If you or someone you love is struggling with suicidal thoughts, there are resources to get them help. Call the National Suicide Prevention Lifeline at 988 or 911.

The topic of suicide isn't an easy discussion, but a necessary one to help guide and protect the lives and mental health of our teenagers. Every year, approximately 45,000 Americans die by suicide, and in 2020, suicide was the second-highest cause of death in Americans ages 10 to 14.

"Fostering an environment where open communication is the baseline is vital," says Jerry Walker, PhD, Nebraska Medicine psychologist. "An open and empathetic ear is our first priority. It's never too late to work on improving communication – the big key is trust and vulnerability. I encourage parents to be open, vulnerable, and willing to talk about their own difficulties and failures." 

To help keep the lines of communication open long-term, we've put together a quick, how-to reference guide for parents, guardians and coaches.

How to keep the lines of communication open

• Start early to set up the "norms" for communication. If you haven't before, start now
• Kids take cues from how adults have responded to them in the past. Practice nonjudgmental, open discussions so your teen feels safe
• Be open and vulnerable. Vulnerability is key to building trust
• Early and often, have conversations about keeping open lines of communication
• Designate several trusted individuals (ideally responsible adults) or agencies that your teen can also feel safe confiding in

Questions to ask that can help foster open communication, give you an idea of how they're doing and areas of possible growth:

• What do you do for fun? What is enjoyable for you that's not necessarily productive?
• What do you do to manage stress?

Dos and don'ts on how to talk to teens about suicide

Do:

• Ask directly about thoughts of suicide, depression and anxiety. Naming these things is important to open the door to a discussion
• Keep an open mind and a nonjudgmental attitude. Remember, having suicidal thoughts is nobody's fault. Listen for the message behind the words
• Be prepared to listen and empathize even if you don't understand
• If a teen is willing to talk and has expressed struggling with thoughts of self-harm, ask them if they have a suicide plan. You won't be planting any ideas if they've already thought about how they may do it. The goal is to find out how far along the teen is in the process to help parents know what they can do to create a safe environment 
• If they have thoughts of suicide, ask if they intend to follow through with their plans. Are the thoughts intrusive thoughts or do they actually intend to hurt themselves?

Don't:

• Invalidate their feelings. Often people can't help that they're having these thoughts and need someone to help them process them. Validate their feelings instead
• Try to "just focus on the positive." Don't ignore what they share. Leave room for negative emotions
• Steer the conversation immediately toward problem-solving. Although this may be tempting, what teens need is for someone to listen, to feel heard, understood and validated

What to watch for in high-achieving teens 

• Where is their motivation coming from? Intrinsic (doing things for themselves) or extrinsic motivation (fear of letting others down)
• Do they have perfectionistic tendencies (this can lead to anxiety)?
• Are they feeling guilt and self-doubt?
• How are they relieving stress? What do they do for fun (that's nonproductive)?
• Do they feel connected to others and supported?

Children and adolescents are at a higher risk for suicide if they:

• Are male (four-times higher risk than females)
• Identify as homosexual, bisexual or transgender
• Suffer from multiple psychiatric conditions, such as depression and anxiety
• Are a victim of abuse – emotional, physical, sexual
• Have previously attempted suicide
• Struggle with impulsivity or aggression

Watch and listen for:

• If they've expressed being bullied, harassed, isolated or socially shunned
• If they feel a lack of control over things happening to them (this is a huge developmental stage need)
• Thoughts that not only are things bad but that they'll never get better

If they express being bullied or harassed:

• Ask them how they feel the problem should be addressed and empower them to do so
• Involve them in the decision making so they feel some sense of control over the outcome

Extra tips for coaches:

• Be mindful of how, when, and where sensitive conversations happen
• Foster trusted relationships with students so they feel they can come to you
• Be conscientious about how pursuing a conversation may look to others and feel to the student in the moment

Resources:

National Suicide Prevention Lifeline: 988
Suicide Prevention Lifeline Chat: Lifeline Chat: Lifeline
Resources for Parents: https://afsp.org/teens-and-suicide-what-parents-should-know