Caregiver Attitudes and Youth Suicidality: Implications for Involving Caregivers in Outpatient Crisis Care for Adolescents

Objective

Suicide is a leading cause of death among young people 10 to 24 years old in the United States. Interventions that include both adolescents and their caregivers demonstrate promise in reducing adolescent suicidal thoughts and behaviors (STB), suggesting that caregiver attitudes may impact treatment outcomes. Better understanding of how caregiver attitudes impact youth STB outcomes may highlight important treatment targets.

Method

This study examined data from youth (N = 187) and their caregivers who participated in a 4-session outpatient crisis stabilization intervention (mean [SD] youth age = 14.6 [1.9] years; majority cisgender female [62%], mean [SD] number of sessions attended = 3.7 [1.2]). Paired-samples t tests examined changes in caregiver attitudes over the course of the intervention, and moderation analyses examined how baseline caregiver attitudes regarding youth STB impacted the relationship between intervention attendance and self-reported suicide risk at intervention completion.

Results

Caregivers’ confidence that they could keep their child safe and their child would not attempt suicide again and hopefulness/optimism for the future significantly moderated the relationship between number of sessions attended and suicide risk (b = .17, t₁₅₁ = 2.12, p < .05; b = .51, t₆₀ = 2.89, p < .01; b = .24, t₁₅₂ = 2.39, p < .05), and caregiver confidence significantly increased over the intervention.

Conclusion

Differences in caregiver confidence and hopefulness for the future at intervention initiation impacted youth suicide risk outcomes at intervention completion. These results highlight the need to assess and address caregiver confidence and hopefulness through involving caregivers directly in adolescent crisis interventions to improve youth STB outcomes.

Plain language summary

This study examined data from 187 adolescents with suicidal thoughts and behaviors (STB) and their caregivers who participated in a 4-session outpatient crisis stabilization intervention (mean youth age = 14.6 years, SD = 1.9). Differences in caregivers’ confidence in youth’s safety and hopefulness for the future at intervention initiation impacted youth suicide risk outcomes at intervention completion. In addition, caregivers’ confidence in being able to manage their child’s suicidality and keep youth safe significantly increased over the intervention (p < .05). Results highlight the need to assess and address caregiver confidence and hopefulness by incorporating caregivers directly in adolescent crisis interventions in order to improve youth STB outcomes.