Dartmouth Health shares suicide prevention tips and how to help struggling teens

Suicide is the second-leading cause of death for Americans ages 15 to 24, and nearly 20 percent of high school students report serious thoughts of suicide, according to the National Alliance on Mental Illness. That number is even higher among LGBTQIA+ young people, as nearly 47 percent of whom report having had suicidal thoughts, according to a 2019 Youth Risk Behavior Survey. September is Suicide Prevention Month, a time to raise awareness for a tragically common, yet entirely preventable, cause of death—especially amongst young people.

“One of the reasons why the risk is so much higher in children, teens, and young adults is related to development,” says Rose Hitchings, PsyD, a member of the integrated behavioral health team at Dartmouth Health’s Cheshire Medical Center. “Our brains do not reach full maturity until the mid-20s. From a biological perspective, when the pre-frontal cortex—the front part of the brain—is not fully developed, we are more impulsive. When the amygdala—the area in the brain that holds emotions—is activated, the front of the brain can’t keep up, and this creates behavior that is reckless and impulsive. It is hard to think of the future in these moments.”

With the right medical and mental healthcare and support from caring adults, a young person experiencing suicidal ideation may fully recover and live a long, happy life. While it may feel overwhelming for parents, guardians, grandparents, mentors, and other adults in a distressed teen’s life, following these steps can help, Hitchings says.

1. Know the warning signs: If a young person has expressed they don’t want to live anymore or makes life-ending statements, it should always be taken seriously. Seek professional help immediately if this happens. Other signs that may be more subtle but also warrant immediate action may include: self-harm or researching how to harm themselves (i.e., looking up how to buy a gun); substance abuse; acting anxious, agitated and/or recklessly; sleeping too little or too much; extreme mood swings; and withdrawing socially, among others.
2. Say the right things: If you believe your teen is struggling, starting the conversation—even if it feels uncomfortable at first—can be life-saving. Be sure to listen with respect and empathy and without judgment. For example, say, “I’ve noticed you’re sleeping in lately,” instead of “Why are you sleeping so much lately?” They may say they want their privacy and don’t want you controlling them, but ask the questions anyway. Make sure to listen and respond empathetically. Be sure not to minimize or downplay their thoughts or feelings, like: “If you’re not okay, what is going on in your life right now that is making you feel sad?” And, “How can I help?”
3. Make the home a safer environment and instill hope: Here are some simple steps you can take today to make your home safer for someone who may be thinking about suicide:
   • Possible weapons: While locking guns may feel safe, removing them from the home entirely promotes safety (bullets, too). This would include reducing access to knives, sharp gardening tools, power tools, or farming equipment.
   • Make sure that over-the-counter and prescription medications are locked up or stored away from the person’s access. If necessary, consider putting all medications into a lock box and keeping the key with an adult caregiver. 
   • Monitor common household chemicals (paint thinner, gasoline, cleaning products) and store these out of the person's access, monitoring their levels.
   • Identify a list of settings that can provide a distraction during a stressful situation (i.e., movies, games, TV, books, or a journal).
   • Make a plan to create a “Hope Box” that can remind your teen that life is balanced with positive moments, such as a letter to self from when not feeling suicidal, photos or souvenirs from favorite vacation spots, images of family members, children’s artwork, etc.
4. Know who to call: Make a list of people your teen would feel comfortable talking to—perhaps a therapist or clergy member—to have on hand. Make sure the National Suicide Prevention Hotline number (1-800-273-8255) is readily accessible in an emergency. In case of an emergency, you can always call 911 or go to your nearest emergency department. The following resources are also helpful:
   • Parents and loved ones of LGBTQIA+ children can visit The Trevor Project website for more focused information.
   • Parents and teens facing racial stress may benefit from these strategies and tools offered by the American Psychological Association.
   • National Suicide Prevention Hotline: 1-800-273-8255
   • New Hampshire Crisis Line: Text or call 1-833-710-6477. Visit NH988.com for further information.
   • Vermont: How to Get Help
   • YouthLine: 877-968-8491 or text teen2teen to 839863.
   • Crisis Text Line: Text HELLO to 741741.

“One of the first things you can do as a person caring for a teen with signs of suicide risk (or really at any moment) is to provide hope,” Hitchings says. “Difficult times do not last forever. They are not alone. This reassurance will help a child or teen feel you will support them.”