Recognising the warning signs of teen suicide

When Amelia’s* parents discovered that she was engaging in self-harm, their immediate reaction was to get upset and go into denial – which caused her self-cutting behaviour to worsen. The reasons behind Amelia’s tendencies were manifold. Already struggling with depression, her grades suffered as she was unable to concentrate in school. This caused the troubled teenager – who benchmarked herself against her successful parents and high-achieving older siblings – to go further into a downward spiral. 

According to Dr Jared Ng, senior consultant and chief, Department of Emergency and Crisis Care at the Institute of Mental Health (IMH), the reaction of Amelia’s parents to her acts of self-harm is not unusual. “Some parents I have interviewed insisted that the scars were the results of accidents,” he said.

While it is understandable that parents may feel shocked and at a loss, it is important that they take steps to support their child as soon as possible. “Parents can share their concern for the teen’s safety and well-being in a constructive way,” he said. “Validate your child’s feelings and ask if there is anything you can do to help.” 

To avoid worsening the situation, Dr Ng recommends that parents remain calm and keep clear of immediate confrontations. “In one case, the parents interrogated their daughter after noticing the scars. The child became even more withdrawn and started cutting herself in places that were less noticeable.”  

Here are further points parents ought to take note of when it comes to safeguarding the well-being of their teens. 

KNOWING WHEN SOMETHING’S AMISS

In Amelia’s case, it was a letter her parents found at her desk that changed the way they approached the situation. In it, Amelia wrote about her struggles, including those she had with her parents.

“This hit them hard, and they decided to take their daughter to the hospital for help,” said Dr Ng, adding that Amelia’s concerned classmates had also noticed the sad and morbid images she had posted on social media, and alerted the school’s teachers who reached out to her parents. 

He pointed out that it is common for teenagers to hide their emotional distress from adults, especially if they do not trust or feel a sense of rapport with them. “It could be peers such as classmates who are the first to spot the red flags.” 

According to Dr Ng, some common physical signs of self-harm include unexplained cuts, bruises, burns or bite marks that often appear on the wrists, arms, thighs and chest. Behaviourally, teens may display a lack of motivation or interest; withdraw from family and friends; blame themselves for their problems; and pass comments like “I’m useless”, “I’m not good enough” and “I’m a failure”.  

“There are a few reasons why teenagers engage in self-harm – the pain could distract them from difficult situations; it could also be a way for them to obtain temporary relief from intense psychological distress,” said Dr Ng. He went on to caution that “if self-harm is left unchecked, it could become a habit”.

For parents to pick up on their child’s distress as early as possible, a strong parent-child relationship that is built on the quality and quantity of time spent together is needed. “Only then would parents be sensitive to changes in their teenager’s behaviour, actions, moods and routines, right down to the clothes they usually wear,” he said. “For example, if a teen who often wears T-shirts starts donning cardigans or other long-sleeved attire, this could be an indication that he or she wants to conceal scars or marks on their body.” 

To avoid further triggering a self-harming teen, Dr Ng recommends that parents steer clear of certain actions: “These include yelling, invading the child’s privacy – going through their diary or rummaging through their bedroom – and issuing threats and ultimatums. More importantly, do not trivialise your child’s concerns by saying things like ‘I know exactly how you feel’, or try to guilt-trip your child with phrases like ‘you are doing this just to make me feel sad’.” 

FROM SELF-HARM TO SUICIDE

According to Dr Ng, some studies show that recurrent self-harm behaviour is a predictor of later suicidal thoughts and may increase the risk of suicide attempts. 

While acts of suicide can often be impulsive and triggered by fleeting crises – such as the pressure to succeed; confusion over one’s identity, gender or orientation; or relationship breakdowns – many youths may show signs of suicidal ideation beforehand, such as giving away treasured possessions, researching suicide methods and writing suicide notes, said Dr Ng. 

The mental health expert has encountered youths who hand over sealed letters or notes to their friends, which are to be opened only after a certain date or event. “These are sometimes farewell messages and such instructions should sound the alarm that something is amiss. In such cases, youths must be assured that breaking confidentiality and informing teachers or parents is in the best interest of their distressed friend,” he advised.

HELPING A DISTRESSED TEEN 

If a teen speaks about suicide, their words should be taken seriously and not dismissed as attention-seeking attempts, said Dr Ng. Nor should parents silence them for fear that the act of talking about suicide will plant more suicidal thoughts in their child’s mind. “Having open and honest conversations about suicide provides opportunities to communicate the underlying distress or stressors one has been facing,” explained Dr Ng. “Do not rush through the process, as it may cause the troubled teen to feel invalidated or brushed aside. All suicide threats and attempts must be taken seriously.” 

Safety is top priority, he underscored. Parents should ensure that teenagers who have displayed suicidal tendencies are always accompanied, and dangerous objects placed out of reach. “If they are in immediate danger, call 995 or 999,” he advised. “If the teen has had suicide ideation but is not in immediate danger, do still seek professional help promptly.” 

While mental health professionals can offer advice on helping teens manage suicidal inclinations and develop a safety plan for when suicide urges occur, parents are still the main caretakers of their children’s mental health. 

Dr Ng’s patient, Amelia, was able to begin her journey of recovery after her parents gained her trust by learning to communicate and solve problems more effectively with her. They now have a closer parent-child relationship. 

“As parents, we need to be there for our children and be a source of support, both physically and emotionally,” said Dr Ng. “Parents must never give up hope.”

Learn how to build a positive relationship with your teen and respond in times of mental and emotional distress by visiting Spot The Warning Signs. 

*Not her real name.