Parents' Role as Care Managers During and After Adolescent Suicide Crises.

Background: Adolescent suicide crises usually require mental health services (inpatient and/or outpatient) to address their needs. Navigating the health care system, especially around suicide crises, is difficult and parents of adolescents usually manage their treatment access and engagement. Little research has examined how parents take on this care management role, vital to maintaining safety and improving adolescent menta health, and the barriers and facilitators they experience in these processes.

Aims: To explore parents' experiences around adolescent suicide crises, with a focus on care management and barriers/facilitators to this role.

Methods: Interviews were conducted with 18 parents of adolescents in the United States who had suicide crises in the previous 3 years. Using a family-systems lens and thematic analysis, researchers identified three themes and three subthemes.

Results: Relevant themes and subthemes were Care Manager Role Transition (subtheme: Home Safety); Barriers after Barriers (subthemes: Logistical and System Barriers; Poor Communication); and Facilitating Engagement. Parents had a sudden transition to the role of care manager during the adolescent's suicide crisis. They experienced difficulty in managing safety and navigating health care systems. Parents of adolescents with eating disorders had more difficulty in navigating systems and managing safety.

Conclusions: Policies and clinical practice must recognize the role and value of parents as care managers of adolescent's mental health services, especially around transitions out of acute care settings. Psychiatric nurses are well positioned to assist parents with this role transition so that parents can better support adolescents during and after suicide crises.