Should I hospitalize my suicidal teen?
Note: This blog is a general background for parents and is not applicable to every situation. Please contact a mental health professional for more specific guidance in your unique situation.
One of the scariest moments for parents is finding out that their teen is having suicidal thoughts. In these life-or-death situations, it is normal to panic and do anything that you can to keep your child alive. And oftentimes, the suggestions from many mental health professionals is to have your teen go to the emergency room. Is that always the right choice?
The difference between ideation and intention
Suicidality is not an on/off switch. It is a spectrum of thoughts and behaviors that range from passive to active. Thoughts can range from passive thinking about not existing such as, “I don’t want to be here anymore to deal with my problems,” to more active ones such as “I can see myself being dead.” Suicidal intentions include preparatory behaviors, such as planning out how to carry out their suicidal thoughts, visiting places where they may be able to jump, or by accumulating medications, acquiring weapons, ropes or knives.
Hospitalization is not the only answer-and it may even be wrong
A 2019 article in the Journal of the American Medical Association found that people presenting to the emergency room with suicidal ideations were more likely to make subsequent suicide attempts and have severe accidents in the following 12 months than if they had not been admitted at all. The subsequent discussions around this study have led to some important conclusions about treating suicidality.
Often times, people with suicidal ideation without intentions do not need to be hospitalized. They are at very difficult times in their life, but those who face those problems and get through them learn valuable coping skills and self-reliance to be more resistant to those feelings in the future. It is theorized that people who are hospitalized with suicidal ideation do not learn these skills and instead learn that others must step in to save them from bigger feelings. They are also put into clinical environments that can make them feel even more helpless-being isolated away from family members, woken up every few hours, and transitioned back out with no new skills to handle tougher feelings after just a few days.
Hospitalization is necessary when suicidal behaviors are present. It is the last and most intrusive level of intervention for someone with suicidality. It is a life saving-intervention, but should be reserved for life-saving situations.
What should parents do?
If your teen is facing suicidality, work with a mental health professional to help determine the level of intervention that is the least restrictive for your teen. They may make suggestions that include therapy sessions, getting into a psychiatrist as soon as possible, dialectical behavior therapy , or even more intensive therapy schedules. If your teen needs immediate support, have them call the 988 Suicide and Crisis hotline (phone number 988).
Be aware that some mental health professionals may not be equipped to work with you and your child at this time. This does not necessarily mean that your child is beyond helping, but is an indicator that the therapist recognizes that they do not have the necessary resources and skills to be an effective team member in helping. Some therapists may even be looking for ways to pass the legal liability of working with a suicidal person on to someone else.
Curt Widhalm LMFT #47333
