Suicide is a serious concern affecting children and adolescents, and pediatric healthcare providers have an important role in prevention. Although conversations about suicide can feel uncomfortable or frightening for parents and caregivers, recognizing warning signs, encouraging open communication, and seeking help early can make a meaningful difference in a young person's life.

Children and adolescents may experience significant emotional challenges related to school, friendships, family relationships, bullying, social media, mental health conditions, or other stressful life events. Sometimes, however, a child who is struggling may not openly communicate what they are experiencing. Understanding changes in behavior and knowing when to seek help can help families respond before a situation becomes a crisis.

Recognizing Warning Signs

• There is no single behavior that can predict suicide risk. However, parents and caregivers should pay attention to significant or persistent changes in a child's mood, behavior, or daily functioning.
• Potential warning signs may include withdrawing from family or friends, losing interest in activities they once enjoyed, changes in sleep or appetite, declining school performance, increased irritability or agitation, frequent expressions of hopelessness, or feelings of worthlessness or being a burden to others.
• Parents should take any statements about suicide, death, self-harm, or not wanting to live seriously. Even if a comment is made during an argument or appears impulsive, it should not simply be dismissed. A child's emotional distress deserves attention, understanding, and appropriate evaluation.

Talking With Your Child

Parents do not need to have the perfect words to begin a conversation. A calm, compassionate, and nonjudgmental approach can help a child feel safe enough to share what they are experiencing.

If you notice changes in your child's behavior, start by sharing what you have observed. For example, you might say, “I've noticed that you've seemed different lately, and I'm concerned about how you're doing.” Give your child time to respond and listen without immediately criticizing, minimizing, or trying to solve the problem.

If you are concerned about suicide, it is appropriate to ask your child directly whether they are thinking about suicide or hurting themselves. Asking directly does not cause suicidal thoughts or increase suicide risk. Instead, it can create an opportunity for a young person to talk about feelings they may have been afraid or unable to share.

When Therapy Can Help

Therapy can provide children and adolescents with a safe, supportive space to talk about difficult emotions and develop healthier ways to cope with stress. Depending on the child's age, needs, and circumstances, therapy may focus on emotional regulation, coping skills, communication, self-esteem, problem-solving, relationships, or processing difficult experiences.

A therapist can also help parents and caregivers better understand their child's behavior and learn strategies for providing support at home. Therapy does not mean that something is “wrong” with a child. Seeking mental health support can be a proactive step toward improving emotional well-being and building skills that can help a young person throughout their life.

When to Contact Your Pediatrician

Parents should contact their child's pediatrician when they notice concerning emotional or behavioral changes, particularly when symptoms persist, interfere with school or daily activities, or involve self-harm or thoughts of suicide.

Your pediatric healthcare team can help evaluate your child's emotional and behavioral health, discuss concerns with your family, identify potential risk factors, and determine whether additional mental health services are appropriate. Depending on the situation, a pediatrician may recommend counseling, behavioral health services, psychiatric evaluation, or other community-based resources.

Seeking help early is important. You do not need to wait until your child is in crisis before talking with their healthcare provider.

Creating a Safe and Supportive Home Environment

Suicide prevention also includes creating an environment where children feel comfortable asking for help. Regular conversations about emotions and mental health can help reduce stigma and make it easier for children to speak up when they are struggling.

Parents and caregivers should also consider reducing access to potentially dangerous items in the home. Medications, firearms, and other potentially harmful objects should be stored securely and appropriately. If your child is experiencing suicidal thoughts or significant emotional distress, speak with your pediatrician about additional steps you can take to help maintain a safe environment.

Encouraging healthy routines, adequate sleep, physical activity, positive relationships, and time away from excessive screen or social media use can also support overall emotional well-being. These strategies are not substitutes for professional treatment when a child is experiencing a mental health crisis, but they can contribute to a supportive home environment.

You Don't Have to Face It Alone

Suicide prevention is a shared responsibility. Parents, caregivers, pediatricians, mental health professionals, schools, and communities can work together to identify concerns and connect young people with appropriate support.

If you are worried about your child, trust your instincts and reach out to their pediatric healthcare provider. Asking for help is not a sign that you have failed as a parent, it is an important step in protecting your child's health and well-being.

If your child is in immediate danger, has attempted suicide, has seriously injured themselves, or cannot be kept safe, call 911 or go to the nearest emergency department. In the United States, you can also call or text 988 to reach the Suicide & Crisis Lifeline.

Every child deserves to feel heard, supported, and valued. Early recognition, compassionate support, and access to appropriate care can help children and adolescents move through difficult moments and toward hope and recovery.

Shannon Richardt, LCSW

Pediatric Associates of Greater Salem