The 18-Month Impact of an Emergency Room Intervention for Adolescent Female Suicide Attempters

• Published in: Journal of consulting and clinical psychology 2000-12, Vol.68 (6), p.1081-1093
• Main Authors: Rotheram-Borus, Mary Jane, Piacentini, John, Cantwell, Coleen, Belin, Thomas R, Song, Juwon
• Format: Article
• Language: English
• Subjects: Adolescent; Attempted Suicide; Biological and medical sciences; Crisis Intervention; Distress; Emergency Service, Hospital; Emergency Services; Family psychotherapy. Systemic therapy; Family Relations; Family Therapy; Female; Females; Follow-Up Studies; Hospitals; Human; Humans; Major Depression; Medical sciences; Mothers; Patient Care Team; Patient Education as Topic; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapies. Psychological and clinical counseling; Psychotherapy; Recurrence; Referral and Consultation; Suicidal Ideation; Suicide Prevention; Suicide, Attempted - prevention & control; Suicide, Attempted - psychology; Suicides & suicide attempts; Teenagers; Treatments
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/0022-006X.68.6.1081

Following a suicide attempt by female adolescents, the impact of a specialized emergency room (ER) care intervention was evaluated over the subsequent 18 months. Using a quasi-experimental design, this study assigned 140 female adolescent suicide attempters (SA), ages 12-18 years, and their mothers (88% Hispanic) to receive during their ER visit either: (a) specialized ER care aimed at enhancing adherence to outpatient therapy by providing a soap opera video regarding suicidality, a family therapy session, and staff training; or (b) standard ER care. The adjustment of the SA and their mothers was evaluated over 18 months (follow-up, 92%) using linear mixed model regression analyses. SA's adjustment improved over time on most mental health indices. Rates of suicide reattempts (12.4%) and suicidal reideation (29.8%) were lower than anticipated and similar across ER conditions. The specialized ER care condition was associated with significantly lower depression scores by the SA and lower maternal ratings on family cohesion. Significant interactions of intervention condition with the SA's initial level of psychiatric symptomatology indicated that the intervention's impact was greatest on maternal emotional distress and family cohesion among SA who were highly symptomatic. SA's attendance at therapy sessions following the ER visit was significantly associated with only one outcome-family adaptability. Specialized ER interventions may have substantial and sustained impact over time, particularly for the parents of youth with high psychiatric symptomatology.