‘My son has admitted he is suicidal. What do I do now?’

This article focuses on the awkward days or weeks after a heart-to-heart confession from your child that he has been suicidal. Or perhaps it’s after a hospital stay for suicide risk or an attempt. You are likely feeling very anxious and don’t know what to do or say. Perhaps your child has already had the suicide risk assessment and safety planning and you’ve already been through your home taking to “remove means.” Maybe you have made have an appointment with a therapist or psychiatrist. You may even feel you are on “suicide watch.” In any of these scenarios you might feel, “now what?”

If any of that fits, this article is for you

You probably want to ask, “Are you OK?” every time they walk in the door. You may even jump every time that phone rings fearing it’s “the call.” You may even be tempted to exact a promise they won’t try suicide or dismiss their thoughts as “trying to get attention” or otherwise say things like, “You have so much to live for.” By the way, they are not the right things to say. Instead, you want to say, “Tell me more.” And then listen without fixing.

This article focuses on your worry and how you work through that with yourself and your child.

Agonizing about any projected scenario does not help because it puts your brain in an emotional state that doesn’t allow you to connect to your thinking brain. It freezes you. It was only after a few visits to my support group that I was able to let go of the tortuous worry that was keeping my stomach wound as tight as a washcloth being wrung out.

So what do you do?

First, take a deep breath. This is not something that is solved by a single therapist visit or in a week or two. You’re in this for the long haul. And just know that recovery is not only possible it’s probable. There are far more attempts than there are suicides.

These days, a hospital is not always step one unless the child is unresponsive, has attempted, or has been assessed as being a high risk for suicide which is determined with an evaluation or assessment. Consider yourself fortunate your child shared this with you. Now, you must learn to communicate and connect with your child in a different way and that includes opening up and confessing your worries with “I feel” words.

Tell your child that you are trying to figure this out, too, but you are there, no matter what

Share with them where you are coming from, being careful not to judge or lecture your child. They are likely feeling helpless, confused, frightened, and ashamed and not quite sure what to do with all those feelings.

You can’t expect them to just open up if that’s not what they’ve done before. So start a conversation with your confession. Adapt this conversation to your situation.

“I am honored and grateful you confided in me about your thoughts of suicide. That took enormous courage and I’m grateful and proud of you. I am working through this, too, and have to confess that at times, I feel panicked and terrified of the thought of losing you. And that means I want to constantly ask, call or text you to find out and ask how you are doing but I know how annoying and unproductive that is so I try to resist. It makes me feel short-tempered, irritable, and anxious.

The look you see on my face doesn’t mean you have let me down. That look you see is pure fear. I love you so much that the thought of losing you scares the life out of me.

Number one, I will figure out my own feelings but I’m asking if you can help me work through this by offering your mom (or dad) a random hug and connecting with me more so that I feel less panicked. I will find some support for myself because I want to understand. That includes educating myself, understanding this more and understanding you. That means listening more and lecturing less.

Number two. Until you can meet, or we can meet as a family, with a therapist and establish a plan to keep you safe during periods when you are suffering thoughts of suicide, I am going to ask you to enter these numbers into your phone. It will make me feel better. Call me any time, but should I not be available because I am in the shower or some other reason, plan now to contact the crisis text line at 741-741, or reach out to the suicide hotline at 988.

Thank you for listening to me and know that I am here to listen to you, too.”

When they express a feeling, make sure to understand their fears by asking, “What frightens you about that?” Ask without passing judgment and listen with empathy without providing a solution.

You can ask how you can help or ask how they might deal with the issue. But when you try and fix it, they resist. Tell your child you are confident they, and you, and a professional will work through this together.

In the next few weeks and months, let your child in on any decisions made for them giving them agency in the process. For example, practice what he/she/they will say to a mental health professional. And allow them to decide how they want to tell and if they want you to be there for support. They may prefer to do a video and share that with a therapist. They might prefer to tell their story by writing it out.

You want to give them agency whenever possible. If they are coming out of a hospital setting, it’s likely they are feeling helpless and not in control over anything. And this is way to hand some of that control back to them and allow them to develop important coping skills.

Then share other things you might be struggling with

Not huge catastrophic issues but some bite-sized problems for which you’d like another point of view.

For example, if you have a choice at work to take a new position and you are wrestling with the decision, ask your child for his thoughts. For one, they’ll reflect back to you things you didn’t think of. That helps them learn to problem solve and that you respect and trust they are capable of coming up with solutions. It doesn’t mean you have to do them but thank them for their insight. You’ll also get some ideas you had not thought of.

While this might seem like “the wrong time” to include them in decision-making, this is a way to give them some of their power back and illustrate you have confidence they can make decisions and think through problems.

Overall, asking more questions, and not the probing kind, helps them develop their own solutions. Ask with curiosity and not judgment.

Questions like,

“How do you think you might handle that?” Or, “What do you think would work best?” “My coping strategies always include riding my bike. I could use some more ideas. What are some of yours?”

I know this is a tough place to be and there is no easy, quick fix. I wish there was. There may be medication involved and adjustments, as well as diagnosis of mental illness in some cases. Keep your mind open to being part of the recovery plan. Because you are not taking your child to get “fixed.” It’s not just their recovery it’s ours, too.

We need to learn more and become educated, empathic, understanding, and thoughtful. We need to admit we don’t know everything but we are there for support through a crisis as they work through it. We need to avoid being accusatory, angry, and combative when there are drugs or self-harm involved especially. And we need to learn our child’s signs of suicide and have a safety plan of our own. What do you do in a crisis?

Remove means or restrict access to means

This means removing items from your home that could be potentially used for suicide. You may think, “They’ll find a way anyway,” but that’s not true. If they have a method in mind, they usually don’t think of a new one while in a suicidal crisis because their minds are trapped in tunnel vision. Removing means puts time between thought and action.

Why is that important? Because suicidal crisis episodes dissipate and after the crisis, the person often does not want to die by suicide anymore. So if the person struggling has to hunt down enough medication, that action alone takes time and gives the episode of suicidal intensity to peter out.

Start by removing any firearms from the house. Have a neighbor with a license “babysit” the weapon until things are more settled. 

I wouldn’t trust a gun safe because while the adults tell me “I have it under lock and key” the kids tell me how they get to the weapon and they somehow have combos or find them out. You would not believe the stories I hear and the adults who swear the firearm is safe. The absolute most important step to take is to remove means! Here’s what that means….

Putting prescription medications into a lockbox, removing any large bottles of Tylenol or Advil, and replacing them with a tiny container of Advil (Tylenol causes death and serious liver damage.). Beware of packages from Amazon that are about 6-8 inches square and weigh 3-5 pounds (they sell kits on Amazon for $19), getting a CO detector to detect levels of carbon monoxide, get rid of poisons, and anti-freeze. Hanging is more difficult to prevent but remove any ropes and lanyards and monitor or lock rooms that have easily accessible rafters such as attics and barns. Remove alcohol and drugs, including rediwhip, vanilla flavoring, and mouthwash.

Removal of means is a whole presentation itself so here is a link to a website with more information.

Means Matter, Harvard

What should you expect from a mental health professional?

You should expect:

• psychological evaluation
• a suicide risk assessment and
• a suicide prevention safety plan. Until you get one, here are examples of safety plans.
• The safety planning would also come with “means safety” which would mean removing certain over-the-counter medications, and old prescriptions as well as locking up current prescriptions. If you own a firearm, it would be wise to put that in a thumbprint safe. (There is a lot more to this part)

It is important for you to seek support, too

The solution is not to “send them off to be fixed.” Everyone has to shift, try to understand, and become more educated. Just like you would if your child was blind, lived with autism, or had diabetes.

When your kids see you get support, you are modeling that behavior and promoting seeking help as a sign of strength and not a weakness. Because it’s hard to tell one’s darkest feelings to another. But they are more likely at some point to find support if they know you have.

Seek support for yourself

• NAMI Family Support Group Locator and
• NAMI Family to Family Education (8-week course)
• Families Anonymous (for kids with substance misuse and addiction issues)
• Other mental health resources

Quick guides on what to say when someone is suicidal

6 reasons why kids don’t tell you they want to die