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Equipping Parents: Suicide Prevention Tools and Resources for Helping Suicidal Teens

In this episode, we explore the essential resources and tools parents need when navigating the frightening reality of a suicidal teen. Joined by experts Allison Jenkins, LCSW, and Reggie Wilson, LCSW, we discuss assessment tools like the Columbia Suicide Severity Risk Scale (CSSRS) and Question, Persuade, and Refer (QPR), and explain how parents can implement these potentially lifesaving strategies at home. You'll also learn how to create a safe environment, find emotional support for yourself, and reduce immediate risks. As always, this podcast is a guide, not a substitute for professional mental health care.

National Suicide Prevention Lifeline

Mental health emergencies may increase your teen's risk of suicide or self-harm. If your child is considering self-harm or suicide. For immediate help, call the 24/7 Suicide & Crisis Lifeline by dialing 988. 

For further help with a teen in crisis, reach out to Oasis Ascent at 855-701-2721.

Lifesaving Toolkit for Parents: Resources and Skills for Teens at Risk of Suicide

As a parent, it's natural to feel overwhelmed and unsure when your child is facing suicidal thoughts, especially when perfectionism and masking are involved. In this episode, we delve into these critical issues, offering valuable insights into how the pressure to be perfect can impact your child's well-being and the role that comparisons and unrealistic expectations play in their struggles. Our goal is to provide you with practical tools and actionable steps to better understand and support your teen. Whether you're grappling with how to handle your child’s mental health issues or seeking ways to create a more supportive environment, this episode is for you.

In this episode, therapist Tiffany Herlin, LCSW, along with Clinical Directors and therapists Allison Jenkins, LCSW, and Reggie Wilson, LCSW, from OASIS Ascent, will discuss:

  • Perfectionism and Masking: Discover how the pressure to meet unrealistic standards can lead to depression, anxiety, and self-destructive behaviors in teens, and learn how to identify and address these issues in your child.
  • Impact of Comparison: Learn about the negative effects of comparing your child to their siblings and how it can affect their self-worth and mental health.
  • Normalizing Failure: Understand why it’s essential to normalize failure as a part of growth and how this mindset can alleviate the pressure on your teen.
  • Immediate Actions for Crisis: Get guidance on when to seek professional help, including the role of emergency rooms and outpatient resources in handling suicidal ideation.
  • Creating a Safe Environment: Find out how to create a supportive environment that encourages open communication and reassures your teen that their feelings are taken seriously, even if they’re seeking attention.
Therapeutic-School

If you are a parent of a teen who is experiencing a mental health crisis, we are here to help. OASIS Ascent provides a safe, structured, and therapeutic environment where teens can stabilize and begin their journey toward healing. With a team of experienced therapists and clinical staff, we offer individualized care designed to address the unique needs of each teen. To learn more about how you can help your child, call us at 855-701-2721.

Suicidal Ideation in Teens Podcast Transcript:

Podcast Topics
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    Introduction

    Tiffany: Welcome back to Episode Two. I'm Tiffany Herlin, a licensed clinical social worker. I'm excited to interview Allison Jenkins, an LCSW, and Reggie Wilson, also an LCSW, from OASIS Ascent, a short-term residential program that provides stabilization and comprehensive evaluations for teenagers aged 12 to 17 who may qualify for insurance.

    Before we dive in, please remember this podcast is not a replacement for therapy. Always seek help from a mental health professional for your situation.

    In this episode, we’ve been hinting at a critical topic, and I kept pulling you back from discussing it earlier, but now we’re ready to dive in! We’re going to talk about a life-saving toolkit for parents of teens who may be experiencing suicidal thoughts.
    So, what resources and skills can parents be empowered with? How can they handle the fear and uncertainty of such a serious issue? What tools are available to help assess the situation? Let’s start with that.

    Reggie: There are a few tools out there, and I’ll let Allison talk about the one we primarily use. One tool available online is called QPR, which stands for Question, Persuade, and Refer. It’s designed for parents, but really, anyone can use it. It gives specific questions to ask and offers guidance on what to do if there’s a high risk or if you’re concerned. It also directs you to where you can seek help.

    At OASIS, we use the Columbia Suicide Scale. It’s a structured assessment tool with several questions we ask students if we believe they’re at risk of suicide. For instance, they may tell us they're having suicidal thoughts. When that happens, we administer the evaluation. What’s great about this tool is that it’s not just for therapists— all our staff can use it. Additionally, the evaluation process includes therapeutic oversight, so when an evaluation is completed, the system automatically notifies the therapist.

    Allison: And then the clinical director.

    Reggie: Yes, the clinical director is also involved. We follow up to ensure that everything is therapeutically driven. Allison can explain more about the specific questions and assessments we use.

    Tiffany: Before we hand it over to Allison, I just want to highlight for our listeners that QPR is just one of many tools available. It’s a good option for parents because it’s straightforward. The course takes about an hour to complete, though there is a cost involved.

    So, that’s something to keep in mind. I also want to mention that there’s a national hotline for suicide prevention, and we’ll include that number in the podcast notes. I don’t have it memorized, but I keep it on a magnet on my fridge. The other day, my daughter asked, "Why do we have this suicide hotline number on the fridge?" And I told her, "Just in case anyone ever needs it, you can call and speak to a crisis interventionist." That’s what they’re called, right? They can guide you if you’re unsure what to do and don’t have training.

    Reggie: Yeah, that’s a great point. There are several hotlines out there, and I love that you have one on your fridge. I think all parents should consider doing that as a way to normalize the conversation.

    Tiffany: It’s like, "Tell me your mom’s a therapist without telling me your mom’s a therapist." That’s how I grew up.

    Understanding a Suicide Risk Assessment

    Tiffany: Okay, Allison, can you explain the assessment process you use?

    Allison: The CSSRS, or Columbia Suicide Severity Risk Scale, is a widely used tool in many hospitals and treatment centers. It provides us with a lot of important data. When a student says they’re suicidal, that gives us some information, but not the full picture. This assessment helps us gather more details. As parents, you can also access it—it's copyrighted but available for free online. You can pull it up, start asking the questions, and learn more about what’s really going on.

    For example, the first question is, “Have you ever wanted to go to sleep and not wake up?” This is something we often discuss with younger kids and teens. As their brains develop and depression worsens, they may form more concrete plans. The second question is, “Have you had thoughts of killing yourself?” Notice the difference between those two questions.

    If the answer is “Yes,” the next question becomes, “Do you have any intent to act on those thoughts?” Sometimes kids will say, “I’ve thought about cutting my arm and bleeding out, but I’d never do it.” That’s something I hear a lot—“I’m not going to act on it, it’s just a thought.” The third question, then, is “Do you have the intent to act on that plan?” And the fourth question asks, “Do you have the means to act on it?”

    This sequence helps us assess how serious the situation is. Are they thinking about it? Do they intend to act? Do they have a plan? And do they have the means to follow through? These questions help gather critical information.

    When a student tells one of our youth mentors they’re feeling suicidal, I want to empower the mentors to use this tool so they don’t feel like deer caught in the headlights, immediately rushing to call the therapist. My follow-up question might be, “Do they have intent? Do they have a plan?” Before, the mentors often wouldn’t know and would have to ask again. But with this tool, they can collect that data on the spot.

    For parents, when your child answers these questions, you’ll have much more information. Sometimes they might say, “I have a plan, but I’m not going to tell you what it is.” That’s serious. It’s just as serious as saying, “Mom, I saw that bottle of Benadryl in your purse. I’ve been thinking about taking it and overdosing.”

    Having this information doesn’t fix the problem, but it helps us feel less powerless. That’s why I love this tool. It also brings up important follow-up questions, like “How long have you been having these thoughts? How often? Can you stop them if you want to?”

    One key factor is deterrents. Deterrents are the things stopping them from acting on their thoughts—fear of death, religious beliefs, friends, or pets. I’m telling you, pets are often the main thing keeping kids from taking action. They don’t want to leave their animals behind.

    As I mentioned in the previous episode, sometimes kids say things like, “I want everyone at school who bullied me to know how they hurt me. They’ll get what’s coming when I kill myself.” It's important to help them process those feelings and understand what they're going through. As clinicians or parents, having that information allows you to take the necessary steps.

    There’s a big difference between someone saying, “I had a stressful day, my depression is high, and I just had this passing thought like I don’t want to be here anymore,” versus “Mom, I’ve been eyeing those pills in your purse. I’m struggling—can you lock them up for me?”

    All that data from using this tool provides invaluable information. It’s simple to use—just follow the directions and ask the right questions.

    Tiffany: But what if the parents are therapists? Are they still allowed to use it?

    Allison: Yes, absolutely.

    Reggie: It's available to everyone. What I appreciate about this tool is that it indicates if a child is at high, medium, or low risk. If the child is high risk, it lets you know that they need to be taken to an emergency room immediately. For medium or low-risk, I would advise parents, "If you feel the need to use this evaluation and ask these questions, please reach out to a mental health professional."

    Regardless of the risk level—high, medium, or even low—I still recommend reaching out because something might be going on. Even if they're just having a bad day, we should still investigate. So if it's high risk, try to get them safely to the ER for an evaluation, or take them yourself. But never assume it will just pass on its own, because sometimes it requires urgent attention.

    There are times when we, as parents or adults, might think, "Oh, they just need to sleep it off, and they'll be fine in the morning." But I’d hate to see the worst outcome from that assumption. The great thing about the CSSRS is that it provides those three risk levels and guides you on where to go for help.

    Addressing Attention-Seeking Behaviors in Teens

    Tiffany: But what if you have a child who seems to cry wolf or act dramatic, and it feels like they're just seeking attention? What should parents do in that situation?

    Allison: First, I want to emphasize that all kids need attention, and that's not a bad thing. If they're in such distress that they're saying things like this to get their needs met, that's concerning. I dislike the term 'attention seeking' because I believe it's more about 'connection seeking.' They're trying to create that connection. So if they're coming to you in distress and saying these things, even if it is for attention, that’s okay. It means they need connection and are seeking help.

    Reggie: I completely agree. The other important part is that we can teach them healthier ways to seek that connection.

    Allison: Exactly, instead of resorting to those behaviors.

    Reggie: If they're expressing themselves in harmful ways, whether to themselves or others, we need to guide them toward positive ways of getting that attention and connection.

    Allison: And remember, many kids who come to us don’t have the tools to cope with their mental health struggles. They don’t know how to manage their feelings beyond talking with friends, dwelling on them, or keeping them to themselves. They just don’t have the skills to deal with those thoughts.

    Tiffany: I’d also add that they often don’t have the vocabulary to express what they’re feeling. I’ve had a younger family member mark something like "I don’t want to live" on an evaluation, but when I looked into it, they just didn’t know how to say they were having a hard day. It wasn’t that they wanted to die—it was just a tough day.

    Reggie: That’s a great point, Tiffany. When we talk about kids not having the tools, that includes not knowing how to express themselves. They don’t always know how to put their feelings into words. This is where parents come in—understanding how to help kids connect with their emotions is so important. But sometimes, parents don’t know how to do that either.

    As mental health professionals, we need to introduce these concepts through therapy and parent support groups. Parents might not want to seem vulnerable in front of their children, so they might use words they think are appropriate during sessions. But in a parent support group, where everyone has the same goal—helping their kids—they can feel more open to learning how to express themselves and be vulnerable. Vulnerability is incredibly powerful. If parents can be vulnerable with their children and say something like, "I don’t know the answer, but I’ll find out for you," that can be a powerful tool for connection.

    Tiffany: Because guess what, listeners? We, as therapists, have to do that all the time. I remember when I first started, there were times when I didn’t know what to say. My clinical supervisor told me, "That’s okay. You don’t need to have all the answers." And I was like, "I don’t?" It’s the same for parents—you don’t have to know everything right at the moment.

    The Importance of Dialectical Behavioral Therapy

    Allison: And, you know, dialectical behavioral therapy, or DBT, is the best practice for people dealing with suicidal thoughts, self-harming, or aggression. These are the actual tools. DBT gives both the students and the parents a common language, helping build resiliency and empowering them to think, "I can feel better using my skills."

    Tiffany: I just want to tie in two things—what Reggie said about empowering parents and being vulnerable. When parents ask, "Do you have a plan?" it’s such a scary and vulnerable thing to ask their child. But we want to empower our listeners: if you're concerned, we’re giving you permission—you can ask those tough questions and be vulnerable with your kids.

    Also, for new listeners who might not be familiar with terms like DBT or dialectical behavioral therapy, could you dive a little deeper into what that means and help educate them?

    Allison: Yeah. So, dialectical behavioral therapy (DBT) was developed by Marsha Linehan. She struggled with chronic suicidal thoughts and self-harming behaviors. She was institutionalized for about two years, and during that time, she made a decision: "If I can get out of this hell, I'm going to do everything I can to help others." Fast forward, she developed DBT and researched women with borderline personality disorder.

    Borderline personality disorder is often associated with chronic suicidal thoughts, self-destructive behaviors, and poor interpersonal relationships. People with this disorder are often in significant distress. In her research, she took two groups of women—one group received traditional therapy, and the other went through a skills-based group. And guess which group did better? The skills group.
    They were able to reduce inpatient psychiatric hospitalizations, live more fulfilling lives, and improve their overall functioning compared to the group in traditional therapy.

    At OASIS Ascent, we combine both approaches. We process the "why" behind feelings—understanding why we feel a certain way is important. But once we know the "why," what do we do about it? That’s where DBT comes in. It provides skills, often taught through acronyms, to help manage emotions without acting on them. As I mentioned in episode one, the concept of dialectics teaches that you can have suicidal thoughts without acting on them. Parents must understand and validate this because students sometimes think those thoughts will just disappear. But if someone is predisposed to depression, mood disorders, or anxiety, those thoughts may come back. The key is having the resilience to manage them without acting on them.

    That’s what DBT does. And I love it. I live it. I breathe it. These skills are great—anyone can learn, teach, and use them. It’s not rocket science.

    Tiffany: Just before I let Reggie jump in with his thoughts, I want to point out something to listeners. When you're looking for a therapist for your teen, it's a good idea to ask if they use DBT. This is an important certification to look for if you’re addressing suicidal issues with your teen.

    Allison: Absolutely.

    Tiffany: Okay, go ahead, Reggie.

    Finding the Right Therapist for DBT

    Reggie: Allison did a great job describing DBT, and at OASIS Ascent, we are a DBT-informed program. We help our students learn these skills. When people ask me, "What is DBT?" I try to keep it simple. I explain, "It’s a set of skills we teach that help students regulate their emotions." So, they learn to say, "I’m feeling overwhelmed—what can I do to manage this?" or, "I’m feeling anxious or angry—what can I do to handle it?" There are many different skills, and while one skill might work for one person, it may not for another. But there is always something that works for everyone. It's really about them learning to manage their emotions, instead of being controlled by them.

    Tiffany: Which is something we all need, right, Reggie?

    Reggie: Yes, exactly.

    Tiffany: Even as adults! Being an adult is about learning how to navigate and manage emotions. We can’t control them, unfortunately. It’d be nice if we could, but if you’ve seen Inside Out, you realize emotions pretty much run the show.

    Reggie: And the great thing about DBT is that parents can learn these skills too. This way, parents can coach their kids through distress because they’ve learned the same tools.

    Allison: They know what works.

    Reggie: It's really about preparing parents for when their kids return home. Parents need to be equipped with the skills to say, "Hey, what have you learned to help you get through this moment?" Sometimes it’s not about solving every problem but just getting through the next hour. When kids struggle at home, instead of parents feeling like they're back at square one and throwing their hands up, it’s about offering encouragement.

    Tiffany: That ties into one of the most important tools parents can have—knowing how to manage their own emotions. If you're dealing with your own suicidal thoughts, depression, or mental health challenges, are you being an example for your child? That’s one of the best things you can do.

    Allison: What I love hearing from parents is, "I love DBT. I’m starting to use it myself. I can’t believe I didn’t know this as a teenager. I wish I had learned these skills back then." It creates a common language. The acronyms for the skills become part of that shared language, and I love it when parents use them. For example, a parent might say, "Do you want to use TIP right now? Should I get you some ice? Let’s weigh the pros and cons, even if it’s just about changing your curfew." It warms my heart when parents use the acronyms.

    Reggie: When we talk about DBT, there are four key areas: distress tolerance, emotional regulation, mindfulness, and interpersonal effectiveness. These cover everything you need. DBT addresses all aspects of managing emotions.

    Tiffany: So, like four legs on a table.

    Reggie: Exactly, four legs on the table. It's a well-rounded approach that helps not only students but everyone manage their emotions.

    Allison: And helps them understand their emotions too.

    Tiffany: If you’re a parent listening and thinking, "This is all new to me. What is DBT? What is this all about?" it might be time for you to consider therapy for yourself. If the idea of asking your teen questions like "Do you have a plan?" or "Are you just sad and want to escape pain, or are you considering death?" triggers anxiety for you, that’s a sign you may need to work on regulating your own emotions. Therapy can help you do that so you can support your suicidal teen effectively.

    Allison: And it will help you handle what your teen might say.

    Tiffany: Because it will be hard—and triggering.

    Allison: It really will be.

    Reggie: You might hear, "I want to hurt myself."

    Allison: If you ask the questions, you need to be prepared for the answers.

    Tiffany: If you're going to panic or have an emotional reaction, that’s a strong indicator that you’ve got some work to do on yourself.

    Reggie: Yeah, and it’s also a sign that your kids might stop coming to you. If they sense that you can’t handle the conversation or that it makes you emotional, they’ll hold back.

    Allison: Or they might feel like they’re a burden. They could think, "I don’t want to stress my mom out—she already works two jobs and is always overwhelmed."

    Tiffany: Right, "I don’t want to add to her worries." So, it’s about showing up and being the adults our kids need us to be. I’ll admit there have been times, even in sessions with my own kids, where they’ve shared things and I’m thinking, "Okay, what do I do with this?"

    On the outside, I stay calm. But later, I might talk to my husband or call a therapist and ask, "Did I handle that okay? Am I getting triggered?" I have to reflect on my reactions.

    Creating a Safe Space for Communication

    Tiffany: But at the moment, I have to be that steady presence. So, my question is: how can parents create a safe and supportive environment where their teen feels comfortable coming to them?

    Reggie: Well, I think it comes down to what you said—modeling the behavior that encourages open communication. Be vulnerable, share your own experiences as a teen, laugh about the funny moments, and normalize even the stressful ones.

    Also, check in with your teen from time to time to make sure things are going okay. When my kids were younger, I used to say, "Let’s have a daddy-daughter date," and we’d go out. I’d model what a healthy relationship looks like—opening doors, pulling out chairs—things that society encourages, but it also creates opportunities to talk. We'd discuss school, friendships, relationships—whatever was on their minds. Moms can do this with their sons too; it’s not just for fathers and daughters.

    Allison: I always tell parents, "You need to set aside time every week with your child, no matter what." It shouldn’t be a punishment or reward—it’s just your time together. Even if you're upset with them, like if they’ve snuck out and you're angry, that time still needs to be set aside for connecting.

    Tiffany: Love that. We talked about this in episode one—by the time you have a teenager, if you haven’t nurtured the relationship beforehand, it’s going to be a lot harder when these issues arise.

    Reggie: But not impossible.

    Allison: And you can always catch up. Your kids want to spend time with you, even if they see how busy you are. At the end of the day, they want to share parts of their lives with you.

    Tiffany: Even if they tell you they hate you and don’t want you in their life. No teenager means that forever. I was talking to a family member who said, "My teen hates me," and I told her, "This won’t last. Unless you’re doing something harmful, they’ll eventually realize how much you love them. If you're making them mad now and then, you're probably doing your job right."

    Allison: Every kid I’ve worked with, no matter how strained the relationship, always improves when family therapy helps strengthen those bonds. And when the relationship improves, the kid improves too. It’s just how it works.

    Reggie: I’ll never forget a family vacation I went on with another family. One of the teen boys got upset and yelled, "I hate you," at his dad. His dad was mortified—honestly, we all were. But today, those two are probably the closest father and son I know. I asked the dad about it once. I said, "Do you remember that time your son yelled at you on the ski trip? What happened?"

    He explained that he just let his son vent. The next day, he calmly asked him why he had been so upset, and the kid broke down, apologized, and said, "I’m sorry, Dad." The dad responded, "We all have bad days. I know where that came from, and I know you because we have a relationship." That was great—he didn’t overreact and gave his son space to express himself. Eventually, they were able to talk about what was going on.

    I use that example sometimes in therapy, and it seems to help.

    Tiffany: I love it. Some of the clients I’ve worked with, the ones where we’ve had the most head-on conflicts, where I’ve had to hold really firm boundaries but also offer nurturing, love, and validation—those are the relationships that often end up the closest. It’s a delicate balance between setting boundaries and being supportive.

    I’ve been called all sorts of creative names—ones we obviously can’t say here—but those tough battles often lead to stronger connections. So, if you're a parent listening and you’re afraid that your teen will hate you if you ask about things like suicide, or if you think you'll never be close to them again, know that it’s the opposite. You can become closer through these difficult conversations and challenges.

    Allison: If they get defensive and angry, that probably means you’ve hit on something important.

    Tiffany: You’re doing your job.

    Allison: Yeah, when one of my clinicians tells me a student got mad and yelled at them, I say, "Good job. You must have hit a nerve. That means you’re doing your job, helping them process something hard for them."

    Reggie: I always tell parents, you can’t parent out of fear. You just can’t.

    Allison: Can you explain that a bit more?

    Reggie: Parenting out of fear means avoiding the tough questions because you're afraid your teen will overreact or get upset. Or not setting firm but fair boundaries because you're worried about their reaction. When you parent out of fear, it creates dysfunction in the family. If that’s something you're struggling with, it’s something to discuss with your therapist.

    Tiffany: Yeah, especially for parents with teens who have mental health struggles or suicidal thoughts. There are probably parents listening who feel like they’re walking on eggshells, living in fear, giving their teen everything they want just to keep them safe or avoid being hated. It’s important to realize that you don’t have to live in fear. We're here to empower you to ask those hard questions and take steps to protect your teen, even if their initial reaction is big.

    It’s like what we call an "extinction burst," right? When you first hold those firm boundaries and ask tough questions, their behavior might escalate because they’re trying to deflect or pull at your emotional heartstrings. They might say things to make you feel guilty and take the pressure off them. But when you stand firm—when you're the steady heartbeat they need—that initial reaction will eventually fade. Then, you’ll get to the point where your teen can open up, take accountability, and share how they feel instead of putting up smoke screens, which is what so many kids are doing, they are masking their feelings. Allison, can you talk to us about the pressure on parents to be perfect?

    The Pressure of Perfection in Parenting

    Allison: Sure. I work with adolescent girls, and a common theme is masking. They feel like they have to be perfect all the time, and the pressure that is put on them can lead to depression, anxiety, and even suicidal thoughts. They're constantly hard on themselves for making mistakes, even though no one is perfect.

    So I think a useful tool for parents is to reflect on their expectations. Are they unintentionally sending the message that their child needs to be perfect? Do they expect straight A's, for them to always smile and be happy? Often, we’re taught that some emotions are 'good' and others are 'bad,' but emotions are just emotions.

    Even well-meaning comments like, "You're too pretty to be sad," can feel invalidating. So, parents should ask themselves: are my expectations realistic? Is my child feeling pressure to meet impossible standards?

    I’ve had girls tell me, "I feel like my parents want me to be perfect," and the parents are surprised, saying, "I don’t expect you to be perfect." But if the child feels that way, then something about the message they’re receiving is causing that perception. This often comes up around academics, extracurriculars, and sports—where the pressure to perform perfectly builds up, and they end up feeling like they can’t manage it all, so they mask their struggles.

    Tiffany: And if parents are expecting their kids to be perfect, they’re probably feeling that same pressure themselves, right?

    Allison: Where did that pressure come from?

    Tiffany: Right, and I think about what parents are going through when they have teens struggling with these heavy issues, like suicide.

    Reggie: Yeah, one of the challenges I often face working with males is that parents tend to compare them to their siblings.

    Allison: Good point.

    Reggie: They’ll say things like, "Johnny never had these problems. Why are you acting like this? Why can't you be the athlete he is? We spend so much time and money, but you still don't get it." Conversations like that set kids up for failure.

    We all make mistakes, but for these kids, when they hear those comparisons, their mistakes feel like their whole world, and they can’t see beyond them. So what happens? They start seeking out friends and people who look or feel the same way they do. Instead of turning to their parents, they turn away.

    Parents need to understand that whether those messages are direct or subtle, they create an unhealthy environment for their child to express their true feelings, like, "I feel overlooked" "I feel like a failure" or "I feel like I have to be perfect." When kids don’t feel safe talking about those emotions, it often leads to higher-risk behaviors—things like suicidal thoughts or drug use.
    And all of that ties back to masking.

    Allison: Or they go the opposite direction. Teenagers tend to be black-and-white thinkers. So if they can't be perfect, there's no middle ground for them. They might start causing chaos—using substances and sneaking out. It's like if they can't achieve perfection, they figure, "Well, I’ll just do the opposite. I'm not perfect, so I might as well go all in."

    Tiffany: Because they're so egocentric, it all ties back to their self-worth. It's like, "If I'm not perfect, then I don't have any worth. If I'm not like my brother, I don't have worth. So, screw it."

    Allison: Might as well go all in.

    Reggie: As a society, I think we need to normalize failure. It might sound crazy, but failure is part of our journey toward growth and improvement. We're striving for what we see as 'normal,' and along the way, we're going to fail. We need to normalize failure as part of that process. It's something we need to teach parents.

    Allison: Well said, Reggie.

    Tiffany: Let's wrap up by discussing the steps parents can take. So, say they've used an assessment, asked the tough questions, be vulnerable, and overcome the fear of talking to their teen. Now their teen is showing high-risk behavior—what’s next? What can parents do? What are the steps?

    Reggie: Well, I think the first step is seeking out mental health guidance and support. Often, this might be the first time parents are dealing with a mental health crisis. Maybe they've never encountered it before—neither have their parents or siblings—and now they have a child who's struggling. They may not know where to start and it can be really scary. So, for those parents, I would say, first, seek professional help. There are a lot of resources available.

    Tiffany: Like what, specifically?

    Reggie: Well, for example, here in Utah, there's the SafeUT app, which many schools use.

    Tiffany: And there might be similar resources in other states.

    Reggie: Yes, and schools themselves often have resources parents can tap into as well.

    Tiffany: There are hotlines available.

    Reggie: Yes, there are hotlines and many other resources out there to help parents find some direction. Once you find a place that feels right and meets your needs, it's important to follow the guidance they provide.

    When to Seek Emergency Help

    Allison: Exactly. I worked in the ER for years.

    Tiffany: So when should parents consider taking their child to the ER?

    Allison: That's a great question. I've seen parents bring their kids in as soon as they mention suicidal thoughts, which is understandable. But then I've also had parents who wait for weeks while their child struggles before coming to the ER. As crisis workers in the ER, we’re trained to guide parents through these situations. We conduct thorough assessments, asking how long the issue has been present, what the root cause might be, and what kind of support is needed going forward.

    Sometimes, outpatient therapy is enough. Other times, it might be a day treatment program, or in more serious cases, hospitalization could be necessary. Community ERs are a valuable resource. While I don’t want to suggest that every mention of a mental health crisis means a rush to the ER, know that ER professionals are there to help. They can connect parents to programs, services, and outpatient therapists that might be a good fit for your child.

    One challenge is the wait time for outpatient therapists—sometimes it's three to four weeks before you can get an appointment. If you’re uncomfortable waiting that long, your local ER can help navigate the situation and get your child the care they need sooner.

    Tiffany: And it's always better to be safe than sorry, right?

    Allison: Absolutely, 100%.

    Tiffany: One thing we’ve discussed is how to tell if our kids are crying wolf or seeking attention. As a clinician, I’ve learned that you should always take it seriously.

    Reggie: Always.

    Tiffany: Whether it's truly serious or just attention-seeking, the message to your child should be: "When you say this, I will always take it seriously, and I will always act to keep you safe." By doing this, even if they aren’t serious, they’ll learn that if they mention something like this, you’ll respond by taking steps to help them—whether that’s calling a therapist, texting their therapist, or calling a hotline.

    Hopefully, it will also teach them that if they don’t truly mean it, they can find another way to express themselves. Either way, you’re setting a clear boundary and creating a safe environment where they know: "I love you, I care about you, and I will act to get you the help you need." You’re not overreacting; you’re being proactive by getting the right resources. Whether that means reaching out to a therapist, using a hotline, or driving to the ER just to check things out—it’s not a big deal, but you're showing them, "You’re not alone, and neither am I."

    Reggie: Yeah, I always tell my students—and parents too—to remind their kids that they're there to keep them safe, even when the kids can’t do it for themselves.

    Tiffany: That's what being an adult is about. Our kids are dysregulated, and their brains aren’t fully developed. They don’t know how to regulate their emotions. It's our job to step up, create a safe environment, and give them the support and guidance they need to find safety. Whether they’re saying, "I want to die," or "I just don’t want to be in pain anymore," it doesn’t matter.

    Tiffany: We can say, "Okay, we’re going to create a safe space for you to figure out what's going on", and help them manage this really scary situation.

    I think the important takeaway—and feel free to chime in—is for listeners to know that this is scary, but you're not alone. There are resources and tools out there, and we’ve only scratched the surface.

    You don’t have to be afraid to ask your child about suicide if they’re having these thoughts. There are support groups, books, therapists—therapists trained in DBT—so many resources out there. You’re not the only one going through this.

    Allison: You’re not alone in this.

    Reggie: That’s something parents sometimes overlook. They think, “Oh no, this is just happening to me,” but it’s not. We all know that. That’s the benefit of joining a parent group, where they can share their fears with others who feel the same way. That shared experience can be empowering.

    Tiffany: Yes, and it’s important to mention like I’ve said on other podcasts, that even if you live in a remote area without many resources, social media and Facebook can connect you to private groups. You can reach out to other parents and say, "I need help—what are you doing to handle this issue?" So, as a parent, you’re not helpless. There are things you can do to support yourself and your teen.

    Allison: Absolutely. It’s so important.

    Preview of Future Discussions on Suicide Ideation

    Tiffany: Thank you both. This was such a great episode, focusing on the tools, skills, and resources that parents can use when dealing with a teen struggling with suicidal ideation. In our next episode, we’ll dive deeper into understanding the precursors to suicidal thoughts, exploring what can lead up to it, and addressing some common misconceptions. So, stay tuned, listeners. And again, thank you so much, Allison and Reggie, for joining us today.