Suicide in Children & Teens

Suicide is intentional self-harm that results in death. Among children between the ages of 15 and 19, suicide is the second leading cause of death, and the leading cause of death for 14- to 15-year-olds, according to the Centers for Disease Control and Prevention.

Suicidal thoughts and behaviors are the greatest predictors of suicide. These include frequent thoughts about ending one’s life, making plans, rehearsing or preparing for a suicide attempt, and attempting suicide.

If you think your child might be at risk for suicide, it is important to have them evaluated by a professional. Call your primary care physician, your child’s therapist or psychiatrist, your local mobile crisis team, or visit the closest emergency department. In an emergency, call 911.

What causes suicide?

There is no single factor that causes suicide or suicidal thoughts.

Many people who go through a stressful life event, such as the death of a loved one, may feel intense sadness or loss, anxiety, and anger. Some may even think they would be better off dead. But for most people, stressful life events do not lead to recurring thoughts of suicide.

Yet for someone with mental health concerns such as depression or anxiety, stressful life events or prolonged stress can cause deep feelings of distress and hopelessness and increase the risk of suicide.

Impulsivity and substance abuse can also increase a child’s risk of suicide. However, mental health issues can be treated and most often do not lead to suicide.

Suicide risk factors

• mental illness
• drug or alcohol abuse
• access to guns, drugs, or other means of self-harm
• prolonged stress or a stressful life event
• suicide of a family member, friend, or classmate
• childhood abuse, neglect, or trauma

What are the warning signs of suicide?

People who attempt or die by suicide often exhibit a number of warning signs. A child or teenager who exhibits more warning signs is typically at higher risk of suicide.

Warning signs include:

• sudden changes in behavior
• cutting off contact with friends and family members
• losing interest in activities they used to enjoy
• extreme irritability
• increased use of drugs or alcohol
• change in sleep patterns (either not sleeping or sleeping more than usual)
• change of appetite
• giving away possessions or calling people to say goodbye
• preoccupation with death (recurring themes of death or self-destruction in artwork or written assignments)
• frequently talking about suicide
• previous attempts to harm themselves

What should I do if I think my child is at risk of suicide?

You can start by talking with your child. Ask how they are doing and if they ever think of killing themselves. Be sure to use clear, straightforward language. Having regular conversations in which you show concern and give your child room to express their honest thoughts and feelings lets your child know that they can talk with you when they need to.

If your child expresses suicidal thoughts or exhibits self-harming behaviors, seek professional help through your pediatrician, Boston Children’s Hospital, calling a suicide helpline like the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contacting the Crisis Text Line by texting TALK to 741741.

It’s important to limit your child’s access to possible means of suicide:

• Remove guns or other weapons from the house or keep them locked up where your child can’t access them.
• Store prescription medications safely and dispose of unused or expired medications.

How is a child’s risk of suicide measured?

A child’s risk of suicide is measured in stages by different health care providers.

Suicide risk screening is a set of questions used to identify whether a child is at risk of suicide. A screening may be done by your child’s pediatrician or a nurse as part of a standard health assessment.

Suicide risk assessment is more thorough than a screening and is used to confirm whether your child is at risk of suicide. Assessments are done by trained mental health professionals, such as psychiatrists, clinical social workers, clinical psychologists, psychiatric nurses, and mental health counselors.

For a rapid suicide risk assessment, contact your primary care physician, a local crisis team, or local emergency department.

If my child is at risk of suicide, what happens next?

The mental health professional who assesses your child should work with you and your child to make sure your child receives appropriate care. Your child’s treatment may include inpatient psychiatric hospitalization, a partial hospitalization (day program), outpatient psychotherapy, home-based therapy, psychiatric medication, or some combination of the above.

Is it possible to prevent suicide?

• Yes. Frequent open communication that gives your child room to explore their thoughts and feelings with you is one of the best ways to prevent suicide.
• Your child may not tell you they are thinking about suicide out of concern over how you might react. By asking direct, non-judgmental questions, you can encourage your child to share their thoughts and feelings.
• Don’t be afraid to talk ask your child if they have suicidal thoughts. Studies repeatedly show that people do not start thinking about suicide just because someone asks them about it.
• Have an emergency plan in place. If you suspect your child is at risk, get them help immediately.

Resources for families

• National Suicide Prevention Lifeline
• Society for the Prevention of Teen Suicide
• Suicide Prevention Resource Center
• National Institute of Mental Health
• American Foundation for Suicide Prevention
• Massachusetts Coalition for Suicide Prevention
• Suicide in Children and Teens
• Suicide Safety: Precautions at Home

How we care for children and teens at risk of suicide

The Boston Children’s Hospital Department of Psychiatry and Behavioral Sciences has long been at the forefront of providing expert, compassionate care to children and adolescents with mental health issues. Our approach to mental health care is evidence-based — which means our treatments have been tested and proven effective through scientific studies, both here at our hospital and by other leading institutions worldwide.

For children's who need hospitalization, Boston Children's Inpatient Psychiatry Service provides family oriented psychiatric assessment and treatment with the goal of returning your child to a more comfortable environment for ongoing care.