Exploring Parents' Immediate Reactions to Digital Suicide Risk Alerts: Descriptive Study.

Background: Youth suicide is a critical public health crisis. Subscription-based parental digital monitoring apps have emerged to monitor youths' web-based activities and promptly alert parents in case of detected suicide risk. Parents' responses to digital suicide risk alerts could significantly influence their children's immediate and long-term well-being. However, parent experiences receiving these alerts and their impact on parent-child and co-parent relationships remain unclear. Objective: This study aimed to examine parental perceptions of digital suicide risk alerts, as well as characterize parents' emotional, cognitive, and behavioral responses to alert receipts, and evaluate the impact on their relationships with their child and co-parent. Methods: Parents subscribed to the MMGuardian app (Pervasive Group Inc) who received a suicide risk alert were invited to complete a web-based survey. The survey assessed demographics, experiences with emotional, cognitive, and behavioral responses to alerts, and the impact on parent-child and co-parent relationships. Results: The final sample included 217 parents with an average age of 40.1 (SD 6.82) years and who were predominantly women (183/217, 84.3%), White (189/217, 87.1%), and non-Hispanic (183/217, 84.3%). Approximately 32% (69/217) of parents reported learning for the first time that their child may be at risk for suicide or self-harm through this alert. Parents reported a moderate level of concern about their child's self-injurious thoughts and behaviors risk based on review of the alert (mean 2.12, SD 0.985). Parents reported experiencing a range of negative emotions in response to receiving a risk alert, with nervousness and sadness being the most common. Self-blame was the most strongly endorsed cognitive response, while thoughts of hopelessness, permanence (eg, "My child is never going to be okay"), and skepticism (eg, "My child is manipulating me") were less common. Common behavioral actions taken after receiving the alert involved telling their child they loved them, talking with their child to learn more, validating their child's thoughts and feelings, helping their child use coping skills, and discussing mental health with their child. Approximately 72% (156/217) of parents reported that the alert positively impacted their closeness with their child. Participants were between moderately and quite a bit in sync (mean 2.25, SD 1.26) with their co-guardian regarding alignment in perceptions of their child's current risk as well as their corresponding thoughts, emotions, and plans related to child risk. Conclusions: Findings highlight several points for potential intervention to better support parents in navigating responding to their child's possible suicide risk. As digital parental monitoring tools grow in popularity, research is essential to optimize these tools for the benefit of children and families. Improved understanding of the impact of digital suicide risk alerts will guide the development of effective digital support tools, empowering parents to help both themselves and their child.