When the school tells you your kid is at risk for suicide

[Anonymous]

When I was working on an inpatient adolescent psych unit (not for long, only as a clinical rotation for med school) a lot of the kids there would say they weren't going to hurt themselves to their familes while they would be actively planning when, where, and how to kill themselves (as revealed later after the attempt). If she tells you she's not going to hurt herself she may not be telling you the truth. Also not to start a political war but if you have any weapons in the house I would get them out for now because a gun in the home is a major lethality risk.

Good luck with finding a good child psychiatrist!!

[Anonymous]

I would take it very seriously. Also, I would not allow her to be home alone (or alone anywhere unsupervised) during this time.

[Anonymous]

Anonymous wrote:When I was working on an inpatient adolescent psych unit (not for long, only as a clinical rotation for med school) a lot of the kids there would say they weren't going to hurt themselves to their familes while they would be actively planning when, where, and how to kill themselves (as revealed later after the attempt). If she tells you she's not going to hurt herself she may not be telling you the truth. Also not to start a political war but if you have any weapons in the house I would get them out for now because a gun in the home is a major lethality risk.

Good luck with finding a good child psychiatrist!!

OP here. Thanks for this. No guns in our house, only kitchen knives. It was my understanding that girls generally don't use guns, anyway.

Against my instinct, I let her stay home from school today (when trying to rouse her, she asked for the day off, and I didn't want to push her even though I think normal routine is best). It's nearly noon and she's still in bed. I'm torn between letting her sleep -- maybe catching up on rest will be good for her -- and barging in in case she's taken drugs or something.

This, unfortunately, is what a situation like this makes you think about as a parent.

I think I have identified a therapist and my work EA program is also trying to help. Just need to get the actual appointment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:When I was working on an inpatient adolescent psych unit (not for long, only as a clinical rotation for med school) a lot of the kids there would say they weren't going to hurt themselves to their familes while they would be actively planning when, where, and how to kill themselves (as revealed later after the attempt). If she tells you she's not going to hurt herself she may not be telling you the truth. Also not to start a political war but if you have any weapons in the house I would get them out for now because a gun in the home is a major lethality risk.

Good luck with finding a good child psychiatrist!!

OP here. Thanks for this. No guns in our house, only kitchen knives. It was my understanding that girls generally don't use guns, anyway.

Against my instinct, I let her stay home from school today (when trying to rouse her, she asked for the day off, and I didn't want to push her even though I think normal routine is best). It's nearly noon and she's still in bed. I'm torn between letting her sleep -- maybe catching up on rest will be good for her -- and barging in in case she's taken drugs or something.

This, unfortunately, is what a situation like this makes you think about as a parent.


I think I have identified a therapist and my work EA program is also trying to help. Just need to get the actual appointment.

Op you should look into dbt therapy. It's what is used for teens at risk of suicide

[Anonymous]

As a former school counselor, in each case of a tween/teen mentioning thoughts of suicide, EVERY parent thought that it was blown out of control. They were angry at me for making a fuss about "nothing". It was my job and when it comes to suicide my philosophy is always, better safe than sorry.

My cousin (freshman year of college) told his friends that he wanted to commit suicide. They though he was joking and went back to their dorm rooms. He then jumped out of him dorm window to his death.

[Anonymous]

A lot of good advice above. My summary of the high points would include:

1. Make sure guns are locked separate from ammo (I know you said there are none, but for completeness sake)

2. Make sure all meds are locked also, including over-the-counter. Girls are more likely to do pills, especially Tylenol, because they think it is safer -- but it's actually killer to the liver in high doses, and overdoses are the major cause for teenage liver transplants.

3. Take it seriously. Everyone -- teenager, parents, school, physicians -- needs to be on board that if this language is used, it will be taken seriously. There is no other way to do this safely. (If the time and context is right, someone can talk to the child about using different language like "I am so sad" or "I am so overwhelmed" if that is a better description of their feelings, but if it is talk about death/dying/suicide, it gets a full press of serious intervention as an emeergency)

4. Maintain the pattern. It is SUPER hard for kids to return to school, and it gets harder every additional day they are out. Maintain every level of normalcy you can:

1. Full day of school, or if absolutely not possible, then
2. Half day of school, or if absolutely not possible, then
3. Time is spent in principal's office or study hall working on things, or at least
4. She goes in herself each day to pick up assignments (crossing the door of the school is a barrier for kids who have been out awhile, especially with anxiety/depresison, so do't lose that step), or at least
5. This sounds crazy, but at least keep normal bedtime and wake time, getting dressed, and driving to school on time.

I'm a pediatrician. I so often see kids who hadve been out for weeks, are afraid to go back,a nd have a whacked-out sleep cycle where they are up all night and sleep all day. Every one of those steps is one you have to fight to regain and is a potential point for anxiety attacks, too.

Good luck.

[Anonymous]

Anonymous wrote:A lot of good advice above. My summary of the high points would include:

1. Make sure guns are locked separate from ammo (I know you said there are none, but for completeness sake)

2. Make sure all meds are locked also, including over-the-counter. Girls are more likely to do pills, especially Tylenol, because they think it is safer -- but it's actually killer to the liver in high doses, and overdoses are the major cause for teenage liver transplants.

3. Take it seriously. Everyone -- teenager, parents, school, physicians -- needs to be on board that if this language is used, it will be taken seriously. There is no other way to do this safely. (If the time and context is right, someone can talk to the child about using different language like "I am so sad" or "I am so overwhelmed" if that is a better description of their feelings, but if it is talk about death/dying/suicide, it gets a full press of serious intervention as an emeergency)

4. Maintain the pattern. It is SUPER hard for kids to return to school, and it gets harder every additional day they are out. Maintain every level of normalcy you can:

1. Full day of school, or if absolutely not possible, then
2. Half day of school, or if absolutely not possible, then
3. Time is spent in principal's office or study hall working on things, or at least
4. She goes in herself each day to pick up assignments (crossing the door of the school is a barrier for kids who have been out awhile, especially with anxiety/depresison, so do't lose that step), or at least
5. This sounds crazy, but at least keep normal bedtime and wake time, getting dressed, and driving to school on time.

I'm a pediatrician. I so often see kids who hadve been out for weeks, are afraid to go back,a nd have a whacked-out sleep cycle where they are up all night and sleep all day. Every one of those steps is one you have to fight to regain and is a potential point for anxiety attacks, too.

Good luck.

I'm another social worker parent and I completely agree with this advice, particularly #3. OP, your child might not be actively suicidal. She might be trying to verbalize feelings of depression and/or anxiety (general or related to specific things), but she needs to learn non-alarmist language for those feelings. I have a middle school aged client who often says similar things. In her case, I strongly believe that she is both depressed/anxious and also is trying to get attention. Her previous counselor would drop absolutely everything when she said, "I wish I was dead." The effect was that my client was able to avoid non-preferred activities by verbalizing suicidal ideation. Now, we have an understanding. If she verbalizes those things, we go into full-on crisis response mode. We call her guardian and her case manager and her lawyer and call for an evaluation by the crisis team. She doesn't get to be alone, period - doors not closed, me or one of my colleagues stand outside the bathroom stall when she goes in it, etc. If she is feeling depressed, anxious, or overwhelmed, she doesn't use suicidal language to communicate those feelings, which started by teaching her the difference between "I feel sad" and "I wish I was dead."

I don't think letting her stay home today was necessarily the wrong call, but I do think that realistically, she doesn't get to sleep all day and should not be left alone. If a counselor called you to tell you about the risk, it is probably more serious than you think it is. She should definitely plan to go back to school on Monday, and you should spend a lot of time with her today/through the weekend. I would be concerned that in your situation, your daughter may learn that she can get what she wants (e.g., avoiding the embarrassment of being at school and avoiding the things that are upsetting her) by verbalizing suicidal ideation. You can support her by helping her get to a counselor to talk about her feelings. This should not be framed as "Because you said X and Y at school, now you must see counselor to make sure you are okay" but more along the lines of "After you said X and Y at school, it seemed like it would be helpful for you to have someone to talk to about your feelings and your life. I want you to try this for 3 months and if at the end of 3 months, you still don't feel that it is useful, we can reevaluate."

[Anonymous]

OP, I am also a social worker and I echo all of the above, including the very sage advice from the pediatrician. They will reverse day and night very quickly, do not let her stay home.

I am familiar with many of the therapists in the area and I will urge and practically insist that you look into DBT. Britt Rathbone's practice is excellent, there is also Pat Harvey and Judi Sprei. DBT DBT DBT. That's what you want if you want to keep her safe and you want something that works. It is a lot of work for parents and child but it is the most effective protocol.

DBT.

[Anonymous]

You need to learn a lot more about suicidality, very fast. People in this thread are giving you some of it but the psychiatrist you find should also educate you, as the parent, on it--check out the American Foundation for Suicide Prevention website in the meanwhile.

Not all depression involves suicidality; not all suicidality is depressive. Not all self-harm (cutting, burning) is suicidal. Passive suicidality (not wanting to be alive, but also not having a plan to kill oneself) is a thing.

You are going to have to learn more about this than you want, because our mental health system is terribly broken and determinations that should be up to professionals are often going to fall on you.

Hang in there. Take care of yourself too. Especially, don't neglect the needs of any other children in your family and don't let them become responsible for your DD's safety.

DBT is great. There may be a waiting list for a program.

[Anonymous]

Lots of good advice here. My daughter was very much like yours--very much a people pleaser who would tell me and her therapist that she was fine when she was in fact making a suicide plan. She did tell her best friend, I learned of it and took her back to the therapist that had treated her in the past but that really was no longer a good fit for her. When that therapist (whom my daughter did not want to "let down") told me my daughter was fine, I let down my guard. Had I or that therapist been more on the ball, we could have spared her two more years of suffering and a suicide attempt. My regret around all that is huge and hard to bear. The good news is that after the suicide attempt and hospitalization we did get her into DBT, and that has made all the difference. She on meds and in weekly follow-up therapy, and she is a stable, happy kid looking forward to college. It is gut-wrenching to contemplate that we might have lost her due to our ignorance and inaction and that she suffered with depression for as long as she did. Hugs to you, OP, and good luck.

[Anonymous]

Anonymous wrote:OP, I had the same experience only with my son. New school, call from the guidance counselor, denied that he would kill himself or had a plan and then he tried. I spent a year not knowing if he would be alive when I got home. I had to check the house before I got the other kids out of the car. May have been the worst year ever. Counselor didn't help because he wouldn't talk. Things got better after I made major changes in his life - different school program, lots of structure, volunteer work instead of being home, etc. Good luck.

Also I am a social worker who worked with families of kids who committed suicide. Things I can tell you are these. No one can imagine their child trying to kill themselves and they never see it coming. It's always a shock. And suicide doesn't happen when things are the worst. It happens when things are on the upswing g. At that point people have the energy to plan and they can't fathom ever going back to the dark place they came from.

I wouldnt have left that kid home alone.

[Anonymous]

My understanding (from a friend who went through this with her daughter several times) was that you need to hospitalize the kid to keep them safe until you are absolutely sure they are not going to attempt suicide. In N Virginia kids go to a Dominion Hospital (where they may learn bad habits from each other.)
Is that not a common approach, social workers and pediatricians?

[Anonymous]

Anonymous wrote:My understanding (from a friend who went through this with her daughter several times) was that you need to hospitalize the kid to keep them safe until you are absolutely sure they are not going to attempt suicide. In N Virginia kids go to a Dominion Hospital (where they may learn bad habits from each other.)
Is that not a common approach, social workers and pediatricians?

I'm one of the social worker PPs. I've had clients hospitalized when I believed that they were at immediate risk of suicide. I don't know what I would do in OP's situation. Her daughter denies wanting to kill herself. My clients did not deny it - they disclosed that they wanted to kill themselves (not "be dead" or "not be alive anymore") and described a specific plan for how they would commit suicide.

It's essentially the difference between someone who is sick and needs to see a doctor in the morning and someone who needs to call 911 right now. Given that your friend went through this "several times", it might have been more apparent that hospitalization was the answer. It isn't always necessary, nor is it always a good solution, as you point out re: bad habits.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, I had the same experience only with my son. New school, call from the guidance counselor, denied that he would kill himself or had a plan and then he tried. I spent a year not knowing if he would be alive when I got home. I had to check the house before I got the other kids out of the car. May have been the worst year ever. Counselor didn't help because he wouldn't talk. Things got better after I made major changes in his life - different school program, lots of structure, volunteer work instead of being home, etc. Good luck.

Also I am a social worker who worked with families of kids who committed suicide. Things I can tell you are these. No one can imagine their child trying to kill themselves and they never see it coming. It's always a shock. And suicide doesn't happen when things are the worst. It happens when things are on the upswing g. At that point people have the energy to plan and they can't fathom ever going back to the dark place they came from.

I wouldnt have left that kid home alone.

OP here. She's not home alone. I called off sick and am here.

Thanks for the input.

[Anonymous]

I haven't read all of the responses, but I distinctly remember being a very depressed teen.

Your daughter sounds like me when I was that age. I didn't want to actively kill myself (I never attempted suicide), but I 100% didn't care if something bad happened to me. As a result, I engaged in all kinds of reckless behavior which could have killed me at any point. So she may not be suicidal in a literal sense but if she is depressed please, please, please get her some help. I wish I was medicated a lot sooner than I was.

I recognize the language she is using and there is no way she is not depressed.