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

Ewell Foster C, Magness C, Czyz E, Kahsay E, Martindale J, Hong V, Baker E, Cavataio I, Colombini G, Kettley J, Smith PK, King C.

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.

Keywords: Youth suicide prevention, Family-centered care, Brief interventions, Emergency department