high risk for suicide. Although it is beyond the scope of the current article to detail here, teachers and school staff can be trained to help recognize warning signs of suicide and make timely referrals for play therapy. School-based play therapists can be advocates for children experiencing suicidal ideation by revisiting absence policies and encouraging academic accommodations and extensions, when appropriate. Finally, professional advocacy for more time and attention to mental health services in schools can support the needs of children in crisis.


Play therapists in community settings may be more likely to provide family treatment around issues of suicidality. Community-based play therapists may provide long-term play therapy to diagnose and treat underlying mental health problems that may be risk factors for suicidality, including        disorders. Given the aforementioned connection between ADHD and suicide completion for young children, play therapists need to help children and caregivers develop strategies for impulsivity for children with suicidal ideation. Evidence-based therapeutic interventions for young children’s ADHD symptoms focus on building executive functioning and improving parent-child interactions (Halperin & Marks, 2019). Play therapists working  on skills for making decisions and managing emotions.


More broadly, play therapists should be mindful of how trauma impacts children’s development, emotional regulation, and impulsivity, as child abuse is a risk factor for suicidal behavior (Braquehais et al., 2010). Play therapists working in community settings should include strategies for safety monitoring in various contexts in the safety plan. Community- based play therapists can also offer to consult with school personnel if needed about the child’s safety or treatment plans.


Conclusion Caring and supportive adults serve as a protective factor against suicide. As play therapists learn about children’s experiences through play, they provide hope in the face of despair through relationship, presence, and bearing witness to emotional pain. Play therapists need to be ready to ask about suicide, assess for risk, provide hope, and create safety plans to ethically provide urgent services for children in crisis and to save lives. They may partner with school personnel, other community mental health actors, and parents to effectively respond to suicidal ideation in their clients.


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ABOUT THE AUTHOR


Emily C. Brown, PhD, LPC, RPT-S, NCC is an Assistant Professor and Director of the Play Therapy Institute at the University of Missouri - St. Louis. A former school counselor, she now provides play therapy instruction  Question Persuade Refer, a suicide gatekeeper program.


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