Supporting Suicide Prevention Among Students

This guide provides resources and expert advice to help parents compassionately care for high school and college students and make sure they get

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How to Support Your High School or College Student

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.

What to do if Your Child is Suicidal

If a parent suspects that their child is having suicidal thoughts or is in immediate risk of attempting suicide, an immediate response is needed.

If you have a high school student

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.

At Immediate Risk

  • Call 911 or the Suicide Prevention Lifeline (1-800-273-8255), which is available 24/7
  • Take your child to the nearest emergency room
  • If you or anyone in your household owns a gun, knife or other dangerous weapon, place these items in a safe, securable location
  • Remove any other objects that could be harmful
  • Make sure your child isn't left alone
  • Remove any medications that a child could use to overdose

Having Suicidal Thoughts

  • Take any and all statements related to suicide seriously
  • Talk to your child to figure out exactly what's causing these thoughts
  • Approach the situation calmly and make sure your child knows you are there to provide understanding, love and support
  • Find a therapist that can provide professional support to your child, and possibly a psychiatrist or psychologist if a medical course of treatment is deemed necessary
  • Work together to create a plan that avoids people or situations that trigger these thoughts
  • Keep track of their social media activity; consider monitoring their phones to watch for bullying or other harmful behavior
  • Consider an in-patient rehabilitation program
  • Get him or her involved in some sort of physical activity to increase endorphins

If you have a college student

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.

At Immediate Risk

  • Call the college campus health center and let them know the student is exhibiting dangerous behaviors
  • Call 911 and ask them to go to your child's dorm room
  • Call the resident director of your child's dorm and ask them to assess the situation to ascertain the best course of action
  • Ask campus security or local police to go check on your child
  • Ask one of their friends to stay with your child until help can arrive
  • If the school isn't far away, drive there yourself to check on your child

Having Suicidal Thoughts

  • Encourage your child to go see a therapist or counselor, on or off campus, if they haven't already
  • Find out if your child has been taking any prescribed medications regularly
  • Reinforce your love and support
  • Ensure you're speaking regularly and encourage your child to call you whenever help is needed
  • Remind your child that it's fine to take time off from school if it's too overwhelming
  • Suggest transferring to a school that's closer to home
  • Encourage them to speak to their RD and professors to let them know of the situation and ask for help, if needed

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."

Suicide Warning Signs

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.

In high school

  • Writing about suicide, death or dying – especially when interest in the topic is out of the ordinary
  • Not wanting to get out of bed, sleeping far more than usual or experiencing insomnia
  • Having suicidal thoughts
  • A lack of interest or awareness of future plans, or a loss of interest in upcoming events that would usually promote excitement
  • Dark or hopeless posts on social media, especially if these kinds of posts are out of the ordinary
  • Any attempts to tell a friend, family member or other loved one goodbye in person, on the phone, over text messages or through social media
  • Any expression of feeling trapped or seeking any type of relief and/or escape from a current situation
  • Any expression of not having a purpose in life, or questioning if life is worth living

In college

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.

  • A lack of interest in activities that used to be enjoyable, or a sudden disinterest in following through with goals
  • Overly emotional outbursts, ranging from frequent crying to becoming easily irritated by many different things
  • Shifting from being an engaged, achieving student to one who doesn't seem to care about missing classes or not turning in assignments
  • Ignoring existing friends, or not attempting to make new friends in college
  • Significant changes in eating habits, weight, appearance or level of self-care and hygiene
  • Any attempt to give once-prized possessions away to friends or family
  • Behavior that seems impulsive, or reckless; a lack of appreciation for safety or the value of life
  • Frequent, uncontrollable anger that is often rooted in a lack of self-worth

Risk factors for suicide

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.

  • A history of self-destructive habits
  • Substance abuse
  • Changes in relationships
  • History of family depression and/or suicide
  • Previous attempts at suicide
  • Untreated mental health problems (such as depression, anxiety, bipolar disorder, schizophrenia)
  • Fear or embarrassment over seeking help for mental health issues
  • Feeling lonely, shameful, inadequate or alienated
  • Lack of close relationships

How to Talk to Your High School or College Student About Suicide & Depression

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:

Conversation starters with your high school student

  • "I heard about a good film/TV show that addresses adolescent suicide; let's watch it together."
  • "I read an interesting article about teen suicide rates increasing, have you heard about this?"
  • "Your school is doing a suicide prevention week; are you going to any of the events/training?"
  • "If you don't want to talk with me, let's find someone who will keep your secrets and provide advice without us having to know any details you don't want to share."
  • "We noticed that you seem a bit distracted/tired/listless/depressed recently and just want you to know that we love you and are here for whatever you may need."
  • "Is suicide something you and your friends discuss? Is it something you've thought about?"
  • "Even if this isn't an issue for you personally, let's sit down and talk about this topic because it's really important."
  • "Have you ever felt really overwhelmed by school, life or relationships and not known how to express those feelings in a healthy way?"

Conversation starters with your college student

  • "Did you know that one in 12 college students have made a suicide plan at some point during college?"
  • "Do you feel that you've excessively used drugs or alcohol to combat feelings of depression? Is there a healthier way to deal with these feelings?"
  • "What do you think of your campus's mental health services? I read that free counseling is available."
  • "Do you have any friends who are suffering from depression or suicidal thoughts? What resources can you share with them?"
  • "It's been three weeks since you broke up with your high-school girlfriend/boyfriend. How are you feeling about that?"
  • "Being away from home for the first time can be hard the first few months. Would you like to come home for fall break? Would you like for us to come see you?"
  • "Have you had any suicidal thoughts as you've settled into college life?"
  • "Are you maintaining a healthy schedule to make sure your assignments get turned in on time and you don't get overwhelmed or depressed about school?"

Choosing the Right College or University

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.

Factors to consider

Before signing the dotted line on any school acceptance letter, students and their families should evaluate prospective schools based on the following factors.

Size

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?

Location

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?

Freshman experience

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?

Residence life

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?

Counseling

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.

Social opportunities

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.

Recreation

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?

Resources to look for on and near campus

  • Campus Counseling 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.
  • Local Mental Health Providers 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.
  • National Alliance on Mental Illness 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.
  • Suicide Prevention Training 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.

Preparing for College When Your Teen Struggles with Depression

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.

What to do senior year

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.

Build independence

"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."

Increase responsibilities

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.

Focus on school

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.

Bolster mental health

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.

Get to know school resources

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.

Steps to take before the semester begins

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.

1. Think about therapy

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.

2. Have paperwork in place

"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.

3. Sort out medications

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.

4. Create a plan of action

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.

5. Know all the options

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.

How to Support Your College Student

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.

Set up a Skype date

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.

Get to know roommates

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.

Send mail

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.

Encourage involvement

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.

Check in about their mental health

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.

Don't sweat the small stuff

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.

Visit – or pay for them to come home

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.

Privacy Rules & Your College Student

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.

What privacy laws affect college students and parents?

Family Educational Rights and Privacy Act (FERPA)

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.

What can be shared with parents

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:

  • Attendance (appointments scheduled and met; when the visit took place)
  • Treatment (any diagnoses made and treatments recommended)
  • Safety concerns (whether the student is considered a danger to themselves or others)
  • Alcohol and/or drug use
  • Written mental health records
  • A summary of treatment
  • Issues related to academic performance
  • Billing records
  • Other (the student is allowed to write in an answer)

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.

10 Myths About Suicide

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.

People who talk about suicide don't die by suicide.

Eight out of 10 people who have killed themselves have verbalized their intent beforehand.
: Fact:

When a suicidal person begins to feel better, the danger is over.

Most suicides occur within 90 days following improvement in the person's mental-emotional status.
: Fact:

When someone says they'll attempt suicide, it's largely an empty threat.

Approximately 80 percent of people who die by suicide had previously told at least one person that they were considering it.
: Fact:

If a student is suicidal, it means they are also depressed.

While depression is often a factor, it is not always present in those who attempt or die by suicide.
: Fact:

Suicide is largely a white, middle class male problem.

The factors leading to someone dying by suicide cut across socioeconomic statuses, gender, ethnicity and age.
: Fact:

You shouldn't talk to teenagers about suicide because it might place the idea in their heads.

Research shows that openly discussing suicide and things that lead to suicidal thoughts allows for effective communication and earlier opportunities for intervention.
: Fact:

Most teenagers who attempt suicide haven't shown any warning signs before doing so.

Four in five high school students who attempt suicide have given clear warning signs.
: Fact:

Students who want to kill themselves ultimately can't be helped.

Approximately 80 percent of college students who die by suicide never had contact with any mental health services.
: Fact:

Suicide isn't really a concern for college students.

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 just as likely as any other student population to die by suicide.

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.
: Fact:

Sources: Nevada Office of Suicide Prevention, AAS, WMU Suicide Prevention Program, The Trevor Project & Crisis Services

Where Parents Can Find Support

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.

  • 10 Things Parents Can Do to Prevent Suicide 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.
  • A Voice at the Table 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.
  • American Foundation for Suicide Prevention The AFSP manages an extensive database of support groups for both parents and teens looking to be surrounded by individuals with similar experiences.
  • Local counselor or mental health expert 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.
  • Local support group 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.

Additional Resources for Parents & Students

  • Depression and Bipolar Support Alliance 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.
  • Half of Us This national organization raises awareness about suicidal behaviors within high school and college students and educates individuals about getting help.
  • Mental Health America 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.
  • National Alliance on Mental Illness In addition to a variety of online resources and discussion groups, NAMI provides a number of regional support groups for parents of suicidal teens.
  • National Institute of Mental Health 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.
  • Suicide Prevention Resource Center SPRC provides several helpful services to users, including an extensive guide on promoting mental health and preventing suicide in postsecondary education settings.
  • World Suicide Prevention Day The International Association for Suicide Prevention organizes this annual event, which often has ways for high schools and colleges to be involved.
  • ULifeline 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.

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