“I want to get some bad-ass tattoos”: study reveals why suicidal teens choose to keep living

A new study has revealed the deeply personal reasons that suicidal adolescents give for wanting to live, with family, friends, pets, and hopes for the future topping the list.

The research, co-authored by Dr Mathijs Lucassen from City St George’s, University of London, could transform how mental health professionals support at-risk young people.

To find out more about the personal reasons that young people experiencing suicidal thoughts give for wanting to live, the international research team analysed the words of 211 adolescents aged 13 to 17 who had been hospitalised during a suicidal crisis in the United States. Each young person was asked to share three “reasons for living” (RFL) as part of routine safety planning.

Family connections were the most common reason, but many young people also spoke about personal dreams and simple joys, from career goals and travel to what might seem relatively simple things, such as attending a concert or getting a meaningful tattoo. The study has been published in the American Psychiatric Association journal Psychiatric Services.

Dr Lucassen said:

“Adolescent suicide is a major challenge and determining a person’s reasons for living provides unique insights into who and what is most important to at-risk adolescents. Our research identified a range of reasons, from personal dreams to meaningful activities. RFL can be used to build therapeutic relationships, establish therapy goals, and personalise treatments. This can then lead to tailored support and hopefully reduced suicidal thoughts and behaviours.”

The study found that “my” was the most frequently used word, showing how strongly young people tied their survival to relationships, places, and personal ambitions. Many expressed curiosity about the future, writing things like “to see what the future has for me” or “to live for myself and enjoy my life”.

The researchers, Dr Ana Ugueto (Baylor College of Medicine, Texas Children’s Hospital), Dr Lauren O’Hagan (The Open University) and Dr Lucassen, indicated that these findings highlight the importance of hope-centred, personalised approaches to suicide prevention. Integrating each young person’s unique RFL into therapy could help strengthen protective factors and provide more meaningful support during crises.

The study drew on a diverse group of adolescents, with almost half identifying as Latino or Hispanic and with strong representation also from Black and Caucasian adolescents. This breadth of voices, the researchers note, makes the findings relevant for clinicians working with young people from diverse racial and ethnic backgrounds.

With suicide remaining a leading cause of death among teenagers worldwide, the team says these insights could help clinicians, families, and communities find new ways to help at-risk adolescents feel further seen, valued, and connected.

Get Support

For people who may be affected by the content of this article, a list of organisations from which to seek support in the UK:

for a list of organisations relevant to their work.

If you're a student at City, and need support, you can get help through the Student Counselling and Mental Health Service.

If you're a member of staff at City, you can access support through the Occupational Health Service.

If you, or someone you know, needs support there are a number of helplines you can call:

Samaritans

Whatever you’re facing, a Samaritan will face it with you. We’re here, day or night, for anyone who’s struggling to cope, who needs someone to listen without judgement or pressure.

Call: 116 123 for free from any UK mobile phone network or landline provider (restrictions may be in place on landlines from some offices, organisations and care homes).

https://www.samaritans.org/

Galop

We support LGBT+ people who have experienced abuse and violence

https://galop.org.uk

You can also talk to your General Practitioner (GP) about any concerns you may have and can make an emergency appointment.