Parenting Resources for Suicide Prevention in Teens during Covid-19
Michele Berk, Ph.D., Stanford University
As part of our focus on providing resources for youth and families struggling with mental health issues during the COVID-19 pandemic, the goal of this blog is to offer tips to help parents/caregivers keep teens at risk for suicide safe in the home. During this challenging time, when families are sheltered-in-place together and access to mental health services and other family supports are limited, providing parents/caregivers with evidence-based tools for keeping the home environment safe is of critical importance. If your teen is currently in mental health treatment, please work closely with your teen’s provider to create a safety plan for the home and to continue with regularly scheduled appointments (many providers are currently providing services via telehealth). If you believe your teen is at risk of engaging in suicidal and/or non-suicidal self-injury behavior (e.g., cutting), and they are not currently in mental health treatment, we recommend finding services as soon as possible. Many clinics are continuing to take new patients and are offering services via telehealth during the COVID-19 pandemic.
Tips for Reducing Risk of Suicidal Behavior in the Home
These tips should be followed for all youth with a history of suicide attempts, non-suicidal self-injury (e.g., cutting), and suicidal ideation.
1. Restriction of Access to Lethal Means. Removing easily available means in the home reduces risk of an impulsive suicide attempt or non-suicidal self-injury and gives the teen time to reconsider, seek help, and/or be interrupted by others. Remove or secure access (using a safe or lock box) to all dangerous or potentially life-threatening objects in home, including: firearms, sharps (knives, razors, scissors), medications (prescription and over the counter) and toxic substances (bleach, household cleaners) and alcohol. Ideally, all potentially lethal means should be confiscated and removed from the home. If this is not possible, then needed items (e.g., prescription medications) should be kept in a locked box or safe. Youth at risk for suicidal behavior SHOULD NOT HAVE A FIREARM IN THE HOME. (For tips on how to safely remove/lock firearms, see: https://www.hsph.harvard.edu/means-matter/recommendations/families/#Questions). We recommend checking your child’s room and belongings for any means they may have in their possession. Teens often hide items away “just in case” they may want to engage in self-harm in the future.
2. Parental Monitoring. Teens at risk of attempting suicide or engaging in non-suicidal self-injury should be monitored closely by parents and/or other trusted adults. Depending on the level of risk, the amount of monitoring may include frequent check-ins with the adolescent, not allowing the adolescent to be alone in his or her room or in an isolated part of the home, not allowing the youth to lock the door to his or her bedroom or the bathroom, not allowing the adolescent to leave the home, or not allowing the adolescent to be alone at all (constant monitoring, including sleeping in the same room or bed with the adolescent). Given that 24/7 monitoring by parents may not be sustainable for extended periods of time, an adolescent who requires 24/7 monitoring should be evaluated by a mental health provider to determine if the crisis has resolved to the extent that parents can reduce monitoring or if the youth needs to be transferred to an inpatient level of care.
3. Reduction of Family Conflict. Family conflict is a risk factor for suicidal behavior in teens. It is important to reduce conflict between teens and parents as much as possible. This is particularly important now, when families will be sheltered in their homes together for an extended period of time. It is critical to maintain a positive relationship with your teen, and to reduce conflict, criticism, and anger, so that your teen will go to you for help if they feel suicidal instead of hiding this information from you.
4. Take all Talk About Suicide and Self-Harm Seriously. Talking or writing about suicide and self-harm to family or friends (including posting on social media, writing in a journal) is a warning sign that a teen may be planning to engage in these behaviors. In our experience, it is rare for a teen to “pretend” to be suicidal in order to get attention or get their way, and a teen who is repeatedly talking about suicide/self-harm for any reason is at risk. It is safer to take all communications related to suicide and/or self-harm seriously and be wrong than not to take it seriously and have a potentially life-threatening behavior occur (i.e., “better safe than sorry”).
5. Reduce Contagion. Adolescents are particularly vulnerable to “contagion” of suicidal and self-harm behavior. It is important to closely monitor your child’s phone calls, texts, internet, and social media use to reduce the risk of contagion. Hearing others talk about self-harm behavior and/or seeing images can trigger a vulnerable teen to engage in these behaviors. Teens should also be cautioned not to share or receive information from peers and social media. Teens should also not watch movies or television shows that include this topic.
6. If you believe your teen in is imminent danger of attempting suicide and/or you feel you can no longer keep them safe at home, seek emergency services (see list below).
Some signs of imminent danger include (but are not limited to):
o Threatening to hurt or kill oneself (either verbally or in writing or social media posts) right now or within the next 24 hours.
o Actively looking for ways to kill oneself: seeking access to pills, weapons, or other means.
o Writing a suicide note or goodbye letter, either on paper or via social media, giving away possessions or other preparations for death.
o Severe insomnia, particularly with extreme anxiety and/or agitation.
Remember, as a parent, you know your teen better than anybody else! If you have concerns about your teen’s safety, even if they have not displayed the warning signs above, seek emergency help.
7. Emergency Services for Youth in Imminent Danger of Self-Harm
· CALL 911 OR TAKE YOUR CHILD TO THE NEAREST EMERGENCY ROOM if you believe they are in imminent danger of engaging in self-harm behavior.
· If access to Emergency Rooms connected to medical hospitals becomes limited, contact the Crisis Hotline for your local county mental health department. This information should be readily available online or in your local phone book. Search for “XX County Department of Mental Health.”
You may also call one of the 24/7 emergency hotline numbers below:
o National Suicide Prevention Lifeline: 1-800-273-TALK
o Crisis Text Line: Text START to 741-741