Practical Guidance from Tzivy Reiter, Director of Clinical and National Trauma Services at Ohel Children’s Home and Family Services
Few topics are as difficult or painful to confront as suicide, particularly when it involves children and teens. Sadly, suicide is a reality that has touched the Jewish community, making it all the more important that we approach the subject with openness, sensitivity, and care.
We spoke with Tzivy Reiter, LCSW, Director of Clinical and National Trauma Services at Ohel Children’s Home and Family Services, about what parents need to know to recognize warning signs, approach conversations about suicide with compassion and clarity, and respond when a child is at risk.*
What warning signs might indicate that a child or teen is experiencing suicidal thoughts, including signs that parents may easily overlook?
Parents often expect suicidal distress to look like severe depression: a child who is constantly sad, crying, or unable to function. Sometimes it does look that way, but often the signs are not that obvious.
Warning signs can include talking about wanting to die, feeling hopeless, trapped, or like a burden; withdrawing from friends or activities they formerly enjoyed; major changes in sleep or eating patterns; increased substance use; giving away possessions; or searching online for information about suicide or ways to die.
Irritability, anger, agitation, impulsive or reckless behavior, and sudden mood changes can also present as warning signs.
One of the most significant signs to be attuned to is a change in your child’s functioning. What is different about your child from a few weeks or months ago? A teen who suddenly stops spending time with friends, gives up an activity they used to enjoy, starts sleeping all day, becomes unusually irritable, or says things like, “Nobody would care if I wasn’t here,” may be communicating significant emotional pain and a wish to escape it, including potentially through suicide.
Parents should also pay attention to changes that may occur after a painful or humiliating event — bullying, social rejection, academic failure, or family conflict. These experiences do not necessarily mean a child will become suicidal, but when they are accompanied by significant changes in mood or behavior, they can increase the risk of suicide.
It is also important to note that not every suicidal child will look suicidal. Some kids continue to go to school, laugh with friends, and function outwardly while struggling deeply and painfully inside. A sudden improvement in mood after a period of severe distress can sometimes be concerning as well, as it may indicate that they feel better because they have resolved to end their pain through suicide.
If a parent is concerned that their child may be contemplating suicide, how should they approach the conversation?
Firstly, you must ground yourself so you can cope with your own feelings as you navigate this difficult conversation.
The possibility that your child may be contemplating suicide can be terrifying. It can threaten your sense of parental competence and trigger anxiety over your child’s safety like nothing you’ve ever experienced before.
It’s really important to understand that this is not a reflection of your parenting. The belief that “If my child is suicidal, I must have done something wrong as a parent” can be damaging, leading to shame, self-blame, defensiveness, or depression at exactly the moment your child needs you most. Many responsive, loving, and attentive parents do everything right (to the extent that any parent can), yet still cannot protect their children from severe mental health challenges, including suicidality (suicidal thoughts and or/behavior).
Secondly, be prepared to ask your child directly. Parents are often terrified that saying the word suicide will put the idea into their child’s head, and sometimes avoid the very conversation that could allow their child to disclose what is happening. Research and clinical guidance indicate that asking directly about suicide does not increase suicidal thoughts and may provide an opportunity for your child to receive help.
Choose a quiet moment and start with what you’ve noticed: “You haven’t seemed like yourself lately. I’ve noticed you’ve been spending a lot more time alone. I’m worried about you.”
Then ask clearly: “Have you been thinking about suicide?” or “Have you had thoughts about wanting to die or not be alive anymore?”
Try to avoid euphemisms. Although it is hard to say the “S” word, try not to soften the question so much that your child doesn’t know what you’re asking.
Be prepared to accept your child’s answer, even if it’s not what you want to hear.
Remember that your body language, tone of voice, and facial expression will communicate as much or more than your words. Make sure that the message your child receives at this moment is that it’s safe to share what they are really feeling with you.
If a child or teen tells a parent that they are thinking about suicide, how should the parent respond in the moment, and what should they do next?
Firstly, believe them and take them seriously.
A parent’s natural instinct may be to reassure immediately: “But you have such a good life,” “You don’t really mean that,” or “Think about how much everyone loves you.” As loving as those responses may be, they can unintentionally leave the child feeling invalidated or send a message that you can’t handle their feelings.
Instead, listen. Connect with them in their moment of pain. You might say:
“I’m really glad you told me.”
“I’m so sorry you’re hurting this much.”
“I want to understand what this has been like for you.”
“You don’t have to hide these feelings from me.”
“I love you. I’m here for you. We’ll handle this together.”
The goal is not to talk the child out of feeling suicidal. It is to help them feel seen, heard, and safe enough to continue talking. What you want to communicate, verbally and, even more importantly, nonverbally, is this: I can handle your feelings. You are safe with me. You don’t have to protect me from your pain.
Then move from connection to safety. Stay with the child, involve their mental health professional if they have one, and/or determine whether a more urgent evaluation is needed. If you’re not sure what to do, contact the resources listed below.
Until you have more information (a professional can help you determine whether your child has worked out the details of a plan), it is important to restrict your child’s access to medications, firearms, sharp objects, or other means they could use to harm themselves.
If your child is actively attempting suicide, is about to act on a plan, or can’t be kept safe, this has moved beyond a conversation at home and requires immediate psychiatric or emergency intervention.
These moments can feel overwhelming, but you are not alone. Help is available, and you don’t have to carry this on your own.
You’ve already touched on some common misconceptions parents have about suicide in children and teens. Are there others that can prevent parents from recognizing or responding appropriately to risk?
Another common belief is “My child is doing this for attention.” Suicidal thoughts, statements, or behaviors should always be taken seriously, regardless of what may be driving them. I encourage parents to shift from thinking of the behavior as “attention seeking” to “connection seeking.”
When a child expresses their pain in such an extreme way, rather than asking, “Are they just looking for attention?” we might ask, “What are they trying to communicate, and what do they need from us right now?” Even when a young person is seeking a reaction from others, that tells us something important: they are struggling and reaching out in the way they know how.
Finally, parents may assume that their job is to talk their child out of being suicidal. That is not what your child needs. A suicidal child needs someone willing to understand just how unbearable life feels to them right now. Listening and validating the pain does not mean you’re agreeing with their suicidal feelings or that you’re chas v’shalom endorsing suicide. It simply means you’re accepting that this is what they feel right now.
It communicates something far more important: I hear how bad this is. I’m not overwhelmed by your feelings, and I’m going to stay beside you while we get you the help you need.
For parents, that may be the hardest part of responding to a suicidal child — and one of the most powerful.
Are there statistics on rates of suicide and suicidal thoughts among children and teens in the Orthodox community?
I am not aware of published statistics on this topic and can only speak to the data that we have collected at Ohel. We have seen an increase in suicidality among youth in the last few years, particularly among girls and young adult women.
Girls ages 12 to 21 are represented among clients experiencing suicidality at twice the rate they are represented in our overall client population. Among women ages 22 to 40, that figure is 1.5 times their representation in the overall client population.
However, we have also seen that males are more likely to die by suicide than females.
While our data cannot tell us how prevalent suicidality is across the broader Orthodox community, the data underscores the importance of recognizing and responding appropriately to suicide risk among youth and young adults.
*The information presented in this article is for general informational and educational purposes only. This information is not intended to constitute or substitute for, and should not be relied upon as, medical, mental health, or other professional advice. If you or someone you know is in crisis, please seek immediate help from a qualified professional or emergency service.
Resources
- Suicide & Crisis Lifeline in North America: Call or text 988
- Ohel Crisis Line (U.S.): 718-686-3311
- Youth Suicide Resources for Professionals: https://www.ohelfamily.org/mhp-resources/
- Ohel and BPD (Borderline Personality Disorder) Alliance are launching MSTR (Managing Suicidality and Trauma Recovery), a free, virtual support group for parents of suicidal and self-harming teens, beginning in September. To register, click here.
Tzivy Reiter, LCSW, is a licensed clinical social worker and Director of Clinical and National Trauma Services at Ohel Children’s Home and Family Services. Tzivy has led suicide prevention efforts at Ohel and has implemented universal screening and the Zero Suicide model. Tzivy has created a preteen safety plan, “My Coping Plan,” and has developed multiple trainings for suicide best practices, including “Understanding Suicidality” and “Safety Planning as a Clinical Intervention.” She was recognized as a mental health hero by the NYC Mayor’s Office and is a member of the New York State Suicide Prevention Coalition.