The suicidal behavior of teenagers can be associated with considerable distress for parents, raising issues about the possibility of their unaddressed mental health needs. Parents' level of distress and their potentially higher risk for anxiety and depressive disorders may effect interactions with adolescents, parenting practices, and follow-through with treatment recommendations for youths or involvement with treatment. Nonetheless, little is known about which parents have the most difficulties following their teenager's suicidal behaviors, the nature of these difficulties, or how quickly these reactions resolve. This application is a proposal to address these issues, in response to the NIH Program Announcement 07-079, Research on the Reduction and Prevention of Suicidality. This program announcement invites applications that address the burden, and specifically, the immediate and long-term mental health needs of family survivors who have experiences suicide attempts and/or deaths in the family. In this study, parents of 180 hospitalized teenagers who have made suicide attempts and 180 hospitalized teenagers who have not made attempts will be examined at 1,3, 6, and 12 months following a suicide attempt. The first specific aim of this project is to examine the distress and risk for anxiety and depressive disorders among mothers of suicidal teens relative to the mothers of other hospitalized youths, the diversity of these reactions, and the amount of time for resolution of these reactions. Using latent class trajectory methods, we will identify groups of parents with different patterns of symptoms over time following adolescents' hospitalization. The second Specific Aim of this proposal is examine child and maternal factors that are predictive of maternal emotional symptoms following adolescent suicidal behavior including high medical lethality of the attempt, number of prior attempts, family history of suicidal behavior, and past psychiatric treatment history. The third Specific Aim is to examine the association between material symptoms and anxiety/depressive disorders following adolescent suicidal behavior on parenting practices, mental health specialty service use, length of treatment and follow-through with the treatment recommendations. This project will help us to understand the mental health and treatment needs of mothers of adolescents who have attempted suicide. The results of this study will help shed light on the best strategies for meeting parental needs following adolescent suicide attempts, and involving parents in their son's and daughter's treatment.