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.

ACKNOWLEDGMENTS

The authors gratefully acknowledge the clinical and administrative staff in Psychiatric Emergency Services at the University of Michigan, with a special thank you to Dr. Rachel Glick, M.D. and John Kettley, ACSW for their invaluable support and collaboration. The authors are also grateful for the support of research staff of the University of Michigan’s Youth Depression and Suicide Prevention program, particularly those involved with the ED-MACS recruitment team. We also thank the youth and families who participated in this study.

FUNDING

Support for this project was provided by the University of Michigan Rackham Graduate Student Research Awards; Blue Cross Blue Shield of Michigan Foundation Student Award; and University of Michigan Institute for Research on Women and Gender Award.