Concerns about Suicidal Thoughts or Behaviors

Considerations when Supporting Youth

• Find a private spot to have a conversation with the youth.
• Stay calm – this is your superpower!
• If you have concerns about a youth experiencing thoughts of suicide, ask the youth directly and calmly if they are having thoughts of killing themselves. If they say no, it will be important to continue to address concerns and mental health needs but may not be an imminent crisis scenario. If they say yes, ask the youth if they have a plan for how they would kill themselves and if they have the resources to carry out the plan. Stay with the youth, do not leave them alone. Follow the action steps listed below if the youth has a plan and intent to kill themselves.
• Follow this link for more resources around suicide assessment: The Lighthouse Project – CSSRS

Action steps if youth indicates they have a plan to kill themselves:

• • If there is immediate, imminent risk call 9-1-1 or take the youth to the local Emergency Department.
  • Work collaboratively with the youth to identify who else should/could be notified (parents, guardians, caregivers, support individuals) and establish a short-term safety plan.
  • If the youth is seeking treatment or immediate mental health support, has a plan and intent to kill themselves, take them to the local Emergency Department.
  • If the youth is not open to engaging in treatment or safety planning but you have safety concerns, contact 608-784-HELP (608-784-4357) if you are in La Crosse County and request a mental health assessment from the Mobile Crisis team.
  • The crisis responder will complete their assessment and make recommendations for crisis stabilization. The hope is to serve youth in the least restrictive environment that will support their mental health needs. 
• Throughout this time with the youth, you may find it helpful to explore what is underneath their suicidal ideation and what need they may be attempting to meet.
• You may also want to check in with the youth to see what support they need from you and others in their life to be safe.
• Remove access to sharp or dangerous items as much as possible.
• Make sure the youth is supervised at all times and you may find it helpful to check in with them about how they are feeling. 
• Provide reassurance to the youth by letting them know you are there for them and your priority is keeping them safe.

Utilizing the Emergency Department

• Depending on the situation and action steps from above, you may identify that it is important to take the youth to the local emergency department for an assessment
• Take the youth to the Emergency Department if you feel it is safe for you to transport them.
• If it is not safe to transport, you may need to access emergency services such as law enforcement or use of an ambulance. 
• If there is a concern of overdose, contact 9-1-1 immediately.
• A parent/guardian must be present through the intake/admission process while at the emergency department. 
• Youth can be evaluated in the Emergency Department for mental health concerns and possible placement in the hospital. They can arrive with parents, or with the support of law enforcement and/or other professionals. 
• Youth must go through the process of medical screening, which can take several hours. They will be evaluated by a physician and mental health professional, often a social worker, while in the emergency department.
• If it is determined that hospitalization is appropriate, the social worker will work to facilitate this placement.
• If the youth is agreeable and parents/guardians are agreeable, they will work with the social worker to begin the hospitalization and inpatient treatment.
• If the youth and/or parents/guardians are not agreeable, the youth would need to be evaluated by a crisis responder through La Crosse County to determine appropriateness for involuntary hospitalization. 
• In the case of involuntary hospitalization, law enforcement typically works collaboratively with the crisis responder.
• After the involuntary hold is initiated, law enforcement and the crisis responder do not stay through the process of finding a placement. The hospital social worker works to coordinate treatment and care. 
• If the youth does not need a hospital placement, Emergency Department staff will explore other options with the family. This may include shelter care, partial hospitalization, a safety plan, and information for follow up services.
• Under some circumstances, parents may decide against the recommendation to hospitalize their child. This is a parent’s right, and other community-based options are available. It is important to know that not following this recommendation may result in a report to Child Protective Services from the mental health or medical provider.

• At our local inpatient adolescent unit, the age limit for hospitalization is 13 years old. Youth who are younger and need hospitalization are transferred to another hospital outside of our community to receive treatment and support.

Connect with Supports

• If there is not imminent suicide risk, there may still be a need for additional mental health supports.
• There are several different ways to seek counseling or treatment. This includes a private therapist, a school counselor, mental health center services, and/or substance abuse treatment. Private therapists can be a licensed clinical social worker (LCSW), a licensed professional counselor (LPC), or a psychologist. This is usually covered by insurance and may occur weekly or every other week depending on treatment needs. Therapy is individualized and collaborative. A therapist may offer more frequent sessions if needed or may recommend a higher level of care as needed.
• Youth may also be able to receive counseling at school. This may be in the form of a school counselor who is accessible to all youth. The school counselor can give you more information about services available in the school.
• The School District of La Crosse also has a Student Family Assistance Program which offers short-term solution-focused interventions to support student mental health. If you are interested in this program, reach out to your school counselor. 
• Youth in crisis may need more intensive support than outpatient therapy or school counseling. 
• Teen suicide is preventable. Follow this link for more resources: APA Teen Suicide

Call 9-1-1

• Call 9-1-1 if you are concerned about serious harm and need medical assistance or support from law enforcement or emergency services in getting youth to Emergency Department.
• When calling 9-1-1, be ready to give the dispatcher your name, phone number, current location/address, date of birth, people involved, a description of the situation, and what kind of help you need. It may be helpful to inform the dispatcher of the youth’s mental health concerns so that the responding officer is aware.
• Remember that 9-1-1 is an emergency response, and the goal of the responding officer will be to ensure safety and move on to the next call. Do we need/want this?
• There are several possible responses by law enforcement. Law enforcement may provide support to stabilize, transport youth to the Emergency Department for evaluation, and/or place a youth in detention.
• Once law enforcement arrives, the outcome is up to their discretion. However, in our community law enforcement typically works collaboratively with Mobile Crisis in order to ensure appropriate assessment and support.

What Else Can I Do?

If you would like assistance getting help for yourself or you would like to refer your child, student or friend for professional services, reach out to your school student services offices for additional support and information.

Community Resource

Great Rivers 211

Great Rivers 2-1-1 offers free, confidential community information and referrals 24 hours/day. Dial 2-1-1 or (800) 362-8255 to talk to an information and referral specialist.