Parents were asked whether they had been able to recognise the signs of depression or illness at the time, or only after their child's death and were asked to identify such signs. A large number of parents (21) used this response to outline signs which they now considered with the benefit of hindsight to have been salient, although they had not perceived them to be so at the time.

These responses have been collected together as Group A. Fourteen further parents had recognised signs before their child's death but had not identified these as possibly associated with suicide: these responses are categorised as Group B. Five parents reported signs which were indicative of suicidal intent, notably previous attempts. Two further parents identified their child as having made deliberate and specific preparation for death. This group of responses is designated as Group C. These groups are outlined in Table 6 below.

Table 6 - Parents' Awareness of Warning Signs

Group A

This was the largest group of responses to this question with nearly half the respondents reporting that they had not recognised signs of depression at the time and had considered their child to be experiencing acceptable adolescent traits. However, with the benefit of hindsight, behaviour previously considered normal was reinterpreted. One parent wrote:

....it's easy looking back, but the signs just seemed to fit with her age.

Another that:

Her emotional difficulties that we were aware of (dislike of physical contact, withdrawnness, mood swings, lack of self-esteem, worries about appearance) we felt were within the range of teenage norms.

For some parents, even with the benefit of hindsight, there were still few or no signs:

No signs of depression. Slight withdrawal in the last week of his life, but minimal.

Another parent noted:

No signs. He stayed with us and went on a work camp during the two weeks before he died. He was his normal, cheerful outgoing self.

These responses indicate that many parents had considered their child's behaviour to be well within the spectrum of behaviours considered normal for young people. As they suggest, adolescents are often expected to exhibit difficult behaviour at times within family settings.

Those who were unable to point to any possible signs or indicators may feel that the reasons for their child's death remain unclear. Support groups may have a particular role in offering support to those who continue to be confused as to possible reasons for and the meaning behind their child's death.

Within this group of parents who either did not consider that signs had been evident before their child's death but, in retrospect, were able to identify possible circumstances or signs that might have been relevant, were six main sets or areas. The most frequently mentioned (by twelve parents) sign was that of social withdrawal. This could occur generally and varying extents; one parent described in relation to his/her daughter:

....slight change in behaviour. Not wanting to discuss or plan ahead for such things....

For another family, the nature of social withdrawal had been greater and the parent reported:

Great difficulty in mixing, going to school.

At its most extreme, social isolation could be linked to problems with daily life and all social contact. One parent described the development of such difficulties in respect of his/her child:

Initially often withdrawn and uncommunicative, critical of relatively minor things, not passing on information about successes, perfectionist. Then feeling ill and very lethargic not caring about appearance and cleanliness, inability to concentrate, extra quiet, keeping in own room, no enthusiasm, crying (when very acute), not wanting to go back to university.

Not all parents described such deterioration and some reported that they had interpreted withdrawal from family concerns as another sign of their child growing up.

The second most frequently cited indication was that of sleep problems: a sign which may be one which families are able to identify if a young person is living at home. Seven families commented on this area; however reported difficulties with sleep varied:

Reading his diary now, it appears that he wasn't sleeping well. His moods would change from day to day for no apparent reason. He recognised that he was depressed and occasionally writes in his diary that he must get help - but he never did. He frequently writes of suicidal thoughts and plans. But even if I had read them then, I don't know if I'd have taken it really seriously. Even as a young child he showed signs of depression (as I now see it). He never slept well....

Another parent observed of his/her child:

No signs at the time. In retrospect, he had seemed more tired than usual, but he had been leading a hectic life. It seemed normal.

Other parents referred to sleeplessness, tiredness or a brief complaint about difficulty in sleeping. It appears that there was a variety of experiences in respect of the extent, type and duration of sleep problems.

Within this group of parents who had not perceived their child to have any problems or who thought that those in evidence were associated with normal stages, another group of signs were discernible in retrospect. However, these were not mentioned by many parents - only two or three for each.

They included problems with appetite or eating (3), with self-harming (3), with alcohol (3) and illicit drugs (2). While these signs might appear relatively straightforward it was again clear that experience was not consistent between families. In respect of the three parents who mentioned problems with alcohol, two parents appreciated that these could be interpreted as normal male behaviour for that age. For example:

Drinking too much socially only.... As [he] got older and drank socially he would be the life and soul of the party.

Similarly, another parent noted that his/her son:

.... drank a lot, like his friends, which we did not approve of.

However, for the third parent who noted alcohol problems, these were conceived of differently:

He did not drink alcohol often but when he did it had a strange effect on him. According to what his friends said, it made him really depressed....

As with the other more frequently mentioned signs, these responses show that there is a range of experiences and situations within each group. This suggests that generalised lists of signs may not be particularly helpful and that there is no typical presentation of any particular symptom or indicator.

Group B

In this section we focus on those fourteen parents who reported that they had recognised signs causing concern in respect of their child but that they had not, at the time, interpreted these as life-threatening. Within these responses were those who confirmed the presence of depression. One parent reported:

I knew that [my son] was depressed, as he had been from time to time, during his teenage years.

However, the extent of depressive features varied and for one parent this seemed not serious, particularly as the young person had sought help and, in this instance, the symptoms were:

All .... at a fairly mild level which I did not recognise as so serious.

In some families there was also the experience of fluctuating difficulties or signs:

....I was misled into believing that there was not a serious problem, although he had very 'black' patches which caused real concern.

The analysis explored the type of signs that had been identified as causing concern prior to the young person's death. These mirrored those identified in retrospect by respondents in Group A, particularly the group of responses which described the young person as withdrawn or increasingly socially isolated.

These two factors were mentioned by ten of the fourteen parents who had identified signs prior to their child's death. In contrast, only one parent had, at the time, been concerned about problems with their child's sleeping patterns.

Slightly fewer young people had demonstrated problems with alcohol at the time (1), illicit drugs (1) and self-harm (1). The other sign which was reported slightly more often, and again numbers were extremely small, was found in three families who identified eating problems. While one case was described as anorexia, the others were described as 'eating little' and 'lack of appetite'. Again, the wide variation within classifications was evident.

Group C

This group included the five parents who reported that their child had made a previous attempt at suicide or a series of such attempts. The level of seriousness of these attempts was high. One parent reported nearly twenty attempts while another wrote of her family's experience:

[My son], as a young adult, made no secret of his wish to die. At 17 he took an overdose of paracetamol which required hospitalisation. The NHS follow-up to this entailed one appointment at a psychiatric day centre which the doctor did not attend. No further appointments were offered. [He] spoke often of suicide when he spoke at all.

Also included in this section were those parents who reported signs that might be associated with direct and deliberate preparations for suicide. Two parents reported such behaviour and conveyed the determination behind it.

These findings are helpful in illustrating the variety of the signs identified and in providing evidence that each young person had a set of unique circumstances and characteristics. Simple references to alcohol or eating problems, for instance, are shown to be over-general and were only mentioned by a small number of respondents.

Moreover, parents reported that such problems could be fluctuating, part of peer culture, and variable. Finally, these responses identify a small group of parents whose son or daughter had distressing and clearly recognisable behaviour associated with suicide attempts. There may be scope for specific support to be provided to this group of young people and their parents and for exploring with them and professionals services that might be appropriate and acceptable.

© University of Hull and PAPYRUS
October 2001
ISBN 1 90417600 3

SMHAI Home | About Suicide | About Mental Health | Suicide Prevention | Suicide Survivors
Suicide Attempters | Self-Injury - Cutters | Crisis | Donate | SMHAI Library | Online Support & Resources
Speakers & Presentations | Memorials, Remebrances & Celebrations Of Life | Healing Music
Suggested Reading - Survivors | Suggested Reading - Attempters & Self-Injurers | Mental Health Pros.
Upcoming Events | Dr. Roerich's Welcome | Ann Gay's Welcome | Legal & About SMHAI
Privacy Policy | Copyright Notice | Awards Honoring SMHAI | SMHAI Awards Program | Contact

© SMHAI 2004 - 2006 All Rights Reserved.
No copying or redistribution without expressed written permission of SMHAI.
Logo Design by Allen R. Jacobson.
Site launched July 01, 2004.