicide prevention for kids and young adults at top of mind

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If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline or chat live at 988lifeline.org. You can also visit SpeakingOfSuicide.com/resources for additional support.

Suicide is the second leading cause of death for kids and young adults ages 10-24 years old, according to the U.S. Centers for Disease Control and Prevention. Suicide rates in this age group increased by over 50% (52.5%) from 2000 to 2021.

Some states in New England are taking action in their schools. In Massachusetts and Connecticut, their departments of education are working to promote social-emotional learning programs.

But family can play a major role in helping kids navigate the world when life feels too difficult to handle. For National Suicide Prevention Month, we spoke with Edna Rodriguez, a clinical psychologist and an expert in adolescent mental health with Trinity Health of New England's Mercy Medical Center & Brightside for Families and Children, about what to look out for and what parents and caregivers should know to support their kids.

Rodrigeuz says the most important message she wants to get across is that you should talk to your kids about suicide and keep an open dialogue, even if it feels like a sensitive topic.

"Talking about suicide is as important as talking about anything else, like school grades or team performance. It's an important topic, is often seen as a taboo, but talking about it cannot make things worse, can only help guide and support," she said.

What factors contribute to suicide risk?

Rodriguez says like any potential health issue, family and personal history play a role in risk.

"We're also looking at any mental illness, diagnosis of depression, anxiety, any other diagnosis that with the complication with its complications, can lead to suicide," she said.

A prior history of suicidal thoughts, acts of self-harm or the suicide of an immediate family member, also increase risk.

Then there are also environmental factors - including any trauma from recent acute stress. Environmental factors can be anything that might put a child in a position of struggling with adjustment, including things like a family divorce, moving, or being exposed to violence.

Experts also evaluate what means a child may have to self-harm, including things like the presence of firearms in a home, drugs, and other factors.

"If there are any presence of firearms or other forms that could lead to fatality through suicide, that's also a risk factor."

If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline or chat live at 988lifeline.org. You can also visit SpeakingOfSuicide.com/resources for additional support.

Is there a population more vulnerable to suicide? 

Rodriguez adds that certain populations may be more vulnerable to suicidal thoughts and triggers.

"We look at the LGBTQ community also as a higher risk because of the stigma and other oppression that they receive in the environment. We also look at immigration status people who are coming to a new scenario, a new place where they're confronting social adjustments and and other sort of stressors that might cause the complication of suicide."

Cultural stigma can also increase risk, Rodriguez says.

"I think that minorities, especially Black and brown communities and communities that are not necessarily speak(ing) English often have some sense of being guarded on the mental health and actually medical health system."

She said often these populations will try to solve issues internally when the situation would benefit from professional help.

"There is a lot of stigma in the Latin, Hispanic community, Black community about, you know, seeming like you need help or seeming like, quote unquote, crazy," Rodriguez explained.

She adds that a family's background or religious beliefs can also push people to wait to get help.

"There is stigma within families. Some people have carried stigma based on religious beliefs, thinking that approaching things with the religion only is the answer. And it is a support and is definitely a strength to have a religious practice, sometimes professional help is needed."

What are some warning signs to look for?

While some factors may be easy to identify, in some cases there may not be an obvious stressor or situation in someone's life that flags that risk.

"Other warning signs, such as isolating, preparing and online polls that seem sort of like like saying goodbye or a very existential sort of like posting and writing some poems that can be something that, you know, might trigger just the curiosity of any caregiver or any school personnel to just kind of like do an approach in and ask the questions there."

Rodriguez says it's important to be open about the topic with kids and teens and not to be afraid to ask a direct question if you have concerns.

"There are children or people that are going to be forthcoming and are going to mention some ideations or some preoccupations with death and suicide. And that's always a good opportunity to sort of ask the question, have you been thinking about suicide? Right. That's the right question to ask by asking that question. We are not putting thoughts in anybody's mind. We are not pushing anybody to suicide. We're just making sure that we're going over the potential risk for that to be present in our youth," Rodriguez stressed.

What can parents and caregivers do to be supportive?

Rodriguez says caregivers need to be present, curious and kind while addressing concerns, without pushing too hard. In some cases having a direct conversation may work, but other times a more subtle approach is better.

"Sometimes us parents, we we want to know we want to fix the problem. Right. And in that in the midst of that well-intended desire, we might end up judging our children or we might end up in some sort of way of minimizing whatever internal state depression, anxiety, frustration that the child might be going through," she said.

Instead, parents should make it clear to their child that they are a safe place to approach for help or for comfort in general.

And it's not just about parents. Rodriguez says caregivers should also communicate with others in the child's life - whether that be siblings, friends, teachers, counselors, coaches or other people who spend time with them - so if those people see an opportunity to approach the issue or offer their own support, they can do so.

Schools should have some kind of trained staff and response plan in place if a student becomes suicidal, she says, and caregivers should make sure to connect with the appropriate people to express any concerns. Having those lines of communication open make it easier for school officials to communicate any concerning behavior on their end, as well.

What to do if I think someone is in crisis?

If you believe someone may be experiencing a mental health crisis or seriously considering suicide, you shouldn't wait to take action.

The National Alliance on Mental Illness says signs of an emergency can include if a person is collecting and saving pills or building a weapon, giving away possessions, trying up loose ends, like organizing papers or paying off debts, or saying goodbye to friends and family.

The National Suicide and Crisis Lifeline is accessible by calling 988. Rodriguez says the line, which launched last year, appears to be successful at helping families navigate a pending crisis. But, she adds if you're unsure if a true crisis is afoot, this is a situation where it's better to overreact than underreact.

"Missing something might mean things that are irreversible. So important to know that 911 calling EMS is a resource," she said. She also says if you are with that person, do not leave them alone.

NAMI says that a person's behavior can be unpredictable and change dramatically in a suicide-related crisis. While there is not a set of clear steps to handle the situation, this is a health emergency and should be treated like one.

"If you are in doubt or you have encountered a loved one, a youth in the act of attempting suicide or in the process, or it seems imminent to you, it is OK to stay with them and call 911 and then relay the responsibility of of of evaluation and treatment to a mental health professional," Rodriguez said.

More towns and cities are embracing programs that have trained mental health professionals on standby to work with first responders, or even respond without them, in the case of a mental health emergency.

More resources

If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline or chat live at 988lifeline.org. You can also visit SpeakingOfSuicide.com/resources for additional support.

National Alliance on Mental Illness (NAMI)

Community Behavioral Health Centers (Massachusetts)

The Trevor Lifeline for LGBTQ Youth

The Trans Lifeline