79: What Do Parents Need to Know about Suicide?

Summary

Podcast Summary

Podcast: Ask Lisa: The Psychology of Raising Tweens & Teens
Episode: 79 – What Do Parents Need to Know about Suicide?
Date: May 3, 2022
Host: Dr. Lisa Damour & Reena Ninan
Guest: Dr. Jonathan B. Singer, Associate Professor of Social Work at Loyola University Chicago, co-author of Suicide in Schools

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Episode Overview

This episode features a frank and informative conversation about suicide among teens and tweens. Renowned psychologist Dr. Lisa Damour and journalist Reena Ninan are joined by leading suicide prevention expert Dr. Jonathan B. Singer. The goal is to offer parents science-backed, practical guidance on recognizing warning signs, discussing suicide, and supporting both teens and other families impacted by suicide.

Key Theme:
Empowering parents to talk openly and effectively about suicide with their children, recognize risk factors and warning signs, and support others affected by suicide—while dispelling common myths, understanding the data, and prioritizing both prevention and compassion.

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Key Discussion Points and Insights

1. Common Misconceptions About Suicide Timing

• Myth: Suicides occur most around the holidays.
• Fact: The highest rates are actually in the spring, with another rise in fall for adolescents; the lowest times are during the summer and school holidays.
  • “There's a long standing myth that people kill themselves over the holidays… what's true is that the highest times are in the spring. And then for adolescents, there's also a bump in the fall.” — Dr. Singer (02:10)

2. Root Causes and Risk Factors

• Suicide in teens can stem from:
  • Interpersonal conflicts (with parents, peers)
  • Bullying or cyberbullying
  • A profound sense of not belonging or being valued (structural issues like racism, economic inequality)
  • Unique to youth: Some suicidal acts may be meant as a statement to others (“13 Reasons Why” effect).
• “All these things… really speak to this idea of I'm not valued. People don't care if I live or I die. I don't see a future for myself.” — Dr. Singer (02:44)

3. Warning Signs and "Out of the Blue" Suicides

• Most people, including adolescents, give off warning signs before a suicide, though these are often recognized only in retrospect.
• Warning signs:
  • Verbal hints (“I don’t think anybody would care if I lived or I died.”)
  • Deactivation or withdrawal from social media
  • Uncharacteristic anger or aggression
  • Sudden changes in sleep or eating habits
  • Giving away possessions
• “Most kids display some sort of warning signs. What we find is that it's retrospective…” — Dr. Singer (05:30)
• Important Quote: “At the moment, you're like, well, it couldn't have been suicide. But in retrospect, you're like, yeah, I guess that was a warning sign.” — Dr. Singer (05:36)

4. Teen Communication and Parental Response

• Teens often use slang/acronyms like “kms/kys” (“kill myself/kill yourself”) in conversation—parents must probe gently:
  • If a teen says, “I’m going to kill myself if I don’t get an A,” acknowledge the stress, and ask calmly if they are thinking about ending their life.
• “Just very gently, very… I’m not making a big deal out of this. I’m just saying I want to know.” — Dr. Singer (07:13)
• Script example: “Hey, sometimes… when people are really stressed, they'll say things like, I'm gonna kill myself, but they don't actually mean it. And sometimes they're actually thinking about ending their life because it just seems so overwhelming. They can't imagine going on. And I'm just wondering if you've had any of those thoughts.” — Dr. Singer (06:41)

5. Self-Harm (Non-Suicidal Self-Injury, NSSI) vs. Suicide

• NSSI (e.g., cutting or burning oneself) is often about emotional regulation, not intent to die.
• “Many kids… who engage in non suicidal self injury are either feeling so much intensity of emotion that they want the emotion to kind of chill out, or they're numb and they want to feel something.” — Dr. Singer (09:44)
• Important for parents not to overreact or assume NSSI equates to a suicide attempt, but to open a dialogue:
  • “Hey, I saw you had this cut on your wrist… I just want to understand what’s going on. Were you thinking about ending your life or were you trying to feel something?” (12:48)
• Responding as if NSSI equals attempted suicide can feel punitive and shut down communication.

6. What To Do If a Child Expresses Suicidal Thoughts

• Validate their feelings, show appreciation for their honesty, and gently ask for more detail.
• “Open up the space. Because what that's going to do is it's going to let your kid know I am willing and able to talk without jumping in…” — Dr. Singer (15:08–16:00)
• Ensure adequate sleep, as lack of sleep increases suicide risk.
• If a parent reacts poorly or dismisses a disclosure (“you’ll be fine”), it’s important to circle back and acknowledge the mistake, ask for a “do-over,” and try again. (17:41)

7. Suicide Contagion and Peer Influence

• Suicide can be “contagious” among adolescents—about 5% of adolescent suicide deaths are considered contagion.
• Teens who die by suicide often have friends already at elevated risk.
• Communities must balance awareness without normalizing suicide as an inevitable or “common” outcome.
  • “If you have a script which is like suicide is the inevitable conclusion for all the kids in this community, it's actually more likely that kids are going to be like, oh well, this is probably something that's going to happen to me or my friends…” — Dr. Singer (23:34)
• Uplifting stories of resilience is also important.

8. Suicide in Adults and Connection to Youth Suicide

• Middle-aged white men have the highest suicide rate (statistical, not “media-visible”).
• Risk factors include failed relationships, unemployment, substance abuse, and firearms access.
• Adult suicide increases risk for their children.
• Solutions for adult suicide prevention are protective for youth and vice versa.

9. Substance Abuse and Lethal Means

• Substance use heightens suicide risk, and being under the influence leads to more lethal suicide attempts.
• Access to firearms dramatically increases risk: “Nine out of ten suicide attempts with a firearm ends in death.” — Dr. Singer (27:26)

10. When a Child Tells You About a Friend in Crisis

• Validate your child’s disclosure, assess what the child knows, and encourage/assist in notifying the friend’s parents—unless you have credible reason to believe parent involvement increases harm.
• Establishing relationships with your children’s friends’ parents is helpful before a crisis arises.

11. Supporting Families Who’ve Lost a Child to Suicide

• Don’t ask “how did they do it?” or offer trite reassurances (“God needed another angel”).
• Offer concrete help (meals, childcare, chores) and ongoing, low-pressure support via text or email.
• Siblings also need support.
• After a suicide death, shift from prevention framing (“suicide is preventable”) to support and compassion for survivors.
• Loss is ongoing—milestones continue to be painful reminders.

12. Demographic Data and Trends

• Youth suicide rates have risen significantly since 2007.
  • Increases are most dramatic among American Indian, Alaska Native, Black, and Latina youth.
• Data collection lags impede tailored prevention and response.

13. When and How to Talk to Your Kids About Suicide

• Open, proactive conversation is encouraged in the teen years, even if there are no clear warning signs.
  • “You can do it as a way of talking with your kid about their friend group. Right. Sort of as a check in.” — Dr. Singer (41:27)
• Ask kids how distress is communicated among their friends, particularly online.
• Early conversations “plant the seed” for future openness if problems arise.

14. Hopeful Messages and Final Insights

• Most teens who attempt suicide do not die by suicide; most recover and live satisfying lives.
• “Families can go through a suicidal crisis with their kid and on average their kid is going to be fine. It's just terrifying in the moment because you don't know.” — Dr. Singer (43:27)
• Asking about suicide does not increase distress or risk, even among non-suicidal youth—asking helps.

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Notable Quotes & Memorable Moments

• On adolescent warning signs:
  “At the moment, you're like, well, it couldn't have been suicide. But in retrospect, you're like, yeah, I guess that was a warning sign.” (05:36)

• On parental mistakes:
  “If you've blown it, great thing about life is that gives us lots of opportunities to get it right.” (17:41)

• On asking about suicide:
  “If you're concerned, ask. You won't make things worse and you might make them better.” — Dr. Lisa Damour (45:42)

• On contagion:
  “There is an experience… unique to adolescence, which is suicide contagion… it's about 5% of adolescent suicide deaths…” (21:33)

• On hope:
  “Most kids who attempt suicide report having satisfying or very satisfying lives moving forward… about 90% of people who have attempted suicide don't ever die by suicide.” (43:27)

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Suggested Timestamps

• 02:10 — Suicide seasonality myth vs. reality
• 04:26 — Warning signs and retrospective recognition
• 06:41 — How to respond to “I’m going to kill myself if…”
• 09:24 — NSSI vs. suicidal behavior explained
• 12:48 — What to say if you notice a cut/self-injury
• 15:08 — Responding to expressed suicidal thoughts
• 17:41 — When a parent “blows it”: repairing the conversation
• 21:33 — Suicide contagion in adolescence
• 27:26 — Substances, firearms, and suicide lethality
• 29:01 — What to do if your child tells you a peer is at risk
• 32:05 — Supporting families in the aftermath of suicide
• 37:02 — Trends in youth suicide by demographic group
• 41:27 — How and when to proactively talk about suicide
• 43:27 — Hopeful longitudinal outcomes & closing thoughts
• 45:42 — Asking does not increase risk

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Final Thoughts

This episode normalizes open, proactive discussions about suicide, arms parents with concrete language and tactics, underscores the value of validation and support, and insists on the promise of recovery and resilience.

If you or someone you know is struggling with suicidal thoughts, text a crisis line or call the National Suicide Prevention Lifeline (now 988 in the US).

For more resources, see show notes at drlisadamour.com.

Transcript

[A]

This is Ask Lisa, a podcast to help people understand the psychology of parenting. Psychologist Dr. Lisa Damore, author of two New York Times best selling parenting books, takes your questions. And I'm co host Rena Nainan, a journalist and mom of two. Some of what we talk about comes from raising children ourselves. Most of the time I'll be getting answers to your parenting questions. So send your questions to ask [e-mail] Episode 79 what do parents need to know about suicide? I want to warn our regular listeners and everyone tuning in that we're going to have a very honest and tough conversation about suicide. We're joined by an incredible expert, Lisa, I know you were so excited to have him on Dynamic, Dr. Jonathan B. Singer, who's co author of Suicide in Schools.

[B]

Yes, I am thrilled to have Dr. Singer joining us today. We will have a very direct conversation and I want our listeners to know right away about two resources that you may need right now and you should know about them immediately. There are crisis text lines that you can reach if there's a concern about suicide. You can find them just by searching online. There's also the National Suicide Prevention Lifeline, which, which you can again find by searching online, but the number starting in July will be 988.

[A]

That's great. Just a little more about Dr. Jonathan Singer. He's written about the news media's reporting on suicide deaths of Kate Spade and Anthony Bourdain. He's on several national youth advisory boards including Sandy Hook, Promise, Jed Foundation, Suicide Prevention Resource center and the National Suicide Prevention Lifeline. He's also an associate professor of social work at Loyola University Chicago and the founder of and the host of the award winning social work podcast, Jonathan. So grateful you could join us.

[C]

It's an honor and a pleasure to be here. Thanks so much for having me on,

[A]

you know, doing the research. I was surprised to learn that spring is an unusually high time when teen suicides rise.

[C]

Yeah, there's a long standing myth that people kill themselves over the holidays. And whether it's adults or adolescents, what's true is that the highest times are in the spring. And then for adolescents, there's also a bump in the fall. The lowest times are during the holidays, school holidays, summer and December.

[A]

So what causes kids to become suicidal?

[C]

There are a lot of different things that can lead kids down that path.

[B]

Right.

[C]

You have everything from the interpersonal conflicts that happen between parents and kids, between peers, bullying, cyberbullying. You get kids who are experiencing a sense of like, I don't really belong in this world because of structural issues, racism, economic inequality, all those sorts of things. And so there are lots of different things for any one parent and kid. You might have a different path than somebody else in the same city. But there are all these things that really speak to this idea of I'm not valued. People don't care if I live or I die. I don't see a future for myself. And then something that's kind of unique for kids compared to adults is that there are some kids who kill themselves sort of out of spite, right? Sort of the 13 reasons why effect. Like, ha, I'll show you, right? And I will win if I do this. Which doesn't really happen so much in adult suicides.

[B]

Jonathan One of the things that I hear and you hear, I'm sure in the community is that sometimes when a child dies by suicide or a teenager dies by suicide, families will say, or the discourse in the community will be, it was totally out of the blue. No one saw it coming. I think sometimes that's true. Sometimes that's said more than it is true. What can you tell us about warning signs? How frequently there are out of the blue suicides? Like what? What do you know about this?

[C]

So the research suggests that most people who die by suicide, including adolescents, give some sort of warning. The challenge is knowing what is a warning sign right there. They're the ones that are sort of depicted in the media, right? Where you have kind of the angry or sullen kid, or there's some big thing that happens, an event. But you know when you talk to a kid and they, and they say something like, I don't really think anybody's going to care if I live or I die, right? And then the kind of the knee jerk reaction is like, what are you talking about? You have so much to live for. So that could be a warning sign, right? The person's talking about something that might be suicide. And unless you ask, you don't know. It could just be a kid being like, I don't know, man, I'm going to kill myself if I don't make an A on this test. And you're like, oh yeah, everybody says that, but I'm not listening to, I'm not taking it seriously. So it could be a warning sign. At the same time, some of those statements could just be kids saying kms kys, right? Which they do all the time these days generically. So most kids display some sort of warning signs. What we find is that it's retrospective, right? When we Talk to folks. They're like, oh, yeah, that's right. They did deactivate their social media accounts. They did stop posting. They were saying things like, I can't really imagine, you know, my 18th birthday. Right. So there are all these things then at the moment, you're like, well, it couldn't have been suicide. But in retrospect, you're like, yeah, I guess that was a warning sign.

[A]

And KYS is something that they say about kill yourself.

[C]

Yeah, yeah. Kys, kms. Kill yourself, kill myself.

[A]

Wow.

[B]

In their sort of texting or social media shorthand, this will be a way. And this is such a challenge with teenagers because they can sometimes, you know, they. They don't always have a developed language for talking about distress. You know, they don't always say, oh, I feel real despair at a level I'm not accustomed to, you know, so they use those shorthands. So while we're there on that, Jonathan, if. If a teenager says that, like, oh, I'm going to kill myself if I don't get an A on this test, what should a parent say in that moment?

[C]

Yeah, I think the first thing is to acknowledge how stressed out and how intense this is. You know, we know that adolescence can go to 11 pretty quickly. Right. Everything's really intense. And so for them, they might be like, yes, this is the most intense thing ever. As adults, we're like, this is one of many different tests that you're gonna take in your life. So you acknowledge it, and then you. And then you say, hey, sometimes, you know, when people are really stressed, they'll say things like, I'm gonna kill myself, but they don't actually mean it. And sometimes they're actually thinking about ending their life because it just seems so overwhelming. They can't imagine going on. And I'm just wondering if you've had any of those thoughts. So just very gently, very, you know, I'm not making a big deal out of this. I'm just saying I want to know.

[B]

It's. I love the words and the tone. Like, I love hearing you do both together, like, how to say it and what to say.

[A]

So, Jen, then how do you tell if a kid could be suicidal?

[C]

So there are what we think of as warning signs. Right. And we mentioned one of them, which is hearing kids say things like, I'm going to kill myself. That's pretty obvious. 1. Or, I don't think anybody would care if I lived or I died. Right. Or people would be better off if I were gone. Right. That sense of, like, I'M a burden to others. You know, I'm not part of a group that cares about me. There are other things that if you have a kid who's saying, you know, I don't think people care if I live or I die. And their level of intensity and emotions is sustained and it's high, and they find themselves getting angry at people they normally wouldn't get mad at. Right. I mean, we know kids don't get mad at people. They'll yell at their friends, they'll yell at their parents, but like they're not going to yell at grandma, right. Or they're not going to talk back to the principal. But like, if you get a kid that hasn't been sleeping, deactivates their social media, gets into a fight with a principal or tells their grandparents f off and that's things they normally wouldn't do, you're like, oh, and if they're doing that in the context of saying, I don't really think anybody's going to care if I live. Right. In fact, actually I think people would be better off if I were gone. That's what we consider a warning sign. That means something is probably going to happen in the near future. The kid's probably going to do something to try and end their life.

[B]

Wow. Okay. So one of the questions that came up as we were thinking about this is to try to understand the link between self harm and suicide. These are distinct and there's an overlap. So can you help us tease those apart a little bit?

[C]

Yeah. So the relationship between what we in the, in the biz call non suicidal self injury and suicidal thoughts and behaviors, specifically suicidal behaviors, is that non suicidal self injury is as it's termed non suicidal in the sense that when people are engaging in these intentional destruction of body tissue, right. These acts that are cutting or burning or something like that, that they're not thinking of ending their life. Right. And in fact, many kids, many people who engage in non suicidal self injury are either feeling so much intensity of emotion that they want the emotion to kind of chill out, right. So they want to lessen their suffering or they're numb and they want to feel something which is very different than saying, I'm in overwhelming pain and I wanted to end it forever. Right. And so the relationship is that you get a lot of kids who engage in non suicidal self injury self harm, not because they want to die, but because they're trying to express something that is hard to express. If you have a kid that has been engaging in cutting or burning or Something like that, and they start to have thoughts of ending their life while doing those things. Then they're probably starting to transition into the overlap between non suicidal self injury and self injurious behavior with intention to end their life. And I will just say there are lots of reasons why kids engage in nssi. I worked with a kid who, he actually had thoughts of suicide but he found that when he engaged in nssi. I won't talk about how he did it, but when he did that and it was pretty intentional and it was pretty effective, his thoughts of suicide went away for about a month. Right. And so actually engaging in NSSI was a way that he could protect against being suicidal.

[A]

Sorry, what's NSSI again? Jonathan?

[C]

Sorry, non suicidal self injury. And I use that because we talk about self harm and self harm can be suicidal. Right. Or it can be non suicidal. And so I just use NSSI to clarify that when I'm talking about somebody who's engaging in these intentional destruction of body tissue acts without intent that it's non suicidal as opposed to self harm which could be either.

[B]

So just to follow up then as a parent, if you notice that your child has a cut on their wrist. Right. That is a deliberate cut, of course, it's terrifying and I think a lot of parents minds would jump to questions of suicide. What would you want a parent to say in that moment to address what they've seen, address maybe their own concerns about suicidality but not make the whole thing a whole lot worse?

[C]

Yeah. So one of the things that could be most problematic when addressing non suicidal self injury is to respond to it as if it was a suicide attempt. When we go to the extreme with a suicide attempt, it usually ends up with some version of hospitalization. Right. Emergency department hospital. But if a kid is not engaging in suicidal behavior and in fact they're doing something, either to feel something or to manage intense emotions, going that route can really be seen as punishing. So one of the things that a parent wants to do for is to first of all think about the cut and say I wonder if my kid is engaging in some sort of problem solving here. There's something going on and I don't know what this cut means and so I'm just going to ask. I'm like, hey, so I saw that you had this cut on your wrist and part of me is really concerned because that looks like it was something that you did on purpose. And I know there are lots of reasons why folks do that. I'm just wondering why you did that. And if the kid's like, what do you mean why I did that? Then you can say, you know, when you did that, were you thinking about ending your life? And if a kid is really engaging in non suicidal self injury, they're gonna be like, no. Oh, you know, how could you think that? How could you think that? You know? And so they'll let you know, no, I wasn't suicidal. Like I wasn't doing this to try and end my life. And then you can say, I would love to know what's going on and then open up that conversation. And there's lots of great sort of therapies and writing about self harm for parents and for kids also. So this is not one of these areas where it hasn't been addressed. And so you can start that conversation knowing that there's lots of follow up that can happen.

[A]

You know, we asked for questions from parents, we got, boy, did we get so many from our, in our inbox, one of them was from a parent who's saying, you know, what should parents do if their teen is having suicidal thoughts? Or if they say something like life is not worth living or I want to sleep forever.

[C]

Well, so let me just say the sleep thing. So first of all, as I know that you've talked about on this podcast before, sleep is really important. There's tons of research to suggest that when kids, particularly teens and young adults, are not getting enough sleep, it increases risk for suicide, like controlling for all other sorts of things. And so if a kid says I want to sleep forever, I would take that as an opportunity to say, it sounds like you're exhausted, right? How well are you sleeping? Or if you know they're not sleeping well, just think about, okay, this is a very concrete practical thing that I can do that can actually reduce suicide risk. And my kid is to make sure that they're sleeping more. If you're a parent and your kid is making this statement, that's an amazing thing that they're telling you, right? So you want to acknowledge that and say, I'm really so glad that you're letting me know. It sounds like you're in a really. And again, this depends on where they are. But like it sounds like you're in a really sad place, or it sounds like you're feeling really lonely or you're feeling so frustrated or you're feeling overwhelmed, like whatever the emotional space that they're in, acknowledge that, right? And say, I would love it if you told me more and just open the space for it. Now I know that Some people are going to be hearing me and say, oh, easy for you to say, right? It's on a podcast. Like, you're not in the moment. And yes, it can be a really challenging conversation. And so I think for all parents to practice saying, I appreciate you coming to me with this really challenging thing. Tell me more. And just sit quietly. Right. Open up the space. Because what that's going to do is it's going to let your kid know I am willing and able to talk without jumping in and problem solving or dismissing or criticizing. So then when they come to you with something like, I don't really think anybody's going to care if I lived or I died, and you're like, that sounds so lonely and scary. I would love to know more. They're like, oh, yes, dad actually wants to hear this because he's demonstrated that before.

[B]

So, Jonathan, what if a parent's already blown it?

[A]

What if a parent.

[B]

Yeah, the kid says, ah, you know, I hate this. Like, I don't want to deal with senior year. Like, I. I'm done. I'm over all of it. You know, I could kill myself. And the parent goes, oh, you know, you'll be fine. Don't worry. You know, what if a parent listening is thinking, I. I missed that. What should they do now?

[C]

Yeah. So if. If you've. If you've blown it. Great thing about life is that gives us lots of opportunities to get it right. So what I would do is I would, you know, go to your kid and say, hey. So I realized that yesterday you said something that was really important, and in the moment, I dismissed it. And I can only imagine how hard that was for you to come to me with this and then for me to not realize how important it was. And so I just want to do over. I want to say, hey, and then just do the thing that we just talked about, which is honor and acknowledge and validate and let label the emotions. And also, if the kid's like, no, you blew it. I'm not talking to you. You can be like, fair enough, fair enough. I blew it. And this is so important. This is one of these times that I'm going to say, you got to talk to somebody about this. There's lots of things that you don't have to talk to adults about, but it's not okay for me for you to possibly end your life instead of having a conversation.

[A]

We're gonna pause, take a quick break. We'll be right back on the Ask Lisa podcast. When we return, we're gonna talk about whether friends can influence other friends to take their own life.

[B]

Mental health and physical health come as a pair. We all have both. May is Mental Health Awareness Month and it's time to demand more for mental health, more access to and more affordable health care. More people being honest about what they're going through, more people knowing what to do when someone they know needs help more mental health care and suicide prevention education in schools. Mental health affects every one of us, so please get involved. Join the American foundation for Suicide Prevention and learn how to help move things [e-mail]

[D]

what do you do when your toddler melts down or your teen shuts down? I want to introduce you to the Mindful Mama Podcast. I'm Hunter Clark Fields, author of Raising Good Humans and your host for the past 10 years. I used to be a yelling, overwhelmed mom until I found mindfulness and practical parenting tools that changed everything. Each week I bring you honest conversations and expert advice to help you regulate your emotions, manage your kids behavior with compassion, and break the cycle of reactive parenting. Whether you're raising toddlers or teens, you'll find real strategies for conscious parenting, screen time, ADHD and more. Listen to the Mindful Mama Podcast wherever you get your podcasts because you can raise kind, confident kids without losing your cool.

[A]

Raising tweens and teens comes with a lot of questions and Lisa and I are here to help you find answers.

[B]

That's right. And if you like the Ask Lisa podcast, you'll love my free weekly newsletter that delivers seasoned parenting guidance right to your inbox.

[A]

Every newsletter pivots off of a recent podcast episode to highlight key points in raising tweens and teens. This incredibly popular newsletter is a quick, easy read full of practical parenting guidance.

[B]

So go to my website drlisademore.com to sign up today.

[A]

Lisa's weekly newsletter is one more way that we're here to help you untangle family life. Welcome back to the Ask Lisa Podcast. We're joined by Dr. Jonathan Singer. Jonathan, do you think this idea of suicide or self harm is something that kids can learn from their peers? Is it something that they copy each other?

[C]

So there is and it there's an experience that is almost unique to adolescence which is this idea of suicide contagion or what we some people call diffusion. Right. Sort of. More in terms of like the social scripts like the story of why and how somebody could be suicidal and the reason why I say it's almost unique to adolescents is that the age group with the highest suicide rate in the United States overall is actually middle aged white men, adolescents. Yes. But if you have like a 55 year old white guy who kills himself, it's not likely that his peers are then in rapid succession going to kill themselves. It's about, about 5% of adolescent suicide deaths are classified as, as a contagion. Right. And so you have a kid who's 14 who dies by suicide and then they have within a couple of months a couple more suicide deaths. This is of course the kind of thing that just completely rocks a community. People are just traumatized, they're walking on eggshells. They're like, oh my God, who's next? Right. It's a horrible thing. But part of the reason when you look at, there's been social network analysis research, what they found is that kids who are suicidal are much more likely to be friends with other kids who are suicidal than kids who are not. Right. And so what you have is a situation where you get a kid who's suicidal who dies by suicide. Their friends are already at risk for suicide. And so there is a sense of diffusion of oh well, so, and so did it. It's now an option for me in a way that isn't true for adults. Now, in terms of the script, right, which is sort of what you were talking about, like can they learn it from their peers? In a sense, yes. But it's also something that communities can contribute to, right? Which is the sense that oh, this one kid died by suicide. Now every kid can die by suicide and suddenly it's something that gets in a sense, normalized. So there are two sides to this. One, we want people to be aware, we want people to have the conversations, we want parents to talk to each other, all that sort of stuff. And also, it's not true that all kids kill themselves, right? It's not true that suicide is something that all kids are even going to think about. And so if you have a script which is like suicide is the inevitable conclusion for all the kids in this community, it's actually more likely that kids are going to be like, oh well, this is probably something that's going to happen to me or my friends. As opposed to this is something that sometimes some people think about. And look, lots of people decide not to and we're actually going to uplift those stories as well.

[A]

I want to go back really quickly. You were mentioning that it's actually middle aged white men who have the highest rates of suicide. Why do you think that is?

[C]

So I'll say that the question of why do people kill Themselves is the perennial question. And so some of the things that correlate with adult male suicide risk include things like failed relationships, unemployment, access to firearms, things like that, right. So if you think about the societal pressures on men to achieve at the expense of relationships, right. And I mean, this is my area and I still find myself being like, sorry, kids, I can't do this. I have to go do this professional thing. I have to go give a talk to parents about suicide risk. So I can't make dinner, right? So like I find myself doing things where I am putting my career in front of my relationship to family. So imagine that you're doing that and then you get to a point where you're like, oh, I'm kind of stuck in middle management, my kids don't like me, my relationship's falling apart. Really, I have nothing to show for it. That's kind of one story around adults and suicide. But I think that for this podcast, right, for folks listening, I think one of the things that's important that we rarely think about with youth suicide is that if you have middle aged men at the highest risk for killing themselves, that means there are dads that are dying by suicide and that increases risk for kids. And so addressing the, addressing sort of adult suicide is actually protective for youth. And addressing youth suicide, building reasons for living, making sure this is a world that people want to worth, that's worth living in, will reduce the likelihood that they're going to kill themselves when their parents.

[B]

When they themselves are parents.

[C]

When they themselves are parents. Yeah.

[B]

So helpful. You know, Jonathan, I'm pulling this from the archives, but so it could be wrong. I also think the highest rate of binge drinking is middle aged white men. And you know, people put this on teenagers all the time. And not that all binge drinking is connected to suicide, but I also know that drugs, drinking and firearms and someone who's had a hard day is a very dangerous combination. And I'm wondering if you could just unpack that a little bit.

[C]

Absolutely. There is a very well documented relationship between substance use and suicide risk. And in adolescence, the way that it works is that adolescents who use and abuse substances are significantly more likely to report thoughts of suicide. And adolescents that are under the influence when they make a suicide attempt are much more likely to make a more lethal suicide attempt. To use more lethal means. Right. And when I say lethal means, I mean, so firearms are the Most lethal means 9 out of 10 suicide attempts with a firearm ends in death. And that's significantly different than other, other methods which have lower death rates associated with them. So if you are an adolescent under the influence, it's much more likely that you're going to use a more lethal means, which increases the likelihood that you're going to die.

[B]

Okay, now let's. This question came up a lot, and it comes up in a lot of different ways, and it's something we've talked about on the podcast, but there's nothing. I just love hearing your language and your thinking, and it's just I learn and grow so much as a clinician hearing how you do your work. So I want to run this by you. What do I do if my daughter tells me a friend is hurting herself or thinking about suicide? Should I tell the parents? How can I support my child?

[C]

So I love that this parent's kid came to her and said, this is something that's going on. It's overwhelming for adults to hear about their peers or kids who are suicidal. To have a kid hear about their peer who's suicidal, we have to assume it's at least that overwhelming, if not more so. Props to this parent for having the relationship where the kid went to them. What I would then say is, I would say, look, I appreciate you telling me. It's probably something that you are worried your friend is going to be mad that you told me. But, you know, it's much better to have a friend mad at you for a little bit for telling somebody than for your friend to be dead. So that's. That's a good thing, right? So thank you for doing that. If the. So then the parent would say to the kid, has your friend talked specifically about how they're going to do it, when they're going to do it? Do you know if they've told anybody else? And if the friend's like, yeah, everybody knows, right? Then that means something very different than, no, they've only told me. And then what you can do is you can say, look, this is not something that you need to hold onto by yourself. Right? We can partner with this. We can team up with this. I'm wondering what you think would happen if I told her parent or his parent or their parent and then have the conversation. So really, partner, as an adult, you should always know that letting the parents know is almost always the right idea. If the kid's like, I don't know, because, like, she's talked about how her parents have been really mean to her, have been doing these things, right? There's this. This is the only caveat when it comes to talking to parents is when there is a suspicion that the parents might be abusive in this case. Right. Or do things that would exacerbate the risk. And so you can have a conversation with your kid to try and assess that. You're not gonna know, but then, you know, reach out. And this is one of the reasons why it's really helpful to already have relationships with your kids, friends, parents. And I can talk more about that,

[B]

but that's really helpful. Yeah.

[A]

You know, I think when we hear about a child who has died by suicide, for so many people on the outside, it seems so surprising so often, like, wow, I never would have expected that. I'm so shocked. And then it makes you think, well, I never would expect my kid to do that. And goes through your mind, for families who have just lost someone by suicide, how can we be best supportive? What do they need in those days, months and years following that death?

[C]

Yeah. Well, so first of all, I want to thank you for including sort of months and years because, you know, when somebody loses a kid, they've lost not only sort of those daily interactions, but they've lost that identity of being this person's parent as they go through all the sort of developmental milestones right there. So they're not going to go to prom, they're not going to graduate, all those sorts of things. Right. So there's an incredible loss there. In the very short term, when you hear of somebody who's lost a child to suicide side, some important things not to do are to say things like, how did they do it? Right. This sort of emotional rubbernecking, it doesn't matter. Right. They're dead. You don't want to say things like, they're in a better place. Right. Or God needed another angel or something like that. It really, I mean, unless you know that person's like, faith tradition says that is helpful, but otherwise, don't do that because it really dismisses the pain that they're going through in the moment. And then doing things that you would think about doing when somebody has any sort of loss, right. Whether that's like prepping meals, offering to do laundry, whatever it is that you can do, and then check in with them and know that you can send texts and emails. And the beautiful thing about asynchronous communication is that if the person's not ready, they don't have to read it. Right. They can read it when they're ready. I would also, if they have other siblings, right. Check in with them about, you know, do, like, our kids play together, do you want them to come over, right. And hang out. Would that be helpful? Like, you can call me at any time. We can send just all of those sorts of management things could be really, really helpful. Many communities have survivors of suicide loss groups. Sometimes they are organized through faith communities, but are not necessarily faith focused. And then there are the survivors of suicide loss groups that are just kind of national. Now, most people who attend those groups, there's a waiting period, right. Three months, six months between the time where there's the death and then when they're kind of ready to go. But those can be incredibly powerful and uplifting communities because they're in a group of people that just know, like, what happened and they don't have to explain it.

[A]

Is there a point in dealing with the aftermath of a suicide that you feel hits the family the hardest that people might not know? I guess what I'm asking is, what do we not know that you'd like people to know? For the families that are dealing with this,

[C]

I think one of the most kind of profound things is that there's no good answer. And so families are just left with a perpetual sense of why, you know, and for parents, it's like, what did I do wrong?

[A]

Yeah. That's what I think sort of stabs me in the heart the most, is for the parents, it's the what did I do wrong? Question. I think that's what I would struggle with most.

[C]

Yeah. And what's true is that most parents do the best they can with the information they have, you know, and so I'm grateful you all are doing this episode today because, you know, I mean, just knowing that you can ask about suicide, right. You can follow up on those questions. There are things that you can do. Right. These are all things that can help parents to know. And what's true is that there are some kids that die by suicide. And. And the message that we put out there to the general public, which is suicide is a preventable public health problem, that message actually switches after a death because that message can sound blaming. It's like, oh, it was preventable. So, like, I didn't, or you didn't, or somebody didn't. And so then really the message becomes, how can we help you? How can we support you as a suicide loss survivor? And, you know, this is not comforting, but there are about five and a half to six million people in the United States every year who are newly bereaved by suicide death.

[A]

Do you think suicide rates are going up or are we just talking about it more?

[C]

Yeah. So suicide rates are going up. And if we look at, you know, the past 20 years or so for youth, starting in 2007, there was a pretty steady increase from about 7 per 100,000 to about 10 per 100,000. The most recent stats we have are from 2020, and it was about 10.5 per 100,000. What that means is that if you have 100,000 kids who are ages 10 to 24, about 10 would be 10 would die by suicide. Right. So that's what that means. I think it's important in those numbers to note that the greatest increases have not been in white youth. So they have been amongst American Indian, Alaska Native youth, black youth, and Latina youth, especially in 2020. That's what we saw. We actually saw no increase amongst white youth, and we saw a pretty significant rise in those three other racial and ethnic groups.

[B]

And, Jonathan, my understanding is we're a little bit caught off guard and don't have the kind of data we need to understand why. I think there's been efforts at the congressional level to try to catch up on this. But I feel like this is such a prime example of structural fear features where when we're studying why kids die by suicide, we've thought mostly about in big groups or why white kids are dying by suicide and have not necessarily drilled down on data as it pertains to specific racial and ethnic groups until now.

[C]

Yeah, that's absolutely true. Right. So there was the ring, the alarm studies from the Congressional Black Caucus that came out last year. Michael Lindsay is an incoming dean at the New York University School of Social Work. He did a lot of work pulling together this information, particularly around black youth in terms of data collection. And I know this sounds a little bit wonky, but it's really important. Right. You had politicians all the time during the COVID 19 pandemic, say more kids are killing themselves than are dying by Covid this, but we actually had no data. All of that was just made up. Right. They saw a tweet, they repeated it. I'm talking about 2020 suicide death data. If you asked me about suicide attempts and ideation, I would actually have to go back to 2019 because that's the last time that we had nationally representative data. We're not going to get the 2021 data until 2022. Right. So all of the conversations nationally about, like, well, how did the pandemic affect suicide? It's a little bit of a guessing game in part because we're still in the middle of it, but all we have is 2020 data for suicide deaths. And so my recommendation is that not only should schools collect data about what's going on in their schools, because really, you know, one school's the suicide ideation attempt and death data is going to be different than another school. You have parents who are like, oh, we want to make sure that we're on top of this. What can we do at our school? Like, there's so many things that can be done locally in terms of gathering data that we don't have to wait on the federal government to like, fix this massive data backlog. I mean, it's ridiculous that I could figure out how many positive Covid cases there were in like, Louisiana yesterday, but I had to wait two years to figure out how many kids died by suicide.

[B]

Jonathan, let me wrap us up here. This has been so useful and we're so grateful for your time and expertise. So here's my question. Obviously, if your kid or teenager brings up suicide, you're going to take all your good advice and follow that question and see what is really behind it. Is there a point where parents, if their child doesn't bring it up and there doesn't seem to be anything weighing in particular on your child, should parents bring up this topic at home and if they should, at what age, under what conditions? What do you think?

[C]

Yeah, so I think this is a conversation that, especially during the teenage years, is something that's a reasonable thing to bring up. And you can do it as a way of talking with your kid about their friend group. Right. Sort of as a check in. Right. Say, you know, I know that this idea or the topic of suicide has been, it's been in entertainment, it's been in news, people talk about it. I know that your school sent something that they were doing a presentation on it. And I want to let you know that first of all, I'm okay talking about it. And second of all, I'm just wondering like what you and your friends think about this. So just open that up and then if the conversation's going well, you can say, ah, you know, so I'm wondering like how to, like, how do your friends, like, let each other know that they're not doing well when they're online? Right. Like, what images do they use? What sort of things do they say? Right. How do you know when your friends are distressed, when they're upset? And then you can be like, oh, and so, like what do you do? Right. And so you're slowly kind of getting into that. And then what you're doing is you're you're learning how they communicate when they're upset, particularly online. But more importantly, they're just letting you know. And that's something that you can, that you can fall back on later on when things are happening where they haven't been sleeping well, when they got angry at grandma, when they said, I'm done, I'm no longer on TikTok. And you're like, oh, wait a minute. Huh? Like not sleeping irritable or aggressive, like out of context, disconnecting socially. I'm gonna check in. But you've already set the stage right. You've planted the seed. So that's, so that's good.

[B]

So helpful.

[A]

I learned so much from this podcast and I think it's just a topic that people are scared to talk about.

[C]

Yes, people are scared to talk about it. And which let me just leave you with this. So one death by suicide is one too many. And most kids who attempt suicide report having satisfying or very satisfying lives moving forward. This is based on longitudinal studies. We also know that the vast majority of people, about 90% of people who have attempted suicide don't ever die by suicide. And what I mean is they attempt and then they go on and they live their lives and then they die by natural causes, whatever, but it's not by suicide. And so families can go through a suicidal crisis with their kid and on average their kid is going to be fine. It's just terrifying in the moment because you don't know.

[B]

Thank you for sharing that. That's a really important thing for people to hear. Jonathan, thank you so much.

[C]

You're so welcome. It's been an honor and a pleasure to be on.

[A]

It was really wonderful to hear what you had to say and informing us. Dr. Jonathan B. Singer, co author of Suicide in Schools and host of the award winning social work podcast, thanks so much.

[B]

Dr. Jonathan.

[C]

Thank you.

[A]

So Lisa, what do you have for us for parenting to go?

[B]

So as we were talking with Dr. Singer, I started thinking about one of my favorite studies, I guess I would say, about talking with kids about suicide because parents can really worry that if they bring up suicide or ask about it that they're going to make things worse.

[C]

Worse.

[B]

And there's a fantastic study and we'll put the reference in the show notes that found that when students, a whole school of students was asked about suicide ideation and thoughts about it, what they found was the students who were not suicidal at all were not made any more distressed by the question. Asking the question did not make it worse. But the students who were thinking about suicide felt better having been asked. So I just want parents to know that if you're concerned, ask you won't make things worse and you might make them better.

[A]

It's really great.

[B]

Thank you again for listening. And again, a reminder, if you have any reason to be concerned at all, do not hesitate to reach out to the Suicide Crisis Text line or the National Suicide Prevention Lifeline, and the number for both can be found through an online search. And starting in July 2022, the number for the National Suicide Prevention lifeline will be 988.

[A]

Great resources. Thank you Lisa. And just remember, next week we are going to be talking about how to give your kids independence. When should you take the trading wheels off? I'll see you next week, Lisa.

[B]

See you next week.

[A]

Thanks for joining us. Be sure to subscribe to the Ask Lisa podcast so you get the episodes just as soon as they drop, and send us your questions to ask [e-mail] and now a word from our lawyers. The advice provided on this podcast does not constitute or serve as a substitute for professional psychological treatment, therapy or other types of professional advice or intervention. If you have concerns about your your child's well being, consult a physician or mental health professional. If you're looking for additional resources, check out Lisa's [e-mail] we'll see you next week.