Talking about suicide with kids

There's a new pop song making waves in the music industry and beyond — for positive reasons. Logic, an American rapper, songwriter and producer, co-wrote the 2017 song, titled "1-800-273-8255."

It's a big deal because the title is the phone number for the National Suicide Prevention Hotline, and the lyrics beg listeners to hold on, see the light through overwhelming darkness and live. The song has been on Billboard's Hot 100 Chart for more than 36 weeks now, and charted as high as No. 3. 

Why is the popularity of a song important for parents? Because this particular song is opening the door for conversations about suicide — a topic often so awkward and uncomfortable that parents avoid it with their kids.

Suicide risks

The risk is real, and rising.

The American Association of Suicidology says that a young person between the ages of 5 and 24 killed him or herself every 85 minutes in the U.S. in 2016. According to statistics from the Centers for Disease Control and Prevention, in North Carolina, suicide was the third leading cause of death for children ages 10-14, and the second leading cause of death for teens and young adults ages 15-34.  

Moreover, suicide is a continually growing problem. The rate of youth suicides in North Carolina rose an alarming 62 percent from 2006-14. Suicide rates are higher in Western North Carolina than other regions of the state, as well.  

The 2015 NC Youth Risk Behavior survey revealed that an alarming 26.4 percent of high school students felt sad or hopeless almost every day for two or more weeks in a row. Nearly 16 percent of the students seriously considered attempting suicide in the prior 12 months, and 14 percent made a suicide plan. Nine percent attempted suicide, unsuccessfully, in the 12 months prior to completing the survey. 

"LGBT youth who have experienced severe family rejection due to their self-identity are eight times more likely to report attempting suicide," warns an American Association of Suicidology infographic they offer for public education and prevention efforts.

While these statistics are terrifying, they illustrate the necessity of talking to your children and teens about suicide.

Talking about it

Parents tend to avoid talking to their children about the harsh realities of life, in an effort to protect them from scary or sad things. Yet, adults need children to talk about suicide. The stigma needs to be lifted, to ensure that kids know they can talk to parents or trusted adults about this much-too-prevalent occurrence. 

The N.C. Division of Public Health created the 2015 Suicide Prevention Plan to "empower North Carolinians with knowledge and examples of actions they can take to prevent suicide." The No. 1 strategic direction in the plan is to create healthy and empowered individuals, families and communities. Part of that process is talking about suicide to change knowledge, attitudes, and behaviors. 

Let's explore the best ways to talk about suicide with our children, both in a prevention capacity and after a death by suicide.

Prevention

Mental health is often a taboo subject in our culture, but the best outcomes for our children come when we start talking about feelings and experiences from a young age.

"As they start school, parents should be in the habit of asking 'How was your day?' and talking about feelings and experiences," says Megan Somervill, MS, LPCS, of The True Self Healing Group in Asheville. "This instills a sense of the value of communication in navigating life's waters. It is important for adults to acknowledge some of their feelings of sadness or frustration calmly, to model healthy ways to deal with challenging feelings for children."

In essence, teaching coping skills through the years empowers kids to work through intense pain without resorting to self-harm and suicide.

"The preventive suicide talk is as important as other preventive safety talks, including drug abuse or fighting," says Somervill, "It does not need to be intensely detailed. All questions should be answered honestly, even if the answer is, 'I don't know.' Kids need to know that suicide is generally caused by a disease called depression. Share some basic warning signs, like feeling intensely sad most days, not wanting to talk to others about their sadness, and wishing they were not alive."

Tailor the conversation to your child's age and development.  

Tell your child about the National Suicide Prevention Hotline, and how to reach out for help if they're in crisis and not comfortable talking to you, or if no one is immediately available to help.

Healing

As connected as we are to immediate information today, kids hear about celebrity suicides in the news. Or sometimes it's even a classmate or someone close to them who takes their own life. A conversation with your child is as important at these times as it is beforehand for prevention.

Somervill warns against a common misconception: "Most importantly, talking about suicide does not, in fact, encourage it."

Kids need to know that it's OK, good even, to talk about suicide with a trusted person. The Moyer Foundation, an organization that provides comfort, hope and healing to children and families affected by grief and addiction, suggests that parents and caregivers choose their words carefully when describing a suicide. The common phrase, "committed suicide" sounds like the individual committed a crime. And, saying "completed suicide" gives the idea that there's something accomplished. Instead, use "died by suicide."

Somervill offers exactly the same advice. 

"The event might be a way to encourage the importance of talking about feelings, instead of withdrawing," she adds. "They should know that this person was in emotional pain, even if they hid it well, and did not know what else to do. Let (your child) know they could not have prevented the suicide, but use it as a reminder that everyone can use a good friend." These conversations should be ongoing, and kept fairly short in one sitting.  

Both Asheville City Schools and Buncombe County Schools have crisis response teams. The BCS team consists of counselors and social workers specially trained to support schools experiencing grief, loss, crisis, or trauma. The CRTs go to schools where a student or staff member has died, including if by suicide, to assist students and staff. 

"Asheville City Schools has ongoing professional learning communities with support staff and the mental health liaison for the district, Ms. Kidada Wynn," says Eric Howard, director of student services for Asheville City Schools. "ACS has partnerships with Buncombe County Mobile Crisis Management, Family Preservation and Youth Villages, which provide therapeutic emergency crisis services, as well as longer term and preventive services."

"Many private and school therapists in our area are trained to work with kids with suicidal ideation," Somervill offers. "Once the immediate crisis has passed, these therapists can form strong alliances with kids and help them learn ways to better cope."

Warning signs

Many kids who say or think they want to die really mean that they want the bad feelings and emotional pain to end. Somervill offers some warning signs. "Exhibiting just one of these signs may not indicate that it's time to panic," she says, "but it does signal that it's time to talk to your child."

• obsession with death
• talk about suicide
• giving away their belongings
• withdrawal from friends and family
• bullying or being bullied
• increased risk-taking behaviors
• drastic change in appearance or activities
• running away
• hopelessness
• change in eating and/or sleep patterns
• making suicidal threats or plans
• acquiring the means to attempt suicide (pills, razors, etc.)
• avoiding speaking in a future tense or stating things like "I won't be a problem much longer"
• sudden cheerfulness after a long period of depression
• being part of a high-risk group

High risk groups include: a previous attempt, recent loss, family history of suicide, history of abuse, depression, other serious mental illness, LGBTQ kids who are not supported in their families, dual diagnosis (mental illness combined with substance abuse), addictive behaviors, comorbid eating disorder, chronic pain or illness, and legal problems

Resources in WNC

There are many community facilities and services to help, if your child has suicidal ideation or is showing signs of a possible future suicide attempt. 

C3356 Comprehensive Care Center: 356 Biltmore Ave., Asheville, 828-254-2700. C3356 provides 24/7 mental and behavioral health support trough same-day access walk-in clinic, behavioral health urgent care, NAMI peer and family support services, and mobile crisis management in most WNC counties. Somervill says she often recommends the Mobile Crisis Unit because they will come to your house, make an assessment, and hospitalize, if necessary. Call 1-888-573-1006 to reach mobile crisis management.

Mission Hospital, 428 Biltmore Ave., Asheville, 828-213-1111. Children who need hospitalization will likely go to Mission Hospital Copestone, Mission's mental health facility. Go to Mission's Emergency Room or call 911 in an emergency.

Asheville City Schools: For immediate assistance, the Mental Health Liason, Kidada Wynn, is available at 828-767-3147. Parents can also call any of the ACS schools and ask for the Principal, Assistant Principal, Counselor, or Social Worker to provide information or to request school-based assistance. Central Office individuals to contact are Mr. Shane Cassida, ED of Student Support Services or Dr. Eric Howard, MSW, Director of Student Services 828-747-8023.

Buncombe County Schools: Contact the school counselor or school social worker for assistance. BCS has partnered with four local mental health agencies who provide, with the permission of the parent or guardian, school-based outpatient therapy. Agencies serve schools by district: Enka, Erwin and North Buncombe: RHA Health Services, Inc.; Reynolds and Roberson: Family Preservation Services; Owen District: Access Family Services. These services are accessed through the school counselor or social worker. For general questions about school-based mental health services, please contact David Thompson, Director of Student Services, at 828-255-5918 or Shanon Martin, Day Treatment Liaison, at 828-776-1505.