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Predictors of Parent Behavioral Engagement in Youth Suicide Discharge Recommendations: Implications for Family-Centered Crisis Interventions

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Abstract

The number of youth presenting to Emergency Departments (EDs) with psychiatric chief complaints has almost doubled in the last decade. With pediatric patients, ED brief interventions and discharge recommendations necessitate meaningful parental engagement to optimize youth safety and support. This study examined parent-level factors (stigmatizing attitudes, self-efficacy beliefs, distress symptoms, and illness-related stressors) in relation to parents’ behavioral engagement (i.e., participation in and follow-through with best practice discharge recommendations). In this short-term prospective study, participants were 118 parent-youth (aged 11–18) dyads (57% female) recruited from a psychiatric ED. Parents’ behavioral engagement was measured with parent- and youth-self report at 2-week follow-up. Parents’ self-reported anxious and depressive symptoms, insomnia, stress, and stigmatizing attitudes were not related to engagement 2 weeks later. Higher parental self-efficacy beliefs were significantly associated with greater engagement in standard discharge recommendations. Implications for maximizing parent implementation of clinical recommendations during a youth suicide crisis are discussed.

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Funding

This research was supported by the Substance Abuse and Mental Health Services Administration with grant funds to the Michigan Department of Health and Human Services (Smith, PI, 5U79SM061767). The authors would like to thank the families that participated in the study as well as the clinicians who cared for them. We also gratefully acknowledge the contributions of Brandon Johnson, Adam Swanson, Corey Jackson, Gillian Spitzley, Karlin Stern, Devyn Masterson, Tristayn Owen, Ryan Werner, Amanda Smith, and Danielle Silverman.

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Authors and Affiliations

  1. Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA

    Cynthia Ewell Foster, Christina Magness, Ewa Czyz, Eskira Kahsay, Jonathan Martindale, Victor Hong, Elaina Baker, Isabella Cavataio, John Kettley & Cheryl King

  2. Michigan Department of Health and Human Services, Lansing, MI, USA

    Patricia K. Smith

  3. Institute for Hope and Human Flourishing, Bloomfield Hills, MI, USA

    Gigi Colombini

Authors
  1. Cynthia Ewell Foster
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  2. Christina Magness
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  7. Elaina Baker
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Correspondence to Cynthia Ewell Foster.

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The authors declare that they have no conflict of interest.

Research Involving Human Rights

All procedures performed were in accordance with the ethical standards of the University of Michigan Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Michigan Medicine IRB.

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Informed consent was obtained from all individual participants included in the study.

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Ewell Foster, C., Magness, C., Czyz, E. et al. Predictors of Parent Behavioral Engagement in Youth Suicide Discharge Recommendations: Implications for Family-Centered Crisis Interventions. Child Psychiatry Hum Dev 53, 1240–1251 (2022). https://doi.org/10.1007/s10578-021-01176-9

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