Enhancing treatment adherence with a specialized emergency room program for adolescent suicide attempters

Objective: The evaluation of outpatient treatment adherence among 140 Latina adolescent suicide attempters and their families. Method: Sequentially, 75 attempters received standard emergency room care and 65 attempters received a specialized emergency room program including (1) training workshops for emergency room staff, (2) a videotape aimed at modifying families' treatment expectations, and (3) an on-call family therapist. Results: Attempters receiving the specialized program were more likely to attend one treatment session (95.4% versus 82.7%) and were somewhat more likely to attend more sessions (5.7 versus 4.7) than those receiving standard emergency room care; however, their mothers were less likely to complete treatment. In addition, participants receiving the specialized program reported reduced psychiatric symptoms, and mothers reported more positive attitudes toward treatment and perceptions of family interactions. Conclusions: Adherence was significantly improved by receiving the specialized care program in the emergency room. Adherence was also associated with increased suicidal ideation, more cohesive family relations, and lower self-esteem at baseline.