Common Characteristics of an Acute Suicidal Crisis

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A suicidal crisis can come on rapidly. This doesn't mean it occurs out of the blue. Most people at risk of suicide have struggled with ongoing, underlying problems. But especially when external stressors converge, and internal symptoms worsen, some people can feel desperate to end their pain. They may escalate rapidly from feeling distressed to having suicidal thoughts to making an attempt.

A suicidal crisis can lead to an unplanned or minimally planned suicide attempt. While some attempts are carefully planned, others occur with little deliberation. One study asked people seen in the hospital following a suicide attempt when they had first started thinking about making that attempt; 48% said they first started thinking about it within 10 minutes of attempting.

Duration of Suicidal Crisis

• 0-10 minutes 48%
• 11-60 minutes 2%
• 1-24 hours 9%
• 1-7 days 16%
• 1-4 weeks 15%
• 1-12 months 11%

•  Cutting 2%
• Jumping/Falling 2%
• Gas Inhalation 3%
• Poisoning/Overdose 12%
• Suffocation/Hanging 26%
• Firearms 51%

There are signs of suicidal ideation you can watch for. Though young people may hide or deny their feelings, research shows that nearly 80% of those who attempt suicide will say something beforehand. That is why listening and observing are key. 

You may notice your child is sleeping more or avoiding people and activities they once loved. They may say they’ve given up on solving specific problems or suggest that life has no real meaning.

Self-degrading language and drug and alcohol use are causes for concern. You might also see worsening grades or creative work—writing, drawings, music, videos, or other forms of self-expression—that reflect suicidal ideation.

Even the most caring, dialed-in parents can't read a child's mind. Studies have shown that nearly half of all parents whose adolescent children were thinking about suicide didn't know it was happening. 

Ask Your Child

You should come out and ask your child if you're worried.

Many people believe that talking about suicide makes it more likely to happen. Research tells us the opposite is true. Creating a sense of connection may help prevent suicidal thoughts from spiraling into actions. 

How does one ask their child about suicidal thoughts?

Find a time when you're not rushing anywhere and can talk privately. Consider times when you're driving or watching a TV show together, for example.

Begin with love and concern. You might say, "I care so much about you, and even though I know you are strong, I can't help but notice that you're hurting lately. That makes some people think about suicide. Does this ever cross your mind?"

Expect discomfort, resistance, or even anger when you ask the question. Emphasize that it's safe for them to tell you anything, even if they're unsure what their thoughts mean.

Listen without judging. Remember that you need their trust if you feel tempted to argue with their feelings. Extreme pain changes the way we view life—which means your child's perceptions are their reality, at least for now.

People use a variety of different methods when attempting suicide. Some methods are far more lethal than others. A method is considered lethal if a high proportion of attempts by that method end in death. 

The lethality of the method used in a suicide attempt is one of the most significant factors determining whether the person lives or dies. While the intent matters, means also matters.  

If the method a person wants to use for suicide is not available when they are ready to go through with an attempt, one of two things is likely to occur:

1. They delay the attempt as they try to get access to the method they want to use. The greater the delay, the greater the chance the suicidal crisis will pass.
2. They will substitute another method. If the substituted method is less lethal, this increases the chance the person will not die. And most people who survive an attempt do not later go on to kill themselves.

Firearms are used in more suicide deaths in the U.S. than all other methods combined. They are also highly lethal, irreversible, and easily accessible in many homes with guns (one-third of homes have guns). Since gun owners can voluntarily undertake steps to reduce access, it is critical that safe firearm storage be discussed by all families experiencing the stress of a child coming out. 

Medication overdoses are not as lethal as firearms (though some medications and poisons are very lethal). It is possible for someone to stop an overdose mid-attempt or to be rescued. However, overdose is by far the most frequent method of attempt, and medications are easily accessible in most homes. Therefore, it is wise to routinely ensure that families with an at-risk child dispose of unnecessary medications and keep accessible only quantities that do not pose a lethal threat. 

Suffocation/Hanging fatality rate is around 70%; for those who reach the hospital alive, the majority - 80-90% survive. The truth is that prevention strategies that focus on restricting access are limited.   The best strategy is increasing awareness of risk indicators exhibited by your child. There are signs of suicidal ideation you can watch for. Though young people may hide or deny their feelings, research shows that nearly 80% of those who attempt suicide will say something beforehand. That is why listening and observing are key.  

You may notice your child is sleeping more or avoiding people and activities they once loved. They may say they’ve given up on solving specific problems or suggest that life has no real meaning.

Self-degrading language and drug and alcohol use are causes for concern. You might also see worsening grades or creative work—writing, drawings, music, videos, or other forms of self-expression—that reflect suicidal ideation.

Even the most caring, dialed-in parents can't read a child's mind. Studies have shown that nearly half of all parents whose adolescent children were thinking about suicide didn't know it was happening. 

These findings suggest that you should come out and ask your child if you're worried.

Many people believe that talking about suicide makes it more likely to happen. Research tells us the opposite is true. Creating a sense of connection may help prevent suicidal thoughts from spiraling into actions. 

How does one ask their child about suicidal thoughts?

Find a time when you're not rushing anywhere and can talk privately. Consider times when you're driving or watching a TV show together, for example.

Begin with love and concern. You might say, "I care so much about you, and even though I know you are strong, I can't help but notice that you're hurting lately. That makes some people think about suicide. Does this ever cross your mind?"

Expect discomfort, resistance, or even anger when you ask the question. Emphasize that it's safe for them to tell you anything, even if they're unsure what their thoughts mean.

Listen without judging. Remember that you need their trust if you feel tempted to argue with their feelings. Extreme pain changes the way we view life—which means your child's perceptions are their reality, at least for now.

If your child has a suicide plan or can't stop thinking about ending their life, tell them you love them, support them, and will get them help, and call 988 right away. 

If your child has a suicide plan or can't stop thinking about ending their life, tell them you love them and support them and will get them or help, and consider calling 988. 

Crisis counselors are available 24/7 to connect you with emergency services in your area. The 988 crisis centers have access to interpreters who speak over 240 languages. There is also a chat function at 988lifeline.org/chat and text.

• 988 Live line
• 12 Things Parents Can Do
• How to Know When Your Child Needs Help
• Reduce Teen Suicide Risk
• Blueprint for Youth Suicide Prevention

1. People who attempt suicide typically struggle with ongoing mental health or substance abuse issues.
2. While some attempts are planned, many are not. Acute suicidal crises are often brief, and escalation from thought to action can occur rapidly.
3. The lethality of the method used in an attempt can determine whether that person lives or dies. If a highly lethal means is not available, the individual's chance of survival is greater. 
4. Over 90% of people who attempt suicide and survive do not take their life later on, so reducing access to lethal means can save lives. 
5. An effective way to protect someone at risk of suicide is to reduce their access to highly lethal means before they experience an acute suicidal crisis.