Stephanie Hepburn is a writer in New Orleans. She is the editor in chief of #CrisisTalk. You can reach her at .
Parenting isn’t easy and becomes even more difficult to navigate after a child’s suicide attempt, says psychotherapist Stacey Freedenthal. “If you tell your child, ‘No, you can’t go to that party because you aren’t passing your class,’ and then they attempt suicide, then we may blame ourselves,” she tells parents in the new film After Your Child’s Suicide Attempt. The film is part of Zero Suicide’s resources for parents.
She adds that parents put limits on their children all the time, and nothing bad happens. But parents whose children have a suicidal crisis often blame themselves. “It’s natural that we’re going to canvas our mind for all the things where we could’ve done something differently and wish that we had, and that doesn’t mean that it’s our fault.”
Freedenthal is a mental health professional. She also has personal experience with suicide — both she and her son attempted suicide in their 20s.
The film takes a conversational approach, “as if you’re sitting over coffee,” says Julie Goldstein Grumet, vice president and director of Zero Suicide at the Education Development Center. She adds that parents often don’t know with whom they can share their complex emotions, like anger at their child, who they might see as both victim and perpetrator.
Remembering the teen is also a victim can shift a parent’s perspective, says Freedenthal in the film. “This can help you to feel aligned with your child when you feel you’re on opposite sides,” she said. Judy Gardner, a parent, described the overwhelming anxiety she felt after her son’s hospitalization. “I didn’t want him out of my sight.”
The teenage years are a tumultuous time. Teens navigating life after a suicide attempt are also navigating the push and pull of adolescence. Parents often grapple with questions like, “Should I let my child go back to school? Should I let them take the car and go to a party? Do I sleep in their room?” Grumet said.
The film features parents who’ve been through similar experiences, sharing what worked and what they wished they’d known. Topics range from understanding suicidal thinking to the Health Insurance Portability and Accountability Act, better known by its acronym HIPAA, which prohibits disclosure of sensitive health information without patient consent. In the film, mental health professionals share insights on questions to ask a potential therapist, best practice treatment options and how to handle a teen’s refusal of therapy.
To narrow the focus, Grumet and filmmaker Lisa Sabey interviewed parents and suicide prevention experts. They identified common parental concerns, like shame at missing warning signs and the myth that good parents wouldn’t have a child who attempts suicide. In the film, licensed clinical counselor Melanie Fluellen points out teens are more likely to confide in friends than adults about their suicidal thoughts.
“There’s something going on in their brain that is out of your control,” said parent Jeremy Hunsicker. His child experienced obsessive, intrusive thoughts, telling him he didn’t deserve to live and self-harm was the only way to stop them.
Freedenthal emphasized suicide isn’t a choice, even if teens who’ve attempted say they were making one. “There’s a lot going on that is out of that person’s control,” she said. Clinician and researcher Kimberly O’Brien pointed out that the adolescent brain isn’t fully developed, which may make teen suicides more reactive.
Parental isolation after the attempt can be self-imposed or out of respect for a child’s wishes, says Grumet. “Parents often feel like their child’s attempt is a referendum on them, their parenting or their relationship with their child, so they keep silent,” she said. Finding a support system can help neutralize stigma within the family and community. “Keeping it a secret — feeling like you can’t tell grandma, siblings, the school, friends, your neighbors or anyone at church — reinforces the idea that this was something you did wrong or could have prevented.”
When her daughter’s appendix ruptured, people responded with support, watching her other children while she and her husband were at the hospital. “No one judged us for her appendix bursting,” she said. With suicide, parents fear judgment and want to protect the child. Instead of secrecy, Grumet recommends helping the teen push back on their internal stigma, telling them, “Like your appendix, your brain is a part of your body — the chemistry within your brain told you at that moment that you were depleted and you felt this was your only option.” “We need to beef up your ability to shut that down and seek out help the next time your brain overloads you and keeping it a secret doesn’t help with that.” She adds that most people’s sense of profound hopelessness and thoughts of suicide are transient.
Anne Moss Rogers, a suicide prevention advocate whose son died by suicide in 2015, described suicidality as a tennis match between two parts of the brain — one part trying hard to survive and the other fighting against it. “At no point in that episode of suicidality are they 100% committed to the idea of dying by suicide,” she said. “There is always ambivalence. There is always hope.”
The film addresses practical challenges for parents, like navigating HIPAA after a teen turns 18. Their child can consent to sharing sensitive health information through signed, verbal or implied consent. “If you ask the doctor, ‘Please ask my child if it’s OK to talk with me,’ [that] verbal consent is valid,” said Susan Todoroff. After her daughter returned home from hospitalization and felt better, she asked her to sign a HIPAA release form, telling her, “If this happens again, this will help us to help you more.”
Safety planning, an evidence-based intervention developed by psychologists Barbara Stanley and Gregory K. Brown, is critical in helping prevent future suicide attempts. The researchers developed the plan during a treatment study on suicidal adolescents — they wanted the teens to remain outpatient to minimize disruption to their lives but also needed to ensure their safety until they received the study’s cognitive-behavioral therapy.
Today, the tool is a stopgap between crisis care — whether that’s talking with a 988 crisis counselor, mobile crisis, 23-hour crisis stabilization or hospitalization — and when the teen begins treatment. The risk of suicide is high in the first year after an emergency room or inpatient hospitalization. According to a systematic review of 48 studies examining suicide risk after psychiatric hospitalization, 26% of suicidal events took place within a month, 41% within three months and 73% within a year after discharge.
Safety plans are individualized and list out steps a teen can take when feeling suicidal, including warning signs, internal coping strategies, people and settings that are distracting, people they can ask for help while in crisis and professionals or agencies they can reach out to during a crisis. “Parents hold a tremendous amount of anxiety over the few weeks [after discharge] because their kid may be like, ‘Oh no, I still have suicidal thoughts — I still think about it,’ and as a parent, you think, ‘Do I need to take you back to the emergency department? What do we do?’” said Grumet.
Safety plans help deescalate a teen’s distress and also give parents a way to gauge their child’s acuity. The plan needs to be specific to the kid to be helpful, says Grumet, adding that not every child will do yoga, pet their dog, read a book and play Fortnite. “The goal is to give kids the skills and strategies to be able to manage and reduce their distress,” she said. “Ultimately, we want to keep kids out of the hospital and on the journey to recovery.” She notes the situation may not be manageable at home if the child refuses to use the safety plan, can’t access coping skills and has continuous thoughts of suicide.
Deidre Arms says her daughter often used her safety plan, contacting those she felt safe with when she was distressed, like her cousin or brother. “She would reach out to them — they knew the safety plan, too, they knew they were part of it — and they wouldn’t ask questions.” Instead, if she reached out to them, her family knew to encourage activities that helped her, like photography, art or being outdoors. “Those people knew that if she reached out, we would start to do that something to make [her] feel good, not to talk about the day-to-day until she was safe in talking about that.”
The safety plan includes how to make the teen’s environment safer, such as removing access to lethal means. Psychologist Peter M. Gutierrez says that parents might need to ask their child multiple times for a list of the top three ways they’ve thought of to kill themselves. “Focus the safety plan on, ‘How do I limit their access to those ways,’ and that’s something that the provider should help you think about and problem-solve around.”
Todoroff is a chef and former restaurant owner. When her daughter asked her to lock away the knives, she says her heartbreak was multifold. “I mean, the fact that she asked us to do that, the fact that she might take a knife to take her life, was unbelievable,” she said. “I’m a cook. I love to cook. My knives are out all the time. I use them every day. It was just so weird to do that but we did it, of course, I mean, for a long time.”
Building trust after a crisis can be challenging, especially after hospitalization. The child might be angry at their caregivers or providers. Grumet says validating their feelings as much as possible and acknowledging their overall experience is critical. “You can be deeply compassionate and understanding of your child’s experience but also let them know this is where we go in a medical emergency, and that’s what this was,” she said.
Her hope is that the film is easily accessible to parents whose child has attempted suicide or is experiencing suicidal ideation and that healthcare providers and community groups — “faith leaders, libraries, mobile crisis teams, parent support groups, schools, sports groups, YMCAs, etc.” — share it with families.
“It’s so challenging and complex to go through a mental health crisis with your child,” said Grumet, “and you can feel all alone.” “This film was designed to support parents by validating their feelings, and offers key steps and information about what to do, and importantly, lets them know they are not alone.”
