Suicide and Children

Children's needs are sometimes overlooked following the suicide of a family member or friend. Adults may try to protect children by avoiding the subject.
  • Very young children pick up the emotions of those around them and may "know" that someone is missing. 
  • Until about age seven, children think death is reversible. They may also believe it was caused by their bad behaviour.
  • By thirteen, children have a better understanding of the finality of death.
  • Use specific, concrete words - not euphemisms, and avoid clichés.
  • Loss of a parent can cause psychological problems in adulthood.
Any death is painful and a life-changing experience no matter what the age of the person left behind.

The shock of a sudden death, especially through suicide, can make it more difficult to understand and accept, resulting in different emotions. Because suicide still carries shame and embarrassment, it complicates grief and mourning.

Sometimes adults seek to 'protect' their children by glossing over details, using 'softer' terminology and in the belief that children are too young to understand what is happening. This approach has been roundly condemned by some Suicide Prevention groups who say that experts strongly recommend that parents or other caregivers DO NOT LIE.

The Centre for Suicide Prevention website www.suicideinfo.ca gives the reason for not lying to children as follows:
  • Children are expected to tell the truth; they should be able to count on the adults in their life being truthful with them. Children are quite capable of seeing what is happening around them - they will know something is wrong when older siblings and adults are grieving or a family member is no longer present.
  • When you begin with a lie, trying to decide whether or not to keep up the lie (and how to keep the lie going) becomes a preoccupation which can interfere with normal grief.
  • The child may find out the truth about the suicide in less than favourable circumstances, e.g. being taunted by schoolmates.
  • Lies create an atmosphere of distrust. This is especially true if the child was aware of prior suicidal behaviours. If a child realises the have been lied to about the suicide, they may begin to wonder if lies are being told about other things.
  • Not telling children the truth may lead them to believe, through magical thinking, that they are somehow responsible for the suicide. Without the facts, children may attempt to fill in the details alone - they can imagine things far worse than the truth.
Expressions of grief
Children's expressions of grief are affected by their age, and emotional development, which can help somewhat in knowing what behaviour to expect. The grief might also manifest itself as physical pain (stomachaches, headaches, etc.) because children have underdeveloped coping skills and might not know how to express their feelings.

Very young children (birth to 2 years) express grief mainly as crying and irritability, and through disordered behaviours of poor sleep, variability in appetite, hyperactivity, 'searching,' withdrawal and increased vigilance. Their behaviour can be modified by patient, loving care. 

Preschoolers (3 to 5 years old) have a capacity to remember the deceased person. They do not, as yet, understand the processes of dying and do not recognise that death is a permanent loss. Children may believe they have somehow caused the death and that they can make the person return. They may experience intense anxiety and insecurity about separations. They may act and talk as if the person is still alive. They are keenly tuned in to the emotions of their caregivers. Similar to infants, grief may be expressed in emotions (crying easily, clinging), bodily functions ( bed wetting and thumb sucking) and behaviour (tantrums). They need much loving attention and nurturing by the  adults in their life. 

At 6 to 8 years old, grief is often associated with guilt about causing the death. Children express intense emotions and are preoccupied with thinking about the person who has died and details. They understand that death is a process that happens to everyone. They may display symptoms of anger, denial, irritability, mood-swings, and have problems at school. Support from parents, family and peers is important in helping cope. 

Older school-age children, 9 to 11 years old, often wish to speak about the loss because it offers them a sense of control and mastery. They defend against their painful grief by participating in school and social activities. At this age, children suffer from loss of self-esteem related to perceptions of being different because they lost an important loved one. They may develop previously mentioned behaviours, also withdrawal and academic problems. Support from parents and other adults is important for healthy progress in mourning. 

Young adolescents, 12 to 14 years old, seek support from both peers and parents. They manifest episodic, ambivalent emotions about the loss that reflect their developmental impulses for greater independence. They may feel resentful and angry, and they may exhibit intense emotional variability and withdrawal from parents. Young adolescents avoid expressions of grief and discussions about the death. Their adjustment is facilitated by consistent peer relationships and participation of supportive adults. 

The grief of older adolescents, 15 to 17 years old, approximates that of adults. Older adolescents experience sustained feelings of sadness, anxiety and anger. As they struggle towards independence, they may feel resentful and unsure of themselves, yet pressured to fulfill an adult role. They may develop risk-taking and acting-out behaviors They frequently deny their grief, however. They confide about the loss to peers, rather than to parents, and adapt by participating in school and social activities.

Parental loss linked to adult depression
The bond between a mother and child is generally considered the closest of a young person's life. Yet, it is the death of a father during childhood that leaves a lasting mark on a person's emotional health - so much so that such a traumatic event leaves an individual twice as likely to develop depression during adulthood, even decades after the father's death.

That was the conclusion of a landmark study designed and analyzed by John Jacobs, professor of psychology at Southern Connecticut State University. Nearly 3,500 people living in the mid-Atlantic region were surveyed between 1981 and 1996, making it one of the largest prospective studies ever conducted measuring depression and mental illness. The study was sponsored by John Hopkins University.

The study examined 201 people who lost their fathers during childhood and 111 individuals who lost their mothers during that time. They were compared with those who had not suffered the death of a parent as a kid. Those who lost their father were twice as likely to develop depression during adulthood, while those who lost their mother showed virtually no increased vulnerability to depression than those who had not lost their mother.

Jacobs theorizes that the result stems from three primary reasons.

First, the economic consequences in the loss of a father are generally much more severe than the loss of a mother. This would be especially true of people who grew up at a time when most mothers stayed at home and fathers were the sole "breadwinners." "Not only do the children experience the loss of a parent, which is traumatic in itself, but they also often contend with a change in lifestyle and even relocation to another school district," Jacobs said.

Second, the caregiver role of the mother tends to diminish over time when her husband dies. The wife must contend with her own grieving process, Jacobs said, and her distressed state can have an impact on the children. She also may be spending less time with the kids during a very difficult time.

Third, there is a better chance that a dad with kids will remarry than a mom with kids. Children tend to report their relationship with step-mothers as more positive than those with step-fathers.

The death of either parent during childhood does leave a person more emotionally vulnerable to events beyond their control, Jacobs said. For example, they would have much more difficulty throughout their lives dealing with deaths of other family members and friends, he said.

"The death of a parent in childhood often results in an overwhelming sense of grief, and in about a third of all children, makes them more vulnerable to depressive episodes that often recur throughout childhood," Jacobs said.

"Researchers and clinicians have speculated about the numerous and complimentary ways that childhood grief might increase vulnerability to adult depression," he said. "Among the most commonly noted concerns is that the grief and depression experienced in childhood creates a precedent for the child as responding to losses by withdrawing and becoming depressed."
Source: www.wetheliving.com

A National Tragedy: Helping Children Cope
The following information is from theU.S. National Association of School Psychologists website and is used with permission

Tips for Parents and Teachers
Whenever a national tragedy occurs, such as terrorist attacks or natural disasters, children, like many people, may be confused or frightened. Most likely they will look to adults for information and guidance on how to react.  Parents and school personnel can help children cope first and foremost by establishing a sense of safety and security. As more information becomes available, adults can continue to help children work through their emotions and perhaps even use the process as a learning experience.

All Adults Should:

1.Model calm and control.  Children take their emotional cues from the significant adults in their lives. Avoid appearing anxious or frightened.

2.Reassure children that they are safe and (if true) so are the other important adults in their lives. Depending on the situation, point out factors that help insure their immediate safety and that of their community.

3.Remind them that trustworthy people are in charge.  Explain that the government emergency workers, police, firefighters, doctors, and the military are helping people who are hurt and are working to ensure that no further tragedies occur.

4.Let children know that it is okay to feel upset.  Explain that all feelings are okay when a tragedy like this occurs.  Let children talk about their feelings and help put them into perspective.  Even anger is okay, but children may need help and patience from adults to assist them in expressing these feelings appropriately.

5.Observe children’s emotional state.  Depending on their age, children may not express their concerns verbally. Changes in behavior, appetite, and sleep patterns can also indicate a child’s level of grief, anxiety or discomfort.  Children will express their emotions differently. There is no right or wrong way to feel or express grief. 

6.Look for children at greater risk.  Children who have had a past traumatic experience or personal loss, suffer from depression or other mental illness, or with special needs may be at greater risk for severe reactions than others.  Be particularly observant for those who may be at risk of suicide.  Seek the help of mental health professional if you are at all concerned.

7.Tell children the truth. Don’t try to pretend the event has not occurred or that it is not serious.  Children are smart.  They will be more worried if they think you are too afraid to tell them what is happening.

8.Stick to the facts.  Don’t embellish or speculate about what has happened and what might happen. Don’t dwell on the scale or scope of the tragedy, particularly with young children.

9.Keep your explanations developmentally appropriate. Early elementary school children need brief, simple information that should be balanced with reassurances that the daily structures of their lives will not change. Upper elementary and early middle school children will be more vocal in asking questions about whether they truly are safe and what is being done at their school.  They may need assistance separating reality from fantasy. Upper middle school and high school students will have strong and varying opinions about the causes of violence and threats to safety in schools and society.  They will share concrete suggestions about how to make school safer and how to prevent tragedies in society. They will be more committed to doing something to help the victims and affected community.  For all children, encourage them to verbalize their thoughts and feelings. Be a good listener!

10. Monitor your own stress level.  Don’t ignore your own feelings of anxiety, grief, and anger. Talking to friends, family members, religious leaders, and mental health counselors can help. It is okay to let your children know that you are sad, but that you believe things will get better. You will be better able to support your children if you can express your own emotions in a productive manner. Get appropriate sleep, nutrition, and exercise.

What Parents Can Do
1.Focus on your children over the week following the tragedy.  Tell them you love them and everything will be okay. Try to help them understand what has happened, keeping in mind their developmental level.

2.Make time to talk with your children.  Remember if you do not talk to your children about this incident someone else will. Take some time and determine what you wish to say.

3.Stay close to your children. Your physical presence will reassure them and give you the opportunity to monitor their reaction. Many children will want actual physical contact.  Give plenty of hugs.  Let them sit close to you, and make sure to take extra time at bedtime to cuddle and to reassure them that they are loved and safe. 

4.Limit your child’s television viewing of these events.  If they must watch, watch with them for a brief time; then turn the set off.  Don’t sit mesmerized re-watching the same events over and over again.

5.Maintain a “normal” routine. To the extent possible stick to your family’s normal routine for dinner, homework, chores, bedtime, etc., but don’t be inflexible.  Children may have a hard time concentrating on schoolwork or falling asleep at night.

6.Spend extra time reading or playing quiet games with your children before bed.  These activities are calming, foster a sense of closeness and security, and reinforce a sense of normalcy. Spend more time tucking them in.  Let them sleep with a light on if they ask for it.

7.Safeguard your children’s physical health.  Stress can take a physical toll on children as well as adults.  Make sure your children get appropriate sleep, exercise, and nutrition.

8.Consider praying or thinking hopeful thoughts for the victims and their families.  It may be a good time to take your children to your place of worship, write a poem, or draw a picture to help your child express their feelings and feel that they are somehow supporting the victims and their families.

9.Find out what resources your school has in place to help children cope.  Most schools are likely to be open and often are a good place for children to regain a sense of normalcy.  Being with their friends and teachers can help.  Schools should also have a plan for making counseling available to children and adults who need it. 

What Schools Can Do
1.Assure children that they are safe and that schools are well prepared to take care of all children at all times.

2.Maintain structure and stability within the schools. It would be best, however, not to have tests or major projects within the next few days.

3.Have a plan for the first few days back at school.  Include school psychologists, counselors, and crisis team members in planning the school’s response.

4.Provide teachers and parents with information about what to say and do for children in school and at home.

5.Have teachers provide information directly to their students, not during the public address announcements.

6.Have school psychologists and counselors available to talk to students and staff who may need or want extra support.

7.Be aware of students who may have recently experienced a personal tragedy or a have personal connection to victims or their families.  Even a child who has merely visited the affected area or community may have a strong reaction. Provide these students extra support and leniency if necessary. 

8.Know what community resources are available for children who may need extra counseling. School psychologists can be very helpful in directing families to the right community resources.

9.Allow time for age appropriate classroom discussion and activities. Do not expect teachers to provide all of the answers.  They should ask questions and guide the discussion, but not dominate it.  Other activities can include art and writing projects, play acting, and physical games.

10.Be careful not to stereotype people or countries that might be associated with the tragedy. Children can easily generalize negative statements and develop prejudice. Talk about tolerance and justice versus vengeance. Stop any bullying or teasing of students immediately.

11. Refer children who exhibit extreme anxiety, fear or anger to mental health counselors in the school. Inform their parents.

12.Provide an outlet for students’ desire to help.  Consider making get well cards or sending letters to the families and survivors of the tragedy, or writing thank you letters to doctors, nurses, and other health care professionals as well as emergency rescue workers, firefighters and police.

13. Monitor or restrict viewing scenes of the event as well as the aftermath.

For information on helping children and youth with this crisis, contact NASP at (301) 657-0270 (in the USA) or visit NASP’s website at www.nasponline.org

Modified from material posted on the NASP website in September 2001.

© 2002, National Association of School Psychologists, 4340 East West Highway, Suite 402, Bethesda, MD 20814, (301) 657-0270, Fax (301) 657-0275; www.nasponline.org

This handout from the National Association of School Psychologists (NASP)may be used by other organizations without receiving specific permission as long as it is reprinted or posted to websites verbatim, credits NASP, and includes links to the NASP website.