What Is the Difference in Mothers' Experience When Adolescents Are Psychiatrically Hospitalized for a Suicide Attempt or Other Reasons? “Why You Are Whispering All of a Sudden?”

Purpose:  The trend toward brief psychiatric hospitalizations may place increased demands on mothers after their adolescent is psychiatrically hospitalized. Short inpatient stays may increase mothers’ need to adjust and resolve seemingly insurmountable circumstances with little-to-no external support. Few studies have yet to examine mothers’ experiences after their adolescent is psychiatrically hospitalized, and even fewer studies examine whether their experiences differ because of the reason for the hospitalization (i.e., adolescents hospitalized for a suicide attempt versus adolescents hospitalized for other reasons).  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 adolescents.  The purpose of this study was to address this gap in the literature by exploring the difference in mothers’ experience when adolescents are psychiatrically hospitalized for a suicide attempt or other reasons.

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 assessment from 32 randomly selected mothers of adolescents who were psychiatrically hospitalized (16 suicide, 16 other reasons).  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 11 qualitative software was used for data management and as a tool for data analysis.  Using an iterative process, six individuals collaborated to develop a codebook.  Emergent themes were systematically identified via grounded theory methods.  Inter-rater reliability was achieved when coding reached 67% agreement. 

Results:  Although mothers varied in their experiences after their adolescent was psychiatrically hospitalized, several themes emerged.  In particular, regardless of the reason for the psychiatric hospitalization, mothers felt guilty, stressed, afraid, confused, and optimistic. Nonetheless, mothers of youth hospitalized for other reasons differed from mothers of youth hospitalized for a suicide attempt in three ways.  First, they felt angry. Second, they described seeking treatment prior to the hospitalization and being unable to receive it. Lastly, they felt stigmatized.  For example, one mother stated, “My daughter is in the hospital…no one sent prayers and cards or phone calls or food.  Nothing…it wasn’t fair, cause [daughter’s name] didn’t do this to herself.  And that is where the stigma comes from.”

Conclusions and Implications:  This study provides practice implications for development of interventions that support mothers of adolescents who have been psychiatrically hospitalized.  For example, mothers may benefit from psychoeducation about possible experiences they may encounter, which could validate their emotions.  Further, clinicians should be aware of differences in mothers’ experiences based on reasons for the adolescent’s hospitalization and consider these experiences in treatment planning and implementation.