Parents’ Experiences Supporting Justice-Involved Adolescents at Risk of Suicide During the Pre-Detention Phase in Indonesia

Introduction

Adolescents involved in violent behavior are a vulnerable population often linked to mental health issues such as depression, anxiety, and increased suicide risk.¹ This study, however, focuses on the mental health of parents, particularly mothers, who are responsible for supporting their children during the pre-detention phase. The pre-detention phase refers to the period during which adolescents are undergoing legal processing, particularly the time between police investigation and trial, which constitutes a significant period of legal uncertainty for parents.² During this time, parents face legal uncertainty and significant emotional distress as they balance social stigma with their need to continue supporting their child.

The severity of adolescent violence plays a crucial role in the level of stigma faced by parents. Weapon-related violence or group violence, for example, may contribute to greater social stigma compared to non-violent offenses.³ These types of violence can amplify feelings of guilt and shame among parents, intensifying their emotional burden. In Indonesia, caregiving is largely seen as a maternal responsibility, and mothers often face greater societal pressure than fathers.⁴ This gendered expectation can intensify the stigma that parents experience, especially when their child is involved in violent offenses. The predominant role of mothers in this study reflects this dynamic, where societal judgments about “failed motherhood” contribute to feelings of guilt and self-blame.⁵

Acceptance is a critical turning point for parents in this context. It refers to the process by which parents move from self-blame and guilt toward a more adaptive understanding of their situation, allowing them to regain agency in supporting their child despite the crisis. This shift is crucial, as it enables parents to continue providing emotional support while managing the legal and social challenges they face.⁵ Acceptance does not imply resignation or normalization of harm but instead represents a reframing process that helps parents focus on safety and supportive action.⁶ This coping mechanism can significantly reduce emotional paralysis and encourage active participation in their child’s recovery.

Beyond the psychological impact on parents, the crisis surrounding violence, suicide risk, and legal processing can disrupt the family system as a whole. Families may experience heightened conflict between spouses or extended family members, including mutual blame, disagreement about parenting strategies, and tension related to decision making during legal proceedings.⁷ Economic strain can increase due to legal fees, transportation costs for services and hearings, and reduced work productivity when caregivers must accompany the adolescent or manage crisis situations.⁸ Siblings may also be affected through fear, embarrassment, or changes in family attention and routines, which can lead to emotional distress and reduced perceived safety within the household.⁹ Over time, these cumulative stressors may weaken family cohesion and reduce the availability of protective family resources that are essential for both adolescent recovery and suicide prevention.¹⁰

The pre detention phase prior to LPKA placement represents a critical period marked by legal uncertainty, heightened emotional distress, and disruption of family routines. Adolescents may experience escalating hopelessness, fear of separation from family members, and anticipatory anxiety regarding detention, which can increase vulnerability to suicidal thoughts or behaviors.^11,12 Several studies suggest that suicide vulnerability may increase during transitional stages of justice involvement, particularly when protective structures and consistent mental health support are not yet established.¹³ At the same time, parents often face limited access to timely psychosocial guidance to help them recognize suicide warning signs and regulate their own emotional responses during this high stress period.¹⁴ As a result, families may encounter a gap in care at the very moment when crisis oriented and family inclusive mental health support is most needed.

Given the family psychiatric nursing perspective, nurses are well-positioned to intervene during the pre-detention phase because they can offer trauma-informed support, helping families navigate both the emotional distress and the legal process. Nurses can provide psychoeducation, counseling, and crisis planning, which are essential to support families during this critical period.^15–17 By addressing both psychological needs and practical concerns, nurses can bridge the care gap, ensuring that families receive the support they need during a time of crisis. The findings of this study aim to contribute to understanding how parents navigate these emotional crises and support their adolescents during the transition into the juvenile justice system.

Methods and Materials

Study Design

This study employed a qualitative design to explore the experiences of parents when their adolescents, involved in violent offenses, were identified as at risk of suicide during the pre-detention phase prior to placement in Indonesia’s juvenile correctional system (LPKA). A qualitative approach was selected to capture the depth of parental emotional responses, meaning-making, and coping strategies in a complex context shaped by legal uncertainty, social stigma, and mental health concerns. The study focused on parents because they function as the primary caregivers and decision-makers who influence help-seeking and safety actions during crisis periods. The study’s design adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ), ensuring transparency and rigor in reporting, including detailed descriptions of the research team, sampling, data collection, analysis procedures, and strategies to enhance trustworthiness.¹⁸

In this study, the pre-detention phase was defined as the period in which adolescents were undergoing legal processing but had not yet been placed in LPKA. During this phase, families remained responsible for day-to-day supervision and crisis management. This phase typically involved uncertainty regarding legal outcomes, potential separation, and the timing of detention, which may heighten distress and suicide vulnerability for both adolescents and caregivers. The focus on this stage was considered clinically and socially important because structured mental health support is often limited before institutional placement, despite the intensity of crisis experiences. Thus, the design sought to document the immediate needs and challenges parents face at a point when prevention and early intervention could be most impactful.

Research Team and Reflexive Positioning

Interviews were conducted by the first author, who has an academic background in mental health and nursing and had received training in qualitative interviewing and sensitive topic engagement. The research team included supervisors with expertise in mental health nursing, child health, and adolescent care, who contributed to methodological oversight and analytic discussions. Since the topic involved legal and stigma-related experiences, the interviewer adopted a non-judgmental stance and used open-ended prompts to avoid leading participants toward socially desirable narratives. Reflexive field notes were maintained throughout the study to document assumptions, emotional reactions, and emerging interpretations that could influence the analytic process.

Reflexivity was applied throughout the study to acknowledge how the researcher’s background in mental health and nursing could influence data generation and interpretation. The interviewer maintained a non-judgmental stance and used open-ended questions to support participants’ autonomy in shaping their narratives. Reflexive notes were written after each interview to document assumptions, emotional reactions, and emerging interpretations, and these notes were revisited during analysis to monitor potential bias. Peer discussions with supervisors were used to critically examine interpretive decisions, clarify uncertainties, and ensure that final themes were firmly grounded in participants’ accounts.¹⁹

The team worked collaboratively, with all authors contributing to the analysis, though the first author led the primary data collection and initial coding. The research team engaged in peer debriefing sessions to review and discuss the interpretations. This collaborative process was intended to minimize bias and ensure the credibility of the analysis. The reflexive thematic analysis method is designed to allow the researcher’s positionality to inform the process, but this was balanced by the involvement of multiple researchers in reviewing and refining themes.

Study Setting

The study was conducted within the context of the Indonesian juvenile justice pathway, with an emphasis on the family’s lived environment during the period prior to LPKA placement. Interviews were conducted in settings that supported privacy and participant comfort, including the family home or a private room in a community based service facility, and some interviews were completed online when face to face meetings were not feasible. The setting was selected to minimize institutional pressure and allow participants to speak openly without the constraints of being inside a correctional environment. The study obtained institutional permissions from relevant authorities (LPKA Maros and LPKA Mamuju), to facilitate ethical coordination and referral pathways when needed.

Although the study received permission from LPKA administrators, data collection did not occur inside LPKA, and participants were recruited and interviewed before the adolescent was detained. This approach ensured that the experiences captured reflected parents’ immediate responses to a crisis situation while still living in the community and managing day to day caregiving responsibilities. The pre detention context often includes contact with mental health services, social workers, child protection units, and legal assistance providers, and these interfaces shaped parents’ help seeking opportunities and barriers. The setting description was included to support transferability by clarifying the social, cultural, and legal environment in which parental experiences were situated.

Participants and Sampling

The study was conducted within the context of the Indonesian juvenile justice pathway, with a specific focus on the family’s lived environment before LPKA placement. Interviews took place in settings that supported privacy and participant comfort, including family homes or private rooms in community-based service facilities. Some interviews were conducted online when face-to-face meetings were not feasible. This approach minimized institutional pressures and allowed participants to speak openly without the constraints of being inside a correctional environment. Institutional permissions were obtained from relevant authorities (LPKA Maros and LPKA Mamuju), to support ethical coordination and referral pathways when needed.

While the study received permission from LPKA administrators, data collection did not occur inside LPKA. Participants were recruited and interviewed before the adolescent was detained, ensuring that the experiences captured reflected parents’ immediate responses to the crisis, while still living in the community and managing day-to-day caregiving responsibilities. The pre-detention context often includes contact with mental health services, social workers, child protection units, and legal assistance providers, all of which shaped parents’ help-seeking opportunities and barriers. The description of the study setting was included to support transferability by clarifying the social, cultural, and legal environment in which parental experiences were situated.

Participants and Sampling

Participants were parents or primary caregivers of adolescents involved in violent offenses who were undergoing legal processing and had not yet been placed in LPKA. The inclusion criteria included biological parents or primary guardians who had a central caregiving role, were directly involved in supporting the adolescent during the pre-detention period, and were willing to participate voluntarily with written informed consent. A key criterion was that the adolescent had been identified as at risk of suicide prior to detention based on professional documentation or referral. In this study, suicide risk identification was defined as either documented suicidal ideation or a prior suicide attempt recorded in a referral note, or an explicit suicide risk assessment statement made by a qualified professional involved in the adolescent’s care, such as a mental health clinician or designated health worker.

Exclusion criteria included caregivers with severe cognitive impairment or acute psychological conditions that would prevent meaningful participation in an interview, as judged through an initial screening conversation. Purposive sampling was used to recruit participants who could provide rich information related to the research aim, including varied parental roles, educational backgrounds, and family circumstances. Recruitment was facilitated through collaboration with community-based mental health services, social workers, and child protection or legal assistance units, using a procedure that prioritized confidentiality and voluntariness. Potential participants were first informed about the study by a service liaison, and those who expressed interest were contacted by the researcher to receive detailed study information and make an independent decision without any influence on legal status or access to services.

The sample size was guided by information power and thematic saturation principles in qualitative research, and recruitment continued until additional interviews did not add meaningful new insights to the developing coding framework. Saturation was assessed through ongoing comparison of new transcripts with existing codes and candidate themes, combined with team discussions about whether new conceptual content was emerging. The final sample consisted of 15 participants, which was considered sufficient to support the development of well-defined themes across the dataset. This approach aligns with recommendations that saturation should be operationalized transparently and evaluated in relation to the study aim, sample specificity, and analytic depth.

Data Collection

Data were collected through in-depth semi-structured interviews to explore parents’ emotional experiences, perceptions of stigma, coping strategies, and pathways toward acceptance during the pre-detention crisis phase. Semi-structured interviewing was chosen because it supports consistency in covering key domains while allowing participants to describe personal meanings, timelines, and turning points in their own words.²⁰ An interview guide was developed based on the study aims and relevant literature and was refined through team discussion to ensure sensitivity and clarity. Core domains included initial reactions to the legal and clinical crisis, perceived stigma and social responses, parenting challenges and family dynamics, experiences of seeking help, and reflections on acceptance and future-oriented coping.

Interviews were conducted face-to-face or online depending on participant preference and feasibility, and each interview lasted approximately 45 to 90 minutes. All interviews were audio-recorded with permission, transcribed verbatim, and supplemented by field notes capturing contextual information, non-verbal cues when applicable, and the interviewer’s reflexive observations.²¹ To protect confidentiality, transcripts were de-identified by removing names and any potentially identifying details about individuals and locations. Data collection proceeded iteratively, with early analytic impressions informing subsequent probing questions to clarify concepts and deepen emerging patterns.

Because the topic involved suicide-related distress and legal crises, a participant safeguarding protocol was implemented. Prior to each interview, participants were reminded that they could pause, skip questions, or stop at any time without consequences. If a participant displayed signs of significant distress, the interview was paused, and supportive grounding was offered, followed by an option to reschedule or terminate the session. When needed, the researcher provided referral information for local professional support pathways that had been coordinated with relevant services, ensuring that participants could access appropriate assistance beyond the research context.

Data Analysis

Data were analyzed using reflexive thematic analysis to identify patterns of meaning across parents’ accounts of stigma, emotional burden, acceptance processes, and support needs during the pre-detention phase.²² The analysis was iterative and began during data collection through memo writing and reflective notes, which helped document developing interpretations and guide subsequent interviews. First, transcripts were read repeatedly to achieve familiarization, and initial codes were generated inductively to capture meaningful features relevant to the research questions. Coding was conducted by the first author, and candidate themes were developed through grouping conceptually related codes and examining relationships across the dataset.

Next, candidate themes were reviewed and refined to ensure internal coherence and clear boundaries between themes. The research team engaged in peer debriefing sessions to discuss the coding structure, challenge assumptions, and strengthen interpretive credibility, while maintaining the reflexive principle that themes represent a researcher-developed account grounded in participants’ data rather than a mechanical outcome of software. NVivo was used to support data management, coding organization, and retrieval of coded excerpts, but it did not replace the interpretive role of the researcher. Final themes were defined and named to reflect their conceptual essence, and representative excerpts were selected to demonstrate how claims were grounded in participants’ narratives.

Trustworthiness and Rigour

Trustworthiness was enhanced using credibility, dependability, confirmability, and transferability strategies.²³ Credibility was supported through prolonged engagement with the dataset, iterative analysis, and peer debriefing discussions that examined alternative interpretations and ensured that themes were clearly supported by multiple data excerpts. Dependability was strengthened through systematic documentation of methodological decisions, interview procedures, coding development, and theme refinement, creating an audit trail that can be reviewed. Confirmability was addressed by maintaining a reflexive journal and field notes that recorded assumptions, emotional responses, and decision points, helping distinguish participant meaning from researcher influence.

Transferability was supported through a detailed description of the study context, participant characteristics, and the legal and social environment shaping the pre-detention experience. The manuscript provides information that allows readers to assess whether the findings may be relevant to similar populations and settings. In addition, the use of representative participant quotes contributes to transparency by showing how analytic claims were derived from the data. These strategies collectively aimed to provide a rigorous and ethically responsible qualitative account of parental experiences in a sensitive and under-researched context.

Ethical Considerations

Ethical approval was obtained from the Research Ethics Committee of Padjadjaran University with reference number 763/UN6.KEP/EC/2025. Institutional permission was also granted by relevant authorities (LPKA Maros and LPKA Mamuju), to support coordination and safeguarding pathways. The study complies with the Declaration of Helsinki and all ethical standards for research involving human participants.

All participants received a clear explanation of the study purpose, procedures, potential risks and benefits, confidentiality protections, and the voluntary nature of participation. Written informed consent was obtained prior to data collection. Participants were explicitly informed that refusal to participate would not affect any legal process or access to services. Additionally, the informed consent form included permission for the publication of anonymized responses and direct quotes in the study, ensuring participants understood that their anonymized data might be used in reports and publications.

Dual Vulnerability: Given the dual crises faced by parents, involving both psychological distress (due to their child’s suicide risk) and legal distress (due to the child’s involvement in violent offenses), the study ensured careful handling of participants’ vulnerabilities. Parents were informed of their rights and the voluntary nature of participation, ensuring they understood that their involvement in the study would not impact their child’s legal case in any way. The informed consent process emphasized that participation was not tied to legal outcomes or access to services, and that their emotional well-being would be prioritized throughout the study.

Situational Coercion: To prevent any feelings of coercion, especially considering that parents might be under extreme emotional stress and might perceive participation in the study as a way to improve their child’s legal situation, researchers made explicit efforts to clarify the study’s scope and purpose. During the informed consent process, participants were reassured that the study was purely research-based and would not influence their child’s legal situation or treatment. The research team reiterated that participation had no bearing on the legal proceedings and that their involvement was completely voluntary. Participants were encouraged to ask questions, ensuring that they understood these aspects fully before consenting to participate.

Confidentiality was ensured by de-identifying transcripts and storing data securely with access limited to the research team. Any information that could reveal identities or specific locations was removed from transcripts and reports to minimize the risk of social harm, particularly given the sensitivity of stigma and legal involvement. Given the discussions around suicide-related distress and crisis experiences, the study followed a safeguarding protocol for interviews. This included pausing interviews when necessary and providing referral information to appropriate professional support. Ethical procedures were implemented in accordance with established principles for research involving human participants, ensuring respect for autonomy and minimizing harm.

Results

Sociodemographic Characteristics

Table 1 presents the sociodemographic characteristics of the participants and background information about the adolescents, including parental age, education, employment, marital status, adolescent age, type of violent behavior, suicide risk history, and prior mental health service use. The study included 15 parents or primary caregivers, with mothers comprising the majority of participants (9 out of 15). Most adolescents were aged 16 to 17 years, and suicide risk history included both suicidal ideation and suicide attempts. Only a minority of adolescents (4) had previously accessed mental health services, indicating potential gaps in support before detention. These characteristics provide context for interpreting parents’ accounts of stigma, distress, and coping during the pre-detention phase.

Table 1 Sociodemographic Characteristics of Informants and Adolescents’ Backgrounds

Thematic Analysis

Thematic analysis of interviews identified five key themes that describe parents’ psychosocial experiences during the pre-detention crisis phase. Parents described experiences that fluctuated rather than followed a linear trajectory, moving between fear, guilt, hope, and efforts to maintain caregiving roles under legal uncertainty. Accounts also suggested that stigma, family strain, and limited service navigation intensified distress at a time when safety concerns were prominent. The following themes are presented with brief explanatory details and representative quotations to reflect variation across participants (Table 2).

Table 2 Themes, Definitions, and Representative Participant Quotes

Theme 1: Emotional Turmoil and Self-Blame

Parents described an immediate sense of shock and emotional collapse upon learning about the violent incident and their child’s potential suicide risk. Many parents reported intense fear of losing their child and persistent self-blame. This self-blame shaped how parents made sense of the crisis, often manifesting as intrusive rumination, where parents repeatedly replayed the incident and questioned prior parenting decisions. Some parents expressed helplessness, feeling unprepared to respond to the suicide risk while the legal process was ongoing.

I could not believe it, it felt like the world was collapsing. I kept blaming myself, maybe I was not paying enough attention to him. (P3)

As a mother, I felt like a failure. If only I had been firmer or more approachable, maybe this would not have happened. (P7)

The hardest part was the guilt. I felt like it was all my fault as a parent. (P12)

I was afraid to leave him alone. I kept thinking, what if he does something when I am not watching. (P9)

Theme 2: Family Tension and Psychological Exhaustion

Parents described sustained strain that disrupted family functioning, including conflict within the household and ongoing emotional fatigue. The combination of legal uncertainty, fear of suicide, and practical demands contributed to sleep disturbances and difficulties concentrating, which affected daily responsibilities. Several parents reported conflict between spouses or extended family members, often characterized by mutual blame and disagreement about how to respond. Psychological exhaustion was described as prolonged depletion rather than temporary stress, especially when parents felt the need to remain hypervigilant to prevent self-harm.

There are frequent arguments at home, everyone blaming each other. I am mentally exhausted. (P1)

I have trouble sleeping, I am constantly thinking about it. My body is tired, and my mind is also tired. (P9)

I feel like I do not have time to rest, my mind is constantly preoccupied with my child’s problems. (P14)

At home, the atmosphere changed. Small things could trigger anger because everyone was already stressed. (P6)

Theme 3: Community-Based Social Stigma

Most parents described stigma from their social environment that intensified distress and contributed to social withdrawal. Stigma was experienced through social distancing, labeling, and moral judgment, which reduced informal support at the community level. Several parents limited contact with neighbors or avoided public spaces due to fear of gossip and negative perceptions. Parents described stigma as both external and internal, because community reactions often reinforced feelings of shame and self-blame. These experiences influenced help-seeking as some parents feared being judged if they sought professional support.

Neighbors started to distance themselves, and I felt like I was being seen as a failed parent. (P2)

Some people said my child came from a troubled family. That was very hurtful. (P6)

I became embarrassed to leave the house, afraid of what people would say. (P11)

I felt people looked at us differently, like our family name was already ruined. (P3)

Theme 4: Reflective Turning Point Toward Self-Acceptance

Several parents described a gradual shift from self-blame toward acceptance, which they framed as necessary to regain agency and focus on their child’s safety. This turning point was not described as a complete resolution but rather as a reflective process that helped parents reframe the crisis and reduce emotional paralysis. Parents emphasized that acceptance allowed them to redirect attention from blame to supportive action, such as communication, supervision, and seeking information. Some parents described acceptance as a commitment to remain present for the child despite shame and fear. This theme highlights a coping transition that may be strengthened through timely professional support.

Gradually, I realized that continuing to blame myself was not solving anything. (P4)

I started to learn to accept this situation and think about how to help my child going forward. (P8)

I tried to accept it. The important thing now is that my child is safe and can be helped. (P15)

Even if I feel embarrassed, I cannot abandon my child. I have to stay with him and help him. (P10)

Theme 5: The Need for Family Mental Health Support in the Pre-Detention Phase

All parents emphasized unmet needs for family-inclusive mental health support during the pre-detention phase, including counseling, psychoeducation about suicide risk, and clear service navigation. Parents described confusion about where to seek help and a lack of structured guidance on how to respond to crisis situations. Some parents felt that available responses prioritized legal procedures, while emotional and psychological needs were not sufficiently addressed. Parents also expressed the need for non-judgmental support that acknowledged stigma and caregiver burden. These accounts underscore a perceived care gap during a high-risk period for both adolescents and caregivers.

We need support, not just for my child, but for us as parents as well. (P5)

If there had been counseling from the start, perhaps our situation would not have been as difficult as it is now. (P10)

We were confused about where to seek help before our child entered the LPKA. (P13)

We needed someone to guide us, because we did not know what to do when the fear became overwhelming. (P8)

The findings of this study underscore the importance of addressing the psychosocial needs of parents during the pre-detention phase of the juvenile justice process, specifically highlighting how family mental health support can play a crucial role in reducing parental distress and improving coping. The dynamic nature of the parental experience during this phase, characterized by fluctuating emotions such as self-blame, guilt, and the eventual shift toward acceptance, demonstrates the critical window for early intervention and trauma-informed care. These insights support the call for family-based, community-sensitive interventions in mental health nursing and underscore the role of parents as active partners in adolescent suicide prevention within the juvenile justice pathway.

Discussions

This qualitative study explored the experiences of parents of adolescents involved in violent offenses who were identified as at risk of suicide during the pre-detention phase prior to placement in LPKA. The findings illuminate a layered psychosocial process in which parents navigated intense emotional shock, escalating family strain, community-based stigma, a gradual movement toward acceptance, and unmet needs for family-inclusive mental health support. Importantly, the findings suggest that parental distress is not a peripheral issue, but a central element of crisis management, as parents are responsible for daily supervision, emotional containment, and decisions about help-seeking during a period of legal uncertainty. Taken together, these results position the pre-detention phase as a critical window for suicide prevention and family-based intervention within the juvenile justice pathway, particularly in settings where formal mental health support is not consistently accessible.

Emotional Turmoil and Parental Self-Blame as a Barrier to Early Coping

Parents’ initial responses were characterized by shock, fear of losing their child, and persistent self-blame. These responses align with family stress and attribution theories, in which caregivers attempt to restore a sense of order by locating personal responsibility for adverse events, even when multiple structural and contextual factors are involved.²⁴ In this study, self-blame appeared to function in two interconnected ways. First, it served as an explanatory framework through which parents interpreted the violent incident and suicide risk, often viewing it as evidence of parenting failure.²⁵ Second, it intensified emotional overload, reducing parents’ perceived capacity to act, which may delay help-seeking and limit problem-focused coping during the early crisis period.²⁶

This pattern aligns with evidence that shame and guilt can heighten psychological distress and contribute to withdrawal, particularly among caregivers facing social scrutiny and limited support.²⁷ Although self-blame is often discussed as an internal process, our findings indicate that it also reflected social and moral pressures surrounding parenting reputation, especially salient in community settings like South Sulawesi.²⁸ The implications for practice are significant, as parents overwhelmed by guilt may struggle to engage in safety planning, consistent supervision, and supportive communication with the adolescent. Accordingly, early interventions should address not only the adolescent’s suicide risk but also caregiver distress and self-blaming cognitions that impede adaptive coping and timely access to care.²⁹

Family Tension and Psychological Exhaustion During Legal Uncertainty

The pre-detention phase was experienced as a period of sustained disruption to family functioning. Parents described household conflict, sleep disturbances, and emotional exhaustion while managing legal processes and the constant worry over the adolescent’s safety. These findings extend prior evidence that families linked to the justice system frequently experience high caregiving burdens and mental health strain.³⁰ However, the combination of legal uncertainty and suicide risk produced a particularly intense form of hypervigilant caregiving, where parents felt compelled to monitor the adolescent while also maintaining routine responsibilities and responding to administrative demands.³¹

Family tension was also shaped by divergent interpretations of the crisis, including disagreements about blame, discipline, and the appropriate response to both the legal process and the adolescent’s mental state.³² In practical terms, this tension can reduce family cohesion and the availability of supportive interactions within the home, which are important protective factors when adolescents experience suicidal ideation or emotional instability.³³ From a nursing perspective, these findings underscore the need for family-oriented crisis responses that help caregivers regulate distress, negotiate shared decision-making, and maintain a supportive environment for the adolescent. Without such support, caregiver burnout may reduce the consistency of supervision and emotional availability, potentially increasing vulnerability during this critical stage of risk.³⁴

Community-Based Social Stigma and Constrained Help-Seeking

Stigma was a central theme shaping parents’ experiences, with participants describing labeling, social distancing, and moral judgment. These findings align with the concept of stigma by association, where family members experience courtesy stigma due to their relationship with a stigmatized individual.³⁴ In this study, stigma operated not only as interpersonal rejection but also as a mechanism that reduced informal social support when families needed it most. Parents’ accounts indicate that stigma contributed to avoidance of community spaces and social withdrawal, which can deepen isolation and reduce opportunities for shared coping.¹⁰

Stigma also has implications for formal help-seeking, as fear of judgment may discourage families from contacting mental health services or discussing suicide-related concerns openly. This aligns with evidence that perceived stigma in family and social networks can undermine help-seeking and delay care engagement in youth mental health contexts.³⁵ For juvenile justice-linked families, these barriers may be amplified by concerns about confidentiality and reputational harm.³⁶ Therefore, reducing stigma is not only a social goal but also a suicide prevention strategy, because stigma can obstruct pathways to timely assessment, counseling, and crisis support.

Reflective Turning Points Toward Acceptance as an Adaptive Process

Despite profound distress, some parents described a reflective shift toward acceptance, accompanied by reduced self-blame and a renewed focus on safety and recovery. This turning point mirrors adaptive coping and post-crisis adjustment processes described in family resilience frameworks, where meaning-making and acceptance support functional adaptation under adversity.³⁷ Importantly, acceptance in this study did not reflect resignation or normalization of harm. Instead, it represented a reorientation toward constructive involvement, where parents attempted to stabilize emotions, remain present for the adolescent, and seek ways to support recovery.³⁸

The findings suggest that acceptance may serve as a psychological bridge between emotional paralysis and protective action, including supervision, supportive communication, and willingness to engage with services. This resonates with evidence that family resilience and positive adaptation can be strengthened when families receive structured support and opportunities to develop coping skills.³⁹ Clinically, this indicates that interventions should not merely identify risk but should actively support caregiver meaning-making and self-compassion, as these processes can enhance engagement in rehabilitation-oriented care. Strengthening acceptance-oriented coping may also reduce conflict and improve the emotional climate of the home, which is relevant to adolescent suicide prevention.⁴⁰

Unmet Mental Health Support Needs and a Missed Prevention Opportunity

Across the themes, parents emphasized gaps in structured mental health support during the pre-detention phase. Participants described confusion about where to seek help, limited guidance on responding to suicide risk, and a perceived lack of family-inclusive services before detention. These findings align with concerns that juvenile justice responses often prioritize legal processing while the psychosocial needs of families remain insufficiently addressed.⁴¹ The absence of coordinated support during the pre-detention stage represents a missed opportunity, as early crisis intervention could reduce caregiver distress, strengthen protective family processes, and support timely safety planning for adolescents.⁴²

Evidence indicates that community-based mental health interventions can reduce suicidal thoughts and behaviors among youth, particularly when care is accessible and coordinated.⁴³ In the context of this study, parents implicitly described the need for a clear pathway that combines crisis counseling, psychoeducation about suicide warning signs, service navigation, and stigma-sensitive support. Such a pathway would recognize parents as active partners in care rather than passive observers and would strengthen continuity across the transition into LPKA. This is particularly important in settings where prior mental health service utilization is limited, as indicated by the participant characteristics in this study.⁴⁴

Implications for Nursing Practice and Policy

The findings highlight the need to integrate family-focused, trauma-informed mental health nursing interventions into the juvenile justice pathway beginning in the pre-detention phase. In practice, psychiatric and community nurses can play a key role in conducting family-inclusive assessments, providing brief crisis counseling, delivering psychoeducation on suicide risk recognition and response, and facilitating safety planning that is feasible in the home context. Nurses can also function as care coordinators who connect families to appropriate mental health services and community resources, reducing confusion and improving help-seeking. In policy terms, juvenile justice and health systems should establish protocols to ensure early involvement of mental health professionals for both adolescents and caregivers, including referral mechanisms that are confidential, stigma-sensitive, and culturally appropriate.

Policy efforts should also include strategies to reduce stigma at the community level, as stigma influences both family well-being and access to care. Cross-sector collaboration between juvenile justice, health services, social workers, and child protection units is essential to deliver coordinated support that does not end at legal processing. Integrating family-based mental health services into LPKA continuity of care can strengthen rehabilitation outcomes and reduce suicide risk during transitions, including entry into detention and subsequent reintegration stages. Ultimately, treating parents as partners in care is likely to enhance protective factors for adolescents and improve the sustainability of psychosocial support.

Strengths and Limitations

A key strength of this study is its focus on an under researched population and a critical yet often overlooked period, namely the pre detention phase prior to LPKA placement. The qualitative approach enabled rich descriptions of parental distress, stigma experiences, acceptance processes, and perceived support needs within a legally and socially complex context. However, the study also has limitations that should be acknowledged. The sample size and specific context may limit transferability to other settings, and the findings should be interpreted as an in depth account rather than a generalizable estimate of prevalence. In addition, data were collected at a single time point prior to detention, which does not capture how parental experiences may evolve during detention, adaptation to LPKA, or post detention reintegration.

Future research should consider longitudinal qualitative designs to examine changes in parental coping, stigma exposure, and service engagement over time. Studies that evaluate the feasibility and effectiveness of family based interventions during pre detention and transitional periods would strengthen the evidence base for practice and policy. Mixed methods approaches may also be valuable to triangulate qualitative insights with measures of caregiver burden, stigma, and help seeking, while still preserving contextual depth. Such work would help translate qualitative findings into implementable service models for juvenile justice connected families.

Theoretical Contributions and Integration of Themes

This study contributes to stigma and suicide prevention literature by highlighting parents as key actors during a high risk transitional stage within juvenile justice trajectories. The findings suggest that self blame, exhaustion, and community stigma can interact to produce a system of caregiver vulnerability that may constrain supervision, reduce supportive communication, and delay help seeking. At the same time, the identification of a reflective turning point toward acceptance adds nuance to family resilience theory by illustrating an adaptive process that can restore agency and enable supportive engagement during crisis. Conceptually, the themes can be understood as an interconnected trajectory in which emotional shock and self blame are intensified by family strain and stigma, while acceptance may emerge when parents begin to reframe the crisis and prioritize protective action.

The integration of themes underscores that pre detention is not merely a legal stage but also a psychosocial transition that shapes risk and protection for both adolescents and caregivers. The findings therefore support the development of family based, trauma informed care models that begin early, address stigma barriers, and strengthen caregiver coping capacities as part of comprehensive suicide prevention strategies within juvenile justice linked services. By centering parental experiences, the study offers a clinically relevant framework for identifying intervention targets that are often overlooked, including caregiver guilt, family conflict management, stigma sensitive engagement, and service navigation support.

Conclusions

This study highlights the complex psychosocial dynamics experienced by parents of adolescents involved in violent offenses and identified as at risk of suicide during the pre-detention phase prior to placement in LPKA. Parents described an initial period marked by emotional shock and self-blame, followed by heightened family tension and psychological exhaustion, which were often compounded by community-based social stigma and social withdrawal. Importantly, the findings suggest that parental distress and stigma-related pressures can constrain caregivers’ capacity to provide consistent emotional support, supervision, and timely help-seeking during this critical period of vulnerability. Amid these pressures, some parents described a reflective turning point toward self-acceptance, enabling a shift from guilt and paralysis toward more adaptive and safety-oriented caregiving engagement.

In line with these findings, the study underscores the need for family-inclusive, trauma-informed mental health support that begins early, specifically during the pre-detention phase. However, for these interventions to be effective, it is essential that family-focused care be community-based and mobile, offering accessible support to parents during the period when they are most isolated. This period is critical, as adolescents are at their peak suicide risk, and parents are often overwhelmed and under-informed.

In the context of psychiatric nursing, the findings highlight that multi-sectoral collaboration is crucial. The recommendation for integrating mental health support into the juvenile justice pathway must extend beyond psychiatric care to include close collaboration between the Ministry of Law and Human Rights, which manages LPKA, and the Ministry of Health. A mandatory mental health screening protocol for both the adolescent and family at the point of police investigation, rather than waiting until the child is in the correctional system, would ensure early intervention and the timely provision of support to families and adolescents in crisis. Policy integration between these sectors is essential for ensuring that parents and adolescents receive the comprehensive mental health care they need throughout the juvenile justice process.