Half of parents whose child had suicidal thoughts were unaware, according to a new study.
The findings could help explain why many of these adolescents and teens do not receive mental health services and suicide continues to rank among the leading causes of death, the authors suggested.
Researchers set out to study parental awareness as well as children’s denials about suicidal ideation using a computerized screening for major psychiatric disorders. They reported their findings in “Parent-Adolescent Agreement about Adolescents’ Suicidal Thoughts” (Jones JD, et al. Pediatrics. Jan. 14, 2019, https://doi.org/10.1542/peds.2018-1771).
More than 5,000 adolescents ages 11-17 from the Philadelphia Neurodevelopmental Cohort answered questions that included whether they had ever thought about killing themselves or thought a lot about death/dying. They also were asked follow-up questions by trained interviewers. In addition, parents answered questions about their child’s thoughts about suicide and death, mental health history and family history of suicide.
Results showed moderate agreement between parents and children about whether the child had suicidal thoughts and slight agreement on thoughts of death. Among adolescents who reported suicidal thoughts, 50% of their parents were unaware. About 76% of parents were unaware of those reporting thoughts of death.
The study also showed when parents believed their teen had suicidal thoughts, 48% of the teens denied it. When parents reported their child had thoughts of death, 67.5% of teens denied it.
As adolescents got older, they were less likely to deny thoughts of suicide or death, and their parents were more likely to be aware. Authors said that may mean younger adolescents may not be getting the attention or help they need.
Looking at gender differences, parents became more aware of their female children’s thoughts of death as children got older but less aware as males aged, potentially due to differences in the timing of depressive symptoms, according to the study.
Fathers tended to be less aware of suicidal thoughts than mothers, and racial minority families had the highest rates of parental unawareness, with the exception of Hispanic parents.
Researchers could not determine whether the findings could be generalized to a larger population but said that they still have important clinical implications.
“This highlights the urgent need for continued training of pediatric primary care physicians in the evaluation and management of suicidal ideation and the importance of collecting information from multiple informants and rectifying discrepant reports,” they wrote.
Authors of a related commentary said suicidal thoughts don’t always lead to attempts, and clinicians should consider risk factors like impulsivity, substance abuse and family/peer suicide history.
“These risk factors can be used to help identify those most likely to attempt suicide with greater precision and inform treatments that target attempts,” they wrote.
