Child Sexual Abuse: See The Signs and Act To End It

By Kathy Andersen, founder of END1IN4 - a non-profit aiming to end the impact and magnitude of child sexual abuse.

Ashley Judd appears in an End1in4 billboard campaign to stop child sexual abuse.

Those who have experienced child sexual abuse are up to five times more likely to attempt suicide. September National Suicide Awareness Month gives us another reason to pause and “think again” when it comes to the traumas that are in and close to our families and friends, and the devastating outcomes that happen when we don’t see the signs of child sexual abuse and act to end its deadly consequences.

Kathy Andersen, who authored this piece, is the founder of End1in4

The National Institute of Mental Health in 2020 reported that suicide is the twelfth leading cause of death in the United States, the second leading cause of death among those between the ages of 10-14 and 25-34, and the fourth leading cause of death among adults between the ages of 35 and 44.

Child sexual abuse is known to be a common root cause of suicide attempts and death by suicide among youth and adults. With the incidence and prevalence of child sexual abuse higher than many know (on average 1 in 4 children,) the risk of suicide in and close to friends and family is also higher than many imagine. Sadly, for too many readers, this has become a reality beyond imagination.

In its latest study (2017) Miami-Dade Matters reported that Miami-Dade has a higher incidence of death by suicide and attempted suicide than the average in the state of Florida and in the United States. It also highlighted that males are four times more likely to die from suicide than females, yet females are almost twice as likely to attempt suicide; and that there are an estimated 16 – 25 attempted suicides for every suicide committed.

Suicide, and its root causes, is an issue that requires the attention and action of everyone in the community because the signs can be seen by everyone. The problem remains that often people miss the signs in the busyness of everyday life, or don’t know what to do when they see the signs.

As a teenager experiencing child sexual abuse, I wasn’t alone in attempting suicide and consumed by depression and hopelessness. At that time, I didn’t know that I wasn’t alone, and like so many, remained silent about the abuse I was experiencing and about the constant suicidal thoughts. It’s a loud and silent black hole of lifelessness swallowing life. It doesn’t have to be this way for any victim or survivor.

Everyone in the community can see the signs and act to end it, which is the message that will be up in lights in New York’s Times Square on a full-motion digital billboard, on digital displays across Miami and Los Angeles, and across national social media starting September 22. The campaign features actors, survivors, and activists, Ashley Judd and Anthony Edwards, both of whom lived through devastating mental health struggles in their own adulthoods and those of loved ones. Today, they live in healing and are examples of resilience and hope for those struggling with their own history of abuse.

“We need the general public to see the signs and act for children who are often too traumatized and manipulated to self-report sexual abuse—especially when that abuse is often in or close to the family,” encourages Ashley Judd. “The signs in child victims and in adult survivors who struggle with mental health are often very clear. The problem is that we too often fail to act because we don’t want to see it and don’t know what to do to end it.”

Tragically, in 2022, Ashley’s mother Naomi, who experienced child sexual abuse, took her own life, succumbing to the disease of mental illness after many years of struggle. Ashley was sexually abused by a man for the first time in the second grade.

The Mayo Clinic highlights the warning signs of child sexual abuse and suicide risk, including: depression, anxiety and fear; loss of self-confidence; problems sleeping; nightmares; mood swings; substance abuse and addictions; social withdrawal; anger, aggression, and hyperactivity; self-harm and speak of self-harm; and other self-destructive behaviors.

During and beyond September National Suicide Prevention Month, let’s take the extra time to see the signs of abuse, depression, and suicide—among family and friends, children and adults. It’s closer than you may know, yet by looking closer, asking questions, and reaching out for help, we can each act to end child sexual abuse and other contributors to suicide, and together, act to end it.


For 24-hour help and support, and to report abuse, call (240) END-1IN4, which directs all calls to the Childhelp National Child Abuse Hotline. If you or someone you know is struggling or in crisis, call or text 988, the 24/7 Suicide & Crisis Lifeline. In an emergency, call 911.

For more information and a range of local and national resources, please visit, and look out around Miami-Dade for END1IN4’s public awareness campaign to “See The Signs & Act To End It” featuring Ashley Judd and Anthony Edwards, with the hashtags #END1IN4 and #ActToEndIt.

Kathy Andersen is the founder of END1IN4, Inc., a Miami-based non-profit created to help end the impact and magnitude of child sexual abuse through breakthrough public awareness and engagement campaigns, education and advocacy.

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