By Nicole Kawa, Clinical Director, Shelter Youth and Family Services

Every September, during Suicide Prevention Month, we talk about warning signs. We tell people to watch for depression, withdrawal and hopelessness. We encourage young people who are struggling to reach out.

But suicide prevention needs to start earlier.

In my work with young people, I have learned that there is a big difference between telling someone they are safe and having them actually feel safe. For a young person who has experienced trauma or instability, trust is built through consistency when the same adults show up. Tomorrow is predictable. Someone notices when something changes.

We don’t always think of those things as suicide prevention. We should.

Prevention starts before the crisis

In the CDC’s 2023 national Youth Risk Behavior Survey, 20.4% of high school students reported seriously considering suicide in the previous year, and 9.5% reported attempting suicide.

The numbers are even more concerning for some of the populations we serve. A 2024 analysis of 69 studies found that 38% of runaway and homeless youth reported suicidal ideation during their lifetimes and 27% reported a suicide attempt.

Research also points toward what can help. The CDC identifies connection to others, support from family and friends, coping skills and access to consistent behavioral health care as protective factors against suicide.

I see the importance of those things every day.

Many young people who come to Shelter Youth and Family Services have experienced abuse, neglect, homelessness, family disruption, foster care, exploitation or other forms of trauma. We cannot undo those experiences. What we can do is give young people stability, help them develop ways to cope, and make sure there are adults paying attention.

Look for change

There is no single picture of a suicidal teenager. Often, one of the most important things to notice is simply that a young person isn’t acting like themselves.

Grades may start slipping. They may stop seeing friends or participating in something they used to love. They may come home every day and go straight to their room.

None of those things necessarily means a young person is suicidal. Teenagers have bad days and their interests change. But when a change becomes a pattern (or betrays a pattern), pay attention.

Parents and caregivers don’t need to diagnose what is happening. They need to notice it and be willing to ask about it.

Ask the uncomfortable question

One persistent myth is that asking someone about suicide might put the idea in their head. Research shows it does not.

If I am concerned, I believe in being direct: I’ve noticed you haven’t been yourself lately. What’s going on? Are you thinking about suicide?

The young person may not answer. They may tell you they’re fine or that they don’t want to talk.

But you’ve communicated something important.

You noticed.

Keep showing up. They may come back when they’re ready.

Surrounded isn’t the same as connected

We also need to let go of the idea that we know what a young person at risk looks like.

It can be the teenager who has withdrawn from everyone. It can also be the captain of the football team, the popular kid or the student with great grades and plans for college.

When I work with young people, one of the questions I ask is simple,

“If you were in a crisis, who would you call?”

That answer can tell us more than how many friends someone has.

A young person can be surrounded by people and still have no one they believe they can tell, I’m not okay.

Start before the crisis

Suicide is still something many people are afraid to talk about. Too often, we talk about it intensely after a tragedy and then the conversation fades.

Prevention asks us to have the conversation sooner.

It means noticing a change. Ask the uncomfortable question. Help a young person develop coping skills. Make sure they have someone they can call.

I believe suicide can often be prevented. I don’t believe anyone can promise that every suicide can be prevented. But I do believe early intervention matters.

Sometimes suicide prevention is crisis intervention.

Often, it begins long before that.

It begins when a young person realizes someone is paying attention.

To help Shelter and their work with at risk youth, consider being a partner in care.

Research sources

CDC, Youth Risk Behavior Survey (2023); CDC suicide protective-factor guidance; 2024 meta-analysis of non-suicidal self-injury and suicide behaviors among runaway and homeless youth.