Mental Health Treatment Narratives of Suicidal Latina Teens

BACKGROUND AND PURPOSE. About one in six Latina teens attempts suicide, and one-third of suicidal Latinas need medical treatment after an attempt. In this presentation we describe Latina teens’ experiences of mental health treatments, including the participants’ histories of service use prior to attempting suicide; the paths leading them to treatment after an attempt; and the services following a suicide attempt.  

METHODS.  The data presented are drawn from a mixed-method study that examined the sociocultural processes of Latina adolescent suicide attempters.  Participants (n = 68) were recruited from mental health services associated with community base agencies and hospitals. The adolescents were between the ages of 11 and 19 years. Girls were, on average, 15 years old, and predominantly self-identified as Puerto Rican, Dominican, and Mexican (32.4%, 29.4 %, 13.2% respectively). On average, the participants had attempted suicide 3.8 times in their lifetime (SD = 4.5). Forty-seven participants (69.1%) reported that they had required medical care for their latest suicide attempt. All participants were receiving care: outpatient mental health treatment (n = 47; 69.1%); inpatient psychiatric services (n = 17; 25%); inpatient medical (n = 2; 2.9%) and outpatient pediatric care (n = 2; 2.9%). Qualitative data were analyzed using a combination of content and thematic analysis. The analysis was divided into three steps: (a) data coding, (b) univariate statistics with quantified qualitative data, and (c) development and analysis of a matrix of coded text. The data coding and quantification was performed using digital spreadsheet software. Coded data included short segments of text, phrases, or quotes.

RESULTS. Most participants had been or were engaged in mental health treatment when they attempted suicide. In general, the teens described feeling disempowered and alienated while receiving mental health services prior to their latest suicide attempt (n = 23; 48.9%). The teens’ feelings of disempowerment resulted from the mandated nature of previous treatments, as most were initiated by child protective services.  Adults, including relatives, school and medical staff, initiated most of the requests for services (n = 49; 72.1%). Nearly half of participants in our sample were referred to psychiatric inpatient units after receiving services at emergency rooms (n = 33; 48.5%). These teens described experiencing a great deal of anxiety because psychiatric in-patient units conjured up popular images associated with state asylums. “They’re going to send me to a crazy hospital. I’m not crazy… you are going to put me in a straightjacket” (18 years old).  Overall, inpatient and outpatient providers failed to account for the family dynamics at the core of the girls’ suicide attempts. Latinas felt that providers who fostered their autonomy and connectedness helped them become active agents in their recovery. Improved communication with family members was a critical focus of their recovery.

CONCLUSIONS AND IMPLICATIONS. Providers serving suicidal Latinas must allow the teens to exercise agency while feeling emotionally connected. To succeed in reducing suicidal behaviors among Latinas, treatment needs to address the interpersonal tensions that the teens experience with their families.