Stress in Caregivers of Youth Hospitalized for Suicide Ideation or Attempt

Youth hospitalizations for suicide risk-related concerns are increasing. The post-discharge time is a high-risk period for repeated suicide attempts and represents a vulnerable time for youth and their caregivers. However, little is known about caregiving stress during this time and what factors influence its levels. This study characterizes caregiving stress across three months following discharge among caregivers (74% biological mothers) of psychiatrically hospitalized adolescents (N= 80; aged 13-17 years) and explores its baseline and time varying predictors. Participants completed measures at baseline and at 1- and 3-month follow-ups. Caregivers completed measures of caregiving stress, caregiver self-efficacy, and depression/anxiety symptoms. Youth completed measures of depression along with a measure of parent-family connection. Youth suicide ideation (SI) severity was assessed at all time points. Results: Caregiver-reported stress was high at hospitalization and decreased linearly after discharge. Regarding baseline factors, greater youth depression symptoms were associated with higher levels of caregiving stress over time. Regarding time-varying predictors, greater increases in caregiver depression/anxiety symptoms and greater SI severity in the first month after discharge were associated with greater caregiving stress over the follow-up period. This study adds to the growing literature focused on caregiving experiences in a high-risk population. Although caregiving stress tended to decrease post-hospitalization, on average, certain caregiver and adolescent characteristics, particularly those related to internalizing symptoms, emerged as important markers of greater caregiving stress during this high-risk period.