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American Academy of Pediatrics

Suicide Prevention: Signs and Safety Planning

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Suicide is the second leading cause of death for 10- to 24-year-olds. Parents can help protect their children by being aware of risk factors and warning signs and talking with their child. Here is information from the American Academy of Pediatrics about suicide, including how to prevent suicide and what to do in a crisis.

An Important Conversation

The best way to find out whether a child or an adolescent is thinking of suicide is to ask. However, this can be a difficult topic. Your child's doctor may be able to suggest ways to start the conversation.

Signs That Your Child or Adolescent May Be Thinking About Suicide

If your child or teen feels depressed, you should watch for signs that they are considering suicide, including

  • Talking about dying or a wish to die

  • Talking about how they or the world would be better off if they were dead

  • Talking about feeling hopeless or about having no reason to live

  • Withdrawing from activities they used to enjoy

  • Isolating from family and friends

  • Sleeping too much or too little

  • Eating too much or too little

  • Consuming media that focuses on death

  • For young children, using death as a topic during playacting or drawing

  • Searching online for suicide-related topics

  • Giving away possessions

Children and adolescents who feel depressed, express suicidal thoughts, and are also using alcohol or other substances are more likely to die by suicide. Be sure to ask your teen about alcohol use and discuss with the doctor whether you suspect that your child or adolescent is using alcohol.

Safety Planning

If your child is feeling depressed and having suicidal thoughts, help your child create a safety plan. This plan includes the following information:

  • Identifying warning signs/triggers. Your child should write down the thoughts or situations that generally lead to having thoughts of suicide.

  • Using coping strategies. You and your child should list things that they can do, when they are feeling depressed or thinking about suicide, to help them feel better.

  • Socializing. List people and activities that can help your child take their mind off of difficult thoughts and feelings.

  • Contact family members or friends. Make a list of people, and their phone numbers, who can help when your child is under stress or is experiencing the warning signs in step 1.

  • Professional help. Write down the names and numbers of your child's therapist or doctor. Also, add the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) and the Crisis Text Line (text HOME to 741741 to connect with a trained counselor).

  • Make the environment safe. Eliminate things around the house that might be used in a suicide attempt, such as firearms, ammunition, sharp objects, or medicines. Studies show that even teens living in homes where firearms are locked up are more likely to die by suicide than those in homes without firearms. A home is safest without firearms. If you must have a gun, make sure the gun is stored unloaded and locked in a safe or with a trigger lock and the bullets are locked in another place. Secure all medicines up and out of reach of children and teens, and safely get rid of all old or unused medicines.

You can ask your child or teen's doctor for a safety plan you can fill out.

What to Do in a Crisis

It is important to keep supportive and nonjudgmental lines of communication open with your child, especially if they are at increased risk for suicide. Your child's doctor can connect your family with mental health professionals if your child is having thoughts of suicide. In a crisis situation, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text the Crisis Text Line, by texting HOME to 741741, to speak with a trained counselor. Call 911 if self-harm is occurring or is about to occur.

Resources

American Academy of Pediatrics www.aap.org and www.HealthyChildren.org

  • American Academy of Child and Adolescent Psychiatry www.aacap.org/AACAP/Families_and_Youth/Family_Resources/Home.aspx

  • American Foundation for Suicide Prevention www.afsp.org

  • Centers for Disease Control and Prevention ("Suicide Prevention") www.cdc.gov/violenceprevention/suicide/index.html

  • Crisis Text Line www.crisistextline.org Text HOME to 741741 to connect with a trained counselor.

  • National Alliance on Mental Illness www.nami.org

  • National Suicide Prevention Lifeline https://suicidepreventionlifeline.org 1-800-273-TALK (8255)

  • Substance Abuse and Mental Health Services Administration www.samhsa.gov

Disclaimer

Adapted from the patient education brochure, Suicide Prevention: What Parents Need to Know.

The American Academy of Pediatrics (AAP) is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.

In all aspects of its publishing program (writing, review, and production), the AAP is committed to promoting principles of equity, diversity, and inclusion.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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