How Are Mothers Impacted By Their Adolescent's Suicide Attempt over Time? “We're Kind of at a Crucial Point Right Here.”

Purpose:  Suicidal behavior among adolescents is one of the primary precipitants of psychiatric emergencies and psychiatric hospitalization.  The suicidal behavior and need for emergency intervention may have multiple impacts on the primary caretakers, often mothers, of these youths.  Nonetheless, few studies have examined how mothers are impacted by their adolescent’s suicide attempt, and even fewer studies examine how their reactions change over time. The purpose of this study was to address this gap in the literature by exploring the similarities and differences between mothers’ reactions one month, three months, and six 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, second, and third assessment from 48 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 overtime, several themes emerged. First, across all assessments, mothers reported distress, but their descriptions differed overtime.  Mothers often reported (a) one month afterwards feelings of anger, confusion, and disbelief, (b) three months afterwards feeling numb (e.g., I don’t have any feelings.”), nervous, and worried, and (c) six months afterwards feeling stressed and drained (e.g., “tired of it all.”). Second, at the one and three month assessments, mothers discussed their adolescent’s needs for mental health services, whereas at the six month assessment, mothers reported needing mental health care for themselves.  Mothers also reported less support during the second and third assessment than during the first assessment. Third, mothers reported needing to monitor their adolescent less at six months than during the first two assessments.

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

This study provides practice implications for development of interventions that support of mothers of adolescents who have attempted suicide.  For example, mothers may benefit from psychoeducation about how their reaction may change overtime, which could validate their experience.  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.