Talk To Children About Mental Health And Suicide, Experts Say

At Riley Hospital for Children there's been a jump in emergency room visits related to mental health and suicide. From March to December, these visits increased 61 percent compared to the same months in 2019.

Hilary Blake, a psychologist at the Indianapolis hospital, says there is a mental health crisis in Indiana.

“I think COVID has shone light on it, but I think the mental health crisis has been here for a while unfortunately, in the state of Indiana,” she says. “We don't have enough providers, specifically psychiatrists to help with children with mental health needs.”

Blake says closing schools due to the pandemic has affected students’ mental health.

“A lot of times, you know, children and adolescents will feel comfortable confiding in a school counselor or a teacher and things like that,” she says. “I do know that some school counselors are definitely doing things via Zoom and things like that. But it does take a toll because you aren't there face to face with the person.”

Dr. Paul Nestadt, a psychiatrist at Johns Hopkins School of Medicine, also says children may feel more anxiety and other distress due to school closings. 

“We are seeing from surveys, self reports, higher numbers of distress in kids,” he says. “That may be related to the fact that kids are impacted uniquely and that they're cut off from school. Which, especially to young people, has tremendous psychological impact. That's their only outlet. That's their social world, that’s their whole world.”

Nestadt says it is too early to draw a correlation between COVID-19 and suicides. 

“At the end of the day, we don't we don't have the actual mortality numbers, we are seeing increases in calls to suicide hotlines across the age spectrum,” he says. “And so that might that might play out later and actual mortality.”

The National Suicide Prevention Lifeline, a hotline with a traditionally high number of calls, is seeing increases during the pandemic.  In July, for example, calls increased 6 percent compared to the previous year. 

The American Foundation for Suicide Prevention’s Doreen Marshall says it is never too early to talk to children about mental health.

“I think it's helpful to frame mental health as part of our overall health,” Marshall says. “So recognizing that when we have mental health concerns that these primarily are health concerns, and I think kids are spoken to at a young age about their health. And really, it's about incorporating mental health as part of that discussion.”

Marshall says to begin talking with young children about their emotions and how to express themselves. With older children and teens, it is important to introduce the idea of therapy and other resources. 

She says it is vital to have these conversations when there are changes in behavior and mood.

“And certainly, if there's concerns about suicide, not being afraid to ask your teen directly, if they've had thoughts of suicide, you know, the big takeaway is for this to be an ongoing and open dialogue, and to also to reassure them that help is available for their mental health, just like it is for their physical health,” she says.

Marshall says it is a difficult conversation to have, but a necessary one to start. 

“And then allowing for it to evolve from there, reassuring kids and teens ... 'If you ever want to talk about something that's distressing you, or if your feelings are ever confusing to you ... I'm somebody that you can talk to, and ... we can help you get help if that's what's needed,'” she says. 

Marshall says many people fear talking about suicide with young people will make the situation worse. But she says research shows that’s not true. It’s important to ask directly, letting them know you’re a safe person to talk with.

“A lot of times thoughts of suicide are really an indicator that our mental health is struggling or that we're feeling overburdened by things," Marshall says. "And it's an indicator, just like we have other health indicators, that seeking help and reaching out, it's important to do that.” 

People in need can call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor. 

This story was produced by Side Effects Public Media, a news collaborative covering public health.