When your teen is struggling

This page is not medical advice or a diagnosis. Only a trained professional can tell what is going on with your teen. Do Not Lose Hope does not provide counseling or crisis help.

What are the warning signs of suicide?

If your teen talks about wanting to die, has hurt themselves, or you think they might, do not wait. The National Institute of Mental Health lists these warning signs. Get help as soon as possible, especially if a sign is new or has gotten worse.

Your teen talks about:

• Wanting to die
• Great guilt or shame
• Being a burden to others

Your teen feels:

• Empty, hopeless, trapped, or like they have no reason to live
• Extremely sad, more anxious, agitated or full of rage
• Unbearable emotional or physical pain

Your teen's behavior changes:

• Making a plan or looking up ways to die
• Pulling away from friends, saying goodbye, giving away important things, or making a will
• Taking dangerous risks, like driving very fast
• Extreme mood swings
• Eating or sleeping more or less
• Using drugs or alcohol more often

What do I do right away?

1. Ask. "Are you thinking about suicide?" Asking does not make it more likely.
2. Stay with them and listen without judging. Do not leave them alone if you think they are in danger.
3. Keep them safe. Ask if they have a plan. Remove or lock up guns, medicines, alcohol and other things that could be used to hurt themselves.
4. Connect them to help. Call or text 988 together. If a life is in danger right now, call 911.
5. Stay close afterward. Keep checking in, and help your teen keep their appointments.

Where can my family get help?

Start with the school counselor or your teen's doctor. Many families do. You have other doors too.

The school counselor

Ask for a meeting. School counselors see your teen every day and know local services. Need an interpreter? Ask if one can join. You can also tell a teacher you trust what you have noticed.

Your teen's doctor

Call your teen's pediatrician or clinic. Tell the doctor what you have seen and for how long. Doctors check many patients ages 12 to 21 for depression at yearly checkups. Not sure where to go for mental health care? The doctor can help you find it.

Your county's mental health line

Call. You can call for someone you are worried about. These lines answer questions, check what your teen needs and connect you to counseling.

• For San Mateo County residents (including East Palo Alto): ACCESS Call Center, (800) 686-0101, open 24 hours a day. TTY: 711. For residents with Medi-Cal or no insurance. Staff speak English, Spanish and Chinese, with free phone interpreters for other languages.
• For Santa Clara County residents (including Palo Alto): Behavioral Health Services Call Center, (800) 704-0900. For a child or teen in a mental health crisis, the county's youth crisis team is at the same number: press 1, open 24 hours a day, every day.
• Other California counties: find your county's mental health line on the DHCS county list.
• Outside California: call or text 988 and ask what youth services are near you, or ask your teen's doctor or school.

allcove youth centers (San Mateo and Palo Alto)

If you live near San Mateo or Palo Alto, teens can go on their own. allcove says most of its services do not need a parent's consent. It talks with parents only with the young person's permission or when state law requires it. allcove centers are for young people ages 12 to 25 with mild to moderate needs. They offer counseling, peer support, physical health and family support. Services are free or low cost, and staff confirm the cost before an appointment.

• allcove San Mateo: 2600 South El Camino Real, Suite 300, San Mateo. Monday to Friday, 1 to 7 p.m. Services in English, Spanish and Cantonese. Not billed to insurance.
• allcove Palo Alto: 2741 Middlefield Road, Suite 102, Palo Alto. Monday to Friday, 1 to 7 p.m. Services in English, Spanish and Vietnamese. May bill insurance, depending on your plan.

Medi-Cal for your teen

In California, children and teens ages 0 to 18 can get full Medi-Cal no matter their immigration status, if they meet the other rules, such as income. The 2026 freeze on new sign ups for some adults does not apply to children. Medi-Cal includes mental health care for children and youth under 21. It is confidential. Questions: the Medi-Cal Help Line is 1-800-541-5555.

A change is coming. Starting January 1, 2027, Medi-Cal members DHCS lists with "unsatisfactory immigration status," children included, move from a health plan to Medi-Cal Fee for Service. Your teen keeps Medi-Cal; what changes is how you find doctors. County specialty mental health care continues, and the Help Line can help you find providers (DHCS, checked October 21, 2026).

Can my teen get counseling without me?

In California, yes, in many cases. Since July 1, 2024, a teen 12 or older who is mature enough to take part can agree to outpatient counseling on their own, including in Medi-Cal (DHCS BHIN 24-046). The counselor is expected to involve you unless they decide that would not be right for your teen, and they must write down why. This rule does not cover medicine: a teen cannot start psychiatric medicine without a parent's consent.

If your teen chooses to start counseling alone, it is not a rejection of you. It is your teen asking for help. Tell them you are glad, and that you are there when they want you.

Teen Line, for your teen

Some teens open up more easily to another teen. Teen Line is a free, confidential line where trained teen volunteers listen, with adult professionals behind them. It is for young people up to age 19, and right now it is in English only. For parents and caring adults who need support for a teen, Teen Line points to 988.

988 Suicide & Crisis Lifeline

You can contact 988 for yourself or because you are worried about someone else. For other languages, call 988 and ask for an interpreter. Phone interpreters are available in more than 240 languages.

Which changes mean my teen needs help?

Watch for change that lasts, or that gets in the way of daily life. Teens have bad days. Some moodiness is normal. Health experts say to pay attention if your teen:

• Seems sad or cranky much more than usual, most days
• Loses interest in things they used to love
• Sleeps much more or much less, or seems tired all day
• Eats much more or much less
• Spends more and more time alone and pulls away from friends or family
• Has trouble paying attention, or their grades drop
• Often complains of stomachaches or headaches with no clear cause
• Seems scared or worried much of the time
• Stops caring how they look
• Starts using alcohol or drugs, or takes big risks
• Hurts themselves, for example by cutting or burning their skin
• Says they hear things other people cannot hear

One sign alone does not mean something is wrong. Reach out to a professional if:

• Several signs show up together, most days, for more than two weeks
• The changes get in the way of school, home life or friendships
• Your teen asks for help, or says they feel hopeless
• You see signs of self harm, eating problems, or drug or alcohol use

Get help right away if you see any of the warning signs of suicide. You know your teen best. If your heart tells you something is off, act. Getting help early can make a real difference. Asking for help is love, not failure.

How do I start the conversation?

Show you care and that you will not get angry. That matters more than perfect words.

1. Pick a calm time. Not in the middle of a fight. Many teens talk more easily side by side, like in the car, on a walk or while cooking.
2. Say what you noticed, without blame. "I have noticed you have been staying in your room a lot. I miss you. How are you doing?"
3. Ask, then wait. Silence is OK. Give them time to answer.
4. If they do not want to talk, that is OK too. Say "I am here whenever you are ready," and try again another day.
5. Ask directly if you are worried about suicide. It is hard, but asking "Are you thinking about killing yourself?" does not put the idea in their head. Research shows asking does not raise the risk, and it can open the door to help.

Would they rather talk to someone else first? That is fine. A relative, coach, teacher, pastor or school counselor can be another caring adult.

How do I listen when my teen opens up?

Your first job is to listen.

• Let them finish. Do not jump in with advice.
• Repeat back what you heard: "It sounds like school has felt really lonely."
• Take their feelings seriously, even if the problem looks small to you. To them it is big.
• Thank them for telling you. That makes it easier for them to talk again.
• Ask what would help: "Do you want me to just listen, or help you figure out what to do?"

What should I avoid saying or doing?

• Saying "you are just being lazy" or "you are too sensitive." A teen who is depressed is not making it up.
• Comparing them to siblings, cousins or yourself at their age ("When I was your age, I had it much harder").
• Yelling, shaming or punishing them for how they feel.
• Promising to keep a secret if their safety is at risk. You can say "I love you too much to keep this to myself."
• Telling the whole family before your teen is ready, unless their safety is at risk.
• Waiting for it to pass on its own when signs keep going.

What if fear about immigration is part of it?

Many teens in immigrant families carry worry they do not talk about. They may fear a parent will be taken away. They may see raids in the news or on social media. They may feel they have to protect the family, translate for adults, or keep secrets. This stress can show up as anger, stomachaches, trouble sleeping, skipping school or staying in their room.

What helps:

• Be honest, in a calm way. Your teen can tell when something is wrong. Share what is true at a level they can handle. You do not have to share every worry.
• Tell them there is a plan. Knowing who will care for them if something happens can ease a lot of fear. See Make a family preparedness plan and If immigration agents come.
• Keep daily routines. Meals together, regular sleep and school give a teen something steady.
• Notice the news. Hours of scary videos can make fear grow. Ask what they are seeing, and plan time away from screens together.
• Let them be a teen. Try not to make your teen responsible for adult problems.

How do I take care of myself too?

You matter too. Watching your child struggle hurts. It can bring up your own fear, sadness or guilt. You deserve support. You can call or text 988 for yourself, talk with your own doctor, or see Mental health care without fear. Many families also find strength in prayer and in their faith community. A pastor or faith leader can be one more caring adult, alongside professional care. Your teen is not beyond hope, and neither are you.

Who can help

These are public programs, clinics and free helplines. Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org. Free and confidential, available 24/7/365. Spanish: dial 988 and then press 2, or text AYUDA to 988. 988lifeline.org
• For San Mateo County residents: BHRS ACCESS Call Center: (800) 686-0101, 24 hours. TTY 711. smchealth.org
• For Santa Clara County residents: Behavioral Health Services Call Center: (800) 704-0900. Youth crisis team: press 1, 24 hours. Services for children and youth
• Other California counties: DHCS county mental health lines
• allcove San Mateo (for families near San Mateo): ages 12 to 25. (650) 226-7030. allcove.org
• allcove Palo Alto (for families near Palo Alto): ages 12 to 25. (650) 798-6330. allcove.org
• Teen Line: for teens up to age 19. Call (800) 852-8336, 6 to 10 p.m. Pacific, or text TEEN to 839863, 6 to 9 p.m. Pacific. teenline.org
• Medi-Cal Help Line: 1-800-541-5555. dhcs.ca.gov
• 211: free help finding other local services in many areas. In California, 211 does not cover every county. 211: free help finding local services