I see a lot of teenagers in my practice. I actually really enjoy working with teenagers. I often have parents in the room for most of the visit because it helps me see the family dynamic for one, and two I want parents to know how their kids are actually doing.
I want them to hear how their child is still struggling or not because they need to know. I am often surprised at the number of parents who I have to practically glue to the chair to get them to stay in my office. They seem skittish when we talk about depression and suicidal ideation. They will often ask to leave or if we can talk separately or not talk at all about suicide.
If there was an attempt in the past I can’t tell you the number of times I’ve been told that we need to discuss it without the kid in the room. I always respond with, “Well if they want to leave that’s fine, but they were there, so I’m pretty sure they are actually the best person to ask about it.” I’ve never had a kid leave. I’ve never had a kid not tell me what happened.
What’s fascinating about this interaction is that if I ignore the parent the child does too, and we continue to talk about their current and past mental health status. If a kid asks to talk to me alone or declines to answer something I always respect that. But over and over I see kids decline to have their parent leave and then talk openly about their depression and suicidal ideation.
Kids want their parents to know. I want their parents to know. Why do parents not want to know? It’s so rare for us to be let into the world of our teenagers- because they have their own world- so why would you run from that opportunity to be let in?
Don’t run. Sit your butt in that chair.
Recently it was one such moment. I was checking in with a kid I knew had been affected by the death of a classmate. The parents were sitting there after I ignored their questions about leaving. The teen and I kept eye contact and they said, “This may sound weird, but I just keep thinking, that could have been me.”
I nodded my head, and said yes I can see that you’d have a lot in common. Both are/were very successful, hard working, and both wear/wore facades so bright that no one would think they are depressed and struggling to live.
It’s important to keep eye contact in that moment. To let them know I can handle them. I can handle the darkness of that thought. I see them. Eventually we moved on in the conversation and I looked at the parents.
They both had silent tears streaming down their faces.
That’s why I make them stay. They needed to hear that. They needed to know how badly their child struggles with the day to day that they identify more with a child who committed suicide than with anyone else.
I wasn’t going to write this post. But it’s been bouncing around my head since that visit. That very clear and distinct voice, “That could have been me.” The insight and wisdom of that one little statement said so meekly and with such fear. The way it tore through me and their parents.
I hugged my sons a little tighter that night. I maybe cried a little harder than I should have at Frozen 2 because I was thinking of all the teenagers who reach a point of wanting to die.
In 2017 suicide was the second leading cause of death in kids ages 15-24. Specifically ages 14-19 there was a 47% increase in suicide from 2000 to 2017 (Harvard study published in June JAMA).
I grew up in that space where kids are dying. Because this last wasn’t the first suicide in my hometown. When I was in high school 1999-2003…yes that means I’m 34…it wasn’t exactly an accepting culture. It’s been 16 years. I sorta hoped it changed in that time. But I don’t think it has based on what I see in my private practice.
Kids are still bullied. There are still mean girls. Athletes are still allowed to get away with more than non-athletes. I’m hoping there aren’t any teachers still having sex with students, but who knows.
I don’t know what the answer is. But it’s not a coincidence that I opened a mental health practice and am known for taking teenagers just a few exits down.
I see all kinds. The weird artsy quiet ones. The high achieving three sport scholar athlete. The bullied. The bullies. They all struggle with their own demons.
We’ve lost so many children to mental illness. We will lose many more if there are not kids who are willing and brave enough to ask for help. To speak their truths.
We will lose many more if there are not adults and parents willing to listen and willing to start the conversation. Even if it hurts. Even if it feels uncomfortable and awkward. Because if you walk out of the office, you will miss that moment when they choose to let you in. And that moment can lead to more moments. Those moments can be the difference between life and death.
***** This is in no way meant to take the place of actual mental health advice/treatment from a licensed provider.
***** This is in no way meant to detract or cause pain to families who have lost their child to suicide. Even with treatment. Even with open conversations and a loving open supportive family there is still a mortality rate to mental illness.
Suicide Hotline: 1-800-273-8255