One of the first questions that I ask all of my new patients starting therapy (regardless of the reasons they came to see me) is, “Have you ever had thoughts, either currently or in the past, of suicide or wanting to harm yourself?” And in my 15 years of practice in the field, I’m struck by the number of young patients who answer “yes” to this question, with responses ranging from casual passing thoughts of self-harm to active suicidal ideation coupled with recent attempts.

This becomes of particular concern while practicing here in Shanghai, given that, despite being a first-tier city, our community is still sorely lacking in its ability to provide comprehensive, emergency care support for individuals who are a danger to themselves. As with most mental health conditions, early detection and intervention are key, thus our current focus will be on how we as parents can identify and support our young people struggling with thoughts of suicide.

What the Research Says

According to a 2016 research study published by representatives from the World Health Organization, suicide accounts for approximately 6% of deaths amongst our child and young adult population, ranking as the second-leading cause of death for 15-29 yearolds worldwide. For every completed suicide, the number of additional individuals experiencing active suicidal ideation and attempting suicide occurs at an alarming rate of 20 times that.

Given the status of suicide as a global epidemic, happening across culture, class and country of origin, it further stresses the importance for us practitioners working in an international community like Shanghai to screen every one of our patients at the outset of treatment for any evidence of either current or past suicidal ideation and/or attempts. For families with children whom are experiencing thoughts of suicide, I always advocate having an honest, open and ongoing discussion regarding the matter until both the child and parents feel as though the dangerousness of the situation has abated.

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Despite the increased incidence of suicide and suicide attempts worldwide, such thoughts or behaviors are never to be considered a typical reaction to childhood stress—thus the importance of these discussions with your children should not be minimized or overlooked.

Tips for Talking to Your Child about Suicide

1) Do not avoid the discussion.

Oftentimes parents will shy away from a discussion about suicide, for fear that talking about it may increase the likelihood that their child will act upon it. In actuality, research and clinical practice has shown that providing children with a safe and supportive outlet to discuss their feelings is a primary method of suicide prevention.

2) Be direct with the language you use.

We want to avoid using veiled language or euphemisms in discussing suicidal thoughts or worries with our children, as it further contributes to the ambiguity about whether or not this is a safe topic to discuss. An example of being direct with our children about our concerns might sound something like, “I heard that you were feeling so upset lately that you wanted to hurt yourself. This has me worried, and I’d like for us to talk about it.”

3) Refrain from the blaming and the shaming.

The number one reason children give me as to why they avoid discussing thoughts of suicide with their parents is the fear that mom and/or dad would be mad at them. In these sensitive discussions with your child, stay focused on their feelings and avoid using language that might contribute to the shame that they are likely already experiencing about having such thoughts in the first place.

[Cover image via Pexels]

Dr. Balfanz is the Senior Clinical Psychologist at American Medical Center, a comprehensive medical and mental health service clinic for children, adolescents, adults and families living in Shanghai. For more information on clinic services, contact Dr. Balfanz at:  nate.balfanz@amc-shanghai.cn or visit his website at: www.drnatebalfanz.com