By Elissa Smilowitz
Recently, I spoke with a mother who was navigating an issue that has become increasingly common for many families here on Long Island and across the nation. Her 12-year-old daughter told her that she thinks she may be a lesbian, but that she’s feeling confused. The mom asked me how to best approach this conversation so her daughter would feel comfortable sharing her thoughts without fear of being judged or rejected.
The first thing I told this mom was that it’s very promising to hear that she is keeping the lines of communication open and assuring her daughter that she can trust her family to be supportive as she ponders these deeply personal questions.
More and more, we see clients at the Guidance Center who identify as part of the LGBTQ+ community; some call themselves gay or lesbian, while others are exploring their gender and/or sexual identity. Research indicates that a growing number of teenagers are identifying themselves with nontraditional gender labels such as transgender or gender-fluid, and our experience backs that up.
Regardless of the names that are used, one thing is a constant: When young people face disapproval from their families based on preferences or gender issues, they are far more likely to experience depression, anxiety, substance use and suicidal thoughts.
Research from the Centers for Disease Control and Prevention reveals the dangers of rejection. The CDC reports that LGBTQ+ youth contemplate suicide at almost three times the rate as heterosexual youth. In addition, LGBTQ+ youth who come from “highly rejecting families” are 8.4 times as likely to have attempted suicide as their LGBTQ+ peers who reported no or low levels of family rejection.
Some more eye-opening statistics: According to the Human Rights Campaign’s report, Growing Up LGBT in America, a survey of more than 10,000 LGBTQ+-identified youth ages 13-17:
- 4 in 10 say the community in which they live is not accepting of LGBTQ+ people.
- They are twice as likely as their peers to say they have been physically assaulted, kicked or shoved.
- 26% say their biggest problems are not feeling accepted by their family. Other top concerns include trouble at school/bullying and fear to be out/open.
- More than half (54%) say they have been verbally harassed and called names involving anti-gay slurs.
- LGBTQ+ youth are more than twice as likely as non-LGBTQ+ youth to experiment with alcohol and drugs.
- 92% say they hear negative messages about being LGBTQ+. The top sources are school, the Internet and their peers.
Kids around the ages of 12 – 13 are at a time in their lives when they are discovering who they are, and for some, that brings up issues surrounding their sexual preferences and gender identity. As the CDC research shows, parental response is enormously important.
Youth who are exploring these issues need the unconditional support of their families, as they do with any other life concerns. They need to know they can be themselves without risking judgment.
The best response is clear: Express unconditional love and acceptance. Whether or not an adolescent ends up identifying as LGBTQ+ doesn’t change the fact that parents need to be calm and supportive. Tell them you will love them the same no matter what, and that you are there for them always.
There are some great resources to help you on this journey. One is The LGBT Network, an association of non-profit organizations working to serve the LGBTQ+ community of Long Island and Queens throughout their lifespan. It includes a group specifically for young people, called the Long Island Gay and Lesbian Youth (LIGALY), which works to build community, provide a home and safe space for all, end anti-LGBTQ+ bullying and prevent suicide. Nationally, The Trevor Project also provides lots of helpful information.
If your child or teen shows signs of depression or other mental health challenges, don’t hesitate to get help from a professional. To make an appointment at North Shore Child & Family Guidance Center, call (516) 626-1971 or email email@example.com.
Elissa Smilowitz is the Director of Triage, Emergency & Suicide Prevention at North Shore Child & Family Guidance Center, Long Island’s leading children’s mental health agency.
Gender identity terms
- Gender identity: A person’s deeply held internal sense of being male or female or somewhere else on the gender spectrum.
- Sex assigned at birth: The classification people are given at birth regarding sex and, typically, gender, usually based on genitalia.
- Transgender: A person whose gender identity is different, and often fully opposite, from their sex assigned at birth.
- Cisgender: A person whose gender identity is the same as their sex assigned at birth.
- Gender nonbinary: A person who identifies as both male and female, or somewhere in between male and female.
- Gender fluid: Your sense of where you are on the spectrum of male to female can change over time, even from day to day.
Sexual identity terms
- Lesbian: A woman who wants to be in a relationship with another woman.
- Gay: A man who wants to be in a relationship with another man (though sometimes lesbians also use this term).
- Bisexual: Someone who is sexually attracted to both men and women.
- Pansexual: Someone who is interested in having relationships with all genders.
It is a phone call the staff at North Shore Child & Family Guidance Center gets all too often: A parent is in despair, saying their son or daughter is experiencing severe depression, anxiety and thoughts of suicide. And the situation has worsened due to the COVID-19 virus. “The isolation brought on by the pandemic is hard on everyone, but it’s especially difficult for young people,” says Regina Barros-Rivera, Associate Executive Director at the Guidance Center, Long Island’s leading children’s mental health organization.
Sadly, suicide among young people is not a new problem. According to the Centers for Disease Control and Prevention, suicide is the second-leading cause of death for Americans ages 10-24, with more teens and young adults dying from suicide than from cancer, heart disease, birth
defects and other major illnesses combined. This past September, the Guidance Center launched a new program, the Douglas S. Feldman Suicide Prevention Project, an expansive initiative that aims to tackle the epidemic of suicide among young people. “Through the Douglas S. Feldman Suicide Prevention Project, we will bring essential, life-changing services to the children and families in our community,” says Elissa Smilowitz, who is heading up the new program. “We will address high-risk cases with a thorough evaluation for suicide risk; multiple weekly sessions of individual, group and family therapy; and a culturally sensitive treatment plan that focuses on safety strategies, healthy coping skills and relapse prevention.” Evaluation with a psychiatrist regarding the possible use of medication will also be provided,
along with in-home treatment and referrals to programs and services that will support parents’ efforts to protect their children. The Guidance Center will also provide educational forums and a suicide survivors’ support group for those who suffer this tragic loss. Andrew Malekoff, Executive Director of the Guidance Center, says, “We are grateful to the Feldmans for enabling us to develop a suicide prevention initiative that will enhance our ability to reach young people who may see no way out from the despair they are feeling. It’s a prime example of how our dedicated supporters (including the Community Chest) make a profound difference in the well-being of our community.” He adds, “Join us in spreading the word to schools, community organizations and friends. Information is power, and this program can save lives.”
Many people desperately want to know what to say – and what not to say – to someone who is thinking of suicide. The article 10 Things Not to Say to a Suicidal Person is SpeakingOfSuicide.com’s most popular post. Almost a half-million people have viewed it in the last 2½ years. Several hundred have left comments.
Sometimes people complain to me that the post describes what not to say, but it doesn’t say enough about what to say. They’re right. So in this post, I provide 10 things to say to a suicidal person.
First, Some Caveats
Before starting, I want to make some things clear: I came up with this list based on my conversations with suicidal individuals in my work as a clinical social worker, my readings of both clinical literature and accounts by individuals who experienced suicidal crises, and my own past experienceswith suicidal thoughts. Nobody has actually researched systematically the most effective things for friends or family to say to a suicidal person, so opinion and experience are the best we’ve got for now. Results will vary according to different people’s needs and personalities.
I also want to make clear that this list of things to say is not intended to be a script. Instead, I illustrate ways that you can help a suicidal person continue to open up, rather than shutting the person down with a comment that minimizes, invalidates, or even denigrates the person’s experience.
And I want to add that what to say often isn’t nearly as important as how to listen. As I explain in my post “How Would You Listen to a Person on the Roof?”, someone who is thinking of suicide needs to feel understood. Let the person tell their story. Refrain from immediately trying to fix the situation or make the person feel better. These efforts, however well intended, can halt the conversation.
So, with all that said, here are 10 things you can say to someone who tells you that they are considering suicide.
1. “I’m so glad you told me that you’re thinking of suicide.”
When someone discloses suicidal thoughts, some parents, partners, friends and others react with anger (“Don’t be stupid!”), pain (“How could you think of hurting me like that?”), or disbelief (“You can’t be serious.”) Some “freak out.” A suicidal person might then feel a need to comfort the hurt person, provide a defense to the angry person, or retreat internally from the disbelieving person. The person might regret ever having shared in the first place that they were thinking of suicide.
By saying “I’m glad you told me” – or something similar – you convey that you welcome and encourage disclosure of suicidal thoughts, and that you can handle it.
2. “I’m sad you’re hurting like this.”
This simple expression of empathy can go a long way toward validating the person’s pain and soothing a sense of aloneness. There’s no “Oh it’s not so bad,” no “You don’t really mean that,” no “But you have so much going for you,” no other statement denying or minimizing the person’s pain.
3. “What’s going on that makes you want to die?”
This invitation to the suicidal person to tell their story can provide validation, engender a sense of connection, and show that you really want to understand. Ask the person to tell their story. And then, listen. Really listen. To deepen your understanding, follow up with more invitations to share, like “Tell me more.” Show empathy and understanding, too: “That sounds awful” or “I can see why that’s painful.”
4. “When do you think you’ll act on your suicidal thoughts?”
Even if you’re not a mental health professional, you still can ask some basic questions to help understand the person’s risk for suicide. Asking about timing will make the difference between whether you need to call someone immediately for help (for example, if the person says, “I have a gun in my backpack and I’m going to shoot myself during lunch”) or whether you can continue to have leisurely conversation with the person.
5. “What ways do you think of killing yourself?”
This is another risk-assessment question. The answer can help reveal the gravity of the situation. A person who has put a lot of time and thought into suicide methods might be in more danger than someone with a vague wish to be dead, for example.
Understanding the suicide methods that the person has considered also will help you in your efforts to keep the person safe. For example, if you’re a parent and your teenage child discloses suicidal thoughts, knowing that your teenager is considering overdosing on a painkiller alerts you to the need to lock up or throw away all potentially dangerous medications. (See this information from the Center for Youth for ways to make your home safer.)
6. “Do you have access to a gun?”
Even if you think the person doesn’t own a gun or can’t get a hold of one, this information is always important. If the answer is yes, ask the person to consider giving the gun (or a key piece of the gun) to someone, locking the gun up and giving someone the key, or doing something else to make the home gun-free until the danger of suicide goes down. For more information about firearm safety related to suicide risk, also see this gun safety fact sheet.
7. “Help is available.”
By telling the person about help that’s available, you can help them to not feel so alone, helpless, or hopeless. If you are in the U.S., you can give them the number to the National Suicide Prevention Lifeline (800.273.8255) or the Crisis Text Line (741-741). You also can show them the SpeakingOfSuicide.com Resources page, which lists other resources in the U.S. and worldwide to receive help by phone, email, text, or online chat. If the person who reveals suicidal thoughts to you is your child, take them to a mental health professional or an emergency room for an evaluation.
8. “What can I do to help?”
Definitely tell the person about resources for help, but also make clear that you are available, too, if you’re able to do so. That said, there’s only so much you can do, so if you are feeling solely responsible for keeping the person alive, it’s best to involve others, too.
9. “I care about you, and I would be so sad if you died by suicide.”
Be careful here. In my earlier post, one of the 10 things not to say is, “Don’t you know I would be devastated if you killed yourself? How could you think of hurting me like that?” As I note in that post, “Your loved one already feels awful. Heaping guilt on top of that is not going to help them feel soothed, understood, or welcome to tell you more.”
At the same time, a simple statement of how much you care about or love the person can help nurture a sense of connection, if your statement isn’t an attempt to stop the person from talking further about suicide.
10. “I hope you’ll keep talking to me about your thoughts of suicide.”
Just as you want the person to feel welcome for having shared their suicidal thoughts to you, it’s good to make clear that you would welcome further disclosures, as well. Often, someone who has suicidal thoughts senses from others an expectation to “get over it already.” By inviting the person to come to you again about their suicidal thoughts, you can help prevent isolation and secrecy.
What Are Your Ideas about What to Say to a Suicidal Person?
There are many other helpful responses besides those listed here. If you have thoughts of suicide, what do you wish someone would say to you if you told them? If you have ever helped a suicidal friend or family member, what responses from you seemed to foster sharing, connection, and safety? Please feel free to leave a comment below.
Stacey Freedenthal, PhD, LCSW, is the author of “Helping the Suicidal Person: Tips and Techniques for Professionals,” a psychotherapist and consultant, and an associate professor at the University of Denver Graduate School of Social Work.
Copyright 2017 by Stacey Freedenthal, PhD, LCSW. Written for SpeakingOfSuicide.com. All Rights Reserved. Photos purchased from Fotolia.com.
Half a million dollars will be distributed by the Unitarian Universalist Congregation at Shelter Rock to combat food insecurity, homelessness and educational disadvantages exacerbated by COVID-19.
The funding, in addition to $170,000 distributed last year, will go directly to 19 Long Island organizations in the form of unrestricted grants. Recipient organizations include Island Harvest, Sunnyside Community Services and others addressing a range of social needs.
Jana North, who was recently appointed president of the congregation, said she was glad to provide aid to address pandemic emergencies.
“When COVID hit, there was a very strong sense within the congregation that they wanted to try to support local organizations that were going to get hit very hard,” North said. “What we really needed to do was give a substantial amount.”
The most recent round of emergency funding was voted on by the congregation to meet immediate needs. This stands apart from the Veatch program, which awards millions of dollars a year.
“We wanted the money quickly, we wanted the money to go locally, and we wanted it to go to organizations that were doing things right now,” North said. “That brought it out of the sphere that we usually give through the Veatch program.”
In the early days of the pandemic, the congregation was awarding smaller groups of grants near $50,000. Now, the total amount of aid given by the church is closing in on $700,000.
The most recent half million in grants were awarded to organizations selected by a task force, which narrowed down a list from approximately 60 to just under 20. Those groups have set goals aligned with the congregation’s values, according to North.
The other groups that received grants were the Central American Refugee Center, Central Nassau Guidance and Counseling, Choice for All, Elmcor Youth & Adult Activities, Health and Welfare Council of Long Island, Housing Help, La Jornada, Littig House Community Center, Long Island Crisis Center, Manhasset-Great Neck Economic Opportunity Council, NAMI Queens/Nassau, New Ground, North Shore Child and Family Guidance Center, OLA of Eastern LI, Queens Together, SEPA Mujer and St. Aloysius Roman Catholic Church in Great Neck.
“These organizations are pretty well known to us and have been for years,” North said. “The grantees seem to be very pleased to get it and I was glad that we could do it.”
“We have a very active social justice group within the congregation,” North said of the Shelter Rock congregation, which is one of over 1,000 across the country.
“Since this happened, we’re sure aware of what happens when something like this affects so many nonprofits that are already teetering on the edge locally,” North said. “I do think it has made us very aware of the need and I think we’d like to be part of that answer.”
In this monthly column, therapists from North Shore Child & Family Guidance Centeranswer your questions on issues related to parenting, mental health and children’s well-being. To submit a question, email firstname.lastname@example.org.
Question: Our grandson’s pediatrician recently suggested his parents get him screened for autism. We’re so worried and not sure where to turn. Help!
Dear Panicked Grandparents: There are a wide range of autism spectrum disorders, also known as ASD, and many people with the condition live very happy lives. Your first step: Get educated.
Most babies start to show an interest in the world and the people around them at a very young age. By their first birthday, typical toddlers look people in the eye, copy words, play games like peek-a-boo and engage in clapping, waving hello and good-bye and other simple behaviors.
According to the Centers for Disease Control and Prevention, people with ASD—which is a complex developmental disability that manifests in many different ways and to many different degrees—may struggle with social, emotional and communication skills.
Children or adults with ASD might…
- show no interest in objects (for example, not point at an airplane flying over)
- avoid eye contact
- prefer not to be held or cuddled
- appear to be unaware when people talk to them, but respond to other sounds
- repeat or echo words or phrases said to them
- have trouble expressing their needs using typical words or motions
- have trouble adapting to changes in routine.
Other signs include a child not responding to his or her name when called; repeating actions over and over; and having highly restricted interests.
Early intervention is important, but even with older children, treatment can result in real improvements. At North Shore Child & Family Guidance Center, we provide thorough testing and, depending on the results, will create a customized therapeutic treatment plan, which often includes social skills groups and play therapy.
Support groups for caregivers are also very helpful. In addition to parent support groups, we have a program called GASAK, which stands for Grandparent Advocates Supporting Autistic Kids.
Also, our staff includes family advocates who often get involved in the cases, helping clients get appropriate services from their schools and other providers.
The bottom line: It’s important to determine the child’s needs and come up with a good educational and therapeutic plan. Although people with ASD may face challenges, a diagnosis doesn’t mean your grandchild won’t experience feelings of love, bonding and joy. The child is still the same loving child they were before the diagnosis. It’s a condition they have, but it doesn’t have to define their life.
Question: Now that it’s safe to be with their friends, how can I convince my kids to put their phones and tech devices down?
Dear Sick of the Screens: During the height of the pandemic, many families made allowances for extra time on screens and now face resistance to reestablishing more strict limits.
No parent wants technology to rule the roost, especially if it’s making your children isolated. Remember, you have the power!
- Set aside specific times at home when no one (parents included) uses technology. Cell phones, computers, iPads—all must be off. Tech-free time can be spent reading, talking, playing games, cooking, making art… anything creative or social will do.
- Establish a clear schedule. When it comes to gaming, many parents may allow 30 minutes a day during the school week and two hours a day on the weekends.
- When possible, keep all technology in a common space like the living room — not in a child’s bedroom. Avoid allowing your kid to disappear for hours behind a closed door.
- Utilize online services that filter out inappropriate or violent material. These services can also limit Internet access by scheduling times that the Internet is available and times when it is not.
The way you use tech devices influences your ability to effectively guide your children. Although your example is not the sole factor, keep in mind that as distant as some kids become from adults as they are moving through their teen years, they continue to observe you—more closely than you know.
During the pandemic, North Shore Child & Family Guidance Center is seeing clients remotely via telehealth platforms or, when deemed necessary, in person. To make an appointment, call (516) 626-1971 or email email@example.com.