How Are Mothers Impacted by Their Adolescent's Suicide Attempt? “Things Are Never the Same”

Background and Purpose:  Suicidal behavior is a major mental health problem among adolescents.  In order to effectively intervene with youths who have made suicide attempts and their families, it is important to consider how their mothers are affected by their suicidal behaviors.  Mothers’ reactions to their adolescent’s suicidal behavior can vary considerably; their reactions may impact their interactions with adolescents, parenting practices, and follow-through with treatment recommendations.  Nonetheless, few studies examine how mothers are impacted by their adolescent’s suicide attempt.  Such research has direct implications for addressing the mental health needs of mothers and the ways in which mothers can be most effectively involved in the treatment of suicidal adolescents.  The purpose of this study was to address this gap in the literature by exploring mothers’ reactions and experiences after their adolescent attempted suicide.   

Methods:  This study used data collected for a NIMH-funded research study designed to examine the reactions of 288 mothers of hospitalized adolescents that made recent suicide attempts and mothers of adolescents who were hospitalized for other reasons.  The mothers are assessed at 1, 3, 6, and 12 months following youths’ discharge from the hospital. 

The current analysis focused on qualitative data collected during the first assessment from 16 randomly selected mothers of adolescents who attempted suicide.  Semi-structured interviews were conducted by trained Master- or Doctoral-level staff.  Interviews lasted between 20 and 40 minutes and were digitally recorded and transcribed.  Nvivo 9 qualitative software was used for data management and as a tool for data analysis.  Using an iterative process, six individuals collaborated to develop a codebook.  Emergent themes were systematically identified via grounded theory methods.  Inter-rater reliability was achieved when coding reached 75% agreement. 

Results:  Although mothers varied in their reaction to their adolescent’s suicide attempt (e.g., anger, confusion, disbelief), most mothers reported changing how they supervised and monitored their adolescent.  Mothers also reported changes in their relationships with their adolescent (e.g., more communication) and with others (e.g., seeking additional supports and fewer interactions with others because of concerns about stigma).  Mothers encountered barriers to treatment (e.g., access to care, cost) and challenges with communicating with mental health providers.  Mothers provided suggestions on how to improve the mental health system and indicated the need for additional supports (e.g., support groups, pamphlets) to help them cope.  The interviews revealed the mothers’ insight into how their adolescent’s coping and emotions impacted their emotional experience.   

Conclusions and Implications:  Results from this study suggest that mothers would like to be more involved with their adolescent’s treatment providers and that mothers frequently question their parenting practices because they feel like they are “walking on egg shells.”

This study provides practice implications for mothers of youths who have attempted suicide.  Specifically, mothers need more emotional support and may benefit from formal and/or informal support groups.