Suicide and non-suicidal self-injury

Contemporary research and literature demonstrate children and young people with diverse SOGIE-SC have an increased risk of poor mental health outcomes, including depression, anxiety, suicide and non-suicidal self-injurious behaviour than the general population. (Refer to the practice guide Supporting children and young people with diverse SOGIE-SC.)

Non-suicidal self-injury occurs when someone deliberately inflicts harm to their body tissue without intending to end their life. For many, it is a way to communicate or cope with intense emotional pain or distress, often used to manage or change overwhelming feelings. Among young people, common behaviours include cutting and overdosing (Miesch).

While non-suicidal self-injury behaviours are commonly associated with a range of mental health problems, they are not classified as a mental illness or disorder (Orygen (b)). 

Respectful language 

The words used to talk about suicide are an important and simple way to reduce stigma and feelings of shame. Suicide was once a criminal act, however, it is no longer a crime. Therefore, it is not appropriate to say someone has ‘committed’ suicide. Some preferred words to use are set out in the following table. 

Suicide and mental health support services

Disconnection is one of the most common risk factors for suicide. Talking to someone who may be thinking about suicide can make a significant difference. It can help them feel heard, encourage them to reach out to others, and connect them with professional support (Conversations Matter). 

When a person experiencing suicidal ideation can talk openly about suicide without condemnation, this can bring relief. This openness can help redirect any plans toward addressing the underlying pain and suffering (Balaratnasingam). (Refer to Practical tools and strategies.) 

There are many support options available for those experiencing suicidal thoughts or actions and those around that person. The table below displays some which may be useful in different situations.

Risk factors for suicide

Suicide is complex and many factors may contribute to suicidal thoughts or behaviours. These factors are often grouped as: 

• static (unchangeable), such as past history 
• dynamic (changeable), such as current stressors (World Health Organisation (d)). 

Disconnection is the one of the strongest risk factors of suicide for both Aboriginal and Torres Strait Islander peoples and for those from culturally and linguistically diverse backgrounds. This may be disconnection from culture, community, family, and identity, and can result from migration, resettlement, or systemic barriers (Australian Institute of Health and Welfare (c)). 

Key risk factors related to disconnection include:

• loss of cultural identity and traditions
• social isolation
• racism and discrimination
• intergenerational conflict
• trauma and displacement
• barriers to accessing services.

Myths and misconceptions about suicide

There are many myths and misconceptions about suicide which may stop someone reaching out for help, due to feelings of shame or being judged. Correctly understand these by exploring Lifeline’s website Suicide stigmas, myths and misconceptions which integrates debunking common myths with stories from lived experiences. 

Support a parent thinking about suicide

If there are concerns a parent wants to take their own life, SANE Australia offers practical suggestions for how to support the parent:

Talk to a child whose parent is suicidal, self-harming or very unwell

A child whose parent has suicidal thoughts, self-harmed, or is experiencing low mental wellbeing, is likely to feel scared or worried for their parent. They may feel responsible for their parent or fearful Child Safety’s involvement may increase their parent’s distress These feelings may stop them asking for help or seeking support.

It is best if the parent can explain to their child what is happening, however, this may not be possible. As it is important the child is informed, make an opportunity to talk to the child to: 

• let them know what is happening in a way they can understand
• explain who is looking after their parent and who is looking after them 
• ask them about their worries or questions
• provide them with accurate age-appropriate information. 

Consider using The Immediate Story tool.

Support for a child or young person at risk of suicide

Support for a child or young person at risk of suicide requires a holistic and culturally respectful approach that includes their parents and caregivers as a parent’s mental health can directly impact a child’s risk as it influences attachment, stability, and the child’s coping behaviours. Parents may also face their own suicidality, requiring parallel support. (Refer to Meet a child’s health and wellbeing needs.)

Engage parents as partners to build their capacity to act as a protective buffer for their child. Feelings of guilt, shame, or fear of the department’s involvement may be a barrier to seeking help. Refer to the Responding to a child at risk of suicide—flow chart for a visual illustration of the steps required when responding to a child at risk of suicide.

The following 3-minute animated video illustrates Dr Brene Brown’s explanation of how empathy is the best way to ease someone’s pain and suffering.   

Engage with a child or young person about suicide

It is important to have open and supportive conversations with a child about their thoughts and feelings regarding suicide. If a child engages in or initiates such a conversation, use this as an opportunity to discuss their safety in a calm and non-judgemental way.  

Simply focusing on external measures, such as removing their capability or directing adults around them to ensure their safety, may not fully address the underlying risk. This is because the risk often remains internal to the child. Effective intervention should not only involve creating a safe environment but also empowering the child to develop the skills and strategies needed to manage their feelings and avoid seeing suicide as a solution.  

The Queensland Centre for Mental Health Learning has produced a 15-minute video demonstrating safety planning. You will see this brief but essential intervention that comes after an assessment for suicide risk that is an evidence-based, collaborative, and therapeutic strategy to help a person cope with a suicidal crisis. Refer to the Instructional safety planning video.

Suicide among Aboriginal and Torres Strait Islander peoples

Suicide contributes to premature mortality in First Nations people, especially in younger age groups ((Australian Institute of Health and Welfare (c)). 

The following 2-minute video Keeping everyone safe provides advice for when someone threatens to end their life to get something they want. 

Practical tools and strategies 

Starting a conversation with someone you suspect may be feeling suicidal requires sensitivity and care. Ask directly, using the following 4 steps: 

1. Show empathy

'It sounds like you’re having a hard time at the moment.’

2. Normalise

'It’s common when young people are going through big troubles, they can have thoughts of killing themselves.'

3. Ask directly

'I am wondering if you’re having thoughts of killing yourself?'

4. Be specific

Lifeline have made available a free app Beyond Now Safety Planning.

Postvention

Postvention is the support and intervention provided after a suicide to help individuals, families, and communities cope with the loss and reduce the risk of further suicides. It aims to address the emotional, psychological, and social impacts of suicide, particularly for those who were close to the person who died, such as family members, friends, or colleagues, often referred to as ‘suicide survivors’.

The aims of postvention include:

• support the grieving process to reduce feelings of isolation or stigma
• provide mental health support to reduce the risk of complicated grief, trauma, or suicidal thoughts among those affected
• promote healing and resilience within individuals and communities
• prevent suicide contagion, where exposure to suicide may increase the risk of others attempting suicide.

Postvention can involve counselling, peer support groups, community healing activities, and culturally appropriate practices, particularly for Aboriginal and Torres Strait Islander communities, where collective healing and connection to culture are vital.

Non-suicidal self-injury

Non-suicidal self-injury is a complex issue often driven by hidden and multifaceted factors. Caregivers may unintentionally misinterpret the behaviour by relying on assumptions that oversimplify the situation. This can happen when caregivers are grappling with their own strong emotional reactions, uncertainty about the underlying causes, a desire to eliminate risk quickly, or a reliance on consequences to manage the behaviour. 

Addressing this issue requires a deeper understanding of the young person’s experiences and needs (Miesch).

Common myths about non-suicidal self-injury

The following table debunks common myths about non-suicidal self-injury (Miesch).

Support parents in responding to their child’s non-suicidal self-injury

Parents may feel helpless, confused, or guilty upon learning their child is engaging in non-suicidal self-injury. 

Explain to parents that self-injury is used to regulate emotions, rather than being attention-seeking behaviour or an automatic indicator of suicidality.  

Support parents by educating them on harm minimisation strategies and emphasising the importance of maintaining open, non-shaming communication with their child. Connect parents with counselling or support services to help them process their own distress and better equip them to support their child effectively.

Support a child experiencing non-suicidal self-injury

Non-suicidal self-injury often provides temporary relief from overwhelming emotions, trauma triggers, or struggles with identity. Key contributors to self-injury can include cultural disconnection, identity challenges, bullying, and experiences of systemic disempowerment.  

Validate that the child is currently using the only coping mechanism available to them, while supporting them to develop safer and healthier alternatives. Practitioners should prioritise the child’s emotional safety over immediate behaviour management by addressing the underlying distress rather than focusing solely on the behaviour itself.

Practical tools and strategies for non-suicidal self-injury

Engaging with a child who is engaging in non-suicidal self-injury requires a compassionate, non-judgmental, and supportive approach.

Avoid focusing solely on stopping the behaviour; instead, address the underlying emotions and triggers. Be mindful not to express shock or judgement, as this can increase shame or withdrawal. 

Harm minimisation

Taking a harm minimisation approach to non-suicidal self-injury acknowledges that to suddenly cease all non-suicidal self-injury can increase emotional distress and elevate risk. This approach focuses on reducing harm while supporting the individual to develop safer coping mechanisms.

Key strategies include:

• substituting safer alternatives, such as using ice cubes or snapping rubber bands
• providing medical care for wounds to prevent infection or complications
• monitoring emotional triggers in real time to address distress as it arises
• acknowledging sorry cutting as a culturally appropriate practice in some Aboriginal and Torres Strait Islander communities.