What to do if you think a child is considering suicide

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Dr. Matthew Wintersteen, director of research at the Thomas Jefferson University Medical College’s Division of Child and Adolescent Psychiatry, spent five years working at the Children’s Hospital of Philadelphia, where he developed a standardized screening tool to assess suicidal youth.

This four-step protocol may assist youth services workers who are concerned about young people and suicide.

Know the Risk Factors 

Wintersteen said youth services workers should be well-acquainted with common warning signs and behaviors that may indicate suicidal ideation, including impulsivity, a lack of connectivity with others and increased alcohol use.

Information listed on sites like the National Center for Prevention of Youth Suicide (suicidology.org) he added, should be familiar to all those who work with children.

Ask Questions

“It’s easy to be concerned about somebody and never ask the questions,” Wintersteen said. “The harder thing to do is ask them, “Are you OK? How have you been feeling?’”

Listen 

Adults should be very attentive to a young person’s responses, Wintersteen said, and give the child ample opportunities to express how they feel about certain issues in their lives. “Just simply being a sounding board for some youth becomes terribly powerful,” Wintersteen said. “Suddenly, they feel like they can talk about something that’s difficult, that maybe they haven’t shared with other people before.”

Help Them Make A Connection 

After asking a young person what they may be able to do to help them personally, Wintersteen said adults should then try to collaborate with the child to seek out additional supports, such as a counselor, a therapist or a psychologist. “But the important piece before all of that is the listening piece,” he said. “If the kid has learned that they can talk to somebody about how they feel and not get into trouble for it or they’re not going to be judged for it, they may be likelier to talk to the professionals who have some training, and know how to manage those feelings and help them work through those feelings so that they are able to develop a sense of ‘I have a life worth living.’”

Additional resources

The Substance Abuse and Mental Health Administration’s National Registry for Evidence-based Practices and Programs (NREPP) lists several best-practice resources, including, the Lifelines Curriculum and the Emergency Room Intervention for Adolescent Females.

Dr. Alex Crosby, an epidemiologist with the National Center for Injury Prevention and Control, said the latter provides a “strong continuity of care” for girls who are hospitalized following self-inflicted injuries and demonstrates best practice standards for other groups to follow.

The Suicide Prevention Resource Center and the American Foundation for Suicide Prevention also provide best practices registries, including items such as the Question, Persuade, Refer (QPR) Gatekeeper Training for Suicide Prevention and a compilation of state laws regarding suicide prevention.

—James Swift