4 - (SYM 52) Integrated Electronic and Care Support Manager Intervention for Parents of Adolescents with Suicidal Behavior

Adolescents who have been hospitalized for suicidal behavior are at high risk for engaging in additional suicidal behavior. Parents are tasked with ensuring youth safety and follow through with treatment after discharge, and balancing parenting behavior and expectations with the vulnerable mental health status of their teen. To address this, we developed an intervention that combined care support manager (CSM) services with text messaging and website content to support parents following their adolescent’s discharge from psychiatric hospitalization for suicidal behavior.

The study used an iterative treatment development approach to refine the intervention, and evaluated it in an open trial followed by a pilot randomized controlled trial (pRCT). The pRCT included 20 participants who received the intervention, and 22 who received treatment-as-usual (TAU). Sample characteristics included 93% mothers, 2% other female relative, and 5% fathers; 79% White, 14% Black, 5% Asian, 2% Other, 95% Non-Latine, and 5% Latine; parent age ranged from 31-65 years (M = 42.6). Parent outcomes and parent report of adolescent behavior and treatment were assessed at baseline (adolescent’s discharge), and at 3- and 6- months following discharge. Intervention components were reported to be feasible and acceptable (M= 3.83) as measured by the Client Satisfaction Questionnaire (CSQ-8; ratings of 1-4). Participants endorsed feeling supported by the CSM, study text messages and website content. Exit interviews suggested participants found contact with the CSM to be most helpful. Preliminary data suggested that the intervention impacted key outcomes, including reduced parental depression, anxiety, and global severity of psychological symptoms as measured by the Symptom Checklist-90-Revised (SCL-90-R), and reduced subsequent suicidal ideation and suicide attempts by adolescents as measured by the Columbia-Suicide Severity Rating Scale (C-SSRS). The intervention also resulted in reduced teen psychiatric rehospitalizations and emergency department (ED) visits as measured by the Child and Adolescent Services Agreement (CASA). 

These findings highlight the potential benefits of providing needed information and support to parents during the critical period following discharge for their teens, as well as the common areas of support needed by parents in navigating post-discharge challenges and concerns for themselves and their teen. Future research directions and implications for embedding the intervention into existing care systems will be discussed.