Children's self-harm or suicidal thoughts: warning signs and what to do

The short answer

If your child may be in immediate danger, call 911. In Canada, call or text 9-8-8, or call Kids Help Phone at 1-800-668-6868 (text CONNECT to 686868). In the US, call or text 988. If you are worried but there is no immediate danger, ask your child directly whether they are thinking about suicide: asking does not put the idea in their head. Listen calmly, do not promise to keep it secret, and arrange an assessment with a mental health professional right away. Support and treatment work for most people who have thoughts about suicide.

If your child is in immediate danger, call 911 now.

Canada: call or text 9-8-8 (Suicide Crisis Helpline, 24/7, English and French). Young people can also reach Kids Help Phone at 1-800-668-6868 or by texting CONNECT to 686868, 24/7.

United States: call, text or chat 988 (Suicide and Crisis Lifeline, 24/7, free and confidential). You can also text HOME to 741741 (Crisis Text Line).

If you are reading this because something your child said or did has frightened you, you are doing the right thing by acting on it. You do not need to be certain, and you do not need to have the perfect words. This guide explains the warning signs, how to ask your child directly, what to do next, and where to get help. The most important thing to know is that help works. Depression and suicidal feelings are treatable, and support and treatment work for most people who have these thoughts.

Three things to know first

Asking does not put the idea in their head. The American Academy of Child and Adolescent Psychiatry (AACAP) says that asking directly, "Rather than putting thoughts in your child's head," can "provide assurance that somebody cares." Canada's 9-8-8 service says it is "OK to talk" about suicide.
There is no single cause. The American Academy of Pediatrics (AAP) says "Suicide often does not have one direct cause." No single event, including a change in the family, explains why a young person has these thoughts. Many things can add to a young person's distress, and many things protect them.
Treatment and support work. AACAP says: "Depression and suicidal feelings are treatable mental disorders." Safe messaging guidance developed with US public health bodies stresses that coping skills, support and treatment work for most people who have thoughts about suicide.

Warning signs

The AAP notes that "Most youth who die by suicide show some warning signs and behavior changes," and also that "not all youth who are at risk of suicide will show these warning signs, and not all youth who exhibit these behaviors are at risk." If you notice these signs, ask, and get help. You do not have to work out how serious it is on your own.

What they say

talking about wanting to die, killing themselves or not wanting to be here
saying they feel hopeless, trapped or in unbearable pain
saying they are a burden, or that others would be better off without them
saying they have no reason to live
a preoccupation with death and dying

How they feel

deep or frequent sadness, or irritability, day after day
anxiety, agitation, rage or extreme mood swings
strong guilt, shame or humiliation
losing interest in things they used to enjoy
sudden relief or a sudden improvement in mood, which the American Foundation for Suicide Prevention lists among warning signs

What they do

withdrawing from friends, family and activities
sleeping much more or much less, or big changes in eating
using more alcohol or drugs
taking dangerous risks
giving away important belongings, or saying goodbye as if for the last time
looking for ways to end their life
a decline in schoolwork, or no longer making plans for the future
frequent physical complaints, such as headaches or stomach aches, which AACAP notes are often related to emotions

The US National Institute of Mental Health advises getting help as soon as possible, "particularly if the behavior is new or has increased recently." The American Foundation for Suicide Prevention adds that concern is greatest when new or changed behaviour follows "a painful event, loss, or change." A family change is one of those times to stay especially close and watchful. It does not mean a family change causes suicide.

Self-harm

Some young people hurt themselves on purpose without wanting to die. AACAP describes self-injury as "a complex behavior and symptom that results from a variety of factors," and notes that adolescents "who have difficulty talking about their feelings may show their emotional tension" in this way. Self-harm is a sign of real distress and always deserves professional attention. AACAP says: "Evaluation by a mental health professional may assist in identifying and treating the underlying causes." Self-harm and suicidal thoughts can go together, so if you discover your child has hurt themselves, also ask directly about suicide.

If you find out, try to respond with calm care rather than shock or anger. Your reaction will shape whether your child keeps talking to you.

What to do: step by step

1. Find a calm moment and ask directly

Choose a private moment and a calm voice. Say what you have noticed, then ask the question plainly. Using the word "suicide" is clearer than hinting.

"I've noticed you've seemed really down lately, and you said you wish you weren't here. I love you and I need to ask: are you thinking about suicide?"

"You're not thinking of doing anything stupid, are you?"

2. Listen more than you talk

Stay calm, even if what you hear frightens you. Thank them for telling you. Do not argue, lecture or try to talk them out of their feelings.

"Thank you for telling me. That must feel so heavy. I'm really glad you told me, and we're going to get help together."

"How can you say that? You have so much to live for." / "After everything we've been through, you'd do this to me?"

3. Do not promise to keep it secret

"I can't keep this just between us, because your safety matters too much. I'll only tell the people who can help, and I'll tell you who."

"Okay, I won't tell anyone. Just promise me you won't do anything."

4. If there is immediate danger, do not leave them alone

If your child has a plan, has hurt themselves seriously, or you believe they may act soon, stay with them and call 911 or go to the nearest emergency department. The 9-8-8 service in Canada says: "If your safety is at risk, call 9-1-1 right away."

5. Call a crisis line, together if you can

A crisis line can talk you through what to do next. In Canada, call or text 9-8-8, and young people can also call or text Kids Help Phone. In the US, call or text 988. The 988 Lifeline says it "is for everyone."

6. Make your home safer

Limiting access to lethal means is one of the protective factors the AAP lists, and AACAP lists access to firearms as a risk factor. Ask your doctor or a crisis line how to make each home safer, and do it in both homes.

7. Get a professional assessment quickly

AACAP is clear: "Any child or adolescent with suicidal thoughts or plans should be evaluated immediately by a trained and qualified mental health professional." Call your family doctor or pediatrician today, go to an emergency department, or contact your local children's mental health crisis service (see the local services listed below). For self-harm without suicidal thoughts, book an assessment promptly.

8. Keep both homes working from the same plan

If your child lives in two homes, the other parent needs to know, as soon as it is safe and practical, so that the same safety steps, supervision and follow-up happen in both places. This is a moment to set aside disagreements and share information quickly and factually. Neither parent should be blamed in front of the child.

If there is family violence: contacting the other parent or sharing a safety plan with them may not be safe. Tell the professionals involved, so they can plan around it. Read safety planning during separation. Press Shift+Esc to leave this site quickly.

9. Stay close in the weeks after

Keep checking in, keep appointments, and keep talking. Recovery takes time and may have ups and downs. Tell your child's school counsellor what is happening, with your child's knowledge where possible, so there is a caring adult watching during the day too.

What helps protect young people

The AAP lists protective factors including coping and problem-solving skills, connection to family, friends and community, "Supportive relationships with caregivers" and limited access to lethal means. In daily life, that looks like:

regular, warm, one-on-one time with each parent
keeping your child out of conflict between the adults (see keeping children out of the middle)
helping them stay connected to friends, school, sports, faith or community
making it easy to talk about feelings, including hard ones
getting treatment early for depression, anxiety or substance use

Treatment works

AACAP notes that "there are several effective treatments for depression" in children and teens, including cognitive behavioural therapy and interpersonal therapy. The US National Institute of Mental Health states: "Effective, evidence-based programs and treatment options can help prevent suicide." A professional will work with you and your child on what fits.

If your child's friend is the one at risk

Young people often hear these things from friends first. If your child tells you a friend is talking about suicide or self-harm, thank them, take it seriously, and help them tell a trusted adult: the friend's parent, a school counsellor, or a crisis line. Make sure your child knows they do not have to carry this alone, and that telling an adult is being a good friend.

Look after yourself, too

Hearing that your child is in this much pain is one of the hardest things a parent can face. You may feel fear, guilt, anger or numbness. These are normal reactions. If you are blaming yourself, remember what the guidance says: suicide rarely has one cause, and the steps you are taking now, staying close and getting help, are among the things that protect young people. You do not have to hold it alone: crisis lines will talk with you as a parent, and a therapist can support you through the weeks ahead. See finding a therapist for separation.

What the research and guidance say

Suicide rarely has one cause. Many factors combine, and many protect (AAP; American Foundation for Suicide Prevention; 9-8-8).
Most young people who die by suicide show some warning signs, though not all do, and not every young person with these signs is at risk (AAP).
Asking directly about suicide does not plant the idea and shows a child that someone cares (AACAP). Talking openly does not cause harm (9-8-8).
Depression and suicidal feelings are treatable, and any child with suicidal thoughts or plans should be evaluated immediately (AACAP).
Coping skills, support and treatment work for most people who have thoughts about suicide (safe messaging recommendations from SAVE and partners).

Crisis lines

Immediate danger, Canada and US: call 911.
Canada, 9-8-8 Suicide Crisis Helpline: call or text 9-8-8, 24/7, in English and French. 988.ca
Canada, Kids Help Phone: call 1-800-668-6868 or text CONNECT to 686868, 24/7, for young people in Canada. kidshelpphone.ca
US, 988 Suicide and Crisis Lifeline: call, text or chat 988, 24/7, free and confidential, in English and Spanish. At time of writing, the Lifeline says its specialized service for LGBTQ+ young people, the "Press 3 option," has been restored. 988lifeline.org
US, Crisis Text Line: text HOME to 741741, 24/7. crisistextline.org

Sources

American Academy of Pediatrics. Risk Factors, Protective Factors, Warning Signs of Youth Suicide (Blueprint for Youth Suicide Prevention). Undated. aap.org
American Academy of Child and Adolescent Psychiatry. Suicide in Children and Teens, Facts for Families No. 10. 2024. aacap.org
American Academy of Child and Adolescent Psychiatry. Self-Injury in Adolescents, Facts for Families No. 73. 2019. aacap.org
American Academy of Child and Adolescent Psychiatry. Depression in Children and Teens, Facts for Families No. 4. 2018. aacap.org
American Foundation for Suicide Prevention. Risk factors, protective factors and warning signs. Undated. https://afsp.org/risk-factors-protective-factors-and-warning-signs/
National Institute of Mental Health. Warning Signs of Suicide. 2025. https://www.nimh.nih.gov/health/publications/warning-signs-of-suicide
National Institute of Mental Health. Suicide Prevention. Undated. https://www.nimh.nih.gov/health/topics/suicide-prevention
9-8-8 Suicide Crisis Helpline. Media guidelines and Suicide-safe language. Undated. https://988.ca/understanding-suicide/media-guidelines
SAVE and partners. Recommendations for Reporting on Suicide. 2024. https://reportingonsuicide.org/
National Action Alliance for Suicide Prevention. Framework for Successful Messaging. Undated. https://suicidepreventionmessaging.org/
9-8-8 Suicide Crisis Helpline (Canada). Home page. Undated. https://988.ca/
Kids Help Phone. Home page and text service. Undated. https://kidshelpphone.ca/
988 Suicide and Crisis Lifeline. Home page. Undated. https://988lifeline.org/
Crisis Text Line. Home page. Undated. https://www.crisistextline.org/

This guide is general information, not medical, psychological or legal advice. If you are worried about your child's safety or mental health, contact a professional or one of the services listed above.

If someone is in immediate danger, call 911. In Canada, call or text 9-8-8 (Suicide Crisis Helpline), or reach Kids Help Phone at 1-800-668-6868 or text CONNECT to 686868. In the US, call, text or chat 988 (Suicide and Crisis Lifeline).

Common questions

Will asking my child about suicide make them more likely to think about it?

No. The American Academy of Child and Adolescent Psychiatry says asking directly does not put thoughts in a child's head and instead shows them that somebody cares. Use the word suicide, calmly and plainly.

My teenager made me promise not to tell anyone. What should I do?

Your child's safety comes first. Explain kindly that you cannot keep it secret because you love them, and that you will only tell the people who can help. Then contact a crisis line or a mental health professional.

My child hurts themselves but says they don't want to die. Is it still serious?

Yes. Self-harm is a sign of real distress and deserves a prompt professional assessment, even when a young person is not suicidal. Ask directly about suicide as well, since the two can go together.

Can I call a crisis line as a parent, or is it only for the person at risk?

Yes. In Canada, call or text 9-8-8, which describes itself as a safe space to talk, 24 hours a day. In the US, call or text 988, which says it is for everyone. They can talk you through what to do next.

Get help today

If you are worried about your child right now, call 911 in an emergency, call or text 9-8-8 in Canada, or call or text 988 in the US. For ongoing support, the FairWell directory lists verified child and family therapists by region.

Find a therapist near you

This guide is general information for parents, not medical, psychological or legal advice. It draws on published research and guidance from recognised health and family justice bodies, listed under Sources. Every child and family is different. If you are worried about your child or yourself, talk to your family doctor or a qualified professional. FairWell can help you find one through the professional directory.