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Content Warning: This post deals with topics related to suicide. Please take care when reading. If you or someone you know is in crisis, call 988 (Suicide and Crisis Lifeline), go to the nearest emergency room, or reach out to one of the following national resources:

• Crisis Text Line: Text HOME to 741741

• Trevor Project: Text START to 678-678

Suicide prevention is a critical issue that affects children of all ages — not just teenagers and adults. September is Suicide Prevention Month, which means it's a crucial time to address the often-overlooked topic of suicidal ideation in young children. In this article, we aim to educate caregivers about the signs and symptoms of suicidal thoughts in children and provide valuable insights to support their mental health.

Understanding Suicidal Ideation in Young Children

Suicidal ideation refers to thoughts about ending one's life. Contrary to common belief, these thoughts can occur in children as young as 5 years old. Data from our recently published white paper “The Hidden Crisis: Suicidality in Children as Young as 5” revealed that:

• Almost 1 in 5 elementary and middle school-aged children (ages 8 to 14 years old) presented with current positive suicide risk

• 6% of children aged 3-7 showed current suicide risk

• 27.7% of children aged 8-14 screened positive for lifetime suicide risk

These statistics show just how important it is for caregivers to recognize and address suicidal thoughts in young children.

When to Worry: Key Indicators

There are various risk factors that can elevate a person's suicide risk. However, it's critical to remember that even if a person doesn't appear to have these risk factors, it doesn't mean they aren't contemplating suicide. If you notice any of the warning signs listed below, it's important to take action.

Risk Factors

1. Health conditions

Depression is the most common condition associated with suicide. However, other mental health conditions can also elevate suicide risk, especially when not identified or treated by a professional:

• Anxiety

• PTSD

• Substance abuse

• Significant health conditions, particularly those involving chronic pain, and traumatic brain injury can increase the risk for suicide.

2. Environmental and social factors

• Access to lethal means including firearms and drugs

• Prolonged stress, such as harassment, bullying, relationship problems, or unemployment

• Stressful life events, like rejection, divorce, financial crisis, other life transitions, or loss

• Racial and gender identity can also impact suicide risk; it's important to recognize that Black and LGBTQ+ young people are at elevated risk of suicide

  • A 2018 study by JAMA Pediatrics found that black children ages 5-12 were dying by suicide at twice the rate of their white peers

• Exposure to another person's suicide, or exposure to graphic or sensationalized accounts of suicide

3. Life experiences

• Previous suicide attempts

• Family history of suicide

• Childhood abuse, neglect, or trauma

Warning Signs of Suicide Risk

Most people who are considering ending their lives will exhibit warning signs of suicide risk. These warning signs may indicate an immediate risk, in which case, it's important to take action as quickly as possible. Doing so can save a life.

Here are 3 warning signs of immediate suicide risk. If you notice any of the following, it's important to take immediate action:

1. Talking or writing about wanting to die or kill oneself

2. Looking for a way to kill or hurt oneself

3. Talking or writing about feeling hopeless or having no reason to live

If you observe these signs, take immediate action:

• Call or text 988, the Suicide & Crisis Lifeline

• Go to the emergency room

• Send a message to the Crisis Text Line: Text HOME to 741741

• Text the Trevor Project: Text START to 678-678

Here are 8 warning signs indicating serious suicide risk. If you notice any of these behaviors in your loved one, pay attention and speak to a mental health professional:

1. Aggression

2. Changes in irritability and impulsivity

3. Displaying extreme mood swings

4. Feelings of sadness or loss of interest

5. Sleeping too little or too much

6. Withdrawing from activities

7. Talking of being a burden

8. Isolating from friends and family

It's especially important to seek support if the behavior is new, or seems related to a painful event, loss, or change.

Prevention Strategies

Here are key strategies for caregivers:

1. Seek Professional Mental Health Care

Accessing mental health care is a crucial part of suicide prevention. The best way to prevent suicide is to seek mental health support if and when you’re worried about or become aware of suicidal ideation in your child.

2. Open Communication

Have honest conversations with your children about their feelings. If your loved one talks about death, not wanting to live, or suicide, pay attention, and take what they say seriously, even if they're young. Don't assume that children don't understand the importance or meaning of their words.

Research shows that asking someone if they have thoughts or a plan to die by suicide doesn't increase their risk. It actually connects you with your loved one and can open the door to supporting them in getting help.

3. Create a Supportive Environment

The family plays an important role in prevention by supporting their loved one in getting mental health support. Foster feelings of connectedness within the family, as doing this can reduce the risk for suicide. Validate your child's emotions, even if you don't understand them.

4. Limit Access to Lethal Means

Proactively limit access to lethal weapons, like firearms, to create a safe environment for your child. Reduce access and exposure to weapons, certain medications, and dangerous objects.

5. Learn Warning Signs and Develop a Safety Plan

Create a written plan of action or a "safety plan" with your mental health provider. This plan is a checklist of activities and actions you promise to do to stay safe when having thoughts of suicide. Make a list of contacts and resources for when you or your loved one feels suicidal, as well. Include contact information for doctors, therapists, crisis centers, and family members or friends who have agreed to be part of your safety planning. You can access Little Otter’s Home Safety Guide here.

6. Address Environmental and Social Stressors

Pay attention to factors like bullying, harassment, unemployment, financial stress, divorce, and death.

7. Commit to Care

If you or a loved one are in treatment, commit to the care. Take medications if prescribed and engage in therapy (or support them in doing so).

8. Join Support Groups

Doing this can help build connection and ensure that neither you nor your loved ones feel alone.

9. Encourage Healthy Habits

Engage in or encourage physical activity, which may reduce depression symptoms. Try to do positive things, even if you don't feel like it (e.g., reaching out to a friend, taking a walk, getting out of bed and showering). These simple actions can help reconnect and re-engage.

10. Address Substance Use

Avoid drug and alcohol use, or support others in doing so. Alcohol and drugs can increase suicidal thoughts, impair thinking and judgment, and increase impulsivity and likelihood of self-harm.

11. Create a List of Reasons to Live

This list doesn't need to be perfect or comprehensive. It can include things as simple as "being alive". Finding a sense of purpose in life can make a difference.

Resources

For immediate support:

• Call 911 or your local emergency number

• In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

Seeking mental health care and support is the most important action you can take. If you're concerned about your child or want to learn more about this topic, Little Otter's Suicide Prevention Resource Hub for additional resources, including downloadable guides and informative blog articles.

Recognizing the signs of suicidal ideation in young children is the first step in prevention. By staying attentive, fostering open communication, and seeking professional help when needed, we can support our children's mental health and well-being. 

And remember: Neither you, nor your child, are alone.

At Little Otter, we screen all children 8 and older and those under 8 with known factors for suicide risk using evidence-based screening tools and interventions.

If we identify increased suicide risk, we schedule a comprehensive initial assessment with a licensed mental health provider as soon as possible with the child and parents. During that appointment, we conduct a thorough risk assessment and develop a safety plan with the child and family, if indicated. We strive to be proactive and alert, so that we don’t miss these signs of suicide risk.

To learn more about how Little Otter can support your family's mental health needs, click the link below.