Conditions & Treatments
- A to Z Guide

Suicide

Disease Information

Treatment & Care

Learning that your child is thinking about suicide—or has already attempted to take his life—is a terrifying and traumatic experience for any parent. It’s to be expected that you are feeling lost, scared and even outright helpless right now. But rest assured: you are in good hands. Children’s Hospital Boston has extensive experience helping children and teens who have contemplated or attempted suicide. We are here to guide you in supporting your child today, tomorrow and throughout the course of his treatment.

If your child is suicidal, it’s crucial to understand that he cannot just “snap out of it” or will himself to feel better. A depressed child feels a constant sense of discouragement, a loss of self-worth and an inability to imagine a better future. Treatment from a licensed mental health professional, in conjunction with loving support at home and at school, is critical to a full recovery.Your Children’s clinician will work with you and your child to determine the best approach to care during an immediate crisis, as well as over the long term.

Psychotherapy

The mainstay of treatment for suicidal thoughts and behaviors—and for depression in general—is psychotherapy, or “talk therapy.” Here at Children’s, our clinicians use therapy to help your child understand and cope with her feelings. Coping strategies taught in psychotherapy can include:

identifying and talking about feelings, worries and relationships
stopping automatic negative thoughts (“Nothing I do will ever turn out right”)
relaxing the mind and body
identifying activities that are engaging and comforting
recognizing and appreciating positive self-attributes and achievements
building hope for the future

Using these strategies, your child will be able to:

focus on changing her distorted views of herself and the environment around her
work through difficult experiences and relationships
identify stressors in her life and ways to avoid them
improve their general problem solving ability

Family therapy

When a child is suicidal, the entire family is affected. Family therapy can be an invaluable resource in building a support system for the child and addressing the concerns and issues faced by other family members.

Environmental changes

If environmental circumstances in your child’s life—for example, being bullied at school or coping with a parent’s alcoholism—are triggering his suicidal feelings, it is critical to change these circumstances as much and as quickly as possible. Your Children’s clinician can advise you on managing issues at your child’s school, with peers and at home.

Medication

Many children and teens who contemplate or attempt suicide are so depressed that therapy alone is not enough. In these cases, antidepressant medications may be recommended to help the child feel less depressed and subsequently relaxed, motivated and comfortable while working on coping skills in therapy.

Medication is not a “standalone” treatment; Children’s always considers it part of a two-prong approach, with psychotherapy as a necessary component. Our Psychopharmacology Clinic is devoted to helping children, families and clinicians decide whether medication might be a useful part of treatment.

Commonly prescribed antidepressant medications include:

SSRIs (selective serotonin reuptake inhibitors, which adjust the levels of serotonin—a chemical that regulates mood—in the brain)

Celexa
Lexapro
Luvox
Prozac
Zoloft

Atypical antidepressants (drugs that impact both serotonin and other chemical messengers in the brain)

Cymbalta
Desyrel
Effexor
Remeron
Serzone
Wellbutrin

No single medication is effective in all children. Families should expect a trial-and-error process that can last weeks, or even months, as doctors find the drug regimen that works best.

Since 2004, the U.S. Food and Drug Administration has placed a black warning label on antidepressant medications. The warning label states, in part:

“Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with Major Depressive Disorder (MDD) and other psychiatric disorders. Anyone considering the use of [Drug Name] or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior.”

If your child is prescribed any medication, your clinician will carefully go over the specifics of the drug, as well as any potential side effects you should watch for. Our team has years of experience in managing the use of psychiatric medications in children of all ages and with a wide variety of conditions. We will closely monitor your child for any sign of a negative response to the medication, and are always here to address any concerns you may have.

It is important to note that every study has shown that the combination of medication and psychotherapy reduces the risk of suicide.

Learn more about psychiatric medications.

Hospitalization

A child who has attempted suicide—or is severely distraught and on the verge of an attempt—may require a period of intensive, inpatient treatment.

Children’s Inpatient Psychiatry Service is a 16-bed psychiatric unit. The service provides comprehensive medical and psychiatric care for children, ages 8 to 18, who are experiencing a mental health crisis that calls for immediate treatment in a hospital environment. We offer:

family-centered assessments and customized treatment plans
medication consultations and management
referrals to other hospital and community mental health services
coordination of follow-up with primary care physicians and treating mental health clinicians after the child is discharged

Learn more about inpatient mental health treatment at Children's.

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Coping and support

The ups and downs experienced by a child—and family—living with the aftermath of a traumatic event can be frightening, draining and hard to understand. In addition to the information provided here, you may find comfort and support from the following resources:

Patient and family resources at Children’s

Children’s Center for Families is dedicated to helping families locate the information and resources they need to better understand their child’s particular condition and take part in their care. All patients, families and health professionals are welcome to use the center’s services at no extra cost. The Center for Families is open Monday through Friday from 8 a.m. to 7 p.m., and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.

The Children’s chaplaincy is a source of spiritual support for parents and family members. Our program includes nearly a dozen clergy members—representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions—who will listen to you, pray with you and help you observe your own faith practices during your child’s treatment.

The Depression Experience Journal was designed by Children’s psychiatrist-in-chief David DeMaso, MD, and members of his team. This online collection features thoughts, reflections and advice from kids and caregivers who have lived with depression.

Children’s Psychiatry Consultation Service provides several services, including:

short-term therapy for children admitted to one of our inpatient units
parent and sibling consultations
teaching healthy coping skills for the whole family
educating members of the medical treatment team about the relationship between physical illness and psychological distress

Children’s Behavioral Medicine Clinic helps children who are being treated on an outpatient basis at the hospital—as well as their families—understand and cope with their feelings about:

being sick
facing uncomfortable procedures
handling pain
taking medication
preparing for surgery
changes in friendships and family relationships
managing school while dealing with an illness
grief and loss

Children’s Integrative Therapies Team provides a number of services for hospitalized children, their families and their caregivers, including:

massage therapy
acupuncture
yoga
therapeutic touch

Visit our “For Patients and Families” page for everything you need to know about:

getting to Children’s
finding accommodations
navigating the hospital experience

Spotlight on: Center for Young Women's Health and Young Men's Health Site
Young men and young women may have certain concerns that are specific to their genders, and some concerns that they share. At Children’s, the Center for Young Women’s Health and Young Men's Health Site offer the latest general and gender-specific information about issues including fitness and nutrition, sexuality and reproductive health, physical development and emotional well-being.

Helpful links

Please note that neither Children’s Hospital Boston nor the Department of Psychiatry at Children’s unreservedly endorses all of the information found at the sites listed below. These links are provided as a resource.

Helpful links for parents and families