Deteriorating student-teacher relations and bullying increase suicidal tendency in adolescents after hospitalization

The results of a recent study published in the journal school psychology Shedding light on the negative impact of psychotherapy in hospitals on adolescents’ perceptions of their academic environment and relationships at school. Some of the factors reported by adolescents who were admitted to the hospital included worsening relationships with teachers, struggles with academics, exposure to bullying, and their parents’ separation from school-related issues.

After a statistical analysis, researchers found that deteriorating student-teacher relationships and being victims of bullying predicted an increase in suicidal thoughts after teens returned from hospital.

The study was led by Marisa E. Maracchini from the University of North Carolina at Chapel Hill and included other researchers from Brown University and the University of Vermont.

They write, “The findings support the importance of student-teacher relationships and experiences of bullying abuse prior to hospital admission and the potential for worsening relationships and increased experiences of bullying after hospitalization to serve as risk factors for the severity and severity of suicidal ideation during the time period following discharge.”

Although some children and teens feel comfortable and safe during hospitalization, many report negative emotional reactions and increased distress. This is made worse when hospitalization is involuntary, as it is seen as punitive. this leads to Increased distrust of others, including mental health providers. Thus, cautious young people who are forcibly hospitalized are less likely to seek mental health treatment in the future.

To make matters worse, people who felt coerced into hospitalization higher risks Another suicide attempt months even Years after unloading. While psychopharmaceutical therapies have promised stress relief and are often the standard for psychotherapy, the rise in antipsychotic prescriptions in young adults It did not result in a decrease in psychiatric hospitalization in this population. Furthermore, people who used antidepressants after being admitted to a psychiatric hospital were also They will likely be accepted again Within a year of those diagnosed with the same disorders but not using medications.

While institutions have attempted to screen adolescent depression in order to provide preventative treatment, results show that these practices Failed to prevent psychiatric hospitalization and suicide and may It leads to over-diagnosis and over-medication. In addition, research on racial and ethnic disparities in psychotherapy has shown the extent to which black and Latino adolescents are More people are hospitalized against their will than white teens Although death by suicide is more common among non-Hispanic white Americans.

In the current study, Marraccini and her colleagues examined adolescents’ perceptions of school-related issues and relationships after trying out psychotherapy in a hospital setting. The researchers’ goals were to understand how their perceptions of their relationships with teachers, their parents’ involvement, their relationship to learning and academic satisfaction, and the victimization of bullying changed after hospital discharge.

Participants were recruited after being transferred to a psychiatric hospital. To participate, teens must be between 13 and 18 years old, must speak, read and understand English, must have had thoughts or behaviors related to suicide in the past month, and must be comfortable using smartphone technology. Teens had to agree to be part of the study and parents had to provide consent. Next, young people submitted self-reports of their impact, health, and environment. They also participated in clinical interviews whose purpose was to assess the presence, frequency, and severity of suicide during their stay in the hospital, three weeks after discharge, and six months after discharge. Parents of the teens received compensation for their participation in the study.

A total of 155 adolescents participated in the study and 152 completed all research procedures at different time points. 68.6% of participants reported identifying their sex at birth as female and 28.2% identified as male, 59.6% identified as girl or woman, 30.8% identified as boy or man, and 4.5% reported identifying in another way or were unsure about their gender identity. 13.5% of participants reported that their gender did not match their sex specified at birth. In terms of race and ethnicity, 1.9% identified as American Indian/Alaska Native, 1.3% identified as Asian, 7.7% identified as black/African American, 65.4% identified as white, and 14.1% They are identified as more than one race. 14.7% identified as Hispanic while 78.2% identified as non-Hispanic.

The researchers used latent change score models, a type of structural equation modelling, to statistically model how all factors — and their changes over time — affect suicide. They devised a large number of different models that came to a variety of results. Finally, after accounting for depressive symptoms, poor relationships with teachers and bullying remained important predictors of suicidal thoughts.

In the final models that explain depressive symptoms, perceptions of teacher relationships, bullying harm during hospitalization, changes in perceptions of teacher relationships, and bullying abuse after hospitalization remain significant factors in the severity of suicidal ideation, with only positive perceptions of teacher relationships (during hospitalization and changes after hospitalization). Effects that contribute to the severity of suicidal ideation.”

In conclusion, adolescents in psychiatric hospitalization are more likely to attempt suicide after hospital discharge and experience increased suicidal ideation. According to the results of this study, deterioration of relationships with teachers and their being victims of bullying were associated with increased thoughts of suicide.

By identifying indications of suicide after hospital discharge, researchers argue that psychologists, parents, school management, and staff can develop better strategies to prevent suicidal ideation, planning, and intent in adolescents in general and those previously hospitalized. To prevent initial suicidal ideation, researchers suggest the following:

In particular, the findings underscore the importance of adopting school-wide curricula that emphasize strong interpersonal relationships, which appear to have a protective effect against suicide and enhance learning and academic achievement in non-clinical samples.

For students who have recently been discharged, they have suggested check-ins with returning students, alternative solutions for lost items, re-engagement in student-led activities, and collaborative development of re-entry plans with students, parents, mental health providers, and school staff that include ways to mitigate bullying abuse.


Marraccini, M. E., Resnikoff, A. W., Bricks, L. A., Brier, ZMF & Nugent, N.R. (2022). Adolescents’ perceptions of school before and after psychiatric hospitalization: Anticipating suicidal thoughts. School Psychology, 37(2), pp. 199 – 132, two: (Summary)