Worsening Symptoms of Anxiety, Depression, and Sleep Problems in Caregivers Following Youth’s Suicide-Related Emergency Department Visit

Abstract

Objective

Although families assume considerable responsibility in caring for their child after a suicidal crisis, little is known about caregiver well-being following a suicide-related pediatric Emergency Department (ED) visit. This study aimed to (1) describe the course of caregiver distress symptoms (e.g., anxiety, depression, and negative affect) and sleep problems following their child’s suicide-related ED visit and to (2) identify factors (e.g., parents’ mental health history, youth suicide risk chronicity, and perception of feeling supported by the mental health system) hypothesized to be related to caregiver distress symptoms and sleep problems at follow-up using a diathesis-stress model framework.

Method

Participants included 118 caregiver/youth (ages 11–17) dyads presenting to a psychiatric ED due to youths’ suicide-related concerns. Caregivers and youth were assessed during index ED visit and 2-weeks following discharge.

Results

Caregivers’ anxiety and depressive symptoms and sleep problems increased significantly from the time of the ED visit to 2-week follow-up. There was no significant change in caregiver negative affect. Caregivers with their own history of mental illness and those whose children had a previous ED visit due to a psychiatric concern, suggestive of chronic suicide risk, reported higher anxiety and depressive symptoms at follow-up.

Conclusion

In the 2 weeks following an ED visit for their child’s suicidal crisis, caregivers reported significant increases in anxiety and depressive symptoms and sleep problems. Findings highlight the need to consider the mental health of caregivers whose children are at elevated risk for suicide.

Highlights

1. Caregivers report increases in distress symptoms following youth’s suicidal crisis.

2. Caregiver mental health history and youth suicide chronicity impacted distress.

3. Caregiver mental health should be considered when planning youth interventions.

Keywords:

• Caregivers
• emergency department
• parents
• suicide
• youth

ACKNOWLEDGEMENTS

The authors are grateful to the families that participated in the study and the clinical staff at Psychiatric Emergency Services at Michigan Medicine and who cared for them. We are also thankful for the contributions of our team of research assistants who helped with data collection.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Substance Abuse and Mental Health Services Administration with grant funds to the Michigan Department of Health and Human Services.

Notes on contributors

Tayla Smith

Tayla Smith, Christina Magness, Alejandra Arango, Seth Finkelstein, Eskira Kahsay, Ewa Czyz, Victor Hong, John Kettley, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA;

Christina Magness

Tayla Smith, Christina Magness, Alejandra Arango, Seth Finkelstein, Eskira Kahsay, Ewa Czyz, Victor Hong, John Kettley, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA;

Alejandra Arango

Tayla Smith, Christina Magness, Alejandra Arango, Seth Finkelstein, Eskira Kahsay, Ewa Czyz, Victor Hong, John Kettley, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA;

Seth Finkelstein

Tayla Smith, Christina Magness, Alejandra Arango, Seth Finkelstein, Eskira Kahsay, Ewa Czyz, Victor Hong, John Kettley, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA;

Eskira Kahsay

Tayla Smith, Christina Magness, Alejandra Arango, Seth Finkelstein, Eskira Kahsay, Ewa Czyz, Victor Hong, John Kettley, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA;

Ewa Czyz

Tayla Smith, Christina Magness, Alejandra Arango, Seth Finkelstein, Eskira Kahsay, Ewa Czyz, Victor Hong, John Kettley, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA;

Victor Hong

Tayla Smith, Christina Magness, Alejandra Arango, Seth Finkelstein, Eskira Kahsay, Ewa Czyz, Victor Hong, John Kettley, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA;

John Kettley

Tayla Smith, Christina Magness, Alejandra Arango, Seth Finkelstein, Eskira Kahsay, Ewa Czyz, Victor Hong, John Kettley, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA;

Patricia K. Smith

Patricia K. Smith, Michigan Department of Health and Human Services, Lansing, Michigan, USA;

Cynthia Ewell Foster

Cynthia Ewell Foster, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.