Universal or Culturally-Specific? Black and White Mothers' Reactions to Their Adolescents' Suicide Attempts
Suicidal behavior is a major problem for adolescents, and also sometimes has major impacts on the well-being of primary caregivers. Mothers’ mental health may be affected by these behaviors and subsequent hospitalizations, which in turn may affect their capacity to support their adolescents’ treatment. Little is known about impact of youths’ suicide attempts on mothers. Racial differences, however, have been demonstrated more generally with regard to expressions of distress, perceptions of suicide, and preferences for treatment. Therefore, our objective is to examine racial differences in mothers’ reactions to youths’ hospitalizations due to a suicide attempt.
Method
Data were collected for a larger NIMH-funded, longitudinal, mixed method, multi-site study examining the impact of a youths’ hospitalizations on 288 mothers of adolescents hospitalized for suicide and other reasons. Semi-structured interviews were conducted by trained Master- or Doctoral-level staff. Qualitative interviews were conducted during the first 20 to 40 minutes of the overall assessment, digitally recorded, and transcribed. Using an iterative process, six individuals collaborated to develop a codebook. Nvivo 10 was used to sort the data. Inter-rater reliability was set at 75% agreement. Informed by grounded theory, emergent themes were systematically identified.
The current analysis focuses on the qualitative component of mothers’ assessments at one month post their youths’ hospitalization. Black (n = 15) and White (n = 15) mothers of adolescents who attempted suicide were randomly selected. The subgroups were similar with regard to mothers’ and youths’ ages. Comparatively, Black mothers had lower household incomes and more diverse relationships with youths’ fathers.
Results
Mothers of both races emphasized experiences of distress (e.g., fear, guilt, anger, crying) related to the suicide attempt, and reported increased monitoring of their adolescents. Mothers of both races also noted the importance of prayer, supportive relationships, needing a break, keeping busy, and not dwelling on the suicidal behaviors. Racial differences, sometimes subtle, were also noted. In addition to describing experiences of fear, guilt and so forth, some Black mothers utilize analogies (e.g., unclimbable mountain), identified somatic or behavioral concerns (e.g., can’t rest, rock self to sleep, hold my breath) or used other descriptors such as “numb” and “torn between logic and emotion.” Further, Black mothers appeared somewhat more expressive regarding their reliance on religion, focused on their need for emotional support, and reported more instances of improved mother-adolescent relationships. In contrast, White mothers seemed to use a slightly wider array of emotional descriptors (e.g., broken hearted, traumatized, mentally exhausted) to label their experiences of distress, and placed a greater emphasis on their needs for increased volume and higher quality resources both immediately and with regard to the future. White mothers also reported monitoring adolescents’ text messages and social media activities.
Implications
The findings suggest that discharge planning for this population should include mental health services and resources for primary caregivers. Clinicians need to be attuned to racial differences in language used to describe experiences of distress as well as the potential confounding influence of economic challenges that may serve as barriers to supporting adolescents’ treatment.