Understanding and responding to childhood suicidal ideation

Skill one: Sitting with distress and despair

Sitting with distress and despair often means that practitioners need to manage their own reactions, fears and urgency when children say that they want to die or express similar feelings. Practitioners can feel compelled to provide children with quick solutions or information to change their minds. When practitioners can navigate their own emotions and fear, they are better placed to demonstrate curiosity and acceptance of children’s stories, allowing them to feel heard and have their emotions justified.

Skill two: Listening and seeking to understand children's experiences

By holding space for children’s descriptions of their experiences, practitioners create a supportive environment that helps children feel understood and less alone. This skill includes listening to the child, exploring the problems they are experiencing and understanding these problems within the context of their life. It involves recognising how these problems contribute to the child’s distress and to the ideas that inform their despair and their feeling that ‘there is no way out’. It is also important to consider the values of the child and the strategies they have used to keep themselves safe. Practitioners can draw on parents’ understandings of their children’s experiences while facilitating their support.

Skill three: Facilitating children’s assessment of the problem

Practitioners can help children to name, describe and evaluate the problems in their lives using their own language and meaning. Through these conversations, children can begin to see themselves as separate from their problems. They might also be able to recognise the limitations of the problem or times when it is less visible or powerful.

Skill four: Connecting values and actions

By exploring their responses to the problems in their lives, children are better able to identify their own skills, knowledge and abilities. These protective aspects of identity may be hidden and forgotten when children experience distress or despair. When children describe their responses and actions to various situations in their lives, these serve as protective factors and exceptions to feeling uninfluential or powerless when distressed. These actions strengthen their capacity to respond and can be connected to their values and hopes for themselves or family members. This could potentially lead to the development of further strategies and responses. Please watch the video below to view some of the things children and young people say about what they want from practitioners when they are experiencing distress and despair.

Please watch the following video (1 minute, 36 seconds) to view some of the things children and young people say about what they want from practitioners when they are experiencing distress and despair.

This course is designed for practitioners directly working with children and families. It acknowledges that children may endure prolonged distress in isolation, which can lead to despair and suicidal ideation. The course aims to provide practitioners with necessary understandings and insights to support the mental health and wellbeing of children and families.

As you progress through this course, you will explore strategies and practices to help:

• increase awareness of the nature and prevalence of children’s suicidal ideation, distress and despair
• identify and discuss the contextual factors that contribute to children’s suicidal ideation, distress and despair
• allow children to describe their feelings of distress and despair in their own way, using their own language and in their own time
• navigate parents’ fears about children’s distress, despair or suicidal ideation so that they can support children through patient and curious conversations
• consider how ‘double listening’ can help practitioners to:
  • hear children’s descriptions of the effects of distress and despair, as well as identify their skills and knowhow in their attempts to manage the effects 
  • name the problems in children’s lives and understand children’s positions on these problems, as well as their effects on children’s mental health
• bring stories of children’s preferences, actions and values into the light in ways that could help them to develop increased agency and hope.

It is estimated that this course will take you approximately 2 hours to complete, including reading material and watching videos.

You can undertake the course across multiple sessions at your own pace. The last screen you visit before logging off will be bookmarked and you will have the option of returning to that screen when you next log in.

As you work through the course, it's important to be aware of your own emotional responses. Please follow these self-care tips and seek help if needed:

• We do not recommend undertaking the entire course in one sitting. Give yourself some breaks. Even if you don't feel that you need a break, it's a good idea to take one anyway and come back later.
• Be aware of your emotions as you progress through the course and take action if you are starting to feel stressed or upset. For example, consider taking a break and doing something for yourself that you enjoy.
• Be aware of your emotional responses after you complete the course.

If at any point you find you are struggling, please talk with your supervisor, seek help, or call Lifeline on 13 11 14, Beyond Blue on 1300 224 636, or SANE Australia on 1800 187 263.

For the purposes of this course, the term parent encompasses the biological and adoptive parents of a child, as well as individuals who have chosen to take up a primary or shared responsibility in raising that child.

Social and emotional wellbeing refers to the way a person thinks and feels about themselves and others. It incorporates behavioural and emotional strengths and is a facet of child development.¹

In broad terms, social and emotional wellbeing is the foundation for physical and mental health for Aboriginal and Torres Strait Islander peoples. It is a holistic concept that results from a network of relationships between individuals, family, kin and community. It also recognises the importance of connection to Land, culture, spirituality and ancestry, and how these affect the individual.²

Social and emotional wellbeing is also used by some people from culturally and linguistically diverse (CALD) backgrounds, who may have differing concepts of mental health and mental illness.³

Social and emotional development involves the development of skills required to:

• identify and understand one’s feelings
• read and understand the emotional states of other people
• manage strong emotions and how they are expressed
• regulate behaviour
• develop empathy
• establish and maintain relationships.⁴

Suicide is the act of intentionally causing one’s own death. A suicide attempt is an act carried out by a person with the intention of ending their life. A suicide attempt can have a significant impact on individuals or groups, causing distress, anxiety, and vulnerability in others.⁵

Self-harm is when someone deliberately injures themselves. This is also referred to as self-injury or deliberate self-harm. It is generally considered non-suicidal in intent, but in young people it may be hard to clearly define. Some of the more common self-harming behaviours include cutting, burning and scratching. Excessive alcohol and drug misuse is not usually considered self-harm but rather a discrete disorder.⁶

Suicidal ideation refers to the presence of any thoughts, plans, images, imaginings or preoccupations a person may have about ending their own life. Suicidal ideation can range from a vague thought about ‘not wanting to be around’ to very specific thoughts and plans about ending their life. Individuals showing signs of suicidal ideation need to be monitored, supported and referred for a suicide risk assessment as soon as possible.⁶

Throughout this course, we use the term the problem to describe the main contributing factor or factors that are leading to a child's feelings of distress and despair. The problem may be described, named and understood differently by the child and the people in their life. It is important to work collaboratively with the parents and the child to define and understand the problem.

After exploring each of the four practice skills, you will be invited to share your learning with other users by sharing your reflections in a survey. Responses are collated and may be added to the course for future learners to consider. These responses will remain anonymous.

Alternatively, you can simply record your reflections in the ‘notes’ section on the relative screens and print them at the end of each module.

This course draws on the latest research, clinical insights, and the lived experience of Emerging Minds’ child and family partners. We’d like to thank the professionals and families who played an integral role in shaping this course, generously offering their time, wisdom and unique perspectives.

Watch the following video for a quick guide on how to navigate Emerging Minds Learning courses.