Parental Self-Efficacy to Support Teens During a Suicidal Crisis and Future Adolescent Emergency Department Visits and Suicide Attempts

Abstract

This study of adolescents seeking emergency department (ED) services and their parents examined parents' self-efficacy beliefs to engage in suicide prevention activities, whether these beliefs varied based on teens' characteristics, and the extent to which they were associated with adolescents' suicide-related outcomes. Participants included 162 adolescents (57% female, 81.5% Caucasian), ages 13-17, and their parents. At index visit, parents rated their self-efficacy to engage in suicide prevention activities and their expectations regarding their teen's future suicide risk. Adolescents' ED visits for suicide-related concerns and suicide attempts were assessed 4 months later. Parents endorsed high self-efficacy to engage in most suicide prevention activities. At the same time, they endorsed considerable doubt in being able to keep their child safe if the teen has thoughts of suicide and in their child not attempting suicide in the future. Parents whose teens experienced follow-up suicide-related outcomes endorsed, at clinically meaningful effect sizes, lower self-efficacy for recognizing suicide warning signs, for obtaining the teen's commitment to refrain from suicide, and for encouraging their teen to cope, as well as lower confidence that their teen will not attempt suicide; self-efficacy to recognize warning signs was at trend level. Despite endorsing high self-efficacy for the majority of suicide prevention activities, parents of high-risk teens expressed less confidence in their capacity to influence their teen's suicidal behavior, which could undermine parents' effort to implement these strategies. The relationship between parental self-efficacy and youth suicide-related outcomes points to its potential value in guiding clinical decision making and interventions.

SIMON: A Digital Protocol to Monitor and Predict Suicidal Ideation

“…Proximal risk factors are factors that predict the short-term occurrence of suicidal behaviors (11). Recently, there has been an increase in research that investigated proximal risk factors of suicidal ideation in daily life, of which most are based on Joiner's interpersonal theory of suicide (12)(13)(14)(15)(16)(17)(18).…”

Coping long term with active suicide in adolescents: Results from a pilot randomized controlled trial

“…In CLASP-A, we made it mandatory that parents/guardians were in the support role as they are typically the adults with whom adolescents are most engaged. However, parents of adolescents who attempt suicide may have lower self-efficacy in supporting their child through a suicidal crisis (Czyz, Horwitz, Yeguez, Ewell Foster, & King, 2018). Furthermore, family factors, such as family dysfunction or complexity, maternal psychopathology, and quality of the parent–child relationship, compromise treatment follow through (King, Hovey, Brand, Wilson, & Ghaziuddin, 1997).…”

Concerns most important to parents after their child's suicide attempt: A pilot study and collaboration with a rural mental health facility

“…One parent stated that learning the signs of an impending suicide attempt was important to them as this could potentially include the child's behaviors and communication with family and friends before the suicide attempt. This is a recurrent theme in the literature as Czyz et al (2018) found parents had doubts in their ability to keep their child safe if the teen has suicidal ideation in the future. McDonald et al (2007) also found that mothers felt guilty that they were unable to recognize their children were so deeply unhappy.…”

“…Although not specifically asking parents which supports they needed, Czyz, Horwitz, Yeguez, Ewell Foster and King () examined the self‐efficacy of parents to engage in prevention and management of their child's suicidal crisis when seeking psychiatric emergency services. The authors found most parents of high‐risk teens did feel confident in their ability to maintain safety for their child; however, the parents did not feel comfortable in their ability to recognize warning signs of another suicide attempt.…”