Advice for Parents Whose Child Is Seeking Mental Health Treatment

Psychiatry Advisor: How do you address social media issues with parents?

Dr Hartselle: I tell parents that if they are going to allow their child to have a social media app, they have to have access to it. In the case of an older teen who is mentally stable and compliant with parental rules, parents can start to remove the scaffolding. But if a 17-year-old is unstable, has had a suicide attempt, or is taking drugs, parents must be more careful. I say, “Your job as a parent is to be a parent and not an equal friend, and to keep your child safe.”

I encourage parents to keep up with any fake apps that their child might be using to get around parental supervision. Parents can also exert control by taking away smart phones. Children do not need access to iPhones and laptops in their rooms at all times. These can be kept in the living room and the phones can be turned over to their parents at night before they go to sleep.

Psychiatry Advisor: What about parents who do not have the resources to engage in this type of close monitoring, like parents who are at work for long hours?

Dr Hartselle: They can tell their children that they will be subject to periodic check-ins to make sure they are complying with household rules, that there will be rewards for following the rules and consequences for ignoring them. Utilizing community resources and involving people outside the household such as friends, neighbors, churches, and community centers is also helpful. And pediatricians usually have a great wealth of knowledge and can suggest resources that parents do not always think of.

References

1. Lohman RC. 2017 awareness calendar: making 2017 a year of giving back. Psychology Today. www.psychologytoday.com/blog/teen-angst/201701/2017-awareness-calendar. Updated: January 3, 2017. Accessed: June 29, 2017.

2. Rickwood DJ, Deane FP, Wilson CJ. When and how do young people seek professional help for mental health problems? Med J Aust. 2007;187(7 Suppl):S35-S39.

3. Rickwood DJ, Mazzer KR, Telford NR. S. Social influences on seeking help from mental health services, in-person and online, during adolescence and young adulthood. BMC Psychiatry. 2015;15:40.

4. Centers for Disease Control and Prevention (CDC). Suicide. Facts at a glance. www.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.pdf. 2015. Accessed June 29, 2017.

5. Chung DT, Ryan CJ, Hadzi-Pavlovic D, et al. Suicide rates after discharge from psychiatric facilities: a systematic review and meta-analysis. JAMA Psychiatry. 2017;74(7):694-702. doi:10.1001/jamapsychiatry.2017.1044

6. Ho TP. The suicide risk of discharged psychiatric patients. J Clin Psychiatry. 2003;64(6):702-707.

7. Choi NG, DiNitto DM, Marti CN, Segal SP. Adverse childhood experiences and suicide attempts among those with mental and substance use disorders. Child Abuse Negl. 2017;69:252-262.

8. Guvendeger Doksat N, Zahmacioglu O, Ciftci Demirci A, et al. Association of suicide attempts and nonsuicidal self-injury behaviors with substance use and family characteristics among children and adolescents seeking treatment for substance use disorder. Subst Use Misuse. 2017;52(5):604-613.

9. Bostwick JM, Pabbati C, Geske JR, McKean AJ. Suicide attempt as a risk factor for completed suicide: even more lethal than we knew. Am J Psychiatry. 2016;173(11):1094-1100.

10. Lewinsohn PM, Rohde P, Seeley JR. Psychosocial risk factors for future adolescent suicide attempts. J Consult Clin Psychol. 1994;62:297-305.

11. Hultén A, Jiang GX, Wasserman D, et al. Repetition of attempted suicide among teenagers in Europe: frequency, timing, and risk factors. Eur Child Adolesc Psychiatry. 2001;10:161-169.

12. Spirito A, Valeri S, Boergers J, et al. Predictors of continued suicidal behavior in adolescents following a suicide attempt. J Clin Child Adolesc Psychol. 2003;32(2):284-289.

13. Jeglic EL. Will my patient attempt suicide again? Current Psychiatry. 2008;7(11):19-31.

14. Russell ST, Joyner K. Adolescent sexual orientation and suicide risk: evidence from a National study. Am J Public Health. 2001;91(8):1276-1281.

15. Suicide Prevention Resource Center (SPRC). Suicide and bullying. www.sprc.org/sites/default/files/migrate/library/Suicide_Bullying_Issue_Brief.pdf. Accessed July 5, 2017.

16. van Geel M, Vedder P, Tanilon J. Relationship between peer victimization, cyberbullying, and suicide in children and adolescents: a meta-analysis. JAMA Pediatr. 2014;168(5):435-442.

17. Sullivan EM, Annest JL, Simon TR, et al. Suicide trends among persons aged 10–24 Years — United States, 1994–2012. Morbidity and Mortality Weekly Report (MMWR). www.cdc.gov/mmwr/preview/mmwrhtml/mm6408a1.htm. March 6, 2015. Accessed: July 5, 2017.

18. Kerr PL, Muehlenkamp JJ, Turner JM. Nonsuicidal self-injury: a review of current research for family medicine and primary care physicians. J Am Board Fam Med. 2010;23(2):240-259.

19. Miguel EM, Chou T, Golik A, et al. Examining the scope and patterns of deliberate self-injurious cutting content in popular social media [published online June 29, 2017]. Depress Anxiety. doi:10.1002/da.22668

20. &Westers NJ, Muehlenkamp JJ, Lau M. SOARS model: risk assessment of nonsuicidal self-injury [published online July 1, 2016]. Contemporary Pediatrics.