Securing the Environment for Suicidal Teens

Tragically, the prevalence of suicidal teens has increased dramatically over the last decade. According to the National Alliance on Mental Illness (NAMI), approximately 20 percent of high school-age kids report “serious thoughts about suicide,” while 9 percent report having had at least one actual suicide attempt. These are alarming statistics that tell us a lot about the heightened challenges facing young people.  Parenting a child experiencing suicidal thoughts can feel overwhelming, but there are absolutely constructive things that parents can do to help. In addition to making themselves available for necessary support, attention, and open communication, parents can engage practical strategies to reduce the risk of suicide or self-harm.Please note: The advice shared in this post is intended to support parents in creating a secure environment for a child in distress. It is not a substitute for treatment. Securing the environment, as discussed below, is a constructive task for parents when a teen is simultaneously beginning treatment for their suicidality or self-harm.

The following are actions parents can take to create a safe environment and plan ahead for escalating emotions and/or heightened risk of suicide.

1. Remove all dangerous objects.

Sharp objects that can be found in every room of the house need to be collected and locked up. Some examples include razors, scissors, tweezers, needles, etc. Items in the kitchen, like knives and cutting instruments, should also be secured and out of sight unless in active use by an adult for food preparation purposes. Be sure to lock away any ropes, shoelaces, or bungee cords, as well as any items your child could burn themselves with. Even sheets can be torn apart and used for harm, so it’s best to be mindful of this possibility and prepare accordingly.

2. Secure substances and medications.

All prescription and over-the-counter medication should be secured in a safe, with the key to the safe in your possession. If your teen takes medication independently, please talk to your doctor about your child’s self-harm and/or suicidal behaviors and your treatment team’s recommendation to secure your home. Specifically, ask your prescriber what the lethal dose is of each medication your child is prescribed and determine an amount that is safe to leave out for your child to take. This way, if your child acts on their thoughts and takes the medication you left out for them, you will already know that the amount they consumed was not lethal or dangerous.

3. Secure dangerous household cleaners and solvents.

This includes obvious solutions like bleach, ammonia, and other caustic cleaning products common in the home. We advise that you call the poison control hotline to find out the risks of different substances you have in your home.

4. Remove any firearms.

If you keep firearms in your home, be sure to store them securely, which means they are hidden away, unloaded, separated from ammunition, in a locked box or cabinet.

Additionally, when your child is in crisis, here are four things you can do as a parent. 

1. Monitor your child closely while they are in crisis by remaining in their presence.

Stay in the same room as them throughout the day and be prepared to sleep in their room overnight. During an episode of high distress, ensure that there are no immediate safety liabilities, like open windows or driving in a moving car. Confirm that the environment is fully secure as per the guidance above.

2. Prompt your child to call their therapist for support.

You can also encourage them to use skills learned in therapy.

3. Do not allow them to leave the house.

If they’re getting aggressive or physical with you, do your best to calm them or restrain them, if necessary. It can help to say aloud that they are very upset and focus on everyone just calming down and breathing. Even a strong, long hug can be helpful. Calm, reassuring communications are best. Be sure that you’re not stoking the fire by getting caught up in arguing; we just want to do everything we can to de-escalate. Sometimes, giving your child an ice pack or having them splash their face with very cold water can help if they’re willing to accept these tools.It can also be helpful to bring in outside support, like a neighbor or friend, when possible. Some parents find that confiding in a trusted neighbor can create some good backup support during a difficult period. If they understand the challenges you’re having, maybe they can even be instructed to swing by if they hear shouting or if you call them in the midst of a crisis. Most often, the presence of someone outside the family will be “embarrassing” to your child and calm things down immediately. Calling 911 is usually a last resort, but if you find yourself in a position where you need the police to intervene, when you call the authorities, it’s best to specify that you’re having a mental health crisis. Calling 911 might be necessary if your child runs out of the house or if they’re getting very physical and can’t be restrained or calmed.

4. Note that if your child is experiencing a particularly difficult period and expressing high suicidal ideation, it is best that they be escorted to and from school or other activities.

You will want to be sure that they are well monitored and cannot impulsively access traffic, subway tracks, etc.

While your child is in crisis, it’s important that you take their complaints and threats seriously without inadvertently reinforcing suicidality or non-suicidal self-injury.

• When your child threatens self-harm or suicide, immediately jump into “safety officer” mode and confirm that the environment is adequately secured. It’s OK if your child sees you doing this; your child will know you’re taking them seriously and that these threats simply mean that supervision and monitoring need to increase.
• While you’re monitoring your child, continue on with the normal responsibilities and activities of the day, and make sure that they are attending to their responsibilities too.
• Try not to let their threats or comments negatively influence you. You can do so by avoiding arguments or lengthy discussions about suicidal communication. You want to establish a safe and calm environment.
• If possible, avoid allowing your child to miss school or neglect their responsibilities during times of increased suicidal communications. If they do refuse, we suggest that you not excuse their absences or bail them out; it’s important that we allow the natural consequences of their ineffective behaviors to take place, as it’s usually the best way to reduce the likelihood of your child acting similarly in the future.
• Although it’s tempting, avoid providing special or fun activities to distract your child or cheer them up after they make comments about hurting themselves. We want to be sure not to pair suicidal communication with getting special attention.
• After the risk has passed and your child is calm, only then communicate that you do not want them to have to be suicidal or engage in self-harm to communicate their emotional distress. Make a gentle request that they tell you directly what they are feeling. Roleplay and offer suggestions about how they could have communicated to you more effectively and encourage a “re-do.” While they are expressing themselves effectively, you can positively reinforce them by listening attentively and non-judgmentally, reflecting back what they shared, and providing loads of love and validation.

Targeted therapy for a child/teen with suicidality will be focused on extinguishing their life-threatening behaviors.

It will help the individual feel better and increase their ability to commit to keeping themselves safe. In the meantime, via communication and active steps such as those discussed here, parents have the capacity to be central in maintaining safety for their child/teen. Effective parent strategies can help children avoid the revolving door of hospitalization and benefit instead from solid, home-based treatment for their suicidality. If someone is experiencing a psychiatric emergency, please take them to the nearest emergency room, call 911, and/or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).For additional resources, please visit SAVE: Suicide Awareness Voices of Education.If you or a loved one is struggling with an eating disorder and/or suicidal thoughts or behaviors, please reach out to our team at info@columbuspark.com to discuss treatment options.