It is also widely understood in the pediatrics community that there are not enough mental health workers available to our patients, not enough outpatient therapists and not enough inpatient beds. “We’re lobbying every day for more facilities, more beds, more mental health providers,” Dr. Plemmons said. Many adolescents with depression do not look for help, and many don’t have access to mental health specialists; the American Academy of Pediatrics published guidelines earlier this year for primary care pediatricians dealing with adolescent depression, and recommended screening all children 12 and up.
Some experts worry that the suicide theme in the Netflix series “13 Reasons Why,” which recently debuted a new season, may contribute to what is known as suicide contagion.
“I would recommend to parents either ideally don’t have your kid watch ’13 Reasons Why,’ or other shows with graphic depictions of suicide or self-harm,” Dr. Gerson said in an email. But “if your kid wants to watch it, watch it together — the whole series, not just one episode — and talk about what you see, so you can help your kid understand and process anything that is upsetting or triggering.”
“If kids are saying, I’m thinking about suicide, or I wish I didn’t exist, or I wish I didn’t wake up — take that seriously,” Dr. Gerson said. Parents should try not to panic, she said, because if they get very emotional, their children may worry about hurting or disappointing them and stop talking.
“Stay calm. Ask, ‘Tell me more about what you’re thinking,’ show the kid you’re taking it seriously,” she said. “I see parents who in a very well-intentioned way will say things like, ‘Oh no, honey, everything’s fine, let’s think about the good things.’” And again, that may make a distressed child clam up.
Parents who have reason to be concerned must find a way to get the child evaluated. That doesn’t have to mean the emergency room; you can start by calling your pediatrician. But a parent will have to decide whether the child “is able to be safe in that process — emotionally stable enough that they can drive with you to the pediatrician’s office — or is your child really in distress at this moment and you need to call 911.”
“It’s pretty important if this is the first time you’re hearing about this from your child that a professional should evaluate them,” said Dr. Stephanie Kennebeck, an associate professor of clinical pediatrics at Cincinnati Children’s Hospital and the author of a recent review on suicidal behavior in children and adolescents.