Suicide/Self-Harm

The statistics

Every parent would like to believe that suicide is not relevant to them or their family or friends. Unfortunately, it’s all too relevant for all of us. It’s the 2nd leading cause of death for youth age 10-24. Even more disturbing are national surveys that tell us that 17.7% of high school students admit to thinking about suicide and almost 9% acknowledge actually making an attempt. The unfortunate truth is that suicide can happen to ANY kid in ANY family at ANY time!

Does talking about it plant the idea in my child's head?

The short answer - no.

Once you acknowledge that suicide is as much of a risk for your child as not wearing a seat belt while driving, or using alcohol or drugs, you’ve taken the first step in prevention. You talk to your children about these other behaviors which can put them at personal risk, and suicide is no different. It’s something you CAN and SHOULD talk about with your children!

Contrary to myth, talking about suicide CANNOT plant the idea in someone’s head! It actually can open up communication about a topic that is often kept a secret, and secrets that are exposed to the rational light of day often become less powerful and scary. You also give your child permission to bring up the subject again in the future.

How do I start the conversation?

  • Timing is everything! Pick a time when you have the best chance of getting your child’s attention. Sometimes a car ride, for example, assures you of a captive, attentive audience. Or a suicide that has received media attention can provide the perfect opportunity to bring up the topic.

  • Think about what you want to say ahead of time and rehearse a script if necessary. It always helps to have a reference point: (”I was reading in the paper that youth suicide has been increasing…” or “I saw that your school is having a program for teachers on suicide prevention.”)

  • If this is a hard subject for you to talk about, admit it! (”You know, I never thought this was something I’d be talking with you about, but I think it’s really important”). By acknowledging your discomfort, you give your child permission to acknowledge his/her discomfort too.

  • Ask for your child’s response. Be direct! (”What do you think about suicide?”, “Is it something that any of your friends talk about?”, “Have you ever thought about it? What about your friends?”)

  • Listen to what your child has to say. You’ve asked the questions, so simply consider your child’s answers. If you hear something that worries you, be honest about that too. “What you’re telling me has really gotten my attention and I need to think about it some more. Let’s talk about this again, okay?”

  • Don’t overreact or under-react. Overreaction will close off any future communication on the subject. Under-reacting, especially in relation to suicide, is often just a way to make ourselves feel better. ANY thoughts or talk of suicide (”I felt that way a while ago but don’t any more”) should ALWAYS be revisited. Remember that suicide is an attempt to solve a problem that seems impossible to solve in any other way. Ask about the problem that created the suicidal thoughts. This can make it easier to bring up again in the future (”I wanted to ask you again about the situation you were telling me about…”)

Warning Signs of Suicide

Here are some possible warning signs that can be organized around the word “FACTS”:

FEELINGS that, again, seem different from the past, like hopelessness; fear of losing control; helplessness; worthlessness; feeling anxious, worried or angry often

ACTIONS that are different from the way your child acted in the past, especially things like talking about death or suicide, taking dangerous risks, withdrawing from activities or sports or using alcohol or drugs

CHANGES in personality, behavior, sleeping patterns, eating habits; loss of interest in friends or activities or sudden improvement after a period of being down or withdrawn

THREATS that convey a sense of hopelessness, worthlessness, or preoccupation with death (”Life doesn’t seem worth it sometimes”; “I wish I were dead”; “Heaven’s got to be better than this”); plans like giving away favorite things, studying ways to die, obtaining a weapon or stash of pills; suicide attempts like overdosing or cutting

SITUATIONS that can serve as “trigger points” for suicidal behaviors. These include things like loss or death; humiliations, rejections, or failures, getting in trouble at home, in school or with the law; a break-up; or impending changes for which your child feels scared or unprepared

If your child is expressing suicidal thoughts, please contact your local area mental health provider or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

For a downloadable handout of the above information, click here.

About Self-Harm

What is self-harm or self-injury?

Self-injury is the act of physically hurting oneself without the intent to die. It is a sign of emotional distress and indicates a person has a lack of healthy coping skills. The most common forms of self-injury are cutting, burning, or scratching the skin and bruising the body tissue. Most people who self-injure start when they are teenagers.

Why do people self-injure?

Youth and young adults who self-injure generally report that they do it to cope with upsetting feelings, to feel something when they are numb, and/or to express their pain. There is evidence that self-injury releases endorphins in the brain, helping people who self-injure to feel better in the short term. However, self-injury is not a healthy long-term coping skill and is a risk factor for later suicidal behavior. There is also a common belief that self-injury is attention-seeking, but in reality, most people who self-injure hide their cuts, scars, or burns because extra attention is unwanted.

Is self-injury the same as suicidal behavior?

Self-injury is NOT an attempt to kill oneself. Some people who self-injure even say they do it to STOP themselves from acting on thoughts of killing themselves. Even though self-injury and suicidal behavior are very different, many individuals who self-injure may have suicidal feelings too. See above information for the warning signs of suicide.

Is recovery possible?

Recovery is certainly possible! Because self-injury is often used as a coping mechanism, recovery can occur when individuals are provided effective alternatives to manage their emotions. Of course, a youth needs to be motivated to stop self-injury for the road to recovery to begin. Motivation can be low when people feel they only have one tool to manage their pain. A skilled therapist will help youth who self-injure evaluate the role self-injury plays in their lives, challenge the idea that only self-injury can reduce distress, build self-confidence to choose healthier coping skills, establish clear emotional support networks, prepare for possible relapses and celebrate success along the way.

Warning Signs of Self-Harm

Because many youth who self-injure hide their scars and do not wish others to know about this behavior, noticing signs of self-injury can be hard. The following warning signs can alert parents that self-injuring may be occurring:

  • Unexplained cuts, burns, or bruises, typically on the arms, legs, or stomach

  • Wearing bandages frequently

  • Finding razors, sharps, knives, or other items that could be used to self-injure

  • Wearing long-sleeve shirts or pants in warm weather

  • Unwillingness to participate in activities that require less clothing (e.g., swimming)

  • Wearing wrist bands, multiple bracelets, or wide-band leather bracelets to conceal cut

  • Expressions of self-loathing, shame or worthlessness

  • Withdrawing from family and friends

It is important to look for all of these warning signs if you suspect your child is engaging in self-injury. Although many youth who self-injure isolate themselves from others, some continue to hang out with friends and family and appear happy.

If your child is self-harming, please contact your local area mental health provider or talk with your doctor.

Self-harm rarely resolves on its own without treatment.

Talking To Your Child About Self-Harm

  • Address the issue as soon as possible. Self-injury rarely resolves on its own.

  • Be aware of your own emotions. Parents who learn their child is self-injuring may feel a wide range of valid feelings: anger, sadness, shock, anxiety, and/or guilt. If your emotions are running high, it is not the right time to talk.

  • When you’re calm, start by telling your child what you have noticed and why you are concerned.

  • Validate your child’s feelings. This is different from validating your child’s behavior. You do not have to agree with self-injury as a coping tool to be emotionally supportive.

    • Listen non-judgmentally. Let your child speak freely without reacting while he/she is talking. Then offer your thoughts.

    • Speak in a calm and comforting tone.

    • Offer reassurance that you will get through this together.

    • Think about how you wanted adults to react when you were a teenager who was emotionally distressed.

  • Do not pressure your child to talk. If you’re feeling anxious, your child probably is too. Self-injury is an stressful topic for everyone. And if your child is self-injuring, it can indicate your child has difficulty verbalizing his/her emotions. Let your child know you are available to talk and bring up your concerns again at a later time.

  • Get your child professional help from a licensed therapist with experience treating self-injury.

The above information on self-harm is from Nationwide Children's. For the full article, click here.

Helping Your Child Reduce Self-Harm Behavior

1. Create a coping kit.

Put positive and uplifting items in a shoebox or another container, which your child can use when they get the urge to self-harm. This can be anything from a journal to art supplies to upbeat music to photos of friends, family or their heroes. Include anything your child finds calming or inspiring.

2. Model positive imagery.

Visualizing a beautiful, serene place is a great way to reduce anxiety or painful emotions. When you practice positive imagery in front of your child you help them strengthen these skills. Serani suggests talking aloud as you describe a soothing landscape – like a beach – or positive memories of a place you’ve been to. Use vivid details in your descriptions.

3. Talk about triggers.

Help your child better understand the types of situations and stressors that trigger their negative feelings. As Serani notes, “If it’s a test coming up in school, a social event or a dentist appointment, talk about how the days leading up to it can feel stressful.” This helps your child be prepared and have the necessary skills at their disposal. Also, talk about your personal triggers and the healthy ways you cope.

4. Suggest using less severe behaviors.

If the urge to self-harm is still present, Serani suggests “using less severe activities,” such as “holding an ice cube, tearing paper, shredding a sheet, snapping a rubber band, sucking a lemon peel and pounding a pillow.”

5. Suggest engaging in physical activities.

According to Serani, the rush of adrenaline in physical activities, such as running, dancing and playing chase with their pet, actually produces the same chemical surge that self-injury does.

6. Be compassionate about setbacks.

Stopping self-harming behavior isn’t easy, and it’ll take time. Your child may have setbacks. The best approach if a setback occurs is to offer nonjudgmental support. “Research shows that shame, criticism, or overreaction when parents see a wound causes children to withdraw back into self-harming behaviors,” Serani writes.

Again, if you think your child is self-harming, make an appointment with a therapist for a professional assessment, and support them in practicing healthy coping strategies.

Overcoming self-harm isn’t easy, but, with effective intervention, your child can stop these behaviors and get better. The key is to get help.


To read the full article from Psych Central, click here.

Other Resources

KidsHealth: Helping Teens Who Cut

Click here

Cornell Research Program: Information for Parents

For more helpful guidelines on talking to your child about self-harm, click here.

Child Mind Institute: Help for Cutting and Other Self-Injury

Click here

To find a counselor in your area, go to the "Counseling" page under the section Social Emotional Resources.