How Are Mothers Impacted By Their Adolescent's Suicide Attempt Over Time? “Now That It's Over; Its Not Over”

Purpose:  Suicidal behavior is a major mental health problem among adolescents.  In order to develop effective family-based interventions for youth who have made suicide attempts, it is important to consider how mothers are affected by their adolescent’s suicidal behaviors. Moreover, it is important to understand how mothers’ reactions changes over time.  Nonetheless, few studies examine how mothers are impacted by their adolescent’s suicide attempt, and even fewer studies examine their reactions overtime.  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 the similarities and differences between mothers reaction one month and three months 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 and second assessment from 32 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 10 qualitative software was used for data management.  Using an iterative process, six scholars collaborated to develop a codebook. Coding was completed by trained research assistants.  Emergent themes were systematically identified as informed by grounded theory methods.  Inter-rater reliability was achieved when coding reached 67% agreement. 

Results:  Although mothers varied in their reaction to their adolescent’s suicide attempt, several themes emerged. First, mothers reported slightly different emotional reactions at one month compared to three months after the suicide attempt.  In particular, one month afterwards mothers tended to report feelings of anger, confusion, and disbelief, whereas three months afterwards mothers tended to report feeling numb (e.g., I don’t have any feelings.”), nervous, and worried.  It is important to note that some mothers reported feeling “better” three months after the suicide attempt.  Second, in general, mothers reported their relationship with their adolescent was “closer” at both the one and three month assessment.    Third, most mothers reported continuing to implement the safety plan established at the hospital.

Conclusions and Implications:  Results from this study suggest that mothers continue to be impacted by their adolescent’s suicide attempt three months afterwards.  Moreover, mothers’ reactions from one month to three months afterwards appear to shift from confusion to feelings of numbness or anxiety.

This study provides practice implications for mothers of youth who have attempted suicide.  Specifically, mothers may benefit from formal and/or informal supports.  Further, clinicians should be aware of and assess for shifts in a mother’s reactions to their adolescent’s suicide attempt and consider these reactions in treatment planning and implementation.