Ask what keeps a person alive on the hardest night of their life. The honest answer is rarely a program. It is a person — someone who notices, who calls back, whose life is visibly bound up with yours. Usually that is a family member. Family estrangement and suicide risk are rarely named in the same sentence. This month, they should be.
This year’s national theme for Suicide Prevention Month is Stronger Together: Connect. Support. Prevent., and the first week of September asks us to focus on cultivating connection. The Family Preservation Alliance takes that up gladly — with one addition. Prevention does live in families, schools, workplaces, faith communities, and health systems, as the campaign says. Families are named first on that list and funded last. And for the people we serve, together is precisely what has been taken apart.
What the data says
The Substance Abuse and Mental Health Services Administration opened this year’s Suicide Prevention Month with sobering numbers and real hope. SAMHSA reports 48,824 American lives lost to suicide in 2024 — and, in the same breath, declines in serious thoughts of suicide, suicide plans, and attempts among adolescents ages 12 to 17. Four years in, the 988 Suicide & Crisis Lifeline has taken more than 26 million contacts, and a study in JAMA found youth and young adult suicide mortality running about 11 percent below expectations in its first two and a half years.
Demand keeps climbing — a July 2026 GAO review found text volume up roughly 260 percent since launch — and behind every one of those contacts is a trained counselor at one of more than 200 local crisis centers who picks up. Worth remembering as 988 Day on September 8 and World Suicide Prevention Day on September 10 arrive: the number works because people answer it.
Prevention works when it is funded and sustained. The question is what else we should be funding.
Family estrangement and suicide risk: the losses nobody counts
Read SAMHSA’s risk factors closely — relationship problems, legal problems, hopelessness, social isolation — and then its protective factors, which lead with supportive relationships and connection to family and community. Read together, those two lists describe what happens when a family comes apart.
The father who hasn’t seen his children in three years has no diagnosis. The mother whose custody case has consumed her savings and her sleep has no billing code. The estranged adult child, the erased grandparent — none of it is recorded anywhere as a health event, though every one of them has lost the protection prevention science says matters most.
Let me be careful here, because this field is badly served by overstatement. The research on estrangement, high-conflict separation, and suicide risk is thinner than it should be. No honest advocate draws a straight line from a custody ruling to a death. Safety comes first, always. Some separations save lives, and family preservation never means keeping a household intact at the cost of someone’s safety.
What we can say is this. The risk factors SAMHSA names converge in these families with unusual force. And we treat that convergence as a legal problem rather than a health one.
The children are in the room
Parental separation sits on the standard adverse childhood experiences inventory, and SAMHSA names ACEs among the strongest risk factors for suicide. Children absorb what adults do to each other. When a separation becomes a war, they are not spectators to it — they are inside it, often for years, at exactly the developmental moment when hopelessness does the most damage.
The consequences follow them out of childhood. A 2021 systematic review in Current Psychology by Miralles, Godoy, and Hidalgo examined thirteen studies of adults who were exposed to parental alienation as children and found consistent reports of depression and anxiety symptoms, elevated risk of psychopathology, and lower self-esteem. Not suicide statistics — but every one of them appears on SAMHSA’s own list of what puts a person at risk.
Linda Gottlieb, LMFT, LCSW-R, who has spent decades treating these families, describes the core of the injury in a phrase worth holding onto: a child’s rejection of a loving parent is anti-instinctual behavior. It runs against the grain of the child’s own attachment. Whatever else we conclude about how these cases should be handled, that much should trouble everyone — a child made to suppress a bond in order to survive an impossible loyalty conflict is carrying a weight no adult conflict entitles us to hand them.
The encouraging adolescent numbers show that upstream investment reaches young people. Reducing the conflict children live through is upstream investment. It should be counted as prevention, funded as prevention, and asked about by every professional who touches a family in crisis — including judges, mediators, and family law attorneys, who are often the last people in sustained contact with someone in acute distress and the least trained to recognize it.
Your reason is reason enough
The theme of 988 Day 2026, September 8, is 988 Reasons: Your reason is reason enough — a reminder that you do not have to be in crisis to reach out. Whatever you are facing, big or small, your reason for seeking support counts.
Our families need to hear that, because the people we serve are practiced at deciding their pain doesn’t qualify. If you are reading this because you have lost your family and can’t see a way forward, hear it plainly: what you are carrying is real, and it is not a character verdict. Estrangement carries a particular shame — the sense that you must have done something unforgivable. That story is almost never the whole truth, and it is not a reliable narrator at 3 a.m.
A missed birthday is a reason. A hearing date is a reason. A house that is too quiet is a reason. You do not need to be in danger to call, text, or chat 988. Your reason is reason enough.
If you have lost someone
This year’s theme asks us to support recovery and healing long after a crisis has ended, and that obligation runs to the bereaved. Grief after a suicide is heavy under any circumstance. Inside an estranged family it compounds — mourning the person and the reconciliation that will never happen, sometimes without a place at the funeral. If that is you, you are not on the outside of this loss, whatever anyone said. The American Foundation for Suicide Prevention maintains support resources and loss survivor groups at afsp.org/ive-lost-someone, and you have every right to them.
What one person can do
Reach out to someone you suspect is struggling. Listen without steering them toward the bright side. If you’re worried, ask directly about suicide — the question does not plant the idea; it usually comes as relief. Help create time and distance from lethal means, including safe storage of medications and firearms during periods of elevated risk. And if the person you’re thinking of has lost a family, don’t assume time has softened it. Anniversaries, holidays, and hearing dates are hard. Call on those days, and keep calling after the crisis passes — which is when most people stop.
What the Family Preservation Alliance is asking of you
Carry the national message into our corner of it. Share the 988 Day toolkit on September 8 using #988Day, and follow the weekly themes through the month. Reaching the separated, estranged, and alienated is work the national campaign cannot do without organizations like ours.
Put 988 where our families will see it. FPA is adopting SAMHSA’s recommended language across our materials — 988 offers 24/7 judgment-free support for mental health, substance use, and more — and we encourage every allied group, support meeting, and family law practice to do the same. People should know where to turn before they need it.
Bring family court into the prevention conversation. This is the contribution our field is uniquely positioned to make. Judges, mediators, guardians ad litem, and family law attorneys sit with people in sustained distress and receive almost no training to recognize it. The Family Preservation Alliance supports adding basic suicide gatekeeper training to the continuing education requirements for family court professionals, and we encourage you to raise it with your own state’s courts and bar association.
Help close the evidence gap. The research on family rupture and suicide risk is too thin to guide policy. If you are a researcher, clinician, or graduate student looking for a question that matters, this one is wide open.
And press your state. SAMHSA has been direct that the federal government cannot build the crisis care system alone — sustained 988 capacity depends on state and local investment. SAMHSA’s National Behavioral Health Crisis Care Guidance sets out what a working system requires: someone to contact, someone to respond, and a safe place for help. Ask your state legislators which of the three your state has actually funded.
Connect. Support. Prevent. Those three words are a fair description of what a family does when it is working, and a fair description of what has to be rebuilt around a person when a family is not. No family is beyond repair, and no person is beyond reach. The work of prevention is the work of connection, and connection is what a family is for.
988 offers 24/7 judgment-free support for mental health, substance use, and more. Text, call, or chat 988. You can reach out for yourself or because you are worried about someone you love. Specialized support is available for veterans, Spanish speakers, and people who are Deaf or Hard of Hearing. To find treatment, visit FindTreatment.gov or call 1-800-662-HELP (4357). If someone is in immediate danger, call 911 or go to the nearest emergency department.
This September, the Family Preservation Alliance joins SAMHSA in marking 988 Day on September 8 and World Suicide Prevention Day on September 10. Share this piece with #988Day.
For professionals and organizations
- After a Suicide: A Toolkit for Schools — Suicide Prevention Resource Center. For any school supporting students through a loss, including children already navigating a family separation.
- SPRC Best Practices Registry — vetted prevention programs and materials, for anyone building a program rather than starting from scratch.
- Framework for Successful Messaging — National Action Alliance guidance on how to talk and write about suicide safely. Every organization publishing this month should read it first.
- Lived Experience Leadership and Peer Support Services (PDF) — for allied groups running peer fellowship or support meetings.
John S. Hamel, Jr. is President of the Family Preservation Alliance, which works to keep children connected to the parents and grandparents who love them. He has spent years alongside families navigating separation, estrangement, and the family court system.