Quick Answer:

Passive suicidal ideation means an adolescent has thoughts about death, disappearing, or wishing they were no longer alive, but does not have a specific plan or intent to act. Active suicidal ideation means the teen has suicidal thoughts along with intent, a plan, access to means, or steps towards self-harm. Both should be taken seriously, but active suicidal ideation requires immediate intervention.

If an adolescent may be in immediate danger, parents or caregivers should seek emergency support right away. For suicide or emotional crisis support in the U.S., call or text 988, or use the 988 Lifeline chat at www.988lifeline.org/chat.

Why This Matters For Parents

It can be hard for parents to know how serious to take things when a teen or pre-teen says they are thinking about suicide, especially when their child doesn’t say, “I want to die” directly.  Suicidal ideation is a scary, complex and often difficult issue that usually requires professional help such as therapy, counseling, or, in extreme cases, residential treatment. Some adolescents talk about death openly, while others say things that sound vague, hopeless, or passive, such as “I wish I could disappear” or “People would be better off without me.” These statements should not be ignored.

Suicidal thoughts among teens are not rare, including here in Tennessee. According to the 2023 Tennessee Youth Risk Behavior Survey (YRBS), 24.1% of Tennessee high school students seriously considered attempting suicide in the past year, 19.6% made a suicide plan and 15% attempted suicide one or more times. The same survey found that 42.7% of Tennessee high school students felt so sad or hopeless for at least two weeks that they stopped doing some usual activities.

Understanding the difference between passive and active suicidal ideation can help parents respond with the right level of urgency while still taking every expression of suicidal thinking seriously.

What Is the Difference Between Passive and Active Suicidal Ideation

Passive Suicidal Ideation

Passive suicidal ideation in adolescents involves thoughts of death or a desire to die without a specific plan or intent to act on these thoughts. Adolescents experiencing passive suicidal ideation may feel overwhelmed by the challenges they face, but they have not yet formulated concrete plans or taken steps toward self-harm. These thoughts can be distressing and intrusive, often causing significant emotional pain.

Passive suicidal ideation factors include:

• Lack of Intent: Passive suicidal ideation involves thoughts of death or suicide without a specific intent to act on these thoughts. Individuals with passive ideation may wish they were dead or think about what it would be like to die, but they may not have a concrete plan or desire to carry out self-harm.
• Lower Immediate Risk: While passive suicidal ideation is a concerning sign of emotional distress and should not be dismissed, it is generally considered to be at a lower immediate risk compared to active ideation.
• Still Serious: Passive suicidal ideation should not be taken lightly, as it can progress to active ideation, especially if the underlying issues causing the distress are not addressed. It is important to provide support and professional help for individuals with passive ideation to prevent escalation.

“An adolescent may say things like, ‘I wish I could disappear,’ ‘People would be better off without me,’ ‘I don’t see the point,’ or ‘I just want everything to stop,’” said Summer Appleby, program administrator at Embrace U’s clinic in Smyrna. “Some teens may not verbalize these thoughts at all but communicate them through artwork, journaling, music choices, social media posts, withdrawal from activities, or increasing hopelessness.”

It’s essential for parents, caregivers, and mental health professionals to be vigilant and assess the severity and nature of a young person’s suicidal ideation. Both active and passive ideation require attention and intervention, but the urgency and type of intervention may vary. Regardless of the level of ideation, it is crucial to seek professional help promptly and provide emotional support to the adolescent. Encouraging open communication and expressing concern in a non-judgmental manner can be instrumental in helping adolescents who are struggling with suicidal thoughts.

“I pay attention to recurring themes of isolation, emptiness, being trapped, disappearance, or loss of purpose in creative expression,” said Appleby. “While these themes alone do not indicate suicidal intent, they can signal emotional distress that deserves exploration and support.”

Active Suicidal Ideation

Active suicidal ideation in adolescents is characterized by having a specific plan or intent to take one’s own life. It goes beyond mere thoughts and involves a clear intention to carry out self-harm. This is a critical distinction, as active suicidal ideation demands immediate attention and intervention from mental health professionals or support networks.

Active suicidal ideation factors include:

• Intent and Planning: Active suicidal ideation involves thoughts of suicide with a clear intent or desire to end one’s life. In this state, the individual may actively plan or have a specific intention to carry out a suicide attempt.
• Higher Risk: Active suicidal ideation is generally considered a higher-risk situation because there is a greater likelihood that the individual may take immediate action to harm themselves.
• Emergency: When someone is experiencing active suicidal ideation, it is typically considered an emergency, and immediate intervention is needed to ensure their safety. This may involve hospitalization or crisis intervention to prevent a suicide attempt.

“Emergency intervention is generally needed when a teen has: active suicidal thoughts with intent, a specific plan, access to means, inability to agree to a safety plan, and severe impairment in judgment or emotional regulation,” said Appleby.

Why Parents Should Take Passive Suicidal Thoughts Seriously

Passive suicidal thoughts are often an indicator of significant emotional pain. Even if a teen has no plan or intent, those thoughts may suggest they are struggling with hopelessness, helplessness, trauma, depression, anxiety, bullying, family stress, relationship difficulties, or another concern that needs support.

“From a prevention standpoint, we want to intervene before a crisis develops,” said Appleby. “Taking passive suicidal ideation seriously allows families and professionals to provide support early, strengthen coping skills, and address underlying concerns.”

It is important for parents to respond with curiosity and compassion rather than fear, judgment, or punishment. Ask open-ended questions, listen carefully, and let your teen know they are not a burden and do not have to face these feelings alone. A mental health professional can help assess risk, identify underlying concerns, and develop a personalized safety and support plan. Early intervention can help teens build healthier coping skills and remind them that their circumstances, and the way they feel today, can change.

How Embrace U Can Help Adolescents with Suicidal Ideation

Embrace U has helped dozens of teens and pre-teens in Tennessee learn how to manage suicidal thoughts, gain self-esteem, and build communication skills. If your child is showing signs that they are struggling with depression or suicidal ideation, we can create treatment plan based on their symptom levels and goals. Contact us today to learn more about how we can help your child overcome mental health struggles.

Embrace U was created to help adolescents ages 10 to 18 who are experiencing a mental health challenge. Our group-based therapy programs provide education, skill development, medication management as needed, and peer support. To get started we provide an intake assessment, then recommend the appropriate treatment program. Our team builds a plan around your needs, and offers a weekly parent support group. Unlike other treatment centers in Tennessee, we keep parents updated throughout treatment, provide educational opportunities and offer post-treatment follow-up. Our team includes licensed therapists and psychiatric providers who are experienced in making connections with young people.

How Parents Can Help with Passive Suicidal Ideation:

• Open Communication: Provide your adolescent with a secure and nonjudgmental environment in which to express their emotions. Encourage them to communicate their feelings and thoughts to you.
• Seek Professional Assistance: It’s critical to speak with a mental health professional who can offer the necessary advice and support if you notice persistent indications of passive suicidal ideation.
• Maintain Constant Connection: Monitor your child’s well-being carefully. Keep in close contact with them and check in frequently to ensure they feel supported and cared for.

“Passive suicidal thoughts are often an indicator of significant emotional pain,” said Appleby. “Even if a teen has no plan or intent, those thoughts suggest they are struggling with hopelessness, helplessness, or feeling overwhelmed.”

Should I Ask My Child Directly About Suicide?

Some parents worry that asking about suicide could put the idea in their teen or pre-teen’s head. According to the National Institute of Mental Health, asking an at-risk person about suicide does not increase suicidal thoughts, and talking directly can help reduce shame and open doors to support.

“Research consistently shows that asking about suicide does not create suicidal thoughts,” said Appleby. “In fact, direct and compassionate conversations often reduce shame and increase the likelihood that a teen will seek help. Avoiding the topic can unintentionally communicate that it is unsafe to discuss.”

How Parents Can Help with Active Suicidal Ideation:

• Call for Help: Contact emergency services (911) or a crisis hotline (988) if you suspect that your child is experiencing active suicidal ideation.
• Make Their Home a Safe Space: Remove any potential threats, such as sharp objects or prescription medications, that could be used for self-harm from your home to keep it safe. Continually be there for your adolescent and offer unwavering emotional support. Encourage them to be open and honest about their thoughts and feelings.
• Seek Professional Help: Make contact with mental health experts who focus on adolescent mental health to get the necessary therapy and treatment.

“Passive suicidal ideation can progress to active suicidal ideation if emotional distress intensifies and protective factors weaken,” said Appleby. “A concerning shift is when a teen moves from ‘I wish I wasn’t here’ to ‘I’ve thought about how I could do it.’

If you think your child is suffering from suicidal ideation, it is crucial to seek help. Contact Embrace U today to find an adolescent depression treatment near you.

Supporting Adolescents Dealing with Suicidal Ideation

Understanding and addressing the problem of adolescent suicidal ideation is critical for parents. Suicidal ideation is used to describe the troubling thoughts, fantasies, or obsessions some adolescents may have about taking their own lives. It’s necessary to remember that just because a young person has these thoughts doesn’t mean they will necessarily act on them. Suicidal ideation has passive and active forms, which are two different points on a spectrum.

“Emotional pain does not have to reach a crisis point before a teen deserves help,” said Appleby. “You do not need to prove that you are struggling enough. Thoughts about wanting to disappear, not wanting to wake up, or feeling like life is too hard are important signals that you need support, not signs that you are seeking attention.”

Intrusive Thoughts in Adolescents

Intrusive thoughts are unwelcome, distressing, and often unsettling notions that spontaneously enter an adolescent’s mind. Intrusive thoughts can be about many different things, including self-harm. However, it’s essential to recognize that they are different from suicidal ideation.

Factors like ADHD can lead to more frequent occurrences of intrusive thoughts among adolescents. Managing attention and thought processes can be challenging for those with ADHD, potentially increasing the occurrence of intrusive thoughts. To provide effective support, it’s crucial to differentiate between intrusive thoughts related to ADHD and genuine suicidal ideation. When uncertainty arises, seeking professional guidance or consulting a mental health specialist can offer valuable clarity.

Potential Links Between ADHD and Passive Suicidal Ideation

While passive suicidal ideation is not exclusive to individuals with ADHD, there may be a connection between the two conditions. ADHD can contribute to emotional instability, impulsive behaviors, and difficulties in managing stress, all of which could lead to the emergence of passive suicidal thoughts in adolescents with ADHD. If your child has ADHD, it is important to recognize this connection and look for signs that your child may be struggling with passive suicidal ideation.

Connect with Embrace U Today for Assistance

As a parent, being able to understand the differences between passive and active suicidal ideation is vital to estimating the risk levels that your child may attempt to take their own life. If your child is struggling with these thoughts, seeking assistance from a mental health professional is vital. Remember that support is available, and embracing oneself entails taking the necessary steps to safeguard one’s well-being. You need not confront these challenges in solitude; with the proper guidance, a path toward healing and recovery can be found.

Embrace U adheres to the principle that giving your child medical attention shouldn’t come at the expense of their capacity for living. Adolescents learn coping mechanisms and methods to get past the signs of a mental illness, such as depression or anxiety, through Embrace U. Our outpatient programs give teenagers access to a network of peers who can relate to their struggles. Licensed professionals and other parents offer support to parents.