It’s a moment that could strike fear into the heart of any parent—receiving a digital alert on your phone indicating that your child may be experiencing thoughts of suicide or engaging in self-harm.
What emotions do you feel? What actions do you take? How do you discuss the alert with your child? With your parenting partner?
Taylor Burke, PhD
Researchers from Mass General Brigham and colleagues are working to better understand how parents/guardians of children respond to alerts of potential suicide risk provided by paid apps that monitor a child's phone and internet use.
Taylor Burke, PhD, of the department of Psychiatry at Massachusetts General Hospital, is the corresponding author of a recent study in the Journal of Medical Internet Research, “Exploring Parents’ Immediate Reactions to Digital Suicide Risk Alerts: Descriptive Study.”
Here are five things to know about the study, which was conducted in collaboration with colleagues at Vanderbilt University Medical Center and the University of Denver:
Suicide is a leading cause of death among youth. Research suggests that approximately 35-43% of youth do not tell their parents or guardians when experiencing thoughts of suicide or engaging in self-harm.
Without disclosure, parents may not be able to provide support or help connect their child to mental health services if needed.
Subscription-based apps designed to monitor youths’ online activity and alert parents to potential suicide risk are already widely used, and the use of these apps is expected to grow exponentially in the near future. Despite this growing trend, it is unclear how parents react to receiving these alerts, which is the knowledge gap this study sought to address.
Burke and colleagues enrolled 217 parents who subscribed to the MMGuardian digital monitoring app and received a suicide risk alert about their child. The cohort was asked to complete a web survey about their experience shortly after receiving the risk alert.
Parents described a wide range of emotional responses and behavioral actions after receiving the alert.
The most strongly reported feelings among parents were nervousness, sadness and feeling stupid, confused and guilty.
The most common actions taken by parents after notification included:
- Telling their child that they loved them
- Talking with their child to learn more
- Helping their child use coping skills
- Discussing mental health with their child
All of these responses are in line with recommendations for addressing self-harm risk among children, the authors note.
Almost three-quarters of respondents reported that the alert positively impacted their relationship with their child; and that they were generally aligned with their parenting partners in how they responded.
However, a notable proportion of parents reported negative impacts after the alert, specifically a decline in their child’s trust in them (after learning their online activities had been monitored).
Alerts may provide critical awareness, but parents need support.
Approximately one-third of parents reported that this alert was the first time they learned that their child may be at risk of suicide or self-harm. “This significant proportion underscores the potential impact these apps may have as a critical initial point of awareness,” Burke and colleagues write.
Given the increasing usage of these apps, educating parents on how to have these initial conversations with their children about self-harm could set the stage for how children communicate with their parents about mental health struggles in the future.
“Learning about a child’s [self-harm] risk through an app may be more isolating than learning it from a mental health care provider who can offer direct support and resources,” the team writes.
“However, if these apps were equipped with detailed, evidence-based information on how to support parents and provide them with skills to effectively discuss and manage their child’s risk, they could be highly beneficial.”
Limitations and Future Steps
The study had some limitations, the authors note. Participants were mostly of White, non-Hispanic women, limiting generalizability.
The study also only included parents who expressed some level of concern after receiving a suicide risk alert about their child, and thus excluded parents who dismissed the alerts or perceived them as irrelevant. More research is needed to understand the factors and implications of those responses.
The researchers also note that the proprietary algorithm used by MMGuardian has not been independently evaluated in peer-reviewed research studies.
Future research can help to address some of these limitations, and to learn more about how parents and children respond to ongoing digital monitoring and repeated suicide risk alerts.
Suicide Prevention Crisis Hotlines
988 Suicide and Crisis Lifeline
Free and confidential emotional support available 24/7
- Call or text 988 (Veterans: Press 1, Spanish Line: Press 2)
- Chat available on 988lifeline.org/chat
- Visit 988lifeline.org for additional information.
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