Each day in America, nearly 3,500 high school students attempt suicide. Among college students, suicide is the second leading cause of death in the country. Supporting a student who struggles with mental health can be difficult for parents and they may not know where to start. This guide provides resources and expert advice to help parents compassionately care for high school and college students and make sure they get the professional services they need.
If a parent suspects that their child is having suicidal thoughts or is in immediate risk of attempting suicide, an immediate response is needed.
Parents should be alert and aware of the warning signs to be an effective advocate for their child. It's also important that they offer a calm, measured response that doesn't overwhelm the child further.
It can be harder to monitor your child's behavior away from home, but there are still actions you can take to help and support your college student.
Mental health specialist Kryss Shane emphasizes that, while trust between a parent and child is key, there are times when parents must step in to establish their child's safety. "Going to therapy is a helpful exercise, and parents can require their kids to attend in order to earn the right to go out, use their phone or take part in other privileges."
She continues, "College students are different since they are legal adults, but in both cases, it's important to ask the child how they are feeling and to create an environment that feels light and non-judgmental."
When students are considering suicide, they may exhibit warning signs that alert those who care about them that they are suffering. While not every student will exhibit the same characteristics, the most important thing for parents to remember is that if their child is acting out of the ordinary and appears to be struggling, the best possible solution is to seek help.
Although many warning signs may be the same in high school and college, if a parent doesn't live with their child, they may not see the same things. As the relationship transitions and students move into higher education, it's important to think about how warning signs may look different.
It's important to remember that there is no one-size-fits-all when it comes to risk factors for suicide. The list below highlights some of the more common factors, but the most perceptive people in a students' lives – those who understand their habits and personality best – will be the most effective when it comes to identifying specific risk factors.
Many parents fear that by talking about suicide, they are giving their child the idea to engage in that type of behavior. Research shows, however, that bringing up the topic and having an open, frank discussion is one of the most useful tools in fighting against the loneliness and stigma that leads students to take their own lives.
While it's easier to monitor a child's behavior while they're still living at home, the key to maintaining open conversations with both high school and college students is to create and maintain the type of relationship where they know it's safe to come to you with concerns and worries. Once a child moves out of the house and starts college, try setting up a regular time to talk (weekly, bi-weekly, monthly, etc.) so you get a sense of their lives at school and if their mood shifts drastically over a short amount of time.
It's also helpful for parents to take the time to get to know both high school and college friends. These students spend the most time with your child and may be more aware of changes in behavior or warning signs.
Talking about suicide is a tough discussion to have, and many parents aren't sure how to bring up the topic or how far to push their kids in opening up to them. Mental health expert Kryss Shane shares the following conversation starters:
Finding the right college is an exciting process for any student, but it's also one that should be taken carefully and thoughtfully by students who struggle with mental health. Aside from academic considerations, degree seekers also need to take time to understand if the schools they are looking at have the support mechanisms and resources in place to help them flourish.
Before signing the dotted line on any school acceptance letter, students and their families should evaluate prospective schools based on the following factors.
When your student pictures their ideal campus, is it a Big 10 public school where they can blend into massive crowds or is it a small liberal arts college where one-to-one attention is the norm?
Moving across the country may sound like a dream for some students, but for others it can leave them feeling cut off from family and friends. Is it important to the student to be within driving distance of home? Is there reliable, affordable public transport that runs between college and home?
Lots of colleges have really great orientation and first semester programs that work to involve new students in campus activities and help them meet friends. Is it important for your student to receive that extra push to put themselves out there and get to know the campus?
Some schools have adequate on-campus housing for every student who attends, while others may require learners to live in off-campus dormitories. Would your student benefit from the extra attention and support that comes from having dedicated resident directors and an active program of dorm events?
Students who struggle with mental health outlets need a safe, affordable and easily reachable place where they can go to talk through problems and receive support and guidance. Students who have struggled with depression or suicidal thoughts in high school should take extra time during any campus visits to stop by the health services office to learn about offerings.
What is the student-to-therapist ratio? Is someone available 24/7? Does the counseling services department mainly deal with day-to-day stress or are they equipped to deal with more substantial and/or ongoing concerns?
Whether students plan to attend a college where other high school friends are attending can have a tremendous impact on how they socialize – especially during the first year of college. Those who attend a college close to home will likely have a built-in friend group when they reach college, while those attending a school further afield will need to start from scratch.
When considering colleges, pay attention to how students interact with one another. Do they seem to be generally supportive? Do students seem confident in who they are and the choices they make? Does the school have policies in place to punish bullying and limit accidents related to alcohol and drugs?
Spending time outdoors and exercising are great ways to support good mental health, and colleges that offer these types of activities should be high on your student's list. Are there bike or walking paths near the school? Does the gym have enough equipment for the student body? Are intramural sports teams a popular option for fitness?
Schools like the University of California at Berkeley work to ensure students have access to free and supportive counseling services to help step them work through their feelings.
Even if a student's chosen school doesn't have adequate suicide prevention and/or mental health services on campus, there may be qualified and knowledgeable professionals close to the university. Consider contacting the student health services department to ask about local mental health services.
NAMI has organized a number of on-campus clubs for students looking to either speak about their feelings, find resources for any mental illnesses they are dealing with or simply find others who understand what they're going through.
Ohio State University's suicide prevention program is a strong example of how colleges can work to support students. In addition to counseling services, a hotline and the RUOK? Program, OSU offers REACH to all students. REACH is a 90-minute training program that teaches students, faculty, administrators and parents how to identify risks and warning signs and effectively intervene.
College should be something that students and parents look forward to with excitement and anticipation. But for those who struggle with depression, it can also fill them with anxiety. While it's impossible to plan for all the unknowns in this next chapter of life, families can take concrete steps to ensure students are well prepared.
Senior year is a busy time for students as they take standardized tests and apply to schools. It's also an important time for students to think about the new demands of college and how to best cope with them.
As your child prepares to leave the nest, the following suggestions can help them build confidence, self-discipline and independence that will serve them well and help lessen triggers that could cause mental unrest.
"Encouraging students to do their own laundry, wash their own dishes and keep their room as they wish helps them begin learning life skills while you're still there to help and assist," counsels expert Kryss Shane. "Rather than stepping in when they make a wrong choice, let them decide whether they will come to you and ask for help."
Students may be used to having a few chores per week, but parents may want to consider ramping these up during senior year to give their child a sense of the increased responsibilities they'll face at college. This exercise also helps them build time management skills and instills self-discipline.
No matter how great a student your child has been in high school, the reality is that their work load is going to increase dramatically once they enter college. The expectations of professors will be higher, and students will need to spend more than an hour each night completing homework assignments, writing papers and studying for exams. Building good study skills during senior year sets students up for success and helps them manage things like stress more effectively so it doesn't bleed into other parts of their lives.
College can be a busy, stressful time for all students, regardless of extenuating mental health concerns. One of the best ways to combat stress and all the other negative concerns that come from this season of life is to develop good life practices.
The University Health Service program at University of Michigan offers several ideas, including helping students learn to value themselves, take care of their bodies, surround themselves with good friends, meditate, avoid excessive alcohol and all drugs and learn how to set realistic goals.
Rather than waiting to get to college to use services available at school, encourage students to familiarize themselves with them while still in high school. Professionals like guidance counselors and mental health specialists can help students balance their lives, while student groups and organizations can help break down the stigma of depression and/or suicidal thoughts.
After putting in the necessary prep work during your child's final year of high school, the next crucial step is to plan for the realities of college. While attending higher education is often one of the most exciting times in a student's life, living away from family for the first time and meeting the more demanding expectations of postsecondary schooling can also take its toll.
For students who suffer from seasonal affective disorder (SAD), the first semester can also be a trying time. It's important to ensure that students are prepared for the emotions they may experience their first few months on campus and know where to turn if they need help.
Mental health advocate and suicide survivor T-Kea Blackman suggests that parents work with their child's chosen school to find a qualified therapist even before the student sets foot on campus.
"Lots of therapists are accessible via video chat, so students can have a few video sessions to determine that it is a good match if the school isn't close to home." Blackman continues, "This will save the child a lot of stress of having to find a therapist on their own, while also adjusting to all the other changes brought about by college."
"Parents should make sure students have their insurance cards, a list of contact information for their doctors and details about their treatment plans, and any other documentation that will be needed for students to find new doctors and mental health professionals in their new city," says Blackman.
If your child is regularly taking medication to combat depression, anxiety or any other mental health issues, it's important to ensure you have a plan in place for how they will access prescription refills before they move to college. If the college they'll be attending is close to home, it may be possible for them to continue seeing their regular doctor. Otherwise, they'll likely need to find a new doctor.
One of the most important things parents can do for their children is anticipate problems they may encounter once reaching college and develop a practical, concrete plan for what to do if/when that happens. If possible, try to meet with the campus health services team while visiting for summer orientation so your child can meet the staff and familiarize themselves with the services offered.
College is a great time of learning and growing, but sometimes all of the changes that come with a new setting and phase of life can be overwhelming. Mental health professionals can do much to ease these stressors, but those aren't the only options available. Accommodations are also available to help students ease into college, and many schools also allow students to take a leave of absence if their mental health is in jeopardy.
Students can also consider online options if attending class in person becomes overwhelming. Undergraduate students can consider online college, and there are also online homeschool options for high school students.
Many parents may worry they'll become disconnected from their child and perhaps miss warning signs once they reach college. The fear of not being able to protect and support a child is one that has been felt by nearly every parent, but for those with children who struggle with mental health, it can be especially keen.
While your relationships will naturally shift, there are plenty of things parents can do to provide emotional support and keep in touch while kids are away at school.
College schedules are filled to the brim with classes, homework, studying and participation in sports or clubs, but that doesn't mean students can't set aside 30 minutes a week to chat with their parents. By starting this tradition early, students know they have an outlet to talk about what's going on in their lives on a regular basis.
More so than any other new person your child will meet on campus, their roommate likely spends the most time with them. In addition to working with the school to find a suitable person to share a dorm with, parents should consider getting to know their child's roommate as a way of keeping up with their lives.
Even after your child begins to make new friends at college, it's likely they'll still miss and crave the familiarity that comes from parental or grade school relationships. To combat the loneliness of this season, consider sending your child regular care packages.
Ideas include making some of their favorite cookies or baked goods, sending funny videos of family pets, encouraging grandparents to get in touch or collecting notes from people they were close to and creating a little booklet of encouragement.
When young adults suffer from depression or anxiety, getting involved in new student activities and events can be scary but they can also help them in the long run. Taking part in an open mic night may not be the best fit for an introvert, but there are plenty of activities to suit all types of personalities and interests.
Don't be afraid to continue having the same open and frank conversations that were had in high school. Because college students are around people who don't know them as well, it's important for them to have someone check in on how they're doing and if they're taking care of themselves.
While good grades and commendations from the Dean are great things to aspire to, at the end of the day the most important thing is making sure students are healthy and happy at school. If your child calls to say she got a bad grade or had to drop a class, respond in an appropriate and supportive manner that lets them know they can come to you with anything and you won't overreact.
If your student is feeling overwhelmed by the changes brought about by college, going to visit them or paying for a ticket home allows them to disconnect – even if only for a weekend – and reset. Sometimes even just stepping back for a day or two can help students refocus and start the week feeling rested and loved.
Once a student reaches 18, there are privacy laws that may prevent a parent from accessing health information about their child. By understanding the rules set by federal laws such as FERPA and HIPPA, parents and their children can make decisions together about what information should and should not be shared.
Regardless of what a student and their parents decide to share with each other, parents should make sure their child knows that therapists (and other mental health professionals) offer safe spaces where they can speak openly without worrying about information getting out.
Since 1974, the Family Educational Rights and Privacy Act (FERPA) has protected the privacy of student education records and outlined the rights that parents have when it comes to accessing their child's records. This federal law applies to any school that receives funds from the U.S. Department of Education, and specific rules about the types of information a parent can access exist to protect both the student and the institution.
Rules about the type of educational information parents can access tend to be more lenient (e.g. parents can access educational records if their student is claimed as a dependent for tax purposes and the school can inform parents if a student under the age of 21 violates a law or policy related to alcohol or controlled substances). But rules around mental health and/or medical records are more stringent due to a joint privacy law related to the Health Insurance Portability and Accountability Act (HIPPA).Health Insurance Portability and Accountability Act (HIPPA)
Since 1996, the Health Insurance Portability and Accountability Act (HIPPA) has set strict guidelines about the release of any medical records pertaining to students. A student's treatment records, as they are known within the law, includes information related to any visits made to physicians, psychiatrists, psychologists or any other medical professionals who work for a postsecondary institution or within the community.
While only the attending physician and the student have automatic access to these records under HIPPA, the law does state that records can be disclosed provided the student gives prior written consent. The only exception to the law is if/when a therapist or other medical professional has reason to believe that a student might hurt him/herself or another person. In that case, they are permitted to inform the necessary parties.
Parents are able to access basic educational records about their children, but no medical records may be shared without a student's consent. When filling out an authorization for release of health information form, students can select what types of information a parent can access, including:
According to mental health expert Kryss Shane, it's helpful to have a conversation with your student before they go to college to set some ground rules about transparency and openness. "If you're worried about your student and you pay some or all of the bills, you can consider requiring them to sign the authorization of release form so you can gain information if/when you need it," she says. "You can also have them sign a document with their therapist so the therapist can affirm that students are regularly attending sessions. If students aren't great at being consistent with their medications, you can ask them to take the pills each night over Skype so you can see them."
Parents may also consider building a relationship with the Resident Director of their child's dorm so they have someone to check in with if they don't hear from the student for a few days. "Usually, these professionals can help keep an eye on the student without providing information such as grades or class attendance," says mental health advocate T-Kea Blackman.
Part of reducing the number of suicides that take place each year is understanding the myths and facts surrounding it and working to recognize and combat common signals.
Fact: Eight out of 10 people who have killed themselves have verbalized their intent beforehand.
Fact: Most suicides occur within 90 days following improvement in the person's mental-emotional status.
Fact: Approximately 80 percent of people who die by suicide had previously told at least one person that they were considering it.
Fact: While depression is often a factor, it is not always present in those who attempt or die by suicide.
Fact: The factors leading to someone dying by suicide cut across socioeconomic statuses, gender, ethnicity and age.
Fact: Research shows that openly discussing suicide and things that lead to suicidal thoughts allows for effective communication and earlier opportunities for intervention.
Fact: Four in five high school students who attempt suicide have given clear warning signs.
Fact: Approximately 80 percent of college students who die by suicide never had contact with any mental health services.
Fact: One in five undergraduates and one in six graduate students have seriously contemplated attempting suicide in their lifetimes, and between 40 and 50 percent of those students have considered it multiple times.
Fact: LGBTQ students are nearly five times as likely to have attempted suicide when compared to non-LGBTQ students. Approximately 40 percent of transgender adults attempted suicide, with 92 percent of those attempts taking place while under the age of 25.
Parents are naturally going to focus on ensuring their children have the best support systems possible available to them, but it's also important to ensure they're taking care of themselves. Whether that means educating themselves on suicide prevention, seeing a therapist or joining a support group, the resources below are designed to help parents care for themselves while caring for their children.
Healthy Children, a subsidiary website of the American Academy of Pediatrics, offers this enlightening and helpful list of ways parents can support students who are suicidal.
This 35-minute documentary shares the stories of four individuals who attempted suicide and survived. In addition to helping parents better understand drivers of suicide, the director of this film is currently working on a spin-off documentary focused on adolescent suicide attempt survivors.
The AFSP manages an extensive database of support groups for both parents and teens looking to be surrounded by individuals with similar experiences.
In addition to ensuring their students have professional mental health services available to them, parents should also consider seeing a therapist to discuss their own feelings.
Aside from online support and discussion groups, local community centers typically offer similar in-person services to provide a shared safe space for discussing common concerns.
This 24/7 phone line offers free and private support to find resources and prevention tools to parents or individuals experiencing distress.
Michelle LeRoy, a licensed clinical psychologist in the Mayo Clinic Health System, shares her tips and recommendations for supporting suicidal teens in this HuffPost article.
This national nonprofit provides a whole page devoted to helping parents of suicidal teens.
Parentline includes a mix of research and actionable ideas for helping this population cope with suicidal thoughts.
Many local YMCA chapters throughout the country offer support groups for both teens and their parents.
The DBSA provides the Balanced Mind Parent Network, a support program designed to help families raising children with depression or bipolar disorder find resources and answers.
This national organization raises awareness about suicidal behaviors within high school and college students and educates individuals about getting help.
MHA offers a "Life on Campus" guide to help students with depression or other mental health issues address the new experiences of college and maintain good mental health.
In addition to a variety of online resources and discussion groups, NAMI provides a number of regional support groups for parents of suicidal teens.
NIMH dedicates an entire section of its website to suicide prevention, including details about signs and symptoms, risk factors, treatments and therapies, research and action steps for helping someone who is experiencing mental distress.
SPRC provides several helpful services to users, including an extensive guide on promoting mental health and preventing suicide in postsecondary education settings.
The International Association for Suicide Prevention organizes this annual event, which often has ways for high schools and colleges to be involved.
Students who may not be interested in seeing a counselor or taking part in campus-based support groups can take advantage of ULifeline, an online resource for students seeking support for their mental health.