Youth at Risk
For youth | For adults
How to talk to a suicidal teen
Communicating with a teen who may be thinking of suicide is difficult, but it could save their life.
Do
- Assure them that help is available, and that you’re there for them.
- Stay calm, be compassionate and non-judgemental.
- Listen and let them express themselves.
- Gently ask questions until you have a clear understanding of what they’re feeling.
- Be patient if things are not immediately apparent or reasonable to you.
- Start the conversation with “I “statements:
I heard you say you don’t want to be here or that everyone would be better off without you. I am really concerned and want to talk more about this with you.”
- Use open-ended and direct questions to get them talking. When necessary, encourage them to elaborate or clarify.
Tell me more…”
“I am not sure what you mean…”
- Remember their perspective and validate their feelings.
It must’ve been hard for you when your friends didn’t invite you to come out with them. It hurts to feel left out.”
- Identify the positives, and remind them that they have reasons to live.
You’ve talked a lot about your friend, it sounds like they’re really important to you and you have a good time together.”
- Pay attention to their body language; even if they say they are fine, they may show their true thoughts and feelings through their gestures and facial expressions.
- Trust your instincts.
Don’t
- React with anger, shock or frustration at what you may hear.
- Jump in to try to fix their problems.
How to ask if they’re suicidal
First, it’s important to accept the possibility the teen may be considering suicide.
Then, make them feel comfortable; it helps to let them know feelings of suicide are nothing to be ashamed of.
Sometimes when people are going through a really hard time they think about suicide.”
In a straightforward manner, ask them if they’re thinking of suicide.
Are you thinking about suicide?”
“Are you thinking about killing yourself?”
If they say yes, ask them if they have a suicide plan.
Do you have a plan of how you would do it?”
If they say yes, ask them if they have the means to do it (access to the way they plan to kill themselves).
Do you have access to the pills you’re thinking about using?”
If the teen answers yes to the last two questions:
- Get them help immediately.
- Do not leave them alone.
- Take them to the emergency room or call a crisis line (listed above) for advice.
If you’re an educator, follow policies put in place by your school. If it becomes necessary to talk to a parent about a teen considering suicide, help can be found in the Centre for Suicide Prevention’s webinar: How to Talk to Parents about a Teen at Risk of Suicide.
Where the teen is coming from
They may be embarrassed, frightened, or ashamed. The stigma associated with suicide and mental illness is far reaching and may present a barrier to seeking help.
Teens often live in the moment; it may be hard for them to see past the way they’re feeling right now. It’s up to you to show them that help is available and that their life can get better. You may need to help them identify their feelings; in moments of crisis it can be hard for anyone to express themselves.
If you feel you cannot have this conversation, please seek help from an outside source – a teacher, a counsellor, a mental health professional – or call a crisis line for advice on how to proceed.
Getting help
Understand you are not the one to “solve” the problem. Both you and the teen need help to navigate the issues involved in suicide.
- Crisis Line Numbers across Canada: www.crisisservicescanada.ca
- Call a crisis centre for advice on the type of help your teen needs and available resources
- Call 911 if:
- You believe your teen may be in immediate danger of suicide
- Your teen has a specific plan how they will suicide and the means to complete the plan
How do I know if someone is suicidal?
There are certain things people who are suicidal may say or do. Be on the lookout for these warning signs.
Things they may be doing
Watch for any significant changes in behaviour
Significant mood changes
- being really sad when usually they’re happy
- being really happy when they’re usually pretty down or easily annoyed
- getting angry, annoyed, or frustrated easily
Withdrawal
- staying home more often, not hanging out with friends much
- not doing things they normally enjoy like playing sports, music, or going to parties
- skipping school more often than usual
- deleting social media accounts
Other changes in behaviour
- dropping grades
- paying less attention to their personal appearance, e.g. having dirty clothes or unwashed hair when they are usually quite clean
- changing eating habits e.g. loss of appetite or overeating
Risk-taking, spontaneous behaviour that is out of the ordinary
- driving while drunk
- drinking more alcohol or taking more drugs than usual
- wanting to run away from home
- pulling dangerous stunts
Physical symptoms
- always complaining of stomach aches or headaches
- always being tired or feeling sick
Giving away things they like
- asking someone to take care of a pet
I know a teen who is self-harming… are they suicidal?
Self-harm and suicide are different. People who self-harm are not necessarily suicidal. More information can be found here: Self-Harm and Suicide.
Things they’re saying
Some of the things the suicidal person might say and the associated feelings include:
Hopelessness
“What’s the point of even trying?”
“Nothing is ever going to change.”
“Nothing matters.”
“What difference does anything make?”
Social isolation
“I don’t have any friends.”
“Nobody cares about me.”
“Nobody likes me.”
“I feel like I’m invisible to everyone”
Low self-esteem
“I hate myself.”
“I’m such a failure.”
“Everybody thinks I’m a loser.”
Psychological pain
“I’m so miserable.”
“I’m never happy.”
“Nothing is fun anymore.”
“I feel so empty inside”
Feeling worthless or a burden to others
“Nobody would care if I was gone.”
“Everyone would be better off if I was dead.”
“Nobody would miss me if I didn’t come to school.”
Wanting to die
“I’m going to kill myself.”
“I wish I were dead.”
“I wish I had never been born.”
Talking or joking about death
“Why don’t I just off myself?”
All suicidal thoughts or threats must be taken seriously. If you are unsure… ask the teen if they’re suicidal. Think of the warning signs of suicide as an invitation to communicate with them and to learn more.
Myths and Facts
Myth
Talking about suicide will give my friend the idea to attempt suicide.
Fact
Talking about suicide does not cause people to think about killing themselves. Asking about suicide gives them the opportunity to speak openly about what’s going on and shows your friend that you care about them!
Myth
Suicide happens without warning.
Fact
Even when suicidal behaviour seems impulsive, there have usually been prior warning signs and behaviours.
Myth
If my friend is suicidal now, they will be suicidal forever.
Fact
No, your friend’s suicidal thoughts may be related to a temporary situation that is causing them great stress or emotional pain. These feelings will pass especially if they have help working through them.
Myth
My friend will be angry if I try to help them.
Fact
Your friend might become angry or defensive because of embarrassment or shame or feeling that they do not need help. Even if your friend doesn’t accept help, you need to tell an adult you trust that your friend is suicidal.
Myth
My friend seems to be feeling better so they are no longer considering suicide.
Fact
Unfortunately, this is not necessarily true. Sometimes when people act like everything is okay, or they act happy after a long period of sadness, they are still struggling. Make sure that an adult knows that your friend is/was struggling with thoughts of suicide.
Myth
People who are suicidal want to die.
Fact
Most people who die by suicide do not want to die. They simply want the pain of living to stop.
Myth
Bullying causes suicide.
Fact
There is rarely just one factor that will cause someone to think of suicide. People who think of suicide are usually experiencing many negative things, not just one. On the flip side, it only takes one positive thing to prevent people from thinking of suicide. For example, if someone has even one good relationship or one activity that they really love, or if they have one really great personality trait like high self-esteem, this can prevent them from considering suicide at all.
Myth
People who are lesbian, gay, transgendered, or questioning their sexuality have a high risk of suicide throughout their lives.
Fact
LGBTQ youth are more at risk of suicide than other youth, but their risk drops when they become adults. This is because adults generally are more accepting of who they are, and they’ve usually built up friendships with people who accept them, too.
Risk and Protective Factors
There are certain factors that can put one person more at risk or less at risk of suicide than another, though it is important to remember that anyone can be considering suicide.
Risk Factors
- Mental illness (depression, anxiety, etc.)
- Family or personal history of suicide
- Physical or sexual abuse
- Feelings of hopelessness
- Self-harm
- Access to lethal means (e.g. a gun, prescription drugs)
- Struggle with gender identification
- Recent stressful events (divorce, loss of a family member)
- Family disconnection
- Having “tunnel vision,” not being able to see past the difficulties of today and into the future
Protective Factors
- A positive school environment
- A strong family connection
- Supportive relationships with friends
- A positive relationship with a trusted adult that is not a family member (e.g. a teacher or coach)
- Good self-esteem
- Hope in the future, and are not overly focused on their day to day emotions
- Involvement in positive activities outside of regular school hours (e.g. volunteering, participating in cultural activities, sports)
Build protective factors
- Help the teen build connections with family and other adults and youth.
- Help the teen to identify their strengths by asking questions like:
- In previous difficult situations, how did you cope, what did you do?
- Who do you talk to when experiencing stress? How do they help? Can they help you now and in the future? Who else can help?
- Can you use what you have learned in other situations to help you now and in the future?
- Help the teen create a network of support.
- Develop or strengthen your relationship with the teen
- Provide support, communicate positive expectations and invite participation
- Demonstrate attitudes and messages of optimism, strength and overcoming difficulties
After a suicide attempt
A suicide attempt is a sign that a teen needs you and your support more than ever. You must first believe that the incident really was a suicide attempt. You must overcome your own shock, anger and helplessness and give the teen the help they need.
A safety plan
Craft a safety plan with the teen and the treatment team. If the teen has been hospitalized, ensure the safety plan is in place before discharge. All parts of the safety plan (including medications and professional treatment) should be clearly stated and understood by everyone.
Key elements of a safety plan may include:
- Steps to be taken to reduce the risk of further suicidal behaviours at home — e.g. removing highly lethal means such as firearms and medications;
- Contacts for the hospital or other crisis services, family doctor, mental health workers and or family members who can be called upon in an emergency;
- Steps to help the teen develop a sense of self-responsibility that will encourage them to be proactive in getting help if they begin to feel suicidal again — e.g. have them help choose the caregivers and the type of help to be received;
- Actions you will take if you notice warning signs
- How you will build a community of support that will decrease the teen’s actual or perceived social isolation. This community will include professional caregivers, other family members, friends and community agencies;
- Strategies to foster the teen’s problem-solving abilities and a positive self-image;
- Steps to address family problems — e.g. courses on communication skills, parenting skills, building self-esteem, developing coping strategies;
- Self-care strategies for the teen, other siblings and friends, and for yourself;
The plan will also include strategies to increase the chance the teen will comply with its terms, such as:
- Talking to them about counselling and any concerns they may have about it. Discuss how counselling can help him and offer assurance that their issues and feelings will be taken seriously.
- If outpatient treatment is part of the plan, scheduling appointments at times that are convenient and locations that are readily accessible.
- Setting realistic and achievable goals
Above all, the plan should work with the strengths of the teen and family and offer hope that things can change for the better.
After a death by suicide
The sudden loss of a young person is a shocking and traumatic event that will greatly impact you and your community. It is not unusual to feel overwhelmed by sorrow, physically ill and angry. You may also experience disbelief, shock, feelings of failure, loss of self-esteem, a sense of inadequacy, fear for other teens, and guilt.
Grieving is a long process: a journey that is best travelled with people who support you. Remember that you will heal and, with time, the pain of your loss will lessen.
To cope
- Seek and accept support from trusted friends, family, and colleagues.
- Join a grief support group.
- Allow yourself plenty of time for reflection and healing.
- Practice self-care: with physical activity, enough sleep and proper nutrition.
- Try to be open about the suicide. This will give others permission to talk about your loss. Keeping suicide a secret can add to the burden of shame some survivors may feel.
- Seek out information on suicide and grief.
For Parents
You’re not alone
Losing a teen to suicide is an incredible loss. No one is ever prepared for it. The aftermath is often clouded by the misconceptions and stigma that surround both mental illness and suicide.
Participating in a peer to peer support group with others who are going through the same experience will be an important step toward managing your grief. You can find available support groups and more support for survivors of suicide at: Canadian Association for Suicide Prevention – Coping with Suicide Loss
For Educators
How to talk to students about a suicide death
Young people will experience a range of emotions after the death of a classmate, similar to the feelings you may have. However, they may not express their feelings in the same way. They may also revisit their grief as they mature and have new responses to, or new questions about, the suicide at different times in their lives.
Read our After a Student Suicide toolkit for more information.
How to help students deal with their grief
- Remember that you cannot take away the loss, but you can assist as they explore and express their grief.
- Let them talk about their grief.
- Understand and make allowances for their developmental level and maturity.
- Recognize their assumptions about control and their personal safety may be challenged or lost.
- Respect differences in grieving. Let them grieve how they want or need to. Young people cannot control where, when or how they will be affected by their grief.
- Answer questions honestly, providing factual information about suicide.
- Talk about the person who died. Remembering the person who has died is a part of the healing journey. Sharing memories will give others permission to talk about their thoughts and feelings.
- Get back to normal routines as soon as possible.
- Important: Seek professional help for a student ifyou are concerned they are struggling to cope with their griefortheir grief is interfering with the ability to function over a longer period.
For information on how to help a teen after the loss of a friend or classmate from suicide, you can access the following publication: Children, Teens, and Suicide Loss
Caring for yourself
Suicide can be a challenging journey. Caring for yourself is critical if you are going to care for others.
Physical well being
- Get plenty of exercise to relieve tension and stress and reduce depression.
- Prioritize getting enough sleep every night.
- Avoid or limit your intake of alcohol, caffeine, drugs and tobacco.
- Eat well and drink plenty of water each day
Mental well being
- Get professional help if the stress is overwhelming.
- Learn some relaxation techniques and practice them every day.
- Keep a journal to record your thoughts and feelings. Doing so can give you a new perspective or clarify something that has been bothering you.
- Learn new communication skills, parenting or related subjects via online courses or books.
- Talk things out. Meet with a trusted friend, family, colleague or a professional counsellor. Do not try to cope alone. A family physician, member of the clergy, or a counsellor may be able to help you find a new perspective, develop strategies and cope better with the stressors in your life.
- Take a break. Do something you enjoy every day. Listen to music, dance, go to a movie, walk with a friend, pursue a hobby, volunteer in the community.
- Learn to say ‘no’. Turn down extra projects, invitations or work that you don’t have the energy or time for. Recognize that everyone needs quiet time to relax and be alone.
- Schedule some alone time. Reflect on what you have learned or accomplished and what you still need. Take a hot bath, get a massage, read a book or go for a drive.
Spiritual well being
Attend to your spirituality. Visit different places of worship, volunteer at your regular place of worship or read books on spirituality.
Resources
Workshops
- ASIST – Attending this two-day course will train you to intervene with an individual who is suicidal.
- safeTALK – This 3-hour workshop alerts someone to warning signs indicating risk of suicide.
- Looking Forward – This half-day workshop is for people working with youth ages 12 to 18.
- Small Talk – This half-day workshop will examine warning signs in a teen and intervention strategies.
- Little Cub – A one-day, discussion-based workshop examining suicide in Indigenous children and communities.
Webinars for teachers
- Welcome back a student who experienced suicidality
- What to do after a student suicide
- What we wish all teachers knew about suicide
- Social media, contagion and suicide
References
American Foundation for Suicide Prevention & Suicide Prevention Resource Center. (2018). After a suicide: A toolkit for schools (2nd ed.). Waltham, MA: Education Development Center.
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