Why do suicidal teens choose to stay alive? A new peer-reviewed study has an answer, and it’s more personal—and hopeful—than most might expect.
Researchers from St George’s, University of London, and Baylor College of Medicine looked at the real words of 211 adolescents, ages 13 to 17, who had been hospitalized in the U.S. during a suicidal crisis. As part of their care, each teen was asked to name three “reasons for living.” The responses were raw, deeply personal, and wide-ranging—from family members and pets, to dreams of travel, future careers, and even tattoos.
One teen wrote, “I want to get some bad-ass tattoos.” Another said simply, “To live for myself and enjoy my life.”
These reasons, often overlooked in standard risk assessments, could hold the key to helping teens in crisis feel seen and supported in a more human way.
What the Study Found
The study, published in the journal Psychiatric Services, found that:
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Family was the most common reason for staying alive.
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Teens often used the word “my” – pointing to how survival is tied to personal goals, relationships, and identity.
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Many teens talked about the future—curiosity, goals, and even things like concerts and tattoos.
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Hopes weren’t abstract—they were specific and tangible.
Dr. Mathijs Lucassen, one of the study’s lead researchers, says these reasons can and should be used in treatment.
“Our research identified a range of reasons, from personal dreams to meaningful activities. RFL (Reasons for Living) can be used to build therapeutic relationships, establish therapy goals, and personalise treatments,” said Lucassen.
That personalization, he adds, could reduce suicidal thoughts and behaviors.
Why This Matters for Clinicians and Families
The teens in this study came from diverse backgrounds—nearly half identified as Latino or Hispanic, with strong representation from Black and white adolescents as well. That diversity matters. It shows these insights aren’t just relevant—they’re widely applicable.
The takeaway? One-size-fits-all suicide prevention doesn’t work. Teens don’t always respond to lectures about consequences. But they do respond to support that honors their individuality—what they love, who they care about, and the lives they imagine for themselves.
A Shift in Approach
Traditional mental health support often focuses on what drives someone toward suicide. This research flips the lens—looking instead at what pulls someone back from the edge.
And those reasons—family, friendship, pets, tattoos, concerts—might not seem like textbook answers. But they’re real. And they could be lifesaving.
“Determining a person’s reasons for living provides unique insights into who and what is most important to at-risk adolescents,” said Dr. Lucassen.
In short: when a teen says they want to stay alive to get a tattoo or see what the future holds, mental health professionals—and families—should take it seriously
