By Kyle Burke, Crisis Helpline Services Manager
In Iowa, about one out of three 988 users are under 18. Most of them also express having suicidal ideation. That’s not surprising, given what we know about the incredibly high (and increasing!) rates of suicide for youth in America. Suicide remains the second leading cause of death for our young neighbors. Even in the age of ubiquitous well-being content on TikTok and growth of crisis services like 988, keeping our kids alive is a depressingly difficult challenge.
So what are we to do?
You’d be hard pressed to get a simple answer from those in the mental health field. That’s because the factors driving suicide are complex, varied, and (if we’re being honest) less understood than we’d like. You might also hear that the field itself is conflicted about how to interpret the meaning of suicide, with some aching for a more humanistic approach rather than dominant medical model. My personal answer, though, is grounded in simplicity: Be present, patient, and direct.
One of the more common ways that young clients talk with 988 is exemplified below…
Crisis Counselor: You’re handling bullying at school on your own. That takes such strength to walk into the building each morning, knowing what might be said to you. What comes up emotionally when you think about how you’re treated there?
Young Client: idk
Crisis Counselor: That’s alright. Feelings are complicated, and I believe many people would have difficulty processing what’s happening to you. I’m wondering what made you reach out to 988 today. Perhaps you felt differently today than you have in the past?
Young Client: idk. But not really I guess. It just keeps happening.
Even those who don’t regularly interact with teens and pre-teens can sense that there’s significantly more happening in this client’s brain than is coming across to the crisis counselor. Some conversations like this slowly turn into deep emotional discussions, others will repeat the “idk” cycle indefinitely. The profound twist is that young clients will often thank us either way. It’s not our perception of progress or change that defines value for them. They had a comfortable space to tell us what’s happening in their life; a space where we didn’t attempt to solve their issues or their feelings. Our role in supporting them is to stick with it. We show that we care by acknowledging their feelings, asking questions about their wellbeing, and being patient when they seem to stall-out.
Time and supportive listening can do wonders for shoring up protecting factors against suicide. The other critical role that 988 fulfills is asking directly about suicide.
Crisis Counselor: If I was dealing with bullying every day, I think I would feel trapped and exhausted. I might also have thoughts of suicide. Have you thought about ending your life?
Young Client: Yeah
The act of asking directly about suicide, while often scary, is among the most caring things we can do for someone else. Trainings like QPR (Question, Persuade, Refer) or ASIST (Applied Suicide Intervention Skills Training) can help prepare you to notice warning signs and ask about them. One of the most common fears we hear in ASIST is not knowing what to do when someone says “yes.” Perhaps there’s room to relieve some pressure here. It’s OK to not know the path forward. For parents of pre-teens and teens, there might even be benefits in admitting it. I have faith that you’ll figure it out together. The most important thing is that you know whether suicide is on the table. Suicide only thrives in the dark.
So…what are we to do about preventing youth suicide?
I advocate for a relational approach. Spending time, listening, and asking hard questions. Crisis counselors follow these tenets because they are proven to build relationships and help youth feel supported. The good news is that we can all integrate these life-saving practices with our own loved ones.