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The information on this website is designed to offer self-care tips and recommendations based on evidence-based research and literature from professionals in each field. It is not intended to diagnose or treat any specific medical condition. Please consult with your healthcare provider before making any health-related decisions.
Age Appropriate Emotional Coaching Strategies for Suicidal Children and Teens(C-SSRS)
Hearing your child say, “I wish I were dead,” is heartbreaking. Whether it’s a passing comment or a sign of deeper distress, your response matters. This guide helps parents talk with their children in age-appropriate ways, validate emotions, and know when to seek professional help.
At the end of the article, you’ll find the Columbia Suicide Severity Rating Scale (C-SSRS) Family Card, a simple but powerful tool to assess suicide risk and guide next steps.
Birth to Age 5: Young Children
Understanding This Stage:
- Children don’t understand death as permanent.
- Statements like “I want to go away” are emotional expressions, not suicidal intent.
- Children often imitate words they hear.
- Suicide deaths under age 10 are extremely rare, but all threats must be taken seriously.
What to Look For:
- “I wish I could fly away.”
- “I don’t want to be here anymore.”
- “I want to go to heaven.”
- “Nobody likes me.”
- Acting out anger or sadness in play (dolls “disappear” or “die”).
- Hitting themselves or saying they’re “bad.”
How to Talk:
- “That’s a big feeling to say you want to disappear. Can you tell me what made you feel that way?”
- “When you say you want to go to heaven, what do you think heaven is?”
- “Do you know what it means to be dead? Can you tell me what you think happens?”
- “It sounds like you’re feeling really sad and mad at the same time. That’s okay. Grownups feel that way too.”
- “Even when you feel really upset, I’m here to help you feel safe again.”
Connect and Empower:
- Use emotion charts or faces to help name feelings.
- Validate: “It makes sense you’re mad. You didn’t want to stop playing.”
- Offer coping tools: “When you feel like running away, let’s sit in the cozy corner and draw how we feel.”
Ages 6–9: Early Elementary
Understanding This Stage:
- Children begin to understand that death is permanent.
- Expressions of suicide often reflect emotional pain or confusion, not intent.
What to Look For:
- “I wish I was never born.”
- “Nobody would miss me.”
- “I want to die.”
- Drawing violent scenes or writing about dying.
- Withdrawing socially or acting out.
- Struggling with identity or peer relationships.
How to Talk:
- “That’s a serious thing to say. What happened today that made you feel this way?”
- “What do you think dying means?”
- “Do you want everything to stop, or do you want help making something better?”
- “Where do you feel the hurt in your body? Can you draw it for me?”
- “Let’s talk to that part of you that feels really sad. What is it trying to say?”
- “You’re not in trouble for saying that. I’m glad you told me.”
Connect and Empower:
- Use play or drawing to explore feelings.
- Teach problem-solving: “What else can we do when that feeling shows up?”
- Build safety routines: “Let’s make a ‘feeling better plan’ with three things you can do when your sadness feels too big.”
Ages 10–12: Preteens
Understanding This Stage:
- Children understand death is final and begin to hide difficult feelings.
- Suicidal thinking may reflect stress from school, family issues, or social exclusion.
What to Look For:
- “I just want everything to stop.”
- “I don’t want to live anymore.”
- Self-harming behaviors, giving away possessions, school changes.
- Withdrawal, isolation, or feeling like a burden.
How to Talk:
- “Sometimes when people feel overwhelmed, they think about not wanting to be here. Have you had thoughts like that?”
- “What’s happening in your life right now that feels really hard?”
- “When you say you want to disappear, do you mean you want to die or want things to change?”
- “What would you need to feel even a little more okay? Let’s make a plan together.”
- “You are not broken. You are hurting. I’m here to help you through it.”
- “It’s brave to talk about these feelings. Let’s figure out what your pain is trying to say.”
Connect and Empower:
- Encourage journaling or creative expression.
- Help identify emotional triggers: “What usually happens before those thoughts show up?”
- Build hope: “Even though it feels like this pain will last forever, feelings do change. Let’s find small steps together.”
Ages 13–17: Teens
Understanding This Stage:
- Teens may articulate suicidal intent more clearly.
- Many hide distress to avoid being judged or becoming a burden.
- Suicidal ideation can be linked to trauma, identity conflict, depression, or anxiety.
What to Look For:
- “I can’t do this anymore.”
- “I’m done.”
- “What’s the point of being alive?”
- Writing suicide notes, giving away items, risky behaviors.
- Changes in eating, sleeping, or substance use.
How to Talk:
- “Have you been thinking about dying or ending your life?”
- “Have you made a plan or thought about how you’d do it?”
- “Do you feel like life is painful most of the time right now?”
- “I want to understand what’s underneath this pain. Can we talk about what’s hurting?”
- “Even if part of you wants to give up, another part came to me. That’s the part I want to help.”
- “You’re not alone. We’ll figure it out together, but I need to know if you’re safe.”
Connect and Empower:
- Normalize mental health conversations: “Many teens go through this. You’re not alone.”
- Offer choice: “Would you like to talk to a therapist alone or with me there?”
- Build support: “Who else do you feel safe talking to?”
How to Respond at Any Age
- Stay Calm and Present: Your calmness helps regulate their nervous system.
- Validate First: “That sounds really hard.” “You are allowed to feel that.”
- Name Emotions: “You sound hopeless… like there’s no way out.”
- Don’t Minimize: Avoid “You’re just being dramatic” or “You’re fine.”
- Build Coping Plans: Create a “Feel Better Plan” or “Safety Plan” with them.
- Seek Help: Therapy is critical when suicidal thoughts are present. Don’t delay.
When to Seek Immediate Help
Call 911 or go to the ER if:
- Your child has a specific plan to harm themselves.
- There is access to dangerous means (weapons, pills, sharp objects).
- You are uncertain about their safety, even if they insist they are “fine.”
Resources
- 988 Suicide & Crisis Lifeline: Call or text 988
- Crisis Text Line: Text HOME to 741741
- Mobile Crisis Outreach Teams: Available in many areas
- Visit: utah23.org/urgent-emotional-support-resources
Columbia Suicide Severity Rating Scale (C-SSRS) Family Card
The C-SSRS Family Card is a clinically validated tool designed to help parents and caregivers assess suicide risk in youth. Use it to:
- Start open conversations about suicidal thoughts.
- Determine the level of risk.
- Know when to seek emergency care or therapy.
Download the free C-SSRS Mobile App here:
Columbia Protocol App – Save Lives
The C-SSRS Mobile App gives you quick and easy access to the Columbia Suicide Severity Rating Scale right from your phone. You can also use the Family and Friends Screening Card to help determine whether your child may be at immediate risk and in need of crisis intervention. If your child has expressed suicidal thoughts, developed a plan, made preparations, and intends to act, as outlined in the screening tool below, it’s time to seek immediate crisis support to ensure their safety.
