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Talking to kids about suicide

Talking to kids about suicide: A conversation too important to avoid

Child and youth suicide prevention strategies from Seattle Children’s Hospital's Dr. Alysha Thompson

 It can feel uncomfortable and even downright counterintuitive to broach the subject of suicide with your child or teenager.

 But it is also extremely necessary, explained Dr. Alysha Thompson, clinical director for the Seattle Children’s Hospital Psychiatry and Behavioral Medicine Unit.

“We talk about safe sex. We talk about avoiding drug and alcohol use. We also need to talk about suicide,” says Thompson.

Jarring statistics

Between 2012 and 2019, Washington State’s suicide rate for youth ages 15 to 19 was nearly 16 deaths per 100,000 adolescents. That’s slightly higher than the nationwide rate, according to the 2021 Health of Women and Children Report.

At the same time, there are not enough mental health professionals to meet the region’s need, explains Thompson.

The situation can feel daunting. But, as students head into September – and national Suicide Prevention Awareness Month – Thompson says it’s important to remember that there are plenty of resources for families and steps parents and guardians can take to help their children long before crisis hits. National Suicide Prevention Week is set for Sept. 4-10 this year.

Graphic courtesy National Institute of Mental Health.

Open discussions are best

First, start early. 

No, Thompson isn’t suggesting talking about suicide with your toddler. But openly discussing feelings with very young children and labeling emotions can build an important foundation. She gives the example of a child starting to cry after spilling milk. To help that child give words to their emotions, a parent might say, ‘You’re feeling so upset right now because your milk spilled.’

In the toddler years, it’s important for parents to start talking to kids about coping with their feelings, Thomson says. 

Older kids need consistent conversation

By the time kids hit their teens, the job of preventing tragedy becomes more about checking in with them regularly about their feelings.

“It might be in the drive to and from soccer practice; It might be sitting down at dinner; It might be at night before people go to bed,” says Thompson. “There’s all sorts of different ways to weave these conversations in. But making sure that you’re giving space for [checking in]  throughout the week, allows for when kids are having a harder time, you’ve already got a venue for this.”

A topic its important not to avoid

Thompson recommends not avoiding the topic of suicide. Doing so can add to the stigma. Instead, she advises parents to make direct statements to teenagers. For example, she offers this approach: 

‘Hey, I’ve heard that being a teenager is hard, and that these are sometimes things that people think about, that they might think about hurting or killing themselves. Does that ever come up for you or any of your friends?’ 

Bringing up suicide to a child who hasn’t been thinking about it isn’t going to suddenly result in suicidal ideation, Thompson says.

Asking can lead to the help they need

“But kids who are thinking about suicide, if they don’t get asked direct questions about it, might never tell somebody that they’re having those thoughts,” she says. “So then they kind of suffer alone without getting the support that they need.”

In 2021, one in five Washington State 10th- and 12th-graders reported considering suicide in the previous year, while 8% and 7% respectively reported attempting suicide in the previous year, according to The Healthy Youth Survey.

Watch for warning signs

There are several warning signs to look for, Thompson explains. These include such things as sudden changes in mood or level of activity, isolating themselves, talking about death and dying and making plans for suicide.

Although it is rarer for younger children to consider suicide, Thompson says it does happen. So, it’s important to look for warning signs in younger children as well.

988 Suicide & Crisis Lifeline is there to help

Over the summer, the 988 Suicide & Crisis Lifeline was launched across the U.S., giving the public a simple number to reach mental health support. There are also more local resources, such as Teen Link, which offers support by trained youth volunteers, and Seattle Children’s Hospital, which has an online mental health resource hub.

Thompson also highlights the importance of keeping guns away from children and medication, even over the counter pills, locked away. According to The Giffords Law Center to Prevent Gun Violence, 76% of gun deaths across the state are suicides.

If you think a child is planning suicide

If your child says they are thinking about suicide, have a plan and might do it, it’s vital to take immediate steps.

“That’s the time to get in the car and get to the emergency department, and get evaluated to see if they need a more intensive level of care, like inpatient psychiatric treatment,” she says.

Connection makes all the difference

But, she stresses, it’s not just about responding to these acute moments. It’s also about the days and even months leading up to them. If a child who is becoming depressed has a connection with warm, loving, supportive adult can help them navigate their pain,

All, children, but especially those who are struggling with depression or other mental stress, need at least one adule who is  “ a sounding board for the things that they’re going through and is engaged in things that bring them joy.

“All of those are protective, to help prevent future suicidal ideation,” she says.


The 988 Suicide Prevention Hotline is now open. If you or someone you love is having suicidal thoughts, call 988. The current National Suicide Prevention Line number, 1-800-273-TALK (8255), will remain active along with the new 988 dialing code.Call services will be available in Spanish, along with interpretation services in over 250 languages. Spanish speakers may reach the Spanish Language Line by pressing 2 after dialing 9-8-8 or 1-800-273-TALK (8255). Text and chat services are available in English only.

Know the signs of suicidal thinking

Knowing the signs that a person is considering or thinking about suicide is critical to getting them help. Some of these are most likely to be seen in adults, but most apply to children as well. Here are some warning signs from the 988 Suicide & Crisis Lifeline:

  • Talking about wanting to die
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no purpose
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious, agitated or recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

Source: 988 Suicide & Crisis Lifeline

Read more at Seattle’s Child:

“Unmasking anxiety: Resources for parents”

“Kids and mental health: A psychologist’s tips for supporting young people”

“Depression in kids: How to spot it and where to look for help”

About the Author

Hallie Golden

Hallie Golden is a freelance journalist based in Seattle. When she's not writing, she's out running with her German Shepherd puppy named Wally.