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. 2023 Mar 15:325:360-368.
doi: 10.1016/j.jad.2022.12.164. Epub 2023 Jan 6.

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  1 , Suzanne E Gerritsen  2 , Gwendolyn C Dieleman  3 , Mathilde M Overbeek  4 , Giovanni de Girolamo  5 , Paolo Scocco  6 , Manon H J Hillegers  2 , Dieter Wolke  7 , Dimitris Rizopoulos  8 , Rebecca Appleton  9 , Patrizia Conti  10 , Tomislav Franić  11 , Francesco Margari  12 , Jason Madan  13 , Fiona McNicholas  14 , Renata Nacinovich  15 , Adriana Pastore  16 , Moli Paul  13 , Diane Purper-Ouakil  17 , Melanie C Saam  18 , Paramala J Santosh  19 , Anne Sartor  20 , Ulrike M E Schulze  18 , Giulia Signorini  5 , Swaran P Singh  13 , Cathy Street  13 , Priya Tah  21 , Elena Tanase  18 , Sabine Tremmery  22 , Helena Tuomainen  13 , Athanasios Maras  23 ; Milestone consortium
Affiliations
Free article

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 et al. J Affect Disord. .
Free article

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.

Keywords: Adolescent; Mental health services; Suicidal thoughts; Transition to adult care.

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Conflict of interest statement

Conflict of interest SPS is part-funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West Midlands (NIHR CLAHRC WM), now recommissioned as NIHR Applied Research Collaboration West Midlands. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. PS is the co-inventor of the HealthTrackerTM and is the Chief Executive Officer and shareholder in HealthTracker Ltd. AM was a speaker and advisor for Neurim, Shire, Infectopharm and Lilly (all not related to transition research).