The importance of clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their mental health services in Europe

Larissa S. van Bodegom, Suzanne E. Gerritsen, Gwendolyn C. Dieleman*, the Milestone consortium, Mathilde M. Overbeek, Giovanni de Girolamo, Paolo Scocco, Manon H.J. Hillegers, Dieter Wolke, Dimitris Rizopoulos, Rebecca Appleton, Patrizia Conti, Tomislav Franić, Francesco Margari, Jason Madan, Fiona McNicholas, Renata Nacinovich, Adriana Pastore, Moli Paul, Diane Purper-OuakilMelanie C. Saam, Paramala J. Santosh, Anne Sartor, Ulrike M.E. Schulze, Giulia Signorini, Swaran P. Singh, Cathy Street, Priya Tah, Elena Tanase, Sabine Tremmery, Helena Tuomainen, Athanasios Maras

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: To study clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their Child and Adolescent Mental Health Service (CAMHS) and its association with mental health indicators, transition recommendations and mental health service (MHS) use. Methods: 763 CAMHS users from eight European countries were assessed using multi-informant and standardised assessment tools at baseline and nine months follow-up. Separate ANCOVA's and pairwise comparisons were conducted to assess whether clinicians' and parents' awareness of young people's suicidal behaviour were associated with mental health indicators, clinician's recommendations to continue treatment and MHS use at nine months follow-up. Results: 53.5 % of clinicians and 56.9 % of parents were unaware of young people's self-reported suicidal behaviour at baseline. Compared to those whose clinicians/parents were aware, unawareness was associated with a 72–80 % lower proportion of being recommended to continue treatment. Self-reported mental health problems at baseline were comparable for young people whose clinicians and parents were aware and unaware of suicidal behaviour. Clinicians' and parents' unawareness were not associated with MHS use at follow-up. Limitations: Aspects of suicidal behaviour, such as suicide ideation, -plans and -attempts, could not be distinguished. Few young people transitioned to Adult Mental Health Services (AMHS), therefore power to study factors associated with AMHS use was limited. Conclusion: Clinicians and parents are often unaware of suicidal behaviour, which decreases the likelihood of a recommendation to continue treatment, but does not seem to affect young people's MHS use or their mental health problems.

Original languageEnglish
Pages (from-to)360-368
Number of pages9
JournalJournal of Affective Disorders
Volume325
DOIs
Publication statusPublished - 15 Mar 2023

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