Fear leads to stigma, and stigma demands silence. It’s no wonder that we’re reluctant to talk about child suicide. After all, what parent doesn’t fear the unthinkable? Silence, however, will not bring the change we need to make the world a safer, kinder place for children. In a recent webinar hosted by Mental Health America, three advocates explained the importance of involving everyone, especially children, in ongoing conversations about mental health. Shannon CrossBear, a parent advocate, shared the story of the loss of her 19-year-old son to suicide; Lanee Higgins shared the story of her role as a teacher in the healing of students after the loss of their peer to suicide; Dr. Stephen J. Cozza shared psychiatric insights debunking myths around conversations about suicide. 

CrossBear’s story of loss was especially emblematic of the need for conversation about suicide because of the circumstances surrounding her son’s death. Recognizing the risk and his need for immediate help and support, CrossBear’s family ensured that he was in a safe center on suicide watch — but later learned that he had died, in that facility, on suicide watch. The news, CrossBear said, seemed impossible. “Our family was left with this big, huge hole about, first of all, ‘Wait a minute. Everything we’ve been taught is to get this person to safety, and we did all of this. And this was the result,” CrossBear said. If the system designed to support and care for their son had failed him, how could they hold the system accountable? After their loss, CrossBear said, she learned many more important aspects of safe centers, such as having line of sight on the patients at all times and maintaining safe physical environments so implements of harm aren’t accessible to patients. However, she hadn’t known of these standards when they mattered for her son for the simple reason that nobody spoke about those centers or the suicide watch patients they care for. 

After the loss of her son, CrossBear said, she realized just how many others in her community were suffering from the loss of a loved one by suicide, but who were grieving in isolation because of the heavy stigmas around talking about those deaths. “We need to face those things, we need to talk about those things, because the reality is that it does happen,”   CrossBear said. The more a community gets involved in the conversations around mental health and suicide prevention, the better equipped its members are to intervene and create positive outcomes for vulnerable children. For example, doctors should be checking up on mental health as regularly as they check up on children’s physical health. “It’s the third leading cause of death for certain age groups. It’s a public health issue, but we don’t treat it like we treat other illnesses or diseases,” CrossBear said. Mental health and physical health are both health.

Although clinicians and health providers ought to be a reliable front line for catching signs of dangerous mental health in children, CrossBear also gave the example of the neighborhood parent with the full fridge whose house children often go to hang out after school. That parent, being a member of the community with lots of access to the children, would be an ideal candidate to encourage kids to be open and honest about their mental health. However, without an ongoing community conversation about suicide, parents and other people in that position likely won’t have the idea or the education about how to open that dialogue with the kids they interact with. 

By having the whole community involved in the conversation, parts of mental health care that often neglect some parts of the community, like lack of trauma-informed or culturally-sensitive care practices, also ought to be improved. Still, the fear that talking about suicide will somehow encourage it often tamps down those conversations before they can properly take place or include everyone. Dr. Cozza explained that these fears are founded on falsehoods. 

“Parents can ask questions like, ‘I’m worried about you. I want to make sure you’re okay. Are you thinking about doing something to hurt yourself? Are you feeling like you want to die?’ – Asking questions directly to children,” Dr. Cozza said. “We don’t instill ideas with kids by asking those questions. A lot of people think we do, but we don’t. And, in fact, what it communicates is, ‘I as your parent can hear anything you have to tell me, and I can talk with you about anything you have to bring up to me.’ It becomes a line of communication that they may not be sure is available.”

In fact, by opening those lines of communication with children, parents model healthy attitudes about mental health by demonstrating that it’s not a shameful or taboo subject. As Dr. Cozza explained, children may not be initiating those conversations with parents because of fear that the topic is forbidden from discussion. 

There are many ways for adults to open that line of communication. Higgins described a situation in which she was able to help a student who was sobbing uncontrollably in class the day after one of her former students had died from suicide. “He didn’t want to talk to me. He didn’t want to talk to anyone else. He just cried, openly,” Higgins said. “So I went over to him and I said to him, ‘I know this is hard. It’s hard for me. And I know that when it’s my planning period, I’m going to close my doors and just cry, because it’s all I want to do. But there are people here today, in the library, that you can talk to about what you’re dealing with right now. So I’ll write the pass, I’ll put it on your desk, and you can decide when you want to go. I’m not going to force you.’ And he cried for about 10 more minutes, and he grabbed the pass and left. And the next day, he came to me and said, ‘Thank you.’ He really needed that. And that wasn’t the end of our conversation.” 

By opening that line of conversation, Higgins was able to intervene and create a more positive, safer environment for the student, even in such a dire situation. “Sometimes, all you need to do is just be there. Be there.” It was especially important that she didn’t claim to know every part of the grief he was feeling, and left room for him to make his own decisions about what help he needed and when to get it. “Sometimes, as adults, we have a misconception that we understand everything that children are going through, and we really don’t.” 

If you or a loved one are experiencing a mental health crisis, the national suicide crisis hotline number is 988. 

To learn more and use a multitude of mental health-related resources, visit https://mhanational.org/.