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How to Talk to Kids about Suicide
This podcast will focus on how to talk to kids about suicide– whether a parent or educator is having an informational conversation, a conversation because they believe someone is at risk or a conversation because they have lost someone to suicide. Dr. Robyn Silverman talks with SAVE.org’s Dr. Dan Reidenberg about suicide warning signs, the role of media and social media, why certain groups are more at-risk and what we can do now to help prevent or possibly stop a suicide from happening. As suicide rates are going up, this conversation is more important than ever. It might just save a life. Listen, then have the conversation today.
Special guest: Dr. Dan Reidenberg.
Nearly 800,000 people die by suicide in the world each year, which is roughly one death every 40 seconds. Suicide is the 2nd leading cause of death in the world for those aged 15-24 years. Suicide is the 3rd leading cause of death for 15 to 24-year-old Americans, according to the CDC. These are the statistics—but when it comes to suicide and talking to kids, the statistics don’t give us the words, the feelings, the loss, the answers. In fact, Everytime there is a suicide in our communities, in our schools, in our families, and in the lives of our children- it usually leaves us with more questions than answers. How do we talk to kids about this extremely difficult topic?
Dr. Dan Reidenberg is the Executive Director of Suicide Awareness Voices of Education, SAVE, Managing Director of the National Council for Suicide Prevention and is on the Executive Board of the International Association for Suicide Prevention. He is Co-Chair of the International Media and Suicide Task Force—and serves on the numerous national and international advisory boards. He has speaks about suicide and suicide prevention internationally and has written many articles and book chapters about it as well. Dr. Reidenberg has been interviewed by major media sources from around the world including CNN, Larry King, Good Morning America, the New York Times and Washington Post and has helped develop the US National Strategy for Suicide Prevention and the National Research Agenda (US). He has received numerous awards for his work including the Service to Humanity Award, Service to Suicidology Award, and as a Champion of Change by The Obama Administration.
The podcast provides:
- When it’s the right time to talk to kids about suicide
- How to introduce the topic by age group
- Why the rate of suicide is increasing
- How we can use media and social media to help us discuss suicide
- Why certain groups are more at risk
- Warning signs of suicide
- What to say/do when you notice warning signs
- What to say/do when there has been a suicide attempt
- What to say/do when you need to tell your child that someone was lost by suicide
- The most important thing you can do to help prevent suicide
- The numbers are not in our favor—suicide rates are increasing. For younger kids- 5-9 year old range- is increasing as well.
- We need to be age-appropriate and developmentally appropriate.
- If you can have a conversation about suicide before a tragedy happens, this would be best, if possible.
- Tie the conversation with something your child already knows- a disease—a TV show.
- Find a quiet place or a familiar space when you tell a child about a specific suicide. Young kids don’t need much detail. Older kids might need more.
- We have better reporting on suicide- National Violent Reporting System
- People talking more about mental health and suicide. We used to have greater stigma.
- What impacts suicide numbers: The economy has a big impact on suicide. Unemployment rates have a big impact on suicide. Many people with suicidal thoughts feel that they are a burden on family. LGBTQ population are at greater risk for suicide. Antidepressants can impact suicidal thoughts when young people start antidepressents (within first 2 weeks)- so watch them. Media and social media- for example- 13 Reasons Why- there was an increase in suicide.
- Using media: How did you feel about what you saw on that show? (Takes it away from the personal piece). This can open discussion- before you get into questions about friends and self. Start with the less personal- then make it more personalized to them. Then- have you ever felt that way? You can then equate it to feelings- and something they know; “you know when our dog died- and you were really sad- and how you cried- and how we banded together as a family and what we did to band together. They learn mastery over a crisis. “When you have a bad thing to get through, we want to make sure you can get through it. And if you can’t get through it, I want you to come to me or a teacher, coach, someone in the faith community. Talk to someone and you’’ figure it out together.
- We want our kids to learn coping skills. This can help them get through emotional crises.
- Exposed to it but not in crisis: “So now let’s talk about this in a serious way. I’m concerned that you were exposed to this, how did you get though it? Is there something I can do to help you through it because I don’t want you to feel alone with this. I don’t want you to feel that you have to do this on your own. And I want to make sure that you have done what needs to be done—to the degree that we know you are safe.” (Did you get through it? Are you all the way through it? Maybe I should check in with you a couple more times)
- Need to listen to your intuition. If you think a child is not through a frustration, challenge or trauma. Must follow up- research says more than one time- reduces risk of suicide. Also- it’s ok to talk about it- you are not putting the thought in their heads- you are not triggering it. You want to help them know they’ll be ok.
- 90% of people who die by suicide have a mental health issue.
- Mental health is talked about more than ever- Robin Williams, Anthony Bordain, Kate Spade. 13 Reasons Why. Still a stigma but more talked about now.
- 47,000 people died by suicide in 2017. Young people- 6000- most adults and seniors. Low base rate phenomenon. Most people with a mental health issue don’t commit suicide. Too much- but still small amount.
- Pruning happening in adolescence. Impulsive at that time.
- LGBTQ- concerned about talking to anyone about their feelings for fear of what family will say.
- Parents/educators know the children well and see them so much of the day—and yet, have kids who are lost to suicide- how can this be? By and large, most of them say, after it happens, “I had a gut feeling but I didn’t want to believe it…I didn’t think it would happen to my kid. But I knew it.” We rationalize and we think it can’t and this clouds our judgment. But if we trust our gut, we may be able to catch a tragedy before it happens.
- Adolescence is a hard time for teens and it’s a hard time for the parents. Brain changes, world they are living in, separating from parents, getting more aligned with peers, peer pressure, online media, they think about the here and now- everything is monumental to them—it’s huge to them.
- Anecdotal warning signs: Are they acting out of character for who I know them to be?
- Communicating intent to die: “I hate my life; I just want to die.” “I’m going to kill myself tomorrow.” “Everyone would be better off without me.” (disguised, indirect) Must be put into context- and trust your gut again.
- Look for ways to die: Start looking up ways to die or looking for things around the house that could help them die. Gun cabinet. Medications—check, there in the right amount?
- Other warning signs: Feeling trapped, no hope for the future- not looking forward to anything. Verbal statements- “being a burden.” A big percentage- actually use the word “burden”- they feel they are a burden to their family or teammates or community.
- Out of character: Sleeping more or less, acting out, withdrawing, eating a lot more or less, school performance plummeting. BUT- if a child starts to dress differently, listen to different music or hang out with a different crowd- they might just be trying to fit in. Watch- but could be fine- when it’s not fie is if they are starting to smoke, drink, do drugs- as this is out of character. If they are just starting to hand out with a group of kids who they feel more aligned with (from sports to music crowd or drama crowd, that’s not a warning sign). Figuring out identity. But- if now won’t hang out with you, won’t go to church/temple with you on the weekend anymore but they did, they won’t talk to friends at all or go to their favorite sporting events—this is different than finding identity- this says “I’m in trouble, and I don’t know what to do about it.”
- If you know, think or believe someone might be thinking about suicide- (1) have the conversation right now. Don’t wait. You might miss your opportunity. (2) If you have any reason to believe this might be happening, if you are worried or suspicious, you need to be clear. You can’t dance around the issue. Be direct. Don’t say; “Hey Johnny, it doesn’t seem you aren’t really feeling well lately.” Say “John, I’ve been worried about you. Have you had thoughts about killing yourself or taking your life? Do you not want to be alive anymore? Have you thought about committing suicide?” Communicate a fatality component- that is critical. (3) Listen. Do they have a plan? When? Have they been looking it up? Time? Place? Method? (4) This is really concerning- but we’re going to get you some help. We’re going to get you through this. I’m going to stay with you until we get you to the right place/right person.
- Talking about it doesn’t make the person want to do it more or give them the idea- research says it gives them a sense of relief. Take down anxiety. Connect with their brain where it’s at.
- Reintegration plans for a child who has attempted suicide- modified lesson plans, check ins with many people, don’t over burden, don’t want people walking on eggshells- so that they feel isolated and weird about what has happened.
- Reitegration for home- before they come home, have the conversation so everyone knows what to do/say. And relay that they are loved, supported.
- “You get the stomach flu, you don’t go and have a pizza or your first meal. YOU slowly get back into it. You have some water. Bland foods. Same kind of thinking when someone has attempted suicide- slowly get back to their life.
- And a scale of how they are doing each day.
- If there has been a suicide- this IS confusing for kids, for adults and for professionals. It’s about addressing the confusion. We may never know exactly why we lost someone. What got them to this place that they decided they couldn’t get through it.
- Script: “We have to have a tough conversation and before we have it I just want you to know that we are going to be here and we are going to help you through it. We learned today, ____, died. We don’t know all the reasons or the circumstances but we know she’s gone. And it’s really hard and we can’t imagine the pain you must feel and how hard it is for you- but we are going to be here for you and walk you through this. We don’t know everything but we are going to be here and give you the time you need.”
- “What gets me up every morning is the hope—the hope that we can save someone.”
- “These are difficult conversations that we don’t want to have and they are difficult conversations because we don’t know how to have them. If we can speak in English and give some specific tips to people so that they can start these conversations, we have hope. We have hope to catch people before it’s too late.”
- “By in large, it would be best if we had the conversation about suicide before there was a tragedy. Talk to your children when they are ready for it and talk about it before an incident has happened. When that isn’t possible, it’s best to talk to them right away- you don’t want to delay- be honest and open.”
- “Most of the time I find that parents talk too much. They need to listen more.”
- “We can help kids through crises, many emotional situations (even very dramatic ones) just by listening.”
- “We want our kids to learn mastery over crisis. We want them to learn coping skills because we know suicide is connected to a break down in coping skills. If we can build up coping skills and show our kids where they’ve already been successful, hopefully they’ll be able to apply it when they are feeling an emotional crisis too.”
- “Trust your gut. If you can trust your intuition, you’ll have a far leap out in advance of catching someone before tragedy happens.”
- “For adolescents, now is everything.”
- “When we look at those who died by suicide, all of the people did two things: They somehow communicated their intent to die, and they looked for a way to die.”
- “Suicide is very hard and it changes your life forever.”
- “What’s very hard for people to see is that about 85% of the time, people communicate their intent. It’s just not seen or recognized. And it’s done with different people in many different ways so not everybody can put the puzzle pieces together right. So it’s not about guilt or shame that you did something wrong or there was something you missed because that isn’t what suicide is about. Someone who is suicidal might say one thing to you and something very different to somebody else, and because those two people never talked, that’s part of the reason the gap comes in.”
- “If you’ve seen any of the warning signs for suicide, right now, sit down and have the conversation. You can’t wait. Whether you are a parent, teacher, educator or coach, now is the time. We don’t want this conversation to be delayed at all because you might miss your opportunity.”
- “When we are dealing with suicide, if you know, if you think, if you believe, if you have information that someone might be suicidal—that needs to be your priority right now, right this minute.”
- “My top tip is that we can’t shy away from this conversation. We have to do it. Take that step. If you are worried about someone, ask the question. If you want to use this as an opportunity to start a conversation, ask the question. Don’t shy away from it. Do it. It could save somebody’s life.”