The 18-month impact of an emergency room intervention for adolescent female suicide attempters

Following a suicide attempt by female adolescents, the impact of a speciali zed emergency room (ER) care intervention was evaluated over the subsequent 18 months. Using a quasi-experimental design, this study assigned 140 fema le 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 tra ining; 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 regr ession analyses. SA's adjustment improved over time on most mental health i ndices. Rates of suicide reattempts (12.4%) and suicidal reideation (29.8%) were lower than anticipated and similar across ER conditions. The speciali zed ER care condition was associated with significantly lower depression sc ores by the SA and lower maternal ratings on family cohesion. Significant i nteractions of intervention condition with the SA's initial level of psychi atric 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 wa s significantly associated with only one outcome-family adaptability. Speci alized ER interventions may have substantial and sustained impact over time , particularly for the parents of youth with high psychiatric symptomatolog y.