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Half of parents unaware of teens’ suicidal thoughts

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Diverging agreement between parents and teens on teen suicidal thoughts

Suicide prevention relies on identifying individuals at risk, but in the case of young people, this often relies on parents. This study, and previous research, highlights the limitations of parent report of adolescents’ suicidal thoughts, as well as the issue of adolescents’ denying suicidal thoughts when parents report them.

Given that as many as 40% of adolescents who think about suicide act on those thoughts, it is vital that we achieve more specificity in identifying young people at risk of attempting suicide. These findings have implications for screening in the primary care setting, and they suggest a need for multi-informant assessments, as well as careful exploration of disagreements between parents’ and adolescent’s reports.

Khyati Brahmbhatt, MD, and Jacqueline Grupp-Phelan, MD, MPH, are from the University of California, San Francisco, Benioff Children’s Hospitals. These comments are taken from an accompanying editorial (Pediatrics. 2019 Jan 14. doi: 10.1542/peds.2018-3071). No conflicts of interest were declared. The editorial was funded by the National Institutes of Health.



Most parents are unaware their teenager has been having suicidal thoughts or thinking about death, according to a study published in Pediatrics.

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Jason D. Jones, PhD, from the Children’s Hospital of Philadelphia, and his coauthors wrote that more than two-thirds of adolescents who experience suicidal thoughts do not get medical help, and this may be because their parents – the gatekeepers for mental health services – are unaware of what their teen is going through.

In this study, researchers recruited 5,137 adolescents aged 11-17 years and either a parent or step-parent, and interviewed both about the adolescent’s lifetime suicidal thoughts.

While 413 (8%) of the adolescents surveyed said they had had thoughts about killing themselves, 50% of those adolescents’ parents said their teen hadn’t experienced suicidal thoughts. Similarly, 786 (15%) of adolescents surveyed said they had had thoughts about death and dying, but three-quarters of their parents were unaware.

A significant number of parents – 8% – said their teenager had had suicidal thoughts, but in 48% of these cases, the teenager said they had not thought about killing themselves.

Researchers saw more agreement between parents and adolescents when the adolescents were older: The parents were less likely to be unaware that their older teen had had suicidal thoughts, and older adolescents were less likely to deny it.

“This indicates that younger adolescents may be more likely to go unnoticed and not receive services either because their parents are unaware of their suicidal thoughts or because they deny suicidal thoughts that their parents think they are having,” Dr. Jones and his associates wrote. They also suggested younger adolescents may have “interpretive difficulties” around questions of suicidal ideation.

“These age findings are particularly noteworthy in light of recent evidence that deaths by suicide have increased among younger adolescents,” they noted.

There also was an interaction between age and gender. For girls, parents were less likely to be aware of suicidal thoughts in their younger daughters but more likely to be aware of them in their older daughters. However the opposite was true for boys: Parental unawareness increased slightly in older boys.

Parents of Hispanic or Latino ethnicity were less likely to be aware that their offspring had had thoughts about death and dying.

Generally fathers were less likely than mothers to be aware of suicidal thoughts in their adolescents.

However, if adolescents had previously received psychiatric treatment, or there was a family history of suicide, parents were more likely to be aware of suicidal thoughts, and adolescents who had a history of psychiatric hospitalization were less likely to deny suicidal thoughts, the researchers reported.

The study was supported by grants from the National Institutes of Health, the Dowshen Program for Neuroscience, and the Lifespan Brain Institute of the Children’s Hospital of Philadelphia and University of Pennsylvania. The study was funded by NIH. One author declared a board position and stock options in Taliaz Health unrelated to the study subject; the other authors said they had no relevant financial disclosures.

SOURCE: Jones JD et al. Pediatrics. 2019 Jan 14. doi: 10.1542/peds.2018-1771.

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