Suicide affects all age groups and is the second leading cause of death globally of 15-29 year olds. In the United States, suicide is the third leading cause of death for people ages 15-24 and results in 4600 lives lost each year. Nationwide, 7.4% of students had actually attempted suicide one or more times in 2017. Depending on where one lives, the numbers could be higher. Further analyses of state and large urban school district data indicated that across 38 states, the overall prevalence of having attempted suicide ranged from 5.4% to 16.8% (median: 9.3%). While these rates are alarming, suicide is a serious problem in Europe; currently, Ireland has the fourth highest rate of suicide amongst teenagers in Europe with suicides accounting for 24.4% (n=79) of all adolescent deaths in 2017.
Methods: The Social-Ecological Model was used as a framework to better understand the problem of adolescent suicide from the parent perspective. Working in a community based participatory research model, nurse researchers collaborated with interdisciplinary staff at a rural community based mental health facility in the United States to create and pilot the survey tool with content and practice experts validating the survey questions. Nurse researchers traveled to the site to develop the questionnaire and data collection process. Interdisciplinary staff were instrumental in designing best method to collect this sensitive data from participants. Case managers introduced the study to potential participants during a regularly scheduled home visit. In order to be eligible, participants had to be over the age of 18, be the natural or guardian parent of a child who had made a suicide attempt in the past year, and speak and read English. In addition, case managers identified families who were no longer in the crisis stage after the suicide attempt. Participants were given an envelope with the paper survey and asked to complete the survey while the case manager completed their visit with the child. After the visit was completed, the case manager took the sealed envelope and placed it in the locked box supplied by the nurse researchers. The nurse researcher traveled to the community based mental health agency to collect completed surveys. Once data was collected and analyzed by two nurse researchers, we returned to discuss and share findings with the interdisciplinary staff. In order to obtain a global perspective on the problem of adolescent suicide, nurse researchers in the United States contacted a nurse colleague in Ireland to discuss this global problem.
Results: Five parents completed the pilot survey. Results showed that parents have unmet needs after their child’s suicide attempt; reporting the need to ensure safety for their child and the need for understanding how to help their child. Parents stated interest in attending a focus group to discuss their needs and noted transportation and childcare being primary barriers to attending a focus group. Results from this research will inform focus groups of parents whose child has made suicide attempt.
Conclusion:
Suicide has historically been thought of as an individual experience; however it also impacts families, communities and society at large. Youth suicide attempts affect not only the child, but also have damaging effects on peers, families, and communities. While any life lost is tragic, deaths from youth suicide are only one piece of the problem; more youth survive a suicide attempt than actually complete the act. Although some people may perceive suicide as the act of a troubled person, it is a complex outcome that is influenced by many factors. Individual characteristics may be important, but so are relationships with family, peers, and others, and influences from the broader social, cultural, economic, and physical environments. According to the Centers for Disease Control, the long-term goal of public health is to reduce the risk of suicidal behavior by addressing factors at several levels (individual, family, community, and societal levels).
It is clear from this pilot study that parents are fearful of another suicide attempt and are seeking help. One important risk factor for completed suicide is a previous suicide attempt. After a suicide attempt, much attention is given to the child to ensure safety and prevent another attempt. However, understanding the concerns and needs of the parents may also prove useful in supporting the child’s treatment. Nurses and other health professionals working in adolescent mental health would benefit from understanding parent needs in order to provide effective family centered treatment.