The Question Teenagers With Suicidal Ideation Need You to Ask

Warning: this article contains very frank language pertaining to suicide and suicidal ideation. Please plan to care well for yourself if it could be triggering for you.

“Liz, are you thinking about taking your own life?”

I took a pause, surprised by my coworker’s question as we sat across from one another at a local coffee shop near our office.

At the time of our conversation, I was in the middle of a “dark night of the soul,” in the words of St. John of the Cross. I loved my community and my work as a youth minister. But various life circumstances, some family predisposition, and perhaps some spiritual attack had led to time where the dominating thought in my mind was, “I just want to be with Jesus.”

It was shortly after sharing this thought with Justin that he gently interrupted me.

His question broke into a detached place for me, bringing the reality of my words into clarity a bit. He felt the weight of what I was saying even when I didn’t. And he honored that weight with his caring question.

His concerned and compassionate posture allowed me to answer honestly: “No, I am not having any suicidal thoughts. But thank you for asking me.”

I felt a little relief after having responded, even. It was a blessing to have had the reality of my sadness brought to light. It was a profound moment of being seen and cared for. I was very grateful.

I offer this story as an example of how we want to interact with our students any time we suspect they may be struggling with suicidal ideation. Always, always ask them directly.

One of the best resources we have in ministry is our gut instinct fueled by the Holy Spirit. If your gut tells you to ask, please ask. It is absolutely essential that we ask instead of making the assumption that our student probably isn’t thinking about taking his own life. Asking does not put the idea into his mind. It is either there, or it isn’t (as was the case with me). If your student is in such a vulnerable state that you fear having put the idea in his mind, ask him the follow up question, “What was it like for you to have me ask you that?” And then follow up again the next day if you are still concerned.

Realities of Suicidal Ideation

According to a recent CDC report,[1] suicide was the second leading cause of death overall for people aged 10-34 in the United States in 2019. Suicide is a major public health concern, and as difficult as the subject is, we need to be talking and praying about it in our communities in order to decrease stigma and increase awareness.

Suicidal ideation can include thinking about, considering, or planning suicide. Self-harm does not always involve suicidal ideation, and sometimes the term “nonsuicidal self-injury” (NSSI) is used to differentiate the two. Intent is the difference in these two situations. Learning that a student has been harming herself (with intent for suicide or without) necessitates an immediate phone call to her parents or guardians, even if this involves breaking the student’s trust. Similarly, if you are aware of suicidal intent, call the student’s parents. If a student is actively trying to take her own life, call 911 first and then the parents.

The risk for suicide is greater among people who have major depressive disorder and bipolar disorder. It is also important to note that past suicide attempts are an important predictor of future attempts. Further, we want to be aware that a stressful life event—such as a move, a break-up, a divorce, not making a sports team, etc.—can increase the likelihood of suicide among vulnerable students (e.g. those who’ve made prior attempts, those who are underserved, those who struggle socially, and students identifying as LGBTQ+). In this vein, it is wise for us to come before the Lord asking for him to make and keep us aware of “the least of these (Matt. 25:40)” so that we can love and serve them intentionally just as we see Jesus do throughout the Gospels.

Indications of Suicidal Ideation 

Two common, unhelpful assumptions with teenage suicidality are that “it’s just for attention” or “it’s just their way of blowing off some steam.”

No matter what, we always take suicidal threats seriously. Always.

Our job as youth ministers and volunteers is to honor the words of our students by leaning in to clarify—whether it’s an Instagram post, a hasty text, or an indirect comment at youth group. Whenever you suspect suicidal thoughts, a face-to-face conversation is best; however, if you see something you are concerned about via social media or a text, please call your student immediately (and keep calling until you reach him, or call his parents). If you suddenly find yourself in a text conversation surrounding suicidal ideation, getting your student to talk to you in person or via the phone should be the priority. (See below for what to do when a student expresses active suicidality.)

As we have these critical conversations, there are two types of indicators to be aware of: indirect cues and direct cues.

Indirect cues might be provided by the types of videos or lyrics a student is posting, or by verbal phrases like, “I’m tired of life, I just can’t go on,” “My family would be better off without me,” “Who cares if I’m dead anyway,” “I just want out,” “I won’t be around much longer,” or “Pretty soon you won’t have to worry about me.” These subtle signals might also be found in behaviors such as giving away prized possessions, stockpiling pills, or sudden disinterest in former passions. These cues are signs that we need to know more.

Direct cues send us on high alert a little more quickly. These verbal cues sound like, “I’ve decided to kill myself,” “I wish I were dead,” “I’m going to commit suicide,” “I’m going to end it all,” or “If (such and such) doesn’t happen, then I’m just going to kill myself.”

Even if we suspect a student is using suicidal threats falsely or for manipulation, we must still give weight to their words. Should a suicidal threat later turn out to be false, it still serves as a huge red flag that tells us something more serious is happening in a student’s life.

How to Ask About Suicidal Ideation

If you suspect a student may be experiencing suicidal ideation, there are a couple of things to keep in mind as you prayerfully prepare to ask about it directly.

  • Remember: suicidal ideation isn’t the problem. It is only a desperate solution to a perceived unsolvable problem. Our goal is never to get someone to stop thinking about suicide. Instead, it is to clarify what she is actually thinking in order to determine the next best steps to love and support her.
  • If possible, you may want to talk to the student in a more private setting. (Be sure that wherever you meet falls within the boundaries of your child protection policy.) If you’re in public, you might try to find a more private corner, providing space for her to talk.
  • Give your student your time and full attention so she can speak freely as you listen empathetically.
  • If the student is reluctant, answers indirectly, or changes the subject after you ask, be persistent. Get an answer that provides you with enough data to decide what to do next.
  • Have your resources handy (see below).

Here are some suggestions for asking directly:

  • Are you thinking about killing yourself?
  • Have you thought about hurting yourself?
  • Have you thought about taking your life?
  • You know, when people are as upset as you seem to be, they sometimes wish they were dead. I’m wondering if you’re feeling that way too?

Although it is better to ask poorly than not to ask at all, we want to avoid passive, judgmental, or assumptive statements such as, “You’re not suicidal, are you?” Or “I know you; you would never do anything like that, right?” Or “You’re not the kind of person that would do something like that, right?” We will not get clear and honest answers with questions like these, which usually serve to comfort our own fears more than to clarify the mind and heart of our student.

Levels of Suicidal Ideation

You should always contact a student’s parents or guardian when a student expresses suicidal ideation. In the case of active suicidal ideation (see quadrants III and IV below), please make that call immediately. If you are aware that a student is actively attempting suicide, first call 911 and then contact a parent or guardian.

Passive Suicidal Ideation                                                    Active Suicidal Ideation

 

I. “Sometimes I think it would be better to not be around/be in Heaven” III. “I wish I were dead”  “These are the things I would do and what I would use if I were to take my own life”
II. “Sometimes I think about taking my own life” IV. Person wants to take their life/is making attempts

 

If you are with a student who describes passive suicidal ideation, you may invite him to call his parent or guardian while you sit with him, empowering him to share. Or you could ask if he would like for you to go with him as he shares. If he isn’t comfortable with either of those options, you’ll need to let him know that you will be getting in touch with his parent or guardian immediately to share your concern and make a plan.

Actions and Further Resources

The research of leading psychologist and suicide expert Thomas Joiner has shown that people struggling with suicidal ideation share two commonalities. First, they experience a feeling of not belonging. Second, they desire not to be a burden to those around them.

If ever there were a cry for the gospel, it’s this!

The Christian story speaks powerfully to these experiences: First, God has chosen a people for Himself and has adopted us into his family through Christ.[2] We are the covenant people of Yahweh who belong because of the finished work of Jesus on the cross. His words “It is finished” (John 19:30) are the powerful, authoritative words we need to hear over and over again. And second, the Christian life is one that is meant to be centered around love, both through bearing one another’s burdens and sharing our own (Rom. 12).

One of the most significant things we can do any time a student shares something vulnerable with us is to thank her: “Thank you for sharing that with me.” It is essential that we honor a student’s willingness to offer her deepest thoughts and feelings—especially if she is telling us about suicidal ideation. Shame is a frequent companion to suicidal thoughts. So a student who has shared about it has entrusted us with something we must steward prayerfully and wisely. This may mean we seek further support ourselves, from a counselor or trusted pastor or mentor who can bear this student’s suicidal ideation with us.

Students experiencing any level of suicidal ideation can benefit from professional counseling. It is wise for us to recommend this to their parents or guardians (and to let our student know our recommendation, as well). We also want to offer to be part of their ongoing support team as they work through their experience. Loving, committed, trustworthy relationships will be an essential part of the healing process. This is especially true when our students are admitted to inpatient treatment programs at hospitals or behavioral health facilities. We want to check in with parents/guardians regularly to pray with and care for them, and we want to visit our students at the designated times if possible.

When possible, say yes to further training surrounding suicidality (sometimes done by local behavioral health facilities), and reach out to trusted local mental health counselors to learn more. The Center for Parent/Youth Understanding offers some helpful resources, as does the National Suicide Prevention Lifeline (1-800-273-8255).

When I find myself in situations with students that (appropriately) overwhelm and burden me, I often come back to Romans 8. In these moments especially, I am aware of my need for a God whose love isn’t dependent on me. His love has been secured through the life, death, and resurrection of Jesus Christ – for us, and for our students.

For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, nor height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord (Romans 8:38).

  

 

This blog is made available to you by the Rooted Ministry for educational purposes only, not to provide specific therapeutic advice. The views expressed are the personal perspectives of the author and do not represent the views of all counselors or the profession. This blog does not create a counselor-client relationship and should not be used as a substitute for competent therapeutic counsel from a licensed professional in your state.

 

[1] “Leading Causes of Death Reports, 1981 – 2019,” WISQARS Injury Data, Centers for Disease Control and Prevention, last modified February 20, 2020, https://webappa.cdc.gov/sasweb/ncipc/leadcause.html.

[2] Gen. 12:3; 17:7; Ex. 6:7; Ezek. 36:28; Jer. 31:33; John 1:12; Eph. 1:5; Gal. 4:5-7; Rom. 8:14-19; 9:8; I Pet. 2:9, I John 3:1, etc.

Liz Edrington serves as the Associate Director of Care for McLean Presbyterian Church. She received her M.A. in Counseling from Reformed Theological Seminary in Orlando, Florida, and she's taught as an adjunct professor in the psychology department at Covenant College. She is an emeritus member of the Rooted steering committee, and she’s the author of Anxiety: Finding the Better Story (P&R Publishing, 2023), which won The Gospel Coalition 2023 Book Award for Bible Study & Devotional Literature. Pickled things delight her, as does her snuggle beast, Bella the Dog.

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