Editor’s Note: This article is the third in a three-part series: (1) Risks and warning factors of teen suicide, (2) Stories of youth and families affected by suicide, and (3) How to talk to youth about suicide ideation and getting treatment


During the recent Suicide Prevention Town Hall, Susan Tolle, a former field advocate for the American Foundation for Suicide Prevention, along with several Iredell-Statesville Schools counselors and other counseling professionals, shared advice for talking with someone who may be experiencing suicide ideation.

North Iredell High School counselor Paul Veach noted that five students took their lives in Iredell County during the last two years. In his daily work, Veach said he frequently encounters students with depression and suicidal thoughts.

According to research data, 7 to 8 percent of students have either thought about suicide in the past three months or are currently thinking about suicide.

“You cannot walk through a school and not bump into or walk by someone who’s been impacted by this issue,” he explained.

Parents and students are his best partners in his work, alerting him to youths that may be in crisis, Veach said.

Alex Dow of Children’s Hope Alliance, a nonprofit that provides mental health treatment for Iredell-Statesville Schools students, noted a definite uptick in youth suicide ideation, especially with the isolation that COVID-19 restrictions imposed.

Ideation is the first step of thinking about suicide as an option — how, when and where the person is considering the act. Parents are usually the first one to notice something is off.

“I think the first thing is to name it. The first thing is to say, ‘Have you been thinking about hurting yourself?’ It’s going to incite some fear within you as a parent, absolutely, to talk about it, but nothing would be scarier than not talking about it and having your child take their own life,” Dow said.

Suicide ideation is now being talked about more openly.

With the right help and resources, a person is not “doomed” to be suicidal the rest of their lives, he said.

Dow pleaded with teens to not ignore their friends who are struggling with a mental health crisis.

“Sometimes you are the first line of defense. Many times you are the only line of defense. You may be the only person your friend feels comfortable talking to, so take them seriously.

“We see a lot of times kids will use humor to veil the seriousness of what they are talking about,” he added. “We call it dark humor. Any type of conversation about taking your own life is serious. As a friend to that person, taking that seriously . . . can be the first step to getting the help they need.”

NIHS counselor Jennifer Trent said some students fear betraying a friendship by telling someone of their concerns.

“You are not betraying a trust. You are helping them. Sometimes as friends, sometimes as caretakers, we have to learn that we have to speak up about something like this to prevent suicide.”

Veach said parents can contact Student Assistance Professionals at all middle at high schools with concerns about their child.

The “Say Something” app is also a venue for students to anonymously report concerns about friends. Veach said the app has had great results, helping counselors intervene proactively and get parents involved with helping troubled teens.

Kelly Marcy, I-SS executive director of Student Services, urged students to tell an adult if a friend was in crisis. She also urged students to be “positive bystanders” who step in to diffuse incidents of bullying that can cause student stress and anxiety.

Jeff Eades of Partners Health Management suggested adults and teens consider QPR (Question, Persuade, Refer) training, which he likened to CPR for mental health crises.

The two-hour training can help attendees make a huge difference in another person’s life, added Eades. Partners’ Amber Matthews offers the training to those interested in schools, churches, and community organizations.

The organization is also starting to offer the training to teens to raise their own self-awareness of mental health as well as to offer help to their peers.


Reaching out to a young person in crisis requires compassion and listening skills. Addressing your concern about suicidal risks or warning signs sends the message that you truly see the child, you care, and you will get the help needed for him or her.

The parent or adult should talk to the teen in private and listen carefully to concerns and feelings, resisting the temptation to offer solutions, downplay feelings, explain how he or she should feel, or trying to convince the teen that life is worth living.

A depressed teen in the tunnel of suicidal thinking cannot hear advice in the midst of crisis, the professionals said.

Instead, the adult should express concern and caring, asking them what they need. Most importantly, ask directly if they are experiencing suicide ideations. Calmly ask, “Have you ever felt so bad that you have had thoughts of hurting yourself, of suicide?”

If they are, calmly reassure them that help is available and you are going to get the treatment they need. Treat their feelings as valid and important and express your love and concern for their well-being. Thank them for being brave enough to tell you their feelings.

Others suggested getting the teens to think and to talk to defuse poor crisis thinking skills. Ask them what they would like to live for. Ask what you can do for them. Let them guide the conversation rather than telling them what to think.

Tolle said that impulsivity is a danger when a teen is in a suicide crisis situation. She advised doing whatever possible to put time and distance from lethal means and a suicide impulse.

Veach emphasized that the teen needs to express all the swirling feelings and emotions first. The youth cannot problem solve and find solutions when in a mental health crisis, he said.

The next step is to get a mental health evaluation with a professional as soon as possible. Suicidal ideation should always be taken seriously, and parents must act immediately to get help, going to the emergency room if the teen is in imminent crisis.

Reducing immediate stressors is also important, as is removing all lethal means of hurting themselves.


Signs a teen is in crisis include a specific suicide note or suicidal expressions in journals or art. Another signal is a youth saying voices are encouraging suicide. Discovering a non-lethal attempt at self-harm, such as cutting or taking pills, is also a crisis indication.

Another sign involves the parents’ gut feelings: are they afraid to leave the teen alone, fearing a suicide attempt?

In these situations, immediate help is required. For a suicide in progress, call 911. Do not leave the child alone, and remove or secure all items that could be used in a suicide attempt.

If not in process, get the teen to an emergency room or mental health center for evaluation as soon as possible.

For mental health resources, parents can call Partners Health Management’s 24/7 crisis line at 1-888-235-HOPE (4673). They can also call 211 for 24/7, free, confidential help to find mental health resources in your county.

Another resource is the 24/7 National Suicide Prevention Lifeline (1-800-273-TALK (8255)) or through texting TALK to 741741 for help.


Early awareness and treatment of depression reduces suicide risk for all ages.

The good news is treatment is effective for eight out of 10 people with depression. No single approach works for everyone; however, trying a variety of treatments may help find the most effective solution.

Finding a mental health professional who is a good fit for the teen is important to successful treatment. Parents should keep mental health professionals informed about progress or regression at home or school.

Keeping track of medications, if necessary, and taking medications as prescribed are also essential. Keeping the school counselor and other school personnel informed of the teen’s situation can also help.

Most of all, parents must be patient with the teen as treatment continues.

Depressed teens can show improvement in four to six weeks with psychotherapy alone, according to Tolle. Many teens see increased benefit when the whole family participates in therapy together.

Others may require the addition of antidepressants to reduce their symptoms. Medication is essential with some conditions, including severe depression, bipolar disorder, or schizophrenia.

Patients must also be aware that mental health conditions can reoccur, even if previous treatment was successful.

Mentors and family members also are important components of treatment for depressed individuals. Encouraging a healthy, active lifestyle, including such components as exercise, yoga, breathing exercises to promote calm, and a nutritious diet, is important to improve mood and reduce stress and anxiety.


To keep teens safe, parents and other concerned adults can do several things. For teens in crisis, getting them effective mental health care is paramount.

Helping teens establish positive connections to family, peers, community, and social activities gives them the resilience and strong relationship network to get them through times of stress and anxiety without falling prey to suicidal thoughts.

Schools also need to foster safe and supportive environments. Helping teens develop strong problem-solving skills also reduces stress and anxiety.

Parents should also openly support communication about mental health, checking in with their teens often about their lives. Parents can also role model seeking help themselves when they are anxious, stressed, or down.

Another important suicide prevention strategy is removing access to lethal means to teens who may act impulsively. Locking up guns, leftover narcotics, and other dangers is an important preventative step.


Matt Weisner of Children’s Hope Alliance shattered several common myths about suicide.

#1: Talking about suicide will make them want to do it.

In fact, Weisner said the opposite is true. Confronting suicidal feelings head on makes the person less likely to go through with it. Expressing concern and creating attachment for the person helps distract them from suicidal crisis.

#2: People who talk about killing themselves aren’t really serious.

Weisner said we should never ignore talk of suicide. The person may be looking for a way to talk about their feelings. Reach out and ask them about their feelings, and get them help.

#3: Killing yourself is because of a mental disorder.

Many people who attempt or commit suicide have no diagnosed mental problems, said Weisner. Sometimes a trauma, loss, bullying, or other environmental experience leads to suicidal ideation.

#4: If someone wants to kill themselves, they cannot be stopped.

Most people are trying to find another option to escape their pain but are caught up in trapped thinking. Weisner advised expressing concern and support and making a connection can prevent many suicidal people from completing the act.

#5: People who commit suicide do it out of the blue.

Impulsivity is a risk factor, but Weisner said most people display many of the risks and warning signs of suicidal feelings.

#6: People who kill themselves are selfish.

Though suicide leaves terrible pain for friends and loved ones, Weisner said the suicidal person is really only focused on ending their pain. They lose the ability to think flexibly, to see other options, when in a suicidal spiral.

#7: If at high risk for suicide, the person will always be at high risk for the rest of their lives.

Even if suicidal feelings reoccur after earlier treatment, most high levels of suicidal risk are brief, added Weisner. The person can learn to recognize risk factors and warning signs and reach out for help if these feelings re-emerge.


Tolle reminded the audience, “If we can reduce the stigma, we can increase suicide awareness. If we increase awareness, we can reduce the rate of suicide.”


The Suicide Prevention Town Hall was presented by Iredell-Statesville Schools, Partners Health Management, United Way of Iredell, and the Children’s Hope Alliance. 

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