by North Shore Child & Family Guidance Center | Apr 9, 2021 | Blog
Last month, our country reached a devastating milestone: More than a half million Americans have died from COVID-19.
Losing a loved one can be devastating under any circumstances, but it’s especially difficult now, when we’ve also lost many of the traditions that bring us together in our grief, such as wakes, Shivas and funeral services. Moreover, many were unable to say good-bye because of restrictions at hospitals and nursing homes.
In the pandemic era, more children and teens are grieving perhaps than at any other era in our history. Even if they haven’t personally lost someone, odds are that they have a friend who has, and it comes at a time when they’ve lost so much—school routines, graduations and a host of other activities.
While our instincts are to protect our children from pain and sadness, death is a universal experience in all our lives. As a parent or caretaker, it’s your job to help guide them through the often-complicated process of bereavement, but how?
One of the most important things you can do is simple but powerful: Listen and validate your child’s feelings, which may run the gamut from denial and confusion to anger and sadness. All those emotions are a normal part of grieving, and they need to know it’s OK to have them and talk with you about them.
It’s also important for them to know that you are sad, too. When you express feelings of sadness, it will make your child feel more comfortable expressing their own grief.
Younger children may not fully grasp the concept of death and the fact that their loved one is not coming back. That’s one reason to use accurate terms when discussing the loss. Avoid saying grandpa “passed away.” Such vague terminology creates confusion.
It’s also helpful to bring up fond memories of your loved one. Focusing on the person’s life, not only their death, is a part of the healing process.
Also, grief often comes out behaviorally with young children, expressed in tantrums, clinginess or other forms of acting out, so it’s important for you to recognize that this might be their way of coping.
It’s also possible your child may feel some guilt and fear surrounding the death. Reassure them that they are not to blame, and that you and they are safe.
How do you know it’s time to seek professional treatment? If your child or teen isolates and seems withdrawn for an extended period of time, that may indicate that therapy would be helpful. Other signs might be sleep problems, changes in appetite or an academic decline.
Additionally, many children are reluctant to speak about their loss because they are afraid it will make their parents sad, and therapy can help provide a safe space for them to talk about and process their grief.
Of course, if your child expresses recurring thoughts of wanting to join the deceased or any other indication of suicidal feelings, it’s imperative to take that seriously and contact North Shore Child & Family Guidance Center or another mental health provider.
If your child is experiencing grief from a loss, or facing any other mental health challenge, please call North Shore Child & Family Guidance Center at 516-626-1971 or email intake@northshorechildguidance.org.
Elissa Smilowitz is the Director of Triage, Emergency and Suicide Prevention Services at North Shore Child & Family Guidance Center. She also heads up the Guidance Center’s Douglas S. Feldman Suicide Prevention Project.
by North Shore Child & Family Guidance Center | Apr 6, 2021 | Blog
The thought of suicide is terrifying, but we have to make talking about it a part of everyday life.
Dr. Morris is a developmental psychologist whose research has focused on early childhood education. Recently, she has turned her attention to preventing suicide.
I always felt so blessed watching my boy-girl twins; even as teenagers they would walk arm in arm down the street, chatting and laughing together.
But that blessed feeling evaporated in June of 2019, when I lost my daughter, Frankie, to suicide, three weeks before her high school graduation. Ever since that day, I have thought of little else except how I could help the next struggling teenager, the next Frankie.
Several days after her passing, we opened our home up to our community, including Frankie’s very large group of teenage friends. It was a muggy June day, and the air conditioning was no match for the hundreds of people who came through our New York City apartment.
There was a momentary pause in the steady stream of people offering hugs and condolences when a parent of one of Frankie’s friends put her hand on my shoulder and said gently: “What strength Frankie had. It must have taken enormous energy for her to do what she did each day.”
That was Frankie. She had the strength to engage in school and in theater, despite her anxiety and depression. She had an ability to connect — emotionally, profoundly — with others, even when she was struggling herself. Her friends spoke to us of being caught off guard by her hugs or endearing comments. A teacher once described her as “empathy personified, with quite the fabulous earring collection.”
I like to think that some of her strength came from the home we tried to give her. Whether that strength came from her home or somewhere else, or both, Frankie just had a way of drawing out warmth wherever she went.
But like many who struggle with suicidal thinking, she kept her own pain camouflaged for a long time, perhaps for too long.
Suicidal thinking, whether it is the result of mental illness, stress, trauma or loss, is actually far more common and difficult to see than many of us realize. A June 2020 Centers for Disease Control survey found that one in four 18- to 24-year-olds reported that they had seriously thought about taking their lives in the past 30 days; prepandemic estimates found that just under one in five high schoolers had seriously considered suicide, and just under one in 10 had made at least one suicide attempt during the previous year.
That’s a whole lot of kids. And some, like Frankie, are able to muster the energy to make their struggle almost invisible. Despite 50 years of research, predicting death by suicide is still nearly impossible. And with suicidal thinking common, suicide remains the second leading cause of death among 15- to 24-year-olds, after accidents.
Like others who have lost a child to suicide, I have spent countless hours going over relentless “what ifs.” And because I am a developmental psychologist who specializes in prevention programs, my “what ifs” also include the ways the world might look different so that another family won’t experience our fate.
One day while driving on a familiar stretch of highway with “what ifs” swirling in my head, I saw a sign flash “Click it or Ticket.” It struck me: Maybe what we need are seatbelts for suicide.
“Click it or Ticket” was born in part out of a concern in the 1980s about teenagers dying in car accidents. Just as with suicides today, adults couldn’t predict who would get into a car accident, and one of the best solutions we had — seatbelts — was used routinely, in some estimates, by only 15 percent of the population. Indeed, as children, my siblings and I used to make a game of rolling around in the back of our car, seatbelts ignored.
Three decades later, our world is unlike anything I could have imagined as a child. Putting on a seatbelt is the first lesson of driver’s education; cars get inspected annually for working seatbelts; car companies embed those annoying beeping sounds to remind you to buckle your seatbelt; and for added measure, highway signs flash that “Click it or Ticket” message as part of a National Highway Traffic Safety Administration campaign. The result? Most of us (estimates range as high as 91 percent) now wear a seatbelt.
What would it look like if we had an approach to suicide akin to universal seatbelt safety, starting early in adolescence?
Just as my parents couldn’t predict in the 1980s what seatbelt safety would look like now, I am not sure what suicide prevention should look like in the future. But I imagine a world in which every health worker, school professional, employer and religious leader can recognize the signs of suicidal thinking and know how to ask about it, respond to it and offer resources to someone who is struggling. Just as today we all know to dial 9-1-1 in an emergency (a system that came into being in the late 1960s), we would all know the national suicide prevention hotline (1-800-273-TALK, which will also be reachable at 9-8-8 in 2022) and text line (text HOME to 741741). We would “suicide-proof” our homes by locking up handguns, lethal medications and other things teenagers can use to harm themselves. And families would ask their children often about suicidal thinking.
When I told Frankie’s orthodontist about her suicide, his response surprised me: “We really don’t come across that in our practice.” Even though orthodontists don’t ask about it, they see children during their early teenage years, when suicidal thinking often begins to emerge. Can you imagine a world in which signs for the prevention hotline and text line are posted for kids to see as they get their braces adjusted? Or one with pamphlets in waiting rooms that instructed parents about suicide’s warning signs?
What if the annual teenage pediatric checkup involved a discussion of one-at-a-time pill packaging and boxes to lock up lethal medications, the way there is a discussion of baby-proofing homes when children start to crawl? What if pediatricians handed each adolescent a card with the prevention hotline on it (or better yet, if companies preprogrammed that number into cellphones) and the pediatrician talked through what happens when a teenager calls? What if doctors coached parents on how to ask their teenager, “Are you thinking about suicide?”
What if we required and funded every school to put in place one of the existing programs that train teachers and other school professionals to be a resource for struggling students? A number of states mandate training in suicide prevention, some as part of the Jason Flatt Act. States like New York and California (along with 13 others) encourage, but do not mandate, such programming. A few, like Rhode Island (which incidentally has the lowest teenage suicide rate in the nation), have no mandate but have still managed to pair training of teachers with resources for students, who are often the first to notice the signs of suicidal thinking in their friends.
But doesn’t asking about suicide put the idea in a kid’s head? Nope. Scientists at Columbia University have shown that it does not make them more suicidal, findings that were confirmed in a recent meta-analysis across studies of adolescents and adults. While it’s true that safe messaging about suicide matters, asking about suicide among adolescents does not increase their risk.
I recognize that despite progress identifying effective programs to combat suicidal thinking, their success rate and simplicity does not compare with what we see with seatbelts. But that doesn’t mean we shouldn’t do more.
Part of doing more also includes making the world more just and caring. To give one example, state-level same-sex-marriage policies that were in place before the Supreme Court legalizedsame-sex marriage nationally have been linked to reductions in suicide attempts among adolescents, especially among sexual minorities. Just as safer highways and car models make seatbelts more effective, asking about and responding to suicidal thinking is only one part of a solution that also includes attention to societal injustices.
I understand, of course, that asking about suicidal thinking is scary. But if it is scary for you to ask about it, it is even scarier for the teenager who is thinking about it.
I will never forget sitting with Frankie in the waiting room in the pediatric psychiatric wing on the night I brought her to the inpatient unit, three months before she took her life. We had been there for hours, seeing one group of doctors and then another. A nice nurse had given us some apple juice and granola bars. Sipping from those child-size juice boxes and munching on one of the granola bars, Frankie turned to me and said, softly, almost in a whisper, “You know, I am so glad you finally know.” I could hear the relief in her voice. I just nodded, understandingly, but it broke my heart that she held on to such a painful secret for so long.
How do we build a more supportive world for our children? I find myself inspired by Frankie’s teenage friends, who cared deeply for her and now support one another after her passing.
During high school, Frankie found warmth and healing in the theater program office, tucked behind a door in a bustling New York City public school. On good days, she would sit on the worn couch in that office, snuggle in a pile of teenagers and discuss plays, schoolwork and their lives. On hard days, she would hide in an untraveled corner of that same office and allow the anxiety and depression to run its course. And in that corner space, she would text a friend to help her get to class or, after she had opened up about her struggles, encourage others to open up as well.
The fall after Frankie left us, some students decided to remake that hidden corner, dotting the walls with colored Post-it notes. Scrawled on a pink Post-it were the words “you matter”; a yellow one read “it gets better”; an orange one shared a cellphone number to call for help. Tiny Post-it squares had transformed the corner into a space to comfort, heal and support the next struggling teenager.
I don’t know if a seatbelt approach would have saved Frankie. And I understand that all the details of such an approach aren’t fully worked out here. But I don’t want us to lose any more children because we weren’t brave enough to take on something that scares us, something we don’t fully understand, something that is much more prevalent than many of us realize.
If 17- and 18-year-olds who’ve lost a friend have the strength to imagine a world dotted with healing, then the least we can do as adults is design and build the structure to support them.
If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.
Pamela Morris (@pamela_a_morris) is a professor of applied psychology at NYU’s Steinhardt School of Culture, Education and Human Development.
If your child or teen is expressing suicidal thoughts or feelings, we can help through our Douglas S. Feldman Suicide Prevention Project. To learn more, click here.
Illustration by Sally Deng
by North Shore Child & Family Guidance Center | Apr 2, 2021 | In The Media, Newsday
As children return to classrooms and playgrounds, and maybe soon to summer camp, we must not forget that many are still feeling the effects of the social isolation they experienced when school went virtual last year. Learning is still remote for many kids, who continue to be cut off from treasured spaces that nurture positive, developing relationships, caring about others, thinking critically and avoiding negative behaviors.
Even though the physical settings might be restored, many children continue to feel an undermined sense of security. Some will be resilient and bounce back. Others will need extra support from parents and adults in their community.
Mental health workers are seeing young people in their second decade of life who are anxious and depressed. These include both kids who were struggling with their mental health before the pandemic and those who were stellar students with rich social lives who seem to have fallen off the coronavirus cliff.
The unforeseen loss of routine is especially impactful on young folks like these for whom connecting with peers is so integral to their daily life experience. Now, and since the onset of the pandemic, it’s as if the adolescent ecosystem has suddenly been deprived of oxygen and light.
For far too many young people, this is a painful time when an essential aspect of their lives has been suddenly threatened, resulting in lost connections, isolation and longing. This is a lonely time in which the grief they experience is unacknowledged and unsupported by any social ritual, a demoralizing reality that may lead to days and nights of anxiety, desperation and, for some, deep depression and dark thoughts about whether life is worth living even one more day.
Although this may be a time to draw closer to one’s family, the notion of increasing togetherness with parents at the precise time in one’s life that a young person is striving to become more independent can create an existential crisis. Parental support should include encouraging social connection outside the family, either virtually or in safe face-to-face settings. This does not suggest pushing away one’s child, but rather empathizing with the healthy need for some separation and peer connection. Groups of peers can create the sparks necessary to ignite the warm fires of intimacy that will help see many a young person through this public health disaster.
Adults need to understand the uncertainty and shakiness that kids might be feeling. Reinforce to them that you are there for them, that we all went through a very difficult time and there will be more tough times ahead in life, but that you will always stand by their side.
What we know is that young people who feel connected are less likely to engage in high-risk behaviors such as self-harm, violence, early sexual activity or suicidal actions. As my friend and colleague Dr. Ariel Botta, a group worker at Boston Children’s Hospital, advised: “Healthy human development and adjustment require both connection and solitude. At this point in history, there is plenty of isolation and a dire shortage of connection.”
The importance of attachment and connection carries on throughout a child’s life and impacts relationships as they move into adulthood. The support you give them is not just for now — it’s forever.
Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center in Roslyn Heights.
Photo Credit: Getty Images/Marko Geber
