The Oak Life Journal
Jul | Aug 2023
Suicide Prevention in a Children's Shelter
By Aarin Talbot
6 minute read
Oak Life is proud to introduce its newest regular contributor, Aarin Talbot, to its team of writers. Research writer for The Journal and a clinical research professional by trade, Aarin hopes to empower alternative care workers by introducing a literary perspective to major issues. When she is not working on research projects, she enjoys spending time with her family and friends in Indiana, United States.
Protecting children within alternative youth homes is a complex aspect of care. Rather than simply being a form of physical security, child safety spans their physical, mental, emotional, spiritual, and social wellbeing. It requires caregivers to utilize a wide variety of tools so that each child can develop in a way that is similar to those inside of a family dynamic.
Although such a task is already intricate, the role of a caregiver becomes even more involved when thinking about suicide prevention as a form of child safety. According to a study performed in 2021, researchers found that there was a common link between trauma (i.e abuse, neglect, or family dysfunction) and subsequent suicide in children.
Because alternative care workers have direct contact with children of trauma, it is important that they be equipped with the right tools for the identification of potential self-harm or suicidal thoughts.
In consideration of this, the topics of risk factors, warning signs, beginning practices for suicide prevention, and preventing self-harm are discussed to help caregivers, orphanage directors, and any other care team member get started in that pursuit. There are also linked resources for further learning and aid.
Any child that requires an alternative care home may already be at risk for suicide, and should therefore receive regular assessments for warning signs. However, the risk for suicide increases with each factor that is applicable to the child’s situation, such as:
• History of previous suicide attempts
• Family history of suicide
• Trauma— Sexual abuse, physical abuse, or neglect
• Serious health conditions— Especially where the condition has pain; any previous head trauma or brain injury; etc.
• Mental health disorders— Children with depression, anxiety, attention deficit disorders, schizophrenia, Bipolar disorder, conduct disorder, etc.
• Prolonged stress or stressful life events— Rejection from peers and/or bullying, loss of close relationships, transitions into new alternative care homes, etc.
• Exposure to the suicide of another child or adult
Children with one or more warning sign may be suffering from suicidal thoughts. Always take your concerns seriously and seek professional help right away. According to the American Foundation for Suicide Prevention, signs may include:
• Changes in their mood— Depression, anxiety, fatigue, aggression, feelings of shame, anger, irritability, lack of interest, or sudden relief with temporary improvement
• Talking about it— Commenting about wanting to die, wishing they had never been born, or wanting to kill themselves; saying that they feel hopeless or that life is purposeless; saying that they feel unable to escape; talking about being in unbearable pain; taking about feeling like a burden to others
• Changes in their behavior, especially when connected to a recent traumatic or stressful event— Withdrawing from activities; changes in sleep schedule (not getting enough sleep or sleeping in too late); giving away valuable or cherished possessions; isolating from others; drinking alcohol/taking drugs or increasing their use; searching out ways to end their life (caregivers can monitor computer or phone browser history to see if children are searching for methods online)
NOTE: Children who have experienced trauma may regularly suffer from conduct or mood disorders that resemble those listed above. Therefore, caregivers should pay particular attention to any increases in those disorders (i.e. they are more fatigued and withdrawn than usual), which would prompt the need for an assessment of additional warning signs.
However, any concern for a child’s safety should be assessed by a professional regardless of what may be deemed normal behavior for that child.
Beginning Practices for Prevention
Although these lists are not comprehensive, good starting practices for suicide prevention include:
• Remove possible suicide tools— Keep knives, razor blades, firearms, medications, cleaning supplies, and ropes or cords in a protected area out of reach (in safes the require a protected code or in locked cabinets); remove access to pools when not in use and set designated times where children are allowed to be at the pool with qualified supervision; keep children a safe distance from fires used for cooking or heat, and never leave them unattended
• Document regular assessments of child behavior— Caregivers should have assessment tools for the purpose of noticing anomalies in behavior and potential warning signs
• Maintain an environment that promotes open communication and asking for help— Ensure that children feel safe enough to bring their thoughts and feelings to an adult without judgement. If they disclose feelings that are concerning, remain calm and ask clarifying questions in a compassionate manner. Asking questions about suicide does not create a desire in a struggling person, but it can actually relieve the pressure of feeling alone and isolated. Therefore, if it appears that a child may be contemplating suicide, ask questions to clarify if: They have a desire to end their life; they regularly feel this way or only sometimes; they have a suicide plan; or they have attempted suicide in the past. Assessing risk this way can give caregivers an idea of how imminent an attempt may be.
• Create a plan for responding to suicide attempts or the concern that an attempt may arise— Orphanage directors should equip caregivers with the practical steps they need to respond to an event. Documenting a clear protocol is one example of a tool that could be used to help caregivers navigate such a stressful situation.
• Maintain appointments with mental health professionals— Access to mental health professionals is a protective factor against suicide. It allows children to receive the help and treatment they need for past trauma and any current mental disorders.
• Practice self-care: Caregivers have to deal with significant stress on a regular basis, as well as manage their own grief should a suicide attempt occur. It is important that these individuals practice self-care and look after their own mental health, which will greatly increase their capacity to work with children of trauma.
Child safety also includes protecting them from using self-mutilation as a way to cope with stress. Some ways to decrease the potential for self-harm include the removal of useable objects, contacting appropriate health care professionals, and the promotion/modeling of better coping skills.
• Remove potential objects for self-harm— Keep knives, scissors, matches, stove lighters, candles, razors, etc. in a protected area out of reach; regularly trim each child’s nails; provide beauty and health products without sharp edges (i.e. only use bobby pins for girls with coated tips); keep children a safe distance from fires used for cooking or heat, and never leave any hot surfaces or fires unattended; etc.
• Contact mental health professionals and outside resources— Maintain access to churches, mental health organizations, and psychologists/psychiatrists for child assessment and the provision of educational or practical resources
• Promote better coping skills— Teach children to talk about their feelings and create a safe environment for them to express their struggles freely; actively model how to express anger, sadness, and fear in a healthy way; teach and actively model how to handle conflict; provide safe activities for physical exercise; promote regular sleep schedules; provide guided meditation practices and/or prayer times; help them reconnect with close relationships; promote the exploration of hobbies and areas of interest; etc.
Resources for You
Suicide hotlines for multiple countries: https://ibpf.org/resource/list-of-international-suicide hotlines/
An educational resource for youth service workers, including protocol examples for suicide response: https://www.gov.wales/sites/default/files/publications/2019-08/responding-to-issues of-self-harm-and-thoughts-of-suicide-in-young-people-guidance.pdf
Other websites that talk about suicide prevention: • https://www.mayoclinic.org/diseases-conditions/suicide/in-depth/suicide/art-20044707 • https://afsp.org
In conclusion, protecting at risk children requires a unique set of assessment skills and resources. Caregivers should be alert for the signs of potential suicide and self-harm and be ready to contact health care professionals with their concerns.
American Foundation for Suicide Prevention (n.d.) Risk Factors, Protective Factors, and Warning Signs, p. 1, https://afsp.org/risk-factors-protective-factors-and-warning-signs#what-to do-if-you-are-concerned
Llwodraeth Cymru Welsh Government (2019) Responding to Issues of Self-harm and Thoughts of Suicide in Young People, p. 31, https://www.gov.wales/sites/default/files/publications/2019-08/ responding-to-issues-of-self-harm-and-thoughts-of-suicide-in-young-people-guidance.pdf
Ruch DA, Heck KM, Sheftall AH, Fontanella CA, Stevens J, Zhu M, Horowitz LM, Campo JV, Bridge JA. (2021) Characteristics and Precipitating Circumstances of Suicide Among Children Aged 5 to 11 Years in the United States, 4(7), p. 1, https://www.nimh.nih.gov/news/science-news/ 2021/understanding-the-characteristics-of-suicide-in-young-children
youth.gov (2009) Risk and Protective Factors for Youth, p. 1, https://youth.gov/youth-topics/ youth-mental-health/risk-and-protective-factors-youth