When & How Do I Talk to my Child About the topic of Suicide?

After speaking in public schools on this topic I am often asked by students and parents a number of  questions I don’t have time to address in my presentation.  I thought I would offer brief answers to one of those questions here in 2 parts:

When and How Should I Talk to my Child About the topic of Suicide?

My Child Has a Friend Who is Suicidal?  What Do I Tell My Child?

 

When and How Should I Talk to my Child About the topic of Suicide?

When: The topic of suicide normally doesn’t arise unless a family member, friend or celebrity takes their life.  When Netflix premiered their monster hit, 13 Reasons Why, in March 2017, much of the U.S. was talking about the show’s primary subject: teen suicide.  (You can read my blog on 13 Reasons Why here.)  While some choose to take advantage of such opportunities to talk about this difficult and uncomfortable topic, others choose to leave it alone – usually because they simply don’t know what to say.

In regard to our children, there are those things we like to call “teachable moments.”  Should an event prompt this particular topic, it would most definitely qualify as one of those moments.

The days of considering suicide a taboo topic are long gone.  Even the mainstream media has begun giving it quite a bit of press.  And for good reason.  From a 2016 article in the Houston Chronicle:

Suicide is the second leading cause of death in the United States for people ages 10 to 34, according to the Centers for Disease Control‘s data from 2014, and is the 10th leading cause of death overall.

And from the New York Times:

“Suicide in the United States has surged to the highest levels in nearly 30 years, a federal data analysis has found…”

How:  To borrow a slogan from Nike, just do it.  I tell students at every assembly, “We parents are deeply flawed.  We’re just ‘old teenagers.’  Just like you, we laugh and we cry; we have good days, and bad days.  Sometimes we mess up.  Sometimes we get things flat wrong.  But, no one on planet earth loves you more than your parents.” 

My point is this: as a parent, you don’t need a degree in psychology or counseling to talk to your child about suicide.  Just talk to them.  If they refuse to talk about it, this is a clear sign that they desperately need to talk about it.  (Refusing to talk is different than your child saying something to effect of, “I’m so hurt and confused.  I need a couple of days to process this.  Can we talk then?”Never force the conversation, but don’t sweep it under the proverbial rug either.

The suicide of a loved one or friend leaves us with endless questions.  A student approached me following one of my talks.  They said, “My friend took his life.  I was told if you commit suicide you go to hell.  Is that true?”  (I address that question at length here.)

Amidst all the questions regarding suicide, a cornerstone of truth I learned at one of the conferences I’ve attended on suicide intervention is this:

99% of those who attempt suicide don’t want to die – they just want the pain to stop.

No one enjoys talking about suicide (including me.)  But, should an event bring the topic into the public square, take advantage of it.

 

My Child Has a Friend Who is Suicidal?  What Do I Tell My Child?

Because my own son took his life, I counsel people to always err on the side of caution when suspicious of a friend or family member being suicidal.  In other words, intervene immediately.   If you intervene and you’re wrong, at least they will forever know you cared enough to check on them.  If you don’t intervene, and you were right, you might well be soon attending a funeral.

I tell students in no uncertain terms, “Should you suspect a friend of yours of being suicidal, talk to them immediately.  Then tell them, ‘We’re going right now to talk to an adult (if at school, the counselor who will, in turn, notify the parents; if off campus, the parents; if the relationship between the student-at-risk and their parent is estranged, take them to the nearest adult whether that be a school counselor, teacher, coach, youth pastor, etc.).

Mental health professionals agree that communication is a key to helping “talk a suicidal person off the edge of the cliff.”  The Houston Chronicle – written due to a cluster of teen suicides – asserts:

The key to managing grief, mental illness and suicidal thoughts is communication. Often times, those who are struggling tend to isolate instead of communicate… Through it all, communication is key to breaking out of the cycle of hopelessness and connecting to a support system. Sometimes, [the person at risk is] at a place where they can’t communicate.  It’s then we must be their voice.

Regarding the quote immediately above – rather than “sometimes,” I would offer that “most times” the person-at-risk can’t communicate what’s going on – at least this would apply to the vast majority.  Simply put, they are unable.  Since they’re brain is “broken”, unable to connect with logic, the ability to intelligently articulate their crippling pain is out of cognitive reach.  Gradually losing all sense of reality, the individual begins to believe lies common to those considering taking their own life i.e. “my family won’t have to worry about me anymore, ” “the world will be better without me/I don’t matter,” “I’m a burden to everyone,” “the pain is too much to bear,” “there is no hope, no help,” etc.

If you’re reading this – and are presently suicidal – understand that the statements cited immediately above are complete and total lies.  You are loved.  You do matter.  Your family and friends love you and would be devastated at your loss.  The familiar axiom is: Suicide is a permanent solution to a temporary problem.  While your pain may seem to you beyond help, know that there is most certainly help and hope.  Should you not want to speak with a family member or friend, please call the Suicide Hotline at: 800-273-TALK (8255)

Lastly, a child who has a friend they suspect of being suicidal may feel like they will be betraying their friend’s trust should they tell an adult; or, that it’s their responsibility to carry their friend through this crisis.  This is nonsense.  As a parent, tell them, “It is not your job or responsibility to carry a burden of this nature and weight on your own.  There are professionals who’ve gone to school and worked all their life for the sole purpose of helping hurting people just like your friend.”  Again, always err on the side of caution.

I encourage students, “Your friend may at first be very upset, even angry, with you for telling an adult.  Let them be angry.  You may well be saving their life, and saving their family from unspeakable grief.”

 

What to Say to a Person Considering Suicide

Here’s the scenario…

You have good reason to believe (or, at least, strongly suspect) a friend or loved one is considering taking their own life.

First of all, should you say anything?  YES.  Always err on the side of caution.  If you’re wrong, you’ve lost nothing.  But, if you’re right – you’ve just might have saved a life.

So, what can I say that may help them choose to live?

Finding my own son’s body on May 13, 2013, after he’d taken his own life, changed everything, as you can imagine.  He was 19.

When I finally began recovering psychologically I had a decision to make.  I could choose to live in despair the rest of my life, or I could muster the mental and emotional strength I had left and choose to help others choose to live.

My family and I chose the latter.

One of the workshops I attended to begin equipping myself to help suicidal people was sponsored by ASIST, an acronym for Applied Suicide Intervention Skills & Training.

The following questions were taught to us to ask a person we suspect is in immediate risk of harming themselves.

NOTE:  These questions must be asked gently, tenderly, free of any tone of guilt, shame or condemnation.  A condescending tone, alone, could serve as the final “poke in the chest” sending someone over the proverbial edge of the cliff.  A person considering suicide is operating with a brain that is, in some part, broken.  The last thing they need is to be looked upon pitifully or judgmentally.

Question No. 1:

“Are you considering taking your life?”

At first glance, this question may seem odd to ask.  But, chances are high that the person considering suicide has never admitted this out loud.  To actually hear themselves admit they are considering taking their own life may well serve as a warning siren going off in their head helping jolt them back into some sense of reality.

Should they shrug their shoulders, or say “I don’t know,” you simply reply with, “I’m not comfortable with that answer.  I’m not leaving until I know you’re ok.”

Question No. 2:

“Why do you want to die?”

NOTE: Ninety-nine percent of those who attempt to take their life don’t want to die; they just want the pain to stop.

Again, by asking this question, you are gently and tenderly validating their pain which is so crushingly severe it has brought them to a place dark enough to prompt them to the point of considering taking their own life.

This is huge:  while they are sharing reasons for which they want to die, you are listening to reasons for why they want to live.

For example:  often, a person experiencing this level of pain will reply with something like, “I am tired of being a burden to my family.”  This tells us they deeply love their family.  Or, “I am a failure at work, or school.”  This tells us they are suffering from crushingly low self-worth, or feeling void of purpose in life.

Question No. 3:

“What I’m hearing you say is that part of you wants to die.  But I’m also hearing you say part of you wants to live.  Could I be right? So we need to protect the part of you that wants to live.”

Note the latter part of this question: “So we need to protect the part of you that wants to live.”

By saying “we” you are making certain they know they are not alone.  By helping them come to grips with that part of them “wanting to live” you are giving them hope by helping them reconnect with the logical part of their brain.

More food-for-thought:

We commonly say to people who are hurting:

“If you need anything, just let me know.”

A better response: 

“I can see you’re struggling.  I’m here for you.  Can we get through this together?”

One last thing…

I am attaching here a short clip (less than 3 minutes) that I show at the close of my public talks.  It’s from the 1998 film, Patch Adams, based on the true story of physician, Hunter “Patch” Adams.  Patch, played by Robin Williams, has checked himself into a Psychiatric Ward.  During the day, everyone is free to roam around the Day Room where there is a television and opportunities to play games and visit with one another.  One patient, Arthur, angrily approaches one person after another putting his hand in their face with four fingers showing, and asks, “How many fingers do you see?”  Of course, they all reply “four”.  He retorts, “No!” and storms off.  Finally one night, Patch (Williams) visits Arthur’s room to attempt to find the answer to Arthur’s question.  Watch the clip here and I will offer insight I draw from the clip.

When a person is considering taking their life all they can see is despair, depression, shame and hopelessness.  Our goal is to help them “see beyond the fingers” and see what is true:  they are a treasure of infinite worth & value; there is hope; there is help available in abundance; their loss would be devastating; and they are loved beyond comprehension.

For Narnia, Nick

 

 

The Old Rugged Cross

NOTE: I wrote this four months after finding my 19 year old son after he’d taken his own life…

The-Old-Rugged-Cross-By-MidoriEyes-On-DeviantArt

There have been moments these past months that I’ve wanted to give up on God.

I’m simply being honest.

As one who grew up in a violent, alcoholic home, I witnessed more violence as a child than I care to remember.

As a full-time pastor now for 30+ years, I’ve had, on occasion, the unfortunate opportunity to see the very ugly side of what some have otherwise called “Christianity.”

But those pale in comparison to the events of May 13th, 2013, when my world caved in around me.

In light of the pain we suffer on planet earth, what proof is there that there is a God? More than that, what proof is there that that God really loves me?

From their outstanding work, “Name Above All Names,” Alistair Begg & Sinclair Ferguson write,

It is the cross alone that ultimately proves the love of God to us – not the circumstances of our lives.

We must not allow ourselves to be tricked into thinking that if things are going well with us, Then we can be sure of God’s love. For life can often seem dark and painful. Things do not always go well for us.

Rather, we look to the sacrifice of the cross and the proof God gave there of His love. ‘God [demonstrated proof of] His love toward us, in that, while we were still sinners, Christ died for us.’ (Romans 5:8)

This is the proof I need. This is the truth I need to hear. This dispels the lies of the enemy.”

This is the unstoppable, indefensible, indisputable love of God in Christ Jesus.

I love you, Nick

The God Who Hurts Us

“Yet is was the Lord’s will to crush [his Son] and cause him to suffer…” (Isaiah 53:10)

I’ve studied the book of Job (the “o” in “Job” is long as in “stove”) numerous times. But, until recently, I haven’t had the courage to read it devotionally (daily readings) since 2013 when my 19 year old son, Jordan, took his own life.

Of all 66 books that comprise the Bible, no book is more perplexing and disturbing as Job when considering the age old mystery, “Why do seemingly good people suffer?”

I have screamed at the heavens standing next to my son’s grave.

Job stood next to ten graves.

It was after burying all ten of his children Job’s wife told him, “Curse God and die!” She sometimes gets a bad rap. But I have felt her rage and resolution. Consequently, she sounds quite normal to me.

The first two chapters of Job are hard to read. Even though I knew well the story, I still wept as I began daily readings. I can feel Job’s and his wife’s acute pain. What is even harder to accept is this:

Job’s suffering was God’s idea.

It was God who asked Satan, “Have you considered my servant Job?”

Of course, Satan was, as he incessantly does, attacking the character and faith of God’s children, accusing God of favoritism and special treatment. “Of course Job loves you – his life is good,” Satan hissed. “But let me have him for just a few minutes and he’ll curse you to your face.”

So God gave Satan permission (Satan can do only what God allows him to do) to hurt Job.

There’s no way I can dive into the deep end of what the Bible says about God and his relationship to human suffering here. It’s the No. 1 argument for atheism. And rightly so.  I have studied the topic at length since my son – who, at 14 years of age, committed his life to global missions – took his own life after suffering from debilitating depression.

Job begged God to let him die (cf. Job 6:8-9). So did I. Which is why I spent 10 days in a Psychiactric Ward.

I get it.

I have no cheap, hollow bumper-sticker cliches for you here.

Despite what some round-the-clock “Smile, Jesus Loves You” people may say, pain is very much a part of the Christian life. You need to search no further than what’s recorded in scripture and secular ancient – and modern – history to know this to be true. (For crying out loud, an entire Old Testament book is titled, “Lamentations.”)

In defense of God’s relationship to human suffering (I am well aware he doesn’t need me to defend him), he pulls no punches where this fallen, corrupt world is concerned.

David wrote, “The righteous person faces many troubles…”

Jesus, himself, on the night before his execution, said, “In this world you will have many trials and sorrows…”

But, don’t stop reading there. The other half of David’s and Jesus’s words are as follows:

“…but the Lord comes to the rescue each time”, and “But take heart – I have overcome the world.” (Psalm 34:19; John 16:33)

God not once answers Job’s deepest question, “Why?”

He hasn’t answered mine either.

Job was rightfully hurt and angry and demanded a face-to-face meeting with God. In chapter 38, God honors that request. And it scares the you-know-what out of Job.

Wanting to put God on trial, God shows up and a plot-twist ensues: Job is the one on trial.

There are explanations for human suffering sprinkled throughout scripture: the testing and strengthening of our faith; God may use pain to get our attention; judgment and natural consequences of sin, etc.

But these explanations don’t make the pain any less painful.

One theologian wrote about the overriding theme of the book of Job,

“When there is no rational or even theological explanations for disaster or suffering, trust God.”

Even as I now type that statement everything within me wants to mock and say with dripping sarcasm, “Sure – I’ll do that.”

But, what alternatives does the world or atheism give me?

None.

What i’ve discovered Christ gives us in our suffering is hope.

We’re told,

“…And let us run with perseverance the race marked out for us, fixing our eyes on Jesus, the pioneer and perfecter of faith. For the joy set before him he endured the cross,…” (12:1-2)

Translation: Jesus says to us, “I saw the eternal joy on the other side of my temporary pain. If you’ll let me, I’ll help you do the same.”

Indeed, we do not have a Savior who, from his safe ivory tower in heaven, offers empty cheers, “Come on! It’s not so bad!” Nothing could be further from what is true.  The Bible records:

“[Jesus] was a man of sorrows and pain, acquainted with grief… [therefore] we do not have a high priest who is unable to empathize with our weaknesses,…” (Isaiah 53:3; Hebrews 4:15)

My son was merely 10 years old when, with tears in his eyes, he walked up to me and said, “Dad, God told me to paint this.”  It hangs in our home today.  Jordan titled it, “When we hurt, God hurts.”

Christ doesn’t “wait for us on the other side of our pain”.  He is with us in our pain – carrying us through it.

Jesus whispers to us in our pain, “I’ve got this.  Trust me.”

I began this post with the startling messianic prophecy written by Isaiah: “It was the Lord’s will to crush [his Son] and cause him to suffer…” (53:10)

The 20th century beloved pastor, A.W. Tozer, once said,

“I doubt God can use a man greatly until he has first hurt him deeply.”

That’s an unsettling statement.  But, I must confess, I see this pattern throughout scripture.

The purpose of this post is to simply encourage those who are suffering.

I can’t offer satisfying reasons or answers to human suffering.  But, I can offer you hope that it will not always be this way.

The maddening pain of human suffering, for me, is only resolved by the truth given me in scripture:

Because of the Cross and the Empty Tomb “weeping may last for the night, but joy comes in the morning.” (Psalm 30:5)

No other worldview offers me that hope.

Paul, who suffered greatly, encourages his readers:

“I consider that our present sufferings are not worth comparing with the glory that will be revealed in us. (Romans 8:18)

According to God: I’ll see my son again; he’s more alive than he’s ever been; and he is in the presence of the risen Christ, forever free of debilitating depression.

And, because of what Christ gave twenty centuries ago on a cross just outside of Jerusalem – a reunion is coming.

Oh to hold my son in my arms once again – completely free from my own often crushing depression. To quote the popular song, “I can only imagine.”

Because of the suffering – and triumph – of Christ, I choose to stand with Job and say,

“The Lord gives, and the Lord takes away. Blessed be the name of the Lord.” (1:21)

Satan again loses his haughty, myopic bet with God.

I love you, my precious son.

For Jordan Watts.

#ForNarnia.

For Christ.

 

Love and hope to all who are suffering, Nick  (see Side Note immediately below)

(Side note: beginning with chapter 4, Job’s “friends” spend over 30 chapters attempting to explain Job’s suffering based on their mere human logic, intellect and reason. In the final chapter of the book God basically calls them all idiots, indicting them: “You have not spoken the truth about me.” Job’s prayer for them is the only thing that kept them from God’s severe judgment. Our well-meaning “friends”, feeling they must offer an explanation when suffering takes place, can easily fall into the same category as Job’s friends.)

Wall Street Journal: How to Spot Teen Depression

This article from the Wall Street Journal appeared in their May 5, 2018, edition.  For your convenience, the entire article is included here.  Depression is the number one mental condition associated with suicide.  nw

How to Spot Teenage Depression

New guidelines focus on helping better identify teens who may be struggling with depression, as rates for the disorder climb

By Elizabeth Bernstein

Updated March 5, 2018 4:43 p.m. ET

Is your child’s moodiness a sign of typical teenage angst—or the beginning of a depression that needs professional attention?

Statistics show that teen depression is on the rise.

In 2016, around 13% of U.S. teenagers ages 12-17 had at least one major depressive episode in the past year, compared to almost 8% in 2006, according to the Substance Abuse and Mental Health Services Administration, which collects this information. Rates for teenagers ages 18 and 19, which are tracked separately, grew as well: More than 11% had a major depressive episode in 2016, compared with 9-10% in 2006.

The survey also found that almost 60% of adolescents with a major depressive disorder didn’t receive treatment. Parents don’t always identify the problem—or know what to do about it even when they do. And teens often resist treatment because of the stigma around mental-health issues. Yet adolescents whose depression goes untreated struggle in school, in their relationships, and to engage in activities they enjoy.

Many teens are moody. But to help better identify teens who may be struggling with depression, the American Academy of Pediatrics last month issued updated guidelines—the first in a decade—recommending that pediatricians screen all those ages 12 and older for depression annually and involve families in the assessment.

The diagnosis for depression is the same for teens as it is for adults. Psychiatrists and health-care professionals define major depressive disorder as five or more of the following symptoms present for two weeks: depressed mood most of the day, irritability, decreased interest or pleasure in most activities, significant change in weight or appetite, change in sleep, increased agitation or sluggishness, fatigue or loss of energy, feelings of guilt or worthlessness, changes in concentration and recurrent thoughts of death.

Rising rates of adolescent depression are fueled by some unique stressors faced by this generation, the first to grow up with smartphones and social media, mental-health experts say. While teenagers have always felt pressure to be attractive and well-liked, social media amps up the anxiety with real-time measures of popularity such as “follows” and “likes.” Teens also can see immediately when they’ve been left out of an activity by classmates or friends.

Psychologists say this generation of teens also may feel more vulnerable than recent ones because of events such as school shootings, which they follow in real-time—and often via firsthand accounts—on sites such as Twitter or Facebook and through texts and calls.

Add to all of this the pressure to succeed, as colleges become even more competitive. “Teens worry: ‘Am I going to be successful? What do I need to do to get where I need to be? Am I doing enough, in academics, philanthropy and sports?’” says Jessica Feinberg, a licensed clinical social worker and program director of the Adolescent Acute Residential Treatment Program at McLean Hospital, a Harvard-affiliated psychiatric hospital in Belmont, Mass.

Adolescents—who aren’t always in touch with their feelings or mature enough to articulate them—often become more irritable or angry than adults do when depressed, therapists say. They sometimes complain of physical symptoms, such as stomachaches or headaches that don’t have an identifiable cause.

Unlike most adults, they typically lack an awareness of the changes in their behavior.

“Most adults understand if they feel depressed or melancholic—and they’re aware of the effect it has on their work or life,” says Joseph Penn, a clinical professor of psychiatry at the University of Texas Medical Branch at Galveston, and chair of the American Psychiatric Association Council on Children, Adolescents and Their Families. “Adolescents don’t have insight.”

And girls and boys may behave differently. More girls become depressed. They tend to cry more or withdraw, yet they’re still more willing to talk about their feelings than boys, says McLean’sMs. Feinberg. “Boys act out more,” she says. “They may have conduct issues, destroy things in their room or throw things, get into drugs or alcohol.”

But the most significant signs to look for are an impairment in functioning often across several areas of the child’s life—school, social, extracurricular—and an inability to experience pleasure, which appears to have no cause. “It’s the hallmark that differentiates teenage moodiness from depression,” says John T. Walkup, chair of the department of psychiatry at Ann and Robert H. Lurie Children’s Hospital of Chicago.

Corrections & Amplifications 
More than 11% of teenagers ages 18 and 19 had a major depressive episode in 2016, compared with 9-10% in 2006. An earlier version of this article incorrectly stated more than 11% of teenagers ages 18 and 19 had a major depressive episode in 2006.

Steps to Take

What should you do if you think your teenager is depressed?

Be curious. Ask gentle questions and listen without being critical, says Jessica Feinberg, a licensed clinical social worker and program director of the Adolescent Acute Residential Treatment Program at McLean Hospital in Belmont, Mass. “Validate your child’s feelings,” she says. “This does not mean you have to agree with them. It’s enough to say ‘I hear you. Let’s talk.’”

Ask others. A child who is depressed will often have impaired functioning in several areas of life. Check with the school, coaches, family and friends to see if they also notice a change.

Talk to the pediatrician. The doctor can rule out physical causes, such as a thyroid problem or a side-effect of medicine, and make a recommendation to a mental-health professional if needed. Share your family history: Depression, like other mental illnesses, tends to track in families, says John T. Walkup, chair of the department of psychiatry at Ann and Robert H. Lurie Children’s Hospital of Chicago.

Find a therapist. Make sure the therapist is licensed and has experience with adolescents. Look for someone who practices Cognitive Behavioral Therapy, a short-term, evidence-based approach that helps identify inaccurate or negative thinking in order to respond to situations more effectively. Ask the school or your friends for recommendations, and let your teen have a part in the decision.

Consider a psychiatrist.. In the case of a mental-health disorder, research shows a mix of therapy and medication often works best, says Joseph Penn, a psychiatrist and chair of the American Psychiatric Association Council on Children, Adolescents and Their Families. “If you don’t treat depression, one of the major risk factors, while rare, is death from suicide,” he says.

Have a plan for college. If your teen suffers from depression, find a therapist near the school and ask your child to sign the college’s confidentiality waiver, so the school can legally contact you if your child has a health crisis.

Get your own therapist. This shouldn’t be the same person your child sees. Take care of your physical health, as well. “It’s the same idea as on an airplane, when you put the oxygen mask on yourself before you put it on your child,” Ms. Feinberg says.

Act immediately if your child talks about self-harm. “A lot of times it is really hard to figure out if a kid is suicidal or crying wolf,” Dr. Penn says. “But it has to be taken seriously regardless.”

Write to Elizabeth Bernstein at elizabeth.bernstein@wsj.com or follow her on Facebook, Twitter or Instagram at EbernsteinWSJ.

Wall Street Journal: Increase in Teen Suicidal Behavior

The Wall Street Journal article below appeared in their May 18, 2018, edition.  I have included the article in its entirety here for your convenience.  nw

LIFE

Youth Suicidal Behavior Is on the Rise, Especially Among Girls

Suicide was the second-leading cause of death among 10- to 24-year-olds in 2016, up from third place in earlier years, according to the CDC

By  Jeanne Whalen

Updated May 15, 2018 2:21 p.m. ET

A new study finding a rise in suicidal thoughts and attempts among young people adds to the research pointing to a decline in mental health among U.S. children and adolescents.

The study showed the proportion of young people treated at 31 U.S. children’s hospitals for suicidal thoughts or attempts more than doubled between 2008 and 2015, from 0.66% of all visits to 1.82% of all visits. Rates were higher during the school year than in the summer, and nearly two-thirds of the visits involved girls, according to results published in the medical journal Pediatrics.

The research had limitations: It didn’t include data from all U.S. hospitals or suicidal behaviors that didn’t involve a hospital visit. Still, physicians said it fits a pattern of findings that show rates of depression and suicide-related behaviors and deaths are rising among young people.

Loss of Hope

Suicide was the second-leading cause of death among 10- to 24-year-olds in 2016, up from third place in earlier years, according to the Centers for Disease Control and Prevention.

It’s such a critical public-health crisis right now,” said Lisa Horowitz, a staff scientist and pediatric psychologist at the National Institute of Mental Health, which is attempting to boost suicide prevention in part by improving screening at emergency departments and pediatrician offices.

Researchers say they aren’t certain what is driving the growth in depression and suicidal behavior but theorize that decreasing stigma might be causing more children and their parents to seek help, leading to wider reporting of the problems.

Some early research has suggested children’s use of social media and smartphones may also be factors, fueling cyberbullying and feelings of inadequacy. “We need more data to say that’s a contributing cause,” said Ramin Mojtabai, a psychiatrist and professor at Johns Hopkins Bloomberg School of Public Health.

Suicide deaths in the total U.S. population rose from 10.4 per 100,000 people in 2000 to 13.4 per 100,000 people in 2016, according to the CDC. Suicide deaths in 10- to 19-year-olds over the same period rose from 4.7 to 6.1 per 100,000 people.

In the new Pediatrics study, researchers analyzed billing data for patients ages 5 to 17 to identify emergency-room visits and hospitalizations for suicide attempts and suicidal ideation, the clinical term for persistent suicidal thoughts. They drew the details from a database managed by the Children’s Hospital Association, which includes billing and clinical data from children’s hospitals in most major metropolitan areas.

More than half of the suicide-related visits resulted in inpatient hospitalization. Of these, 13% were treated in intensive-care units. The researchers found the visits occurred at a higher rate during the school year, with October accounting for nearly twice as many visits as July.

“What our study made clear was school was a huge influence,” said one of the lead researchers, Gregory Plemmons, a physician and associate professor of clinical pediatrics at Vanderbilt University School of Medicine in Nashville. He said academic pressure and bullying could play a role, though the study didn’t delve into the causes.

The study found the rise in suicide-related hospital visits was higher for girls, who made up nearly two-thirds of such visits overall. The researchers called for further research on possible gender differences in youth mental health, noting that a previous study found larger increases in depression in teenage girls compared with boys over the decade up to 2014.

Dr. Plemmons said he became interested in conducting the study after noticing an increasing number of beds at his hospital being used for young people in need of psychiatric treatment, often after exhibiting suicidal behavior.

“What I’m noticing is kids seem to be less resilient and to have more pressure,” he said. “I think social media also fuels this Instagram life of everything is perfect and cool and you don’t see the other side of life.”

One study published last year found U.S. adolescents who spent more time using electronic devices and social media were more likely to report depressive symptoms or at least one instance of suicidal behavior.

“The increases in new media screen activities and the decreases in nonscreen activities may explain why depression and suicide increased among U.S. adolescents since 2010,” the study, published in the journal Clinical Psychological Science, concluded.

The researchers based their findings on surveys in which adolescents reported their daily activities and symptoms of depression or of suicidal thinking or attempts.

That study found a particular uptick in mental-health issues beginning around 2011 and 2012 and noted that about half of U.S. teens were using smartphones by late 2012. The study also found the correlation between screen time and mental-health problems was stronger in girls.

To Those Who’ve Lost a Loved One to Suicide

May 13th is the day I dread.  But May 12th is the day that haunts me.

It’s the last day I saw my son alive. The last day I talked to him, and he to me.

When I speak in schools on suicide awareness & intervention I close my talk with the following question because, based on emails I have from school counselors, I know for certain there is at least one student there listening who has considered taking their own life. I say to them:

“If today were May 12th, 2013, and my son was sitting next to you in this assembly, what would I want the speaker to have said?”

O God, if only I could go back to May 12th….

If only I had stayed with him. If only I had somehow gotten him to tell me how he was really feeling. If only I had walked into his room a few minutes before…

If only…, if only…, if only…

This “if only” mental incarceration kept me in a state of shock for eight months after Jordan’s death. It was psychologically exhausting, I could barely make it through an entire day without having to lie down due to the “in the danger-red-zone rpm’s” at which my mind was speeding, trying futilely to un-do my son’s death. For the first time in my life I discovered how a person can go insane.

Finally, after eight months, utterly broken and in despair, I realized I was unable to bring my son back.

Psychologists rightly call grief associated with suicide “complicated grief.”

I could write a book on this topic alone (and I think Michelle and I are finally getting to a place where we can seriously consider doing so), but I will make this post brief. (We all know what it means when a preacher says “let me make this brief: we’re all in for another 30 minutes. 🙂 But I promise.)

I once heard a speaker on this topic say, “Suicide is 100% preventable.” I strongly and respectfully disagree. It’s impossible to protect someone from themselves. Not only is this statement, in my opinion, false, it shackles people like me with crippling guilt and shame. If you’ve lost a loved one to suicide never buy into that line. Because it’s simply not true.

As I’ve written in previous blogs, when a person takes their own life they are, at that moment, unable to connect with the logical part of their brain. In short, their brain is broken. To be clear, what I mean by “broken” is that their brain is suffering from a severe and debilitating chemical imbalance. Synapse and neurons are misfiring. They are, in the literal meaning of the phrase, no longer “in their right mind.” ( I’m sure there are exceptions, but based on my study, this is the rule.)

People ask sometimes, “Why didn’t Jordan say something? What was he thinking?” My response: “He wasn’t thinking. His brain was broken.”

99% of people who attempt to take their own life don’t want to die – they just want the pain to stop.

They’re plan plays out like a twisted and convoluted movie script. I am asked, “Why don’t they just say something??” I reply, “Their brain being in the process of breaking, they don’t know how to talk about it. Moreover, believing they’re doing what’s best, they don’t want us to get in the way of their developing plan to end their pain – and remove, once and for all, what they’ve, over time, convinced themselves is a back-breaking burden to us.  “They will no longer have to worry about me,” they think to themselves.

On May 13, 2013, my son was in so much pain he just wanted to go to sleep. His brain being broken, he was unable to connect his shattered logic with the life-changing devastation this would have on his family and friends.

In early May, when Jordan told me, “Dad, I feel like I’m slipping” (our code phrase for when he and I felt like our medicine was not working), we immediately got him to the doctor and into counseling.

He told us it was helping. Had he communicated anything differently we would have never left his side and taken more drastic measures. But, better days seemed to lie ahead. On May 10th he talked about how excited he was about his and his friends’ upcoming wacky camping trip.

I share this today, in part, because writing is therapeutic for me. (As I write I, in essence, am counseling myself). But also to remind those who’ve walked this painful path you were an amazing parent/child/sibling/friend.

Your loved one’s suicide had absolutely nothing to do with your inability to prevent it.

Regardless of what satan may be whispering in your ear, it wasn’t your fault.

Here is the biblical truth:

Because of the Cross and the Empty Tomb your/my loved one is more alive than they ever were on this fallen planet. Further, they would never want to return for, being in the very presence of Jesus, they are this very moment experiencing a level of joy that lies far beyond mere human comprehension.

And – according to the Bible, a reunion is coming.

Love to you all, Nick