When parents of teens research the topic of suicide and learn about all types of suicidal behavior, including the difference between suicidal behavior/ideation and self-harming behavior, one thing is important to understand from the beginning: most people who engage in self-harm – also called non-suicidal self-injury (NSSI) – do not intend to die.
In fact, parents can learn this by reading the definitions of the terms:
Suicide is an intentional, self-inflicted act that results in death, accompanied by evidence that indicates the person had intent to die.
Self-harm is an intentional and often repetitive behavior that involves actions that harm the body without the intent to die.
People who engage in self-harm most often use it as a coping mechanism to provide temporary relief from psychological distress. Most people who engage in self-harm stop when they achieve relief from the distressing emotional state that caused the preceded the behavior. However, accidental death can and does occur in some cases of self-harm.
Recognizing the distinction between suicidal behavior and self-harming behavior is critical. Therapeutic techniques that are clinically appropriate for an adolescent who engages in non-suicidal self-injury may not be clinically appropriate for someone who engages in suicidal behavior, and vice-versa.
Let’s look closer at what we know about suicidal behavior, starting with one primary component: suicidal ideation.
What is Suicidal Ideation?
Suicidal ideation falls under the category of suicidal behavior. The American Psychological Association (APA) offers this definition of suicidal ideation:
“…thoughts of serving as the agent of one’s own death. Suicidal ideation may vary in seriousness depending on the specificity of suicide plans and the degree of suicidal intent.”
Clinicians identify two types of suicidal ideation: active and passive.
In most cases, an individual who engages in passive suicidal ideation:
- Does not have a plan for taking their life
- Has not acquired the means to take their life
- Does not have a specific time they intend to their life
In contrast, an individual who engages in active suicidal ideation most often:
- Has a plan to take their life
- Has acquired a means to enact the plan
- Knows or has a time frame for when they plan to take their lives
Full awareness of the differences between passive and active suicidal ideation is critical for the same reason differentiating between suicidal behavior and self-harming behavior is critical: treatment for one may not be appropriate for the other.
How Many Teens Engage in Suicidal Behavior and Self-Harm?
These prevalence rates, which have increased over the past fifteen years, are one of the main reasons mental health experts and public policymakers – including the U.S. Surgeon General – warn that we’re in the middle of a teen mental health crisis.
Here’s the data from a long-range study published by the Centers for Disease Control (CDC).
Passive Suicidal Ideation, Past Year:
- 2011: 17%
- 2021: 22%
Passive Suicidal Ideation, Past Year, by Gender:
- Male: 14%
- Female: 30%
Active Suicidal Ideation, Past Year:
- 2011:13.6%
- 2021: 18%
Active Suicidal Ideation, Past Year, by Gender:
- Male: 12%
- Female: 24%
Suicide Attempt, Past Year:
- 2011: 8%
- 2021: 10%
Suicide Attempt, Past Year, By Gender:
- Male: 7%
- Female: 13%
Studies published by the American Psychological Association show the following rates of self-harm among teens:
Ever Engaged in Self-Harm:
(no long-term trend data available)
- Overall: 17% of teens
- Among LGBTQIA+ teens: 45%
Studies show that while there are no significant difference in rates of self-harm between males and females, there are differences in why males and females engage in self-harm. To learn more about gender differences in the causes of self-harming behavior, please read this article.
Now let’s take a look at the types of professional treatment and support available for teens who engage in suicidal behavior, including suicidal ideation or attempting suicide.
Treatment for Teen Mental Health: Suicidal Behavior
The goal of treatment for suicidal behavior in teens is to help identify any underlying mental health disorders associated with suicidal behavior, such as mood disorders, depression, anxiety disorders, post-traumatic stress disorder (PTSD), and others.
Treatment modalities may include:
- Individual therapy
- Group therapy
- Family therapy
- Psychiatry and medication management
In addition, teens may engage in complementary activities to improve emotional fluency, well-being, and quality of life, such as:
- Expressive: writing, journaling, role playing
- Yoga and other exercise
- Meditation and mindfulness
How to Deal With Teens Who Engage in Suicidal Ideation
Parents know that some teens like to say provocative things to get attention, look cool, or simply annoy their parents or friends. With regards to suicidal ideation and this phenomenon, here’s a rule:
Even if you’re sure it’s a joke, take it seriously.
The consequences of you being wrong about whether it’s a joke or not are simply too serious. If your teen thinks you’re overreacting, that’s okay: now they know better than to make jokes about something as consequential as suicide.
On the other hand, if you were one hundred percent certain it was a joke, but you dig deeper and find out your teen is engaging in suicidal ideation, then your reaction may save their life. We’re not exaggerating. Studies show that the vast majority of people who attempt suicide show some type of suicidal ideation first, and that the most effective way to prevent a suicide attempt is by talking to a trained professional.
In Crisis, Call 988
In 2022, the federal government streamlined and organized our fragmented national network of suicide and mental health crisis hotlines, helplines, and support lines to create a single, national emergency crisis line:
The 988 Suicide & Crisis Lifeline
988 offers free, confidential support for people in suicidal crisis, emotional distress, or an addiction emergency. How to use it:
- To talk: dial 988 on any phone – it’s live 24/7/365
- To text/chat: text 988 on any phone – it’s live 254/7/265
- For Spanish language, follow prompts
