Youth suicide and suicidal thoughts are on the rise in the United States with increasingly alarming statistics reminding us we need to be paying attention to our children.
Katelyn Mickelson, PsyD, LP, is a Sanford Health specialist in child psychology at Sanford Southpointe Clinic in Fargo, North Dakota, who helps kids and their caregivers learn to cope with the often-challenging circumstances involved in growing up.
As a child psychologist, Mickelson understands the signs associated with thoughts of suicide and the steps needed to prevent it from happening.
The numbers confirm suicide among children and adolescents is a bigger problem than it used to be. According to study published in the Journal of American Medical Association in 2024, the suicide rate for this age group has increased 56% over the last decade.
“We’re seeing quite a few more kids who are completing suicide,” Mickelson said. “We’re seeing younger and younger ages, too. Anecdotally, our emergency department has reached out to us more often for support on how to assess younger kids — kids who are 10, 11 or 12 — who have attempted suicide.”
We asked Mickelson to share how to recognize the environmental and mental factors that can lead to suicidal thoughts, as well as ways to minimize these factors.
Risks of suicide among preteens and adolescents
The teen years are filled with changes. Stress, confusion, fear, and doubt may affect their problem-solving and decision-making. They may also feel pressure to succeed.
For some preteens and teens, normal developmental changes can be unsettling when combined with other events, such as:
- Changes in their families, such as divorce, siblings moving out, or moving to a new town
- Changes in friendships
- Stress from social media activities, including being a victim of cyberbullying
- Problems in school
Parents of kids with depression or ADHD should be especially watchful for signs indicating suicidal thoughts.
“If youth are feeling depressed, they’re more likely to have thoughts of death, which might lead to completed suicides,” Mickelson said. “And then with ADHD, the impulsivity piece can lead to completed suicides.”
Other factors include prior attempts at suicide or a family history that includes suicide, as well as trauma.
“If youth have a prior suicide attempt, they’re more likely to attempt in the future, which I think is really important for people to know,” Mickelson said. “That’s particularly true within a three-month window after the first one. There is a really high risk for another attempt.”
What qualifies as trauma?
Many of the accepted risks of suicide in youth can be categorized as trauma. Sometimes referred to as adverse childhood experiences, they can have significant impact on the lives of young people that can be long-lasting.
This can include isolation, childhood abuse, witnessing domestic violence, parent separation or divorce, living with household members with mental illness, and living with household members who engage in substance use or criminal activity.
According to an article published by the journal Child and Adolescent Psychiatry and Mental Health, people with exposure to traumatic experiences or adverse childhood experiences are at a dramatically increased risk of attempting suicide.
“If a child has dealt with a history of trauma — they’re experiencing neglect, physical or emotional or sexual abuse — they’re at increased risk,” Mickelson said. “In general, it means they’re not getting their needs met within the home. They lack a trusted adult to watch what they’re doing.”
Why is child and adolescent suicide rising?
Many of the core challenges involved in becoming an adult have not changed over the last 30 years but in other ways the terrain for young people has changed dramatically, particularly over the last decade.
“The major changes have been the presence of social media and bullying. Specifically cyberbullying seems to be a trend that has increased the numbers,” Mickelson said.
The CDC’s nationally representative Youth Risk Behavior Survey suggests kids who spend more time on social media are more likely to have experiences with bullying victimization, persistent feelings of sadness or hopelessness, and suicide risk.
“Research in the social media realm indicates that kids who spend more time on social media are more likely to have depression and a lot of the things, like a loss of sleep for instance, that cause depression,” Mickelson said. “Social media use can figure in a lot of things that can lead to thoughts of suicide.”
What signs can indicate a young person has suicidal thoughts?
If a child has talked about suicide, it’s important to take them seriously. This might seem like it should go without saying, but the stats warrant the emphasis. Published statistics vary slightly but all indicate more than half of completed suicides are preceded by the person indicating they are thinking about it.
“If someone is talking about killing themselves, maybe it’s just about expressing frustration, but we shouldn’t be taking that risk because maybe they really mean it,” Mickelson said. “We should be taking it seriously.”
Mickelson outlines suicidal ideation signs like this:
- Talk: Talking about suicide, feeling hopeless, having no reason to live, being a burden, feeling trapped, unbearable pain.
- Behavior: Increased alcohol or drug use, searching for suicide methods online, withdrawing from activities, isolating, sleeping too much or too little, saying goodbye, giving away prized possessions, showing aggression or fatigue.
- Mood: Depression, anxiety, loss of interest, irritability, shame, agitation, and the counterintuitive one — sudden relief or improvement.
“Withdrawing from activities, sleeping too much, saying goodbye and giving things away are all indicators this person is at risk,” Mickelson said. “Giving away prized possessions is a huge warning sign. If they’re irritable or act depressed and then you see a sudden improvement — some kids have been really depressed, withdrawn, not going out with their friends, and then suddenly see they’re happy and at peace — can be a warning sign as well.”
What conversations should you have with your children?
Understandably, people often feel uncomfortable talking about suicide. However, asking a child or adolescent whether they’re depressed or thinking about suicide can be helpful in warding off much more serious issues.
As a child psychologist, Mickelson spends a lot of time talking to parents about how they should talk to their children. In this case, talk is not cheap — it holds incredible value in supporting kids’ mental health.
“When I talk with kids about suicide, I’m very direct about it,” Mickelson said. “The question I usually ask is, ‘Have you ever had thoughts about wanting to be dead or wishing you would go to sleep and not wake up?’”
It is a question from the Columbia – Suicide Severity Rating Scale, an evidence-based list of questions used by counselors to check for suicide risk.
“I think sometimes parents are worried that if they ask about suicide, that is going to make their children start thinking about it. That’s just simply not the case,” Mickelson said. “If a young person is having those thoughts, it’s much better to know.”
Yes, kids can say things they don’t mean borne of anger and frustration. And sometimes it’s tough to tell the difference. All the more reason to ask about it, according to Mickelson. And then come back and ask about it again later.
“You might hear, ‘Oh, I wish I was not here. I wish I was dead,’ in a moment of frustration because they got their Switch taken away,” Mickelson said. “That’s a moment where I’ll pause and be like, ‘Hey, those are some really serious words. If you’re having thoughts of hurting yourself, I really want to know and I want to try and keep you safe.’ Then have that conversation again when they’re calm — you need to know: Did they really mean that?”
In a child’s head these questions can provide assurance that somebody cares and will give your child the chance to talk about problems.
If your child needs help, what should you do?
The first step in establishing a safe home for all families is to eliminate access to potentially dangerous elements. That means locking up firearms and ammunition separately and securing or disposing surplus medications in the home. Mickelson encourages parents to consult lock2live.org for ways to make a home safer.
Parents who suspect their kids are thinking suicidal thoughts are encouraged to practice touch supervision – that is, being close enough to your child to touch them throughout a crisis.
Mickelson also strongly advises children, teens and their parents in need of support to call or text 988 any time, 24/7. This phone number is the nationwide Suicide and Crisis Lifeline in the United States. Those experiencing suicidal thoughts, a mental health crisis, emotional distress, or substance can use 988 to communicate with trained counselors who will provide free, confidential support, listen without judgment, and connect people to appropriate local resources.
How to respond
Sanford Health provides valuable easy-access information and guidance on its suicide prevention page, using the acronym REACH:
- Recognize a need: Spot early indicators that someone may be struggling. Notice shifts in how a person looks, acts, speaks, or handles daily responsibilities. Pay attention to recent major life disruptions or relationship stress.
- Ensure safety: Ask direct questions if self-harm or suicide is suspected and create a safe environment.
- Actively listen: Make sure they see how much you care by giving them your full attention and listening without judgment.
- Connect to resources: Share professional resources, crisis lines and other types of support.
- Help as needed: Follow up to see how they’re doing, keep sharing resources and information, and take care of yourself, too.
Who to call
- SAMHSA National Helpline: (800) 662-HELP (4357)
- Suicide & Crisis Lifeline: 988 or (800) 273-TALK (8255)
- Crisis Text Line: Text HOME to 741741
- SAMHSA Disaster Distress Helpline: (800) 985-5990
- Emergency department or 911 if there’s immediate danger
In non-emergency situations, Mickelson recommends reaching out to a primary care provider for direction in moving forward.
“They can help you with referrals,” she said. “If you’re concerned specifically with suicide, they can refer you to people who have evidence-based training in addressing those concerns.”
Vigilance from adult caregivers can play a crucial role in keeping kids safe.
“Sometimes thoughts are just thoughts,” Mickelson said. “But it’s extremely helpful knowing they can get the support they need. There are a lot of people out there who can help.”
Learn more
- Teen mental health: resources for teens and caregivers
- “What’s on My Mind: A Teen’s Guide to Thinking, Feeling, and Figuring Things Out”
- More resources from Sanford Fit: Children’s Health Initiative
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Posted In Behavioral Health, Children's, Fargo, Parenting
