“Why Didn't He Come to Us?” Fathers' and Mothers' Reactions to Youths' Suicidal Behavior

Background

Youths’ suicidal behaviors likely have major impacts on both mothers’ and fathers’ mental health and parenting practices, which may in turn affect parents’ capacity to support their adolescents’ treatment. Yet, little is known about the impact of youths’ suicidal behaviors on parents, particularly on fathers. Therefore, our objective is to examine mothers’ and fathers’ reactions to youths’ hospitalizations due to suicidal behavior. 

Method

Data were collected for a larger NIMH-funded, longitudinal, mixed method, multi-site study examining the impact of a youths’ hospitalizations on parents of adolescents hospitalized for suicidal behaviors and other reasons. Semi-structured interviews were conducted by trained Master- or Doctoral-level staff, digitally recorded, and transcribed. Using an iterative process, six individuals collaborated to develop the codebook. Inter-rater reliability was set at two-thirds agreement. Nvivo 10 was used to sort the data. Informed by grounded theory, emergent themes were systematically identified. 

The current analysis focuses on qualitative data collected at one month post youths’ hospitalizations for 29 father/mother dyads. Fathers and mothers were primarily Caucasian (86% and 83%, respectively), biological (75% and 90%, respectively), and married (though sometimes not to each other; 90% and 91%, respectively).  Fathers and mothers were similar in terms of age (X = 45.5 years [SD = 7.5], and 44.5 years [SD = 8], respectively). Over half (57%) of mothers and fathers reported annual household incomes of $75,000 or more. On average, adolescents were 15.5 years old (SD = 2), primarily female (62%) and most (82%) had not been previously hospitalized for suicidal behaviors. 

Results

Both mothers and fathers reported experiencing distress, the need to increase monitoring of their adolescents, their coping strategies, and improved relationships with their adolescents post-hospitalization. Gender differences, sometimes subtle, were also noted. For example, mothers often described distress in emotional terms (e.g., fear, guilt); whereas, fathers often discussed “stress,” and the need to “just deal with it.” When reported, fathers’ emotional terms were often qualified by time or extent (e.g., “crying…for…half an hour;” or “…a little angry”). Some fathers reported wanting to “fix” the circumstances. Mothers reported coping through supportive relationships; whereas, fathers often discussed coping by “keeping busy” with activities (e.g., work, exercise). Regarding monitoring, some fathers reported a focus on providing structure and clearly stated expectations for youths’ behaviors. Fathers often described mothers as permissive or lenient. Most fathers reported improvements in the father-child relationship (e.g., improved communication and spending more time together), including some step- and divorced, biological fathers. Somewhat more variation was reported regarding the quality of mother-child relationships. Although many mothers reported improvement in mother-child relationships, some mothers and fathers reported frequent conflict, tension, and/or arguing in mother-child relationships.

 

Implications

Both mothers and fathers are impacted by their children’s suicidal behaviors; therefore, youths’ discharge planning, post hospitalization should include support and resources for both parents. Clinicians need to be attuned to differences in how mothers and fathers may respond to youths’ suicidal behaviors, and the strengths each bring to follow-up treatment for, and monitoring of their children.