Let’s talk.  Suicide rates are rising among our children and it’s time to start the conversation.

“Myra” gets on the school bus everyday. She is teased and taunted, tripped and laughed at, bullied. When she does finally find a seat, she sits alone. She is sad and lonely, everyday. She contemplates ending her life. “Myra” is 10. 

“Jesse” is the star athlete at school. Everyone has high hopes for him. He is well liked by his family and friends. He seems to have it all together, yet he doesn’t. He hides it well because he thinks he has to. He knows there’s a stigma attached to mental health issues, so he doesn’t seek help. He is sad and depressed and doesn’t know what to do about it. He is overwhelmed and attempts suicide. He survives and receives help. “Jesse” is 15. 

“Kim” goes to school everyday, but she dreads it. She’s not one of the “popular girls.” She feels awkward and shy, yet she’s a bright, loyal, and kind young lady. But she doesn’t have anyone to share those qualities with because she doesn’t “fit in.”  The “popular girls” seek to shred her confidence at every opportunity. She’s angry, lonely, frustrated, and sad. She begins to think that her existence doesn’t matter. She contemplates suicide. “Kim” is 12. 

“Joey” overheard his parents talking about his uncle that recently tried to kill himself. He knows what suicide is because he’s heard about it on the news and has seen it on television. He wonders why his uncle did it. He thinks about it from time to time, when the other kids are teasing him and just won’t stop. He’s never tried to hurt himself, but he thinks about it more when he feels lonely or sad and it seems like those feelings will never end. “Joey” is 7.  

These are actual examples, although names have been changed to protect privacy.

Zane

Now meet Zane. Zane lived here in Nashville. He was an intelligent young man, had a job and a girlfriend, and loved riding his motorcycle. “He probably annoyed a lot of people in Nashville with his motorcycle, but he liked going out and being fast,” says Bailey James, Zane’s sister. “He always lived his life in the fast lane.” But Zane was always searching for something, trying to fill a void in his life. “Zane had some things that made him happy, but at some point, it just wasn’t enough,” says Bailey. Zane committed suicide in 2017, when he was just 18 years old. 

Bailey James, rising country music star and National Youth Advocate for The Jason Foundation, a nationally recognized leader in youth suicide awareness and prevention programs based out of Hendersonville, has made it her life’s mission to save at least one life. “If I can take Zane’s story, my pain, my dad’s pain, and turn it into something good, something that can save just one life, than that would be amazing,” she says. “I’ve never really had a goal with my music, but if he were here right now, that’s what he would want me to do. If I can just save one life…saving even one life would be prolonging his legacy. He was always someone who wanted to help others.”

Zane’s dad, Kevin Koehler, tearfully recalls the last few years with his son. “He definitely showed some signs,” he says. “His mom and I tried to get him some help, out on the west coast, but it just wasn’t working. He wanted an opportunity to try again, so I made peace with myself and with God and moved my son to Nashville. I taught him to drive, he got a job, he had a girlfriend, but he was always searching for something, trying to fill some void in his life. We kept battling and we kept hoping, but it was evident, the road he was heading down. But he did have some happiness in those last two years, even if it was just a little bit.” 

Rising Rates Of Suicide

Tragically, stories like Zane’s are becoming more and more common, and the trends are alarming. Suicide rates among adolescents and children are rising. A study published in 2018 in Pediatrics states that “suicidal ideation (SI) and suicide attempts (SAs) have been reported as increasing among US children over the last decade.” Trends were examined for both SI and SAs at US hospitals from 2008 to 2015 (2023 CDC WISQARS updated data).

“How many parents know that – today, according to the CDC – suicide is the second leading cause of death for our young people and across the nation, ages 10 to 24?”

“We have almost 21 years of working in this field, so we’ve seen the progression over the years and they’re right, the suicide rates are not only the highest they’ve been, but they’re increasing more rapidly than at any other time than we’ve been in the business,” says Clark Flatt, president of The Jason Foundation, and father to Jason, whom he lost to suicide in 1997. “How many parents know that – today, according to the CDC – suicide is the second leading cause of death for our young people and across the nation, ages 10 to 24? And it’s more than just better reporting. This is not only a problem for teenagers and young adults. It’s now getting into our younger youth and our younger children. Eight or ten years ago when we talked about the age group 10 to 14, there weren’t enough tragedies to even report on it. But as of 2016, suicide is the second leading cause of death for 10 to 14 year olds. We’ve been brought in on as young as 8 years old. It’s gone from not even on the charts at all, to the second leading cause of death – more than doubling since 2006 – for that specific age group in our nation.”

NOTE: PLEASE SEE 2023 UPDATED DATA PER CDC WISQARS.

Why Are The Rates Rising?

Young people are under more stress today than ever, and we as parents live in a culture of distraction, a world where “busy makes better” by deceptively adding a falsely perceived value to our existence. We are distracted from what’s important and from those around us that need our attention, including our children. Having a conversation about suicide will always lead to another conversation, one that will illuminate what is going on in the life and heart of your child. But the signs are not always clear, and distraction blocks our awareness of the emotional pain going on in the lives of our children. 

“We have to communicate and how we as parents respond is so important. They’re reading off of us,” says Mr. Flatt. “There’s greater stress educationally, socially, and economically – they’re getting more intense pressures at a younger age – and they have fewer coping skills because of that younger age. At The Jason Foundation, we see all kinds of things. You almost have to be committed to college as a seventh grader. Things like grades, how active you are in the community, how broad your skills are, and then throw in the social aspects and the sexual pressures and diseases that are out there today. The stresses on our young people today are greater than ever, and parents have an opportunity to respond positively and supportively, but regretfully, too many times I don’t see that when we’re working with families. We don’t see that level of support that needs to be there.” 

The stresses on our young people today are greater than ever, and parents have an opportunity to respond positively and supportively…

At just 15 years old, Bailey James also faces similar pressures. “Media plays a big part,” she says. “These days they show so much that we shouldn’t see at such a young age. Media has changed. The messages we receive have become stronger based on technology – the drugs, the violence – we saw things sooner than we were supposed to and that’s affected how we interact with others. We’re easily influenced. And the technology we have, you feel lonely. You have more contact, supposedly, with social media platforms, but kids are lonely. I have 81,000 Instagram followers and kids contact me all the time and say they’re lonely. They want to fit in, they want to feel comfortable, but there is so much bullying and triggering on social media and kids can be so mean to each other. I was bullied for doing country music. I was even bullied for Zane, my own brother’s death. Kids don’t know how to communicate with each other or how to communicate with anyone else. Sometimes, you just don’t know how,” explains Bailey. 

“They won’t pick up the phone. They won’t talk to one another,” says Bailey’s dad. “They won’t go next door and talk to a friend, face to face. Everything is through text. If you send a text and ten people read that message, they’re going to read it ten different ways. It’s easily manipulated. It can be easily misunderstood and go in the wrong direction or a downward spiral. Just pick up the phone. I don’t know how to go backward and fix that, but it is definitely one of the leading issues.”

Warning Signs And Risk Factors

The Jason Foundation website (https://jasonfoundation.com/youth-suicide/warning-signs/) lists the warning signs and risk factors of suicidal ideation (please visit the website for more detailed explanations). 

Some include, but are not limited to, the following:

• Suicide Threats

Almost everyone who attempts or completes suicide has given warning signs through their words or behaviors. Do not ignore any suicide threats. 

• Depression

Depression is one of the leading causes of suicide attempts. Mental or addictive disorders are associated with 90% of suicide. One in ten youth suffer from mental illness serious enough to be impaired, yet fewer than 20% receive treatment. 

• Anger, Increased Irritability

Recent research has identified a connection between interpersonal violence and suicide. Suicide is associated with fighting for both males and females, across all ethnic groups, and for youth living in urban, suburban, and rural areas. You should be concerned if a friend is exhibiting unusually irritable behavior.

• Lack of Interest

You should be concerned if a friend suddenly starts to lose interest in sports or hobbies that they used to enjoy.

• Sudden Increase/Decrease in Appetite

• Sudden Changes in Appearance

1. He/She not dressing like they normally would
2. Lack of personal hygiene

• Dwindling Academic Performance

• Preoccupation with Death and Suicide

This can be seen throughout their:

1. Essays and writings about death
2. Poems about death
3. Artwork or drawings depicting death
4. Social media posts and comments
5. Talking a lot about death or dying

• Previous Suicide Attempts

Youth who have attempted suicide are at risk to do it again. In fact, they are eight times more likely than youth who have never attempted suicide to make another suicide attempt.

• Final Arrangements

Once the decision has been made to end their life, some young people begin making final arrangements.

1. Giving away prized or favorite possessions
2. Putting their affairs in order
3. Saying good-bye to family and friends
4. Making funeral arrangements

Along with these warning signs, there are certain risk factors that elevate the possibility of suicidal ideation. They include perfectionist personalities, gay and lesbian youth, transgender youth, learning disabled youth, loners, youth with low self-esteem, depressed youth, students in serious trouble, abused, molested, or neglected youth, genetic predisposition, and a parental history of violence, substance abuse, or divorce. 

“Getting people to talk more, especially around suicide threats, is key.”

“There are major warning signs, or what we like to call signs of concern,” says Mr. Flatt. “ These are really signs that, if you see these, an outcome could be a suicidal ideation or attempt. It doesn’t necessarily mean that for sure, but it’s important because if we say ‘warning sign’ and nothing happens, people can become numb. So these ‘signs of concern’ are important. Often times, suicide threats are obvious, but a less obvious sign may be when somebody says, ‘I don’t make a difference,’ or ‘if I was gone today, nobody would notice.’ Those are indirect expressions of a person thinking about how things would be if they weren’t here. That needs to be taken seriously. As parents and educators, those expressions are opportunities for us to draw that person in to communicate and to talk more about what they’re feeling. Getting people to talk more, especially around suicide threats, is key.”

Laurie Drummond, a school counselor from Nashville, Tennessee, says, “Kids who have positive relationships with multiple caring adults are usually more likely to talk about problems and feelings, but adults also need to know and watch for warning signs. There are many reasons kids consider suicide, but many have told me their personal and/or family problems seem so big and they can’t see any other way things could ever get better, so dying feels like their only option. Kids don’t always want to die as much as they want to simply find a way to stop their emotional pain. No kid or family is immune to the risk, and any talk of suicide has to be taken seriously. Professional help can provide coping tools for kids and insight for parents as well.” 

There are added pressures on our young people today and the need for additional coping skills at a younger age is a necessity. We as parents need to become aware of and recognize the warning signs or “signs of concern” and be prepared to respond appropriately.

Responding Appropriately

It’s usually clear what to do when there’s an obvious suicidal threat, such as calling 911, but it’s not always easy to recognize the warning signs in a child who is considering suicide. You must take action when you do recognize the signs.

“Four out of five young people will demonstrate clear warning signs before they attempt suicide,” says Mr. Flatt. “So that means that 80% of the time, if we know what to look for and respond appropriately, we have an opportunity to stop a suicide attempt or even a regretted tragedy of suicide. Responding appropriately means calling 911 if it’s an emergency situation. Telling someone who is exhibiting signs of concern that they’re just having a crummy day is not appropriate action. It’s just getting away from it because we are uncomfortable. Appropriately responding means making sure that person gets connected with the best professional help that you can get at the time, which could be a crisis line, a school counselor, your pediatrician, or the emergency room if that’s the situation as you see it. You’d be amazed at the number of people who don’t take action, and that can be a deadly choice. Respond by stabilizing the situation, but don’t try to be that professional help. I’ve been doing this for 21 years and I wouldn’t try to do a counseling session with a suicidal young person. Take action. Talk to the young person, stabilize the situation, and keep the person safe until you can get some professional help.”

Don’t just assume it’s a phase your child is going through, and respond appropriately. Parents know what to look for when they suspect there are problems with drugs or alcohol, but we don’t have that same inclination toward mental health. 

Ask questions, ask questions, and ask more questions – and if you’re not satisfied with the answers, take action. 

“Parents don’t need to be running around scared, but they do need to be just as aware of the mental health of their child as they would be if they saw signs of other negative behavior,” says Mr. Flatt. “It could very well be an adolescent phase they’re going through, but that’s where communication comes in – ask questions, ask questions, and ask more questions – and if you’re not satisfied with the answers, take action. 

Awareness Is The Foundation Of Prevention

Most parents are surprised to find that suicide is the second leading cause of death for our youth ages 10 to 24. Suicide warning signs go unnoticed because of a lack of awareness. If you don’t know that suicide is the second leading cause of death among our nation’s youth, you’re certainly not looking for the signs of concern. 

“You haven’t prepared yourself for what you should do if you see the warnings,” says Mr. Flatt. “If your son or daughter comes home and they have a fever or they’re sick, you know exactly what to do. You take action. You don’t hesitate. You take them to the emergency room. Yet there are people, whether they are parents or educators or anyone who works with young people, who don’t take action because they don’t see the threat. If you don’t understand that depression can be a lethal item, a real condition for a young person, then you don’t see the real danger there. We have to get our schools, our churches, our youth organizations to help improve the level of coping skills our children have – we as parents have to do that – and to help with the effort of raising awareness. That’s one of the biggest things The Jason Foundation tries to do, is to raise the level of awareness, because awareness is the foundation of prevention.”

Addressing The Stigma Of The Word “Suicide”

As we become more aware of what our children encounter, we are faced with some sobering statistics. Let’s face it. The word “suicide” terrifies parents, but it’s important to stay calm if you are ever faced with this situation. Our fear does not need to be so strong that it becomes paralyzing, leading to inaction. Of course, no one wants to think that their child is in so much pain and desperation that they would consider taking their own life, but ignoring the signs could be a deadly choice. 

Research consistently shows that more conversation is better.

“When you hear the word ‘suicide’ or the phrase ‘I think about killing myself,’ the key is to remain calm,” says Michelle Sobota, who works with some of Nashville’s at-risk youth, specifically 5-14 year olds, at Cottage Cove Urban Ministries. “They are telling you this because they trust you. It’s important to ask questions, and to expect that they may not be able to articulate what they are feeling. It isn’t something that’s going to go away in just a few days and it’s important for them to know and understand that too. It will be an ongoing conversation. But take action. Check in with them. Most importantly, listen. Let them know that they are loved and cared for no matter what they are feeling or struggling with.”

Some parents worry that by having a conversation with their children about suicide, they will try it, or that it will put the idea in their mind. Research consistently shows that more conversation is better – not worse, proving that idea false.

“That is a myth,” says Mr. Flatt. “There is no clinical basis to that whatsoever. Just the opposite has been proven. If we talk to people about suicide and suicidal ideation and do it in a professional, up front way, without being hysterical, it tells a person who may be struggling with it that it’s okay and you want to help. Believing the myth that talking about suicide puts the idea there takes away the responsibility for us to have to talk about it. It makes us uncomfortable because we don’t know how or we don’t have enough information about it. By not knowing what to do or what to say, we don’t want to answer the question.”

Become aware of the signs, because awareness is the foundation for prevention. Respond appropriately by listening and taking the necessary action according to the situation. Most importantly, don’t be afraid to talk to your child. Prepare yourself to know what to do if you see signs of concern, and if you have a gut feeling, act on it. Have the same inclination toward mental health that you have toward physical health. 

Start The Conversation

“Mental illness is not a weakness,” says Zane and Bailey’s dad. “It’s just like heart disease or cancer. You get it – you didn’t ask for it, you don’t want it – but they treat it. They treat heart disease. They treat cancer. They treat mental illness. And any one of those can take your life.” 

While it is an alarming trend, there is hope. Statistics prove that our kids are in desperate need of intervention on a personal level, and there is something we can do about it. The first step is to start the conversation.

“Don’t ever stop talking to your kids. They need to know you’re there.”

“I would talk with Zane for hours, sometimes every night,” says his dad. “He would call me at 1:00 or 2:00 a.m. and we’d talk for hours. He was struggling, but we kept hoping and we kept fighting. It didn’t change the tide for my son, but I have seen it change the tide for some of these other kids that Bailey talks to. Parents must exhaust every option and never give up hope. If you see a sign, don’t ignore it. Don’t put your head in the sand if you think there’s a sign. Investigate it and try to get to the bottom of it. Don’t ever stop talking to your kids. They need to know you’re there.”

For resources and information, please visit The Jason Foundation’s website at https://jasonfoundation.com. 

If you are experiencing a crisis, call 911 or The National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or call or text 988 for the Suicide and Crisis Lifeline.

Visit their website at https://suicidepreventionlifeline.org.

Note: This article was originally published in the November 2018 edition of Nashville Parent Magazine and Williamson Parent Daily. Links to 2023 updated data from CDC WISQARS have been provided and linked within the article.