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How common are suicidal thoughts and behaviour?
How common are suicidal thoughts and behaviour?
Suicide is the second most common causes of death of young people. It is usually associated with a mental health problem but it's important to recognize that there might be several factors involved that lead to a young person to take their own life. Suicidal thoughts can happen to anyone so it's essential that caregivers and educators know the warning signs, factors that might increase a child or adolescent's risk and what supports are available to help young people and families in need.
What are some risk factors for suicidal thoughts or behaviours?
What are some risk factors for suicidal thoughts or behaviours?
For some children and adolescents, experiencing depression can lead to thoughts of harming themselves including suicide attempts. However, depression isn't the only risk factor for suicide. There are many situations in a child or adolescent's life that can make them more likely to think about or actually hurt themselves.
Some of these factors can't be changed, but it's important to know about them:
Family history: Having family members who have been depressed or who have tried to hurt themselves in the past.
Mental health issues: Children/adolescents who experience significant mental health issues like bipolar disorder, or substance abuse/addiction.
Discrimination: Hardship experienced as a result of belonging to a marginalized community, particularly individuals from racialized groups who identify as Black, First Nations, Metis and Inuit and individuals who identify as Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (2SLGBTQ).
Past attempts: If a child/adolescent has tried to hurt themself before, they're more likely to try again.
Easy access to weapons: Having weapons or dangerous items, especially firearms in the home.
Stressful life events: Big life changes, like the death or illness of a family member or friend or other significant family stressors.
Lack of support: Not having people to talk to or rely on can be lonely and scary.
Health problems: Having a serious medical issue or experiencing chronic pain.
Bullying or abuse: Being mistreated or victimized by peers or having a history of abuse.
It's important to remember that most young people who have these risk factors don't hurt themselves but knowing about these factors can help us understand and support them better.
What are the signs a child or adolescent might be having thoughts of suicide?
What are the signs a child or adolescent might be having thoughts of suicide?
Here are some common warning signs of suicidal thinking or behaviour in children and adolescents to watch for:
Talking about wanting to die or kill themselves
Looking for ways to kill themselves, like searching online for a weapon
Talking about feeling hopeless or having no reason to live
Talking about feeling trapped or in unbearable pain
Talking about being a burden to others
Using alcohol or drugs more often
Acting anxious, agitated, or reckless (e.g., engaging in risky behaviours)
Sleeping too little or too much
Withdrawing or isolating themselves
Showing significant anger or talking about seeking revenge
Having extreme mood swings
Giving away belongings to others and saying goodbyes
How can I have a conversation with my child/student if I'm worried they may have suicidal thoughts?
How can I have a conversation with my child/student if I'm worried they may have suicidal thoughts?
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Having a conversation with a child or teenager about suicide can be very uncomfortable and scary for the adults supporting them. Brief suicidal thoughts are quite common when people are feeling very stressed. Many times, we just want our struggles to be over with and don't want to feel pain anymore (e.g., thinking or saying "I wish I wasn't here anymore") but we have no plan to harm ourselves. However, some children and adolescents have more active thoughts about hurting themselves (e.g., thinking or saying "I want to kill myself"). It's important to know which type of thoughts your child or student is having. However, regardless if the young person is having passive or more active thoughts about suicide, we need to take all suicidal thinking seriously.
People who think about suicide often feel two main things:
1) they think they're a burden to others or
2) they feel very lonely or like they don't belong to a bigger group.
Here is some information that can help an adult speak to a child or teenager who might be at risk of suicide:
Talking about about suicide doesn't make people want to hurt themselves: Talking about suicidal feelings with young people actually helps keep them safer and helps them understand that others care about them. Don't wait for an ideal moment - it's better to have the conversation right away than to wait.
Take all threats seriously: Never minimize or dismiss suicidal talk as attention-seeking. While your first reaction might be to downplay talk of suicide to help keep yourself calm, it's important to act on the information right away and create a safety plan.
Be direct: Asking young people direct questions is key, such as if they're considering suicide, if they've attempted suicide in the past and if they have a plan. Although many young people don't have a plan and often act on impulse, this kind of information is important to know as having a plan places them at higher risk of attempting suicide. Use specific terms like "suicide" or "wanting to die" rather than using vague words that children might not understand (e.g., don't use phrases like "Do you want to pass away?).
Be calm: Although you may likely be feeling a range of strong emotions, try to keep your feelings in check. If you become overly emotional or stressed, it won't help the young person who's trying to communicate with you. They need you to help co-regulate their feelings.
Be consistent: Young people in distress need to be know that every time they come to you to talk about suicide that you will approach the conversation in the same way-with openness and without passing judgement.
Show compassion: Listen and let them express their feelings openly without fear of getting lectured or being punished. Reassure them that they're valued and that you're there to support them. It's also important not to try to solve their problem or provide a magical solution (e.g., "You just need to calm down and then you'll feel fine"). Try to find a balance between showing you care but also recognizing that their feelings and the issues involved might be complicated.
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Remove harmful items: If you have any weapons, sharp objects, ropes or medications that are easily accessible, remove them whenever possible or lock them securely.
Don't leave them alone: Ensure constant supervision if you believe a young person in distress is at immediate risk.
Seek out help immediately: Contact a mental health professional, crisis hotline, or emergency services (see resources below). Remember, you are not alone.
Create a safety plan: Work with the child or adolescent and professionals to develop a plan for handling suicidal thoughts. Part of the plan may include monitoring a young person's social media use to make sure they aren't exposed to harassment or bullying.
Encourage healthy coping strategies: Promote exercise, practicing mindfulness, creative activities (e.g., doing puzzles, drawing, building), being outside in nature and social connections (e.g., going on a family walk, joining a club).
Take care of yourself: As a caregiver, it's normal to feel overwhelmed and stressed. Once you've got a safety plan in place and have support from professionals, it's important for you to try to manage your stress by engaging in self-care. By doing so, you are also modelling good coping techniques for the young person in your life.
Where can I get help for my suicidal child?
Where can I get help for my suicidal child?
If you are a family member concerned about a young person in distress, there are many resources available. Here are some places to seek out support immediately and many resources are Canada-Wide and Available 24/7.
Crisis Lines:
Crisis Lines:
Text or call 988 for all ages trauma-informed and culturally affirming support to anyone who is thinking of suicide, or who is worried about someone they know https://988.ca
If your child is in immediate danger, go to your nearest Emergency Department or call 911.
Help Lines:
Help Lines:
Kids Help Phoneline 1-800-668-6868 Text and Live Chat options: https://kidshelpphone.ca
Youthdale’s Crisis Support Team: 416-363-9990 https://www.youthdale.ca
Trans LifeLine (All Ages) 1-877-330-6366 https://resources.youthline.ca/resource/Trans-Lifeline
LGBT Youthline 647-694-4275 Live chat messaging available: https://www.youthline.ca available Sunday-Friday 4:00 to 9:30 pm.
First Nations and Inuit Hope for Wellness 1-855-242-3310 https://www.hopeforwellness.ca
Canadian Indian Residential Schools Crisis Line 1-866-925-4419
Individuals impacted by the issue of Missing and Murdered Indigenous Women and Girls are encouraged to contact the MMIWG Crisis Line toll-free at 1-844-413-6649.
Anishnawbe Health Toronto 24/7 (Indigenous clients) – Mental Health Crisis Management Service: 1-855-242-3310
Assaulted Women’s Helpline: 416 863-0511; Toll-free: 1 866 863-0511
Community Crisis Program, Scarborough Health Network: 416 495-2891 for 24/7 telephone crisis support. Service borders: south to the lake, north to Steeles Avenue, east to Port Union Road, and west to Victoria Park
Gerstein Crisis Centre: 416 -929-5200
Homeless Help: If you are seeking shelter, call 416-338-4766, 1-877-338-3398 toll-free or 311
Spectra Helpline: 416-920-0497 or 905-459-7777; Languages: English, Punjabi, Hindi, Urdu, Spanish, Portuguese
Other Mental Health Resources:
Other Mental Health Resources:
Your child's school: Speak to an administrator at your child's school and ask for help. According to the TDSB's Life Promotion, Suicide Prevention and Postvention Protocol, the administrator will arrange for the school Social Worker to assess your child for imminent risk. Every school also has a Psychological Services professional who is a regulated mental health provider trained to assess, diagnose, consult and provide support to families in need. Here is a link to the Psychological Services Department and information on how referrals for services are made.
Help Ahead is a centralized phone line to access child, youth and family mental health and well-being resources in Toronto 1-866-585-6486
Strides Toronto (eastern part of Toronto) offers community, autism, developmental and mental health support, services and referrals in Toronto’s east end.
Lumenus (western part of Toronto) offers mental health, developmental, autism and early years intervention services to children, youth, families, and individuals across Toronto.
BounceBack Ontario is a free cognitive behavioural therapy (CBT) program that offers guided mental health self-help supports for adults and youth 15 and older. Toll-free: 1-866-345-0224
Youth Wellness Hubs offers youth services to support the well-being of young people aged 12 to 25, including mental health and substance use supports, primary health care, community and social supports.
Good 2 Talk is a free service for post-secondary students ages 17-25.
Where can I can help for my student having suicidal thoughts or behaviours?
Where can I can help for my student having suicidal thoughts or behaviours?
If you are an educator or staff member, speak to an administrator immediately. If a student is in crisis, the School Social Worker will be called to assess the student for imminent risk. Every school has a School Team with a Psychological Services professional who is a regulated mental health provider trained to assess, diagnose, consult and provide support to families and staff. After getting immediate help, a follow up meeting with the School Team and family is highly recommended. Recommendations that result from the meeting might include referral(s) to different school team members (Psychology, Social Work, Speech and Language, Occupational & Physiotherapy, Child and Youth Workers/ Child and Youth Counsellors), accessing central teams, such as the Autism Team or Behaviour Prevention and Intervention (BPI) team or mental health nurses. Contact can also be made to community agencies through the School Team.
Here are some other resources that you might find helpful:
BeSafe app: Free, evidence informed safety planning app that is specific to your location
TDSB Life Promotion, Suicide Prevention, Intervention and Postvention Protocol
School Mental Health Ontario: Youth Suicide Prevention, Intervention and Postvention
School Mental Health Ontario: What to do if you're concerned about a student's mental health?
Resources
Resources
Parents - Suicide Tip Sheet.pdfSuicide Tip Sheet for Parents
Educators - Suicide Tip Sheet.pdfSuicide Tip Sheet for Educators
Student Suicide Tip Sheet.pdfSuicide Tip Sheet for Students
For more information and resources, please see:
School Mental Health Ontario: Common student mental health concerns
School Mental Health Ontario: Supporting minds-strategies at a glance
Kids’ mental health is in crisis. Here’s what psychologists are doing to help
References:
References:
Bhatia SK, Bhatia SC. Childhood and adolescent depression. Am Fam Physician. 2007 Jan 1;75(1):73-80.
Canadian Institute of Child Health, (2019) “The Health of Canada’s Children and Youth”, Canadian Institute of Child Health. https://cichprofile.ca/module/1/section/3/page/suicide-rates-youth-15-to-19- years-of-age-by-gender.
Coleman, I. & Swanson, S., (2013) “Association between exposure to suicide and suicidality outcomes in youth”, CMAJ May 21, 2013 First published May 21, 2013, doi:10.1503/cmaj.1213 Centre for Addiction and Mental Health, (2017) “Mental Health and Well-Being Among Ontario Students”, CAMH. http://www.camhx.ca/Research/OSDUHS_Mental_Health_2017.
David-Ferdon, C., & Kaslow, N. J. (2008). Evidence-Based Psychosocial Treatments for Child and Adolescent Depression. Journal of Clinical Child & Adolescent Psychology, 37(1), 62–104.
Garber, J. (2006). Depression in children and adolescents: Linking risk research and prevention. American Journal of Preventive Medicine, 31(6, Supplement 1), 104-125.
Gaynes, B. N. (2013). Pediatric depression: An evidence-based update on treatment interventions. Psychiatry in Primary Care, 15, Article 381.
Griffin, E., McMahon, E., McNicholas, F. et al. Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007–2016. Soc Psychiatry Psychiatr Epidemiol 53, 663–671 (2018). https://doi.org/10.1007/s00127-018-1522-1.
Hidalgo, M. A., Ehrenstaft, D., Tishelman, A. C., Clark, L. F., Gorofalo, R., Olson, J., Rosenthal, S.M., Spack, N.P., (2013), The Gender Affirmative Model: What We Know and What We Aim to Learn, Human Development; 56:285–290 DOI: 10.1159/000355235.
Hoagwood, K., Burns, B. J., Kiser, L., Ringeisen, H., & Schoenwald, S. K. (2001). Evidence-based practices in child and adolescent mental health services. Psychiatric Services, 52(9), 1179-1189.
Ontario Student Drug Use and Health Survey (Author). (2024, August). 2023 OSDUHS Drug Use Report - Summary. Retrieved from https://www.camh.ca/-/media/research-files/osduhs-summary-drug-use-report_2023.pdf
Saewyc, E., (2007) “Contested Conclusions: Claims that Can and Cannot be Made from the Current Research on Gay, Lesbian and Bisexual Teen Suicide Attempts”, Journal of LGBT Health Research 3 (1): 79-87.
"Self-Injury–A guide for those who self-injure." Self-Injury and Self Report (2018, August 31), https://sioutreach.org/learn-self-injury/if-you-self-injure/#ffs-tabbed-14. Accessed 21 August 2024.
School Mental Health Ontario. (2020, September). Prepare; Prevent; Respond: A Suicide Prevention Guide for Parents and Families During COVID-19 and Return to School. Retrieved from https://smho-smso.ca/wp-content/uploads/2020/09/Prepare_Prevent_Respond_Web.pdf.
Toronto District School Board. (2023, September 20). Life Promotion, Suicide Prevention, Intervention and Postvention Protocol for School Staff. Toronto, Ontario: Author.
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