How to Recognize Suicide Warning Signs amid the National Children's Mental Health Emergency

Last month, pediatric experts declared a national state of emergency in children's mental health.

In their declaration, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children's Hospital Association said stressors related to the COVID-19 pandemic and the ongoing struggle with systemic racism have contributed to "soaring rates" of childhood mental health emergencies, including suicide attempts.

"The number of adverse childhood experiences, or childhood traumas, has skyrocketed. And correlating to that has been a dramatic increase in depression, anxiety, trauma symptoms, PTSD, even feelings of loneliness," says Dr. Jonathan Goldfinger, a pediatrician and CEO of non-profit Didi Hirsch, which provides free mental health and suicide prevention services.

"Domestic violence, child abuse of all kinds, drinking among parents, all of these things increase during pandemics and times of enormous stress," Goldfinger tells PEOPLE ahead of the Alive Together: Uniting to Prevent Suicide event on Sunday. "Sadly, there are about 140,000 kids across the United States who actually lost a parent or caregiver to COVID. And they are disproportionally Black and Latinx. We're talking about significant trauma and loss."

According to a November 2020 report from the Centers for Disease Control and Prevention, mental health-related emergency room visits for children 5-11 rose 24% last year compared to 2019, while visits among adolescents 12-17 increased 31%.

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Goldfinger is urging everyone — especially parents — to openly discuss mental health with their families and join community efforts to promote mental health care accessibility.

"We are seeing suicide attempts and losses at alarming, alarming rates across the United States. Now is the time to really talk about it with our loved ones and ensure that mental health care is available to all those who need it," he says.

Warning signs of childhood suicide attempts often "present differently" than they do in adults. "The frightening thing is that probably the symptoms are not as obvious in younger people," Goldfinger explains about indicators of potential self-harm in kids ages 5-11. "When we talk about adults, usually we say know the signs: someone who says their life is not worthwhile, they feel not worthwhile, they start putting their affairs in order, they act a little bit strange about the future. But a child does not have the brain lobes developed to tell them to think about the future. The kids are not putting their affairs in order. A lot of times what we hear from parents is, 'I had no idea.'"

"If there's anything, absolutely anything we can do" to mitigate risks, he says, "it's teaching all children about suicide and the risks and symptoms of suicide, as well as talking to our kids. Every single parent should be having some form of a conversation with their child about how they're feeling, how they're doing, and check in frequently."

Goldfinger says quality listening and immediately reaching out to a suicide prevention service is essential when helping someone you suspect is in danger, regardless of their age. "Tell the person, 'I'm here for you.' Repeat that over and over again. Say, 'I am listening' and then actually listen. Don't judge. Don't try to act how you feel about it in terms of ethics, in terms of your particular religious or moral system. Just listen and you can save a life just by being there. And then absolutely call [the National Suicide Prevention Lifeline at 1-800-273-8255]," he encourages.

While vigilance within individual homes is imperative, Goldfinger notes that only collective action to combat "structural or systematized stigma" will lead to substantial and equitable changes to the current crisis.

"If there is one thing people can do in addition to talking to their kids, speak to your members of Congress, speak to your elected officials in your state. Tell them that mental health is health. It's a right," he urges.

Goldfinger, along with celebrities including Melissa Rivers, Lance Gross and Selena Gomez, will be supporting survivors of suicide loss and attempts during the Alive Together: Uniting to Prevent Suicide event on Sunday. Participants can join the walk at Exposition Park in Los Angeles or virtually through Didi Hirsch's social media channels.

If you or someone you know is considering suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), text "STRENGTH" to the Crisis Text Line at 741-741 or go to suicidepreventionlifeline.org.