There is perhaps nothing more shocking than hearing about young children taking their own life.
It is difficult for us to comprehend that children as young as five could even conceive of killing themselves. There has been a widely held belief among adults that young children do not have the planning ability or understanding of death's finality to consciously make this decision. Yet they do. Our inability to acknowledge this has even impacted the focus of research on child suicide, with most investigators beginning with 12-year-olds.
The number of young children who kill themselves has always been small, but it has been steadily increasing over time. The American Foundation for Suicide Prevention states that overall, there is an average of 123 suicides a day. For the very young, it is one every five days. These numbers may not fully reflect reality, however, as failed attempts are not reported and some completed acts may be seen as mere accidents.
The following are important facts that we need to know about child suicide:
- According to 2016 data from the Centers for Disease Control (CDC), young children are most likely to kill themselves by hanging, strangling, and suffocation. Guns are the second most common method used.
- Children can experience feelings of depression and hopelessness, but a 2016 study found that attention deficit/hyperactivity disorder (ADHD) was a factor in 60 percent of suicide attempts and completions, while only 33 percent had depression.  Due to a similarity of symptoms, it may be that some children diagnosed with ADHD might actually have a bipolar disorder. Other research from Penn State College of Medicine found that bulimia in children as young as six seemed to be a greater risk factor for suicide than depression. 
- A 2018 study that appeared in the Journal of American Medical Association (JAMA) Pediatrics, found that young black male children had a higher suicide rate than young white male children. Indeed, since the 1990s, suicide by hanging has nearly tripled among young black males. Overall, however, suicide rates in whites have been higher across all age groups. In this case, from age 13 to 17, the trend was again reversed with suicide rates for whites being greater than for blacks. It has been speculated that the difference in the rates for the young black children may be related to a disproportionally higher exposure to violence or trauma. The exact cause is yet unknown. 
- There are other factors that make some children more vulnerable to suicidal thoughts and behaviors. Bullying, for instance, has been found to be a significant factor in child suicide.  Now, due to the pervasiveness of social media, it is more difficult to escape being bullied even while at home. Other risk factors can include physical abuse, sexual confusion, antisocial behaviors, being neglected, sexual abuse, aggressive behaviors, and feeling a sense of worthlessness or hopelessness. The risk is also higher if someone else in the family has committed suicide. Younger children seem to be more impacted by family conflict—while for teens, it is their peer relationships that have the biggest effect.
The important thing is to recognize that children as young as five do kill themselves. What can we do? For starters, we can recognize that if a child is thinking about suicide, that it is an indication that they are experiencing a great deal of pain and distress.
There is an old myth that talking to someone who is suicidal will increase their risk of doing it. This is not true. With young children, it is important to ask them directly if they are having thoughts of hurting themselves, as they will not usually offer the information on their own. You can never go wrong with talking and listening to a child. Ignoring their thoughts and feelings is much more of a problem—and could lead to deadly results.
Parents should talk to their pediatrician and contact a therapist to help the child and family cope. Additionally, parents can help their children to develop resilience and problem-solving skills by asking them what they would do in different situations that might be harmful or dangerous for them. Practicing skills in a safe environment allows them to think through scenarios so they can be better prepared to cope more effectively with adversity.
At the present time, there is not enough research on treatment-based outcomes with young children to say that there is a "proven" therapeutic approach for working with them. Questionnaires and interventions for adults and adolescents, such as the Collaborative Assessment and Management of Suicidality (CAMS), are undergoing revisions to make them more appropriate for young children. 
What can schools and communities do? John Hill, LCSW, is a school suicide prevention specialist with the Mercy Family Center in New Orleans, Louisiana. He states that they have recently been getting more and more requests for help with children in the first and second grades. Like most school suicide prevention programs, a team goes out to the school and assesses their needs. Schools are the most logical place to start, as children spend the majority of their time there.
He states that some schools do not even have a protocol for how to address suicidality. The team helps them to either develop one or review and update an existing one. They also provide training to all the faculty and staff at the school. Personnel at the schools are often the first ones to become aware that a child may be having problems. Essentially, anyone working with young children should be alert to the fact that children of any age can be vulnerable to suicidal thoughts and feelings. Taking them seriously—and intervening—might prevent an attempt or completion for younger as well as older children.
1) Sheftall, A.H., Asti, L, Horowitz, L.M., et al. (2016) Suicide in Elementary School-Aged Children and Early Adolescents. Pediatrics, 138(4): e20160436.
2) Mayes, S.D., Fernandez-Mendoza, J., Baweja, R., Calhoun, S. Mahr, F., Aggarwal, R. and Arnold, M. (2014) Correlates of Suicide Ideation and Attempts in Children and Adolescents with Eating Disorders. Eating Disorders. 22 (4): 352-366
3) Bridge, Jeffrey, Horowitz, L.M., Fontanella, Cynthia, A.; et al. (2018) Age related Racial Disparity in Suicide Rates among U.S. Youth from 2001 to 2015. JAMA Pediatrics. 172(7): 697-699.doi:10.1001/jamapediatrics 2018.0399.
4) Anderson, Abby R., Keyes, Grace M. and Jobes, David A. (2016) Understanding and Treating suicidal Risk in Young Children. American Psychological Association, Practice Innovations. Vol 1, No 1, 3-19.