Two pathways to Mexico: Forced deportation or voluntary return of parents and US citizen children.

Hundreds of thousands of undocumented Mexican immigrants were deported from the United States or returned to Mexico voluntarily in the past two decades, taking with them their US-born citizen children (USCC). A family's relocation-forced deportation or voluntary return-and the subsequent settlement and adjustment to Mexico affect everyone's well-being. We interviewed 18 USCC whose parents were forcibly deported and 18 whose parents returned voluntarily about their circumstances, experiences, and perceptions. Four categories of relocation and adjustment issues emerged. USCC with deported parents felt the sudden and harsh arrest, detention, deportation, and separation from parents, and family reunification after deportation. Those in the voluntary-return group told of concerns about the planned separation and relocation to Mexico. Both groups experienced issues of family reintegration and adjustment to a new environment. While relocation prompted similarities and differences in families' settlement, issues unique to families played a part in children's adjustment. Clinicians in both the United States and Mexico must take into consideration the nature of the relocation, families' distinctive reactions, and the individual child's experience as some USCC will remain in Mexico and others will return to the US Mexican clinicians will encounter USCC still settling and adjusting to Mexico, and USCC who decide to remain permanently in Mexico. US clinicians may encounter USCC facing the challenges of re-entering American society, joining educational institutions, and becoming part of the labor force. USCC forming families may feel the impact of their pasts in parenting dynamics.

Sibling relationships among U.S. citizen children of undocumented Mexican parents.

Current U.S. immigration policies disproportionately impact Mexican-origin mixed-status families, yet few studies examine the consequences of immigration enforcement (e.g., immigration-related arrest and detention) and deportation on sibling dynamics. Given this gap, this study focuses on the experiences and changes within sibling relationships in the aftermath of parental detention and deportation. We analyzed a subsample of 20 citizen children interviews (7 sibling dyads; 2 sibling triads) from a multi-site binational study that examined the psychosocial functioning of U.S. citizen children with undocumented Mexican parents. Using inductive thematic analysis, we explored the roles and functional importance of sibling relationships before and after experiences of parents' detention and deportation. Our findings suggest that prior to detention or deportation experiences, sibling relationships were described as "normal." After these experiences, however, sibling relationships changed and developed protective adaptations, including more open communication about their experiences and the assumption of caregiving roles. In cases where deportation did not occur, there still existed the threat of future immigration-related action, which contributed to fear and an inability to share feelings and experiences among siblings. Our findings suggest that sibling relationships might serve as an important locus of stability and protection. Yet, adaptive communication may not emerge as long as the threat of apprehension, detention, and deportation exists.

Las políticas migratorias actuales de los Estados Unidos afectan de manera desproporcionada a las familias de condición migratoria mixta de origen mexicano, sin embargo, pocos estudios analizan las consecuencias de la aplicación de las leyes de inmigración (por ej.: el arresto y la detención relacionados con la inmigración) y la deportación en la dinámica fraternal. Teniendo en cuenta esta falta de datos, el presente estudio se centra en las experiencias y los cambios dentro de las relaciones fraternales después de la detención y la deportación de los padres. Analizamos una submuestra de 20 entrevistas a niños ciudadanos (7 díadas de hermanos; 2 tríadas de hermanos) de un estudio binacional realizado en varios sitios que analizó el funcionamiento psicosocial de niños ciudadanos de los Estados Unidos con padres mexicanos indocumentados. Utilizando el análisis temático inductivo, analizamos los roles y la importancia funcional de las relaciones fraternales antes y después de las experiencias de detención y deportación de los padres. Nuestros resultados indican que, antes de las experiencias de detención o deportación, las relaciones fraternales se describieron como "normales". Sin embargo, después de estas experiencias, las relaciones fraternales cambiaron y surgieron adaptaciones protectoras, por ejemplo, una comunicación más abierta acerca de sus experiencias y la asunción de roles de cuidado. En los casos donde no hubo deportación, igualmente existió la amenaza de una futura acción relacionada con la inmigración, la cual generó miedo e incapacidad de compartir sentimientos y experiencias entre hermanos. Nuestros resultados sugieren que las relaciones fraternales podrían servir como lugar importante de estabilidad y protección. Sin embargo, es posible que la comunicación adaptativa no surja mientras exista la amenaza de arresto, detención y deportación.

Father-Daughter Relationships among Latina Adolescents Who Attempted Suicide: An Exploratory Dyadic Analysis.

Among adolescents, Latinas are at an increased risk of experiencing suicidal ideation and attempts compared to non-Hispanic, White youth. Previous research indicates that family dynamics are influential as both protective and risk factors. Although significant research has been conducted over the past several decades examining the mother-daughter relationship, few studies have examined the father-daughter relationship among Latina adolescent suicide attempters. The relationship dynamics between fathers and daughters of Latina descent are both similar and unique compared to mother-daughter relationships. Given this, an in-depth analysis is warranted. To address this gap, the present study utilized dyadic thematic analysis to describe father-daughter relationships (N = 10 dyads, 20 individual interviews) and fathers' reactions to their Latina daughters' suicide attempt(s). Three themes emerged from the results (a) dynamic proximity, which describes the variation in emotional and physical closeness between fathers and daughters; (b) father as protector, which describes fathers' roles in protecting or failing to protect their daughters; (c) responses to the suicide attempt, which describes the various ways fathers responded to daughters' suicide attempts, ranging from helpful action to apathy. Themes gleaned from in-depth interviews informed a deeper understanding of these complex, multifaceted relationships, and how they may be linked to fathers' responses to daughters' suicide attempts. Implications for future research and clinical practice with youth at risk for suicidal ideations and behaviors, along with the impact of such experiences on families, are discussed.

Entre las adolescentes, las latinas corren un mayor riesgo de tener ideación e intentos suicidas en comparación con las jóvenes blancas no hispanas. Hay investigaciones previas que indican que la dinámica familiar influye tanto como factor protector como de riesgo. Aunque se ha investigado bastante durante las últimas décadas sobre la relación entre madre e hija, en pocos estudios se ha examinado la relación entre padre e hija en adolescentes latinas que han intentado suicidarse. La dinámica de la relación entre padres e hijas de ascendencia latina es tanto similar como única en comparación con la de la relación entre madres e hijas. En virtud de esto, es necesario un análisis profundo. Para subsanar esta carencia, en el presente estudio se utilizó el análisis temático diádico para describir las relaciones entre padres e hijas (N = 10 díadas, 20 entrevistas individuales) y las reacciones de los padres a los intentos de suicidio de sus hijas latinas. De los resultados surgieron tres temas: (a) la proximidad dinámica, que describe la variación en la cercanía emocional y física ente los padres y las hijas; (b) el padre como protector, que describe los roles de los padres a la hora de proteger o no proteger a sus hijas; (c) las respuestas al intento de suicidio, que describe las diversas maneras en las que los padres respondieron a los intentos de suicidio de las hijas, las cuales variaron desde medidas de ayuda hasta apatía. Los temas obtenidos de entrevistas detalladas informaron una mayor comprensión de estas relaciones complejas y multifacéticas, y de cómo pueden vincularse con las respuestas de los padres a los intentos de suicidio de las hijas. Se debaten las consecuencias para futuras investigaciones y para la práctica clínica con las jóvenes en riesgo de ideaciones y conductas suicidas, así como el efecto de dichas experiencias en las familias.

Trajectories of Well-Being Among Latina Adolescents Who Attempt Suicide: A Longitudinal Qualitative Analysis.

Significant research questions persist regarding the short- and long-term outcomes of Latina adolescents who attempt suicide. To address these limitations, we utilize an ecodevelopmental framework to identify potential factors that shape differential outcomes following a suicide attempt. Through an exploratory, longitudinal, qualitative research design, we investigate two research questions: How do trajectories of well-being vary among Latina teens after a suicide attempt? What risk and protective factors might contribute to different trajectories? We conducted qualitative interviews with 17 Latina participants living in predominantly low-income households in New York City. Interviews took place within the 6 months following their suicide attempts, and again, 12 months later. Analysis revealed three distinct trajectories after a suicide attempt: resilience, tenuous growth, and chronic stress. Our findings elucidate potential factors that contribute to resilience following a suicide attempt and underscore the importance of prevention and intervention programs that foster adolescents' connectivity across ecodevelopmental contexts.

"I Just Kept It to Myself": The Shaping of Latina Suicidality Through Gendered Oppression, Silence, and Violence.

Suicide is a critical issue among Latina youth. In this study, we use family case analysis to explore how gendered oppression, silencing, and violence shape suicidal behaviors among a sample of Latina daughters (n = 10), and their parents. For comparison, we include family narratives from Latina adolescents with no histories of suicide attempts (n = 10). Results suggest how secrets and silence, as indicative of gendered oppression, may catalyze a suicide attempt. The risks are particularly salient when daughter and mother both have experienced violence that conflicts with gendered cultural scripts. Findings highlight the importance of parental engagement and exploration of histories of violence in the treatment of Latina suicide attempters. Future research should incorporate the risk factors of gendered oppression and violence to better understand the development of suicidality among Latina women.

El suicidio es un problema crítico entre las jóvenes latinas. En este artículo, usamos un análisis de casos familiares para averiguar cómo la opresión de género, el silenciamiento y la violencia determinan conductas suicidas entre una muestra de hijas latinas (n = 10) y sus padres. Para comparar, incluimos relatos familiares de adolescentes latinas sin historias de intentos de suicidio (n = 10). Los resultados sugieren cómo los secretos y el silencio, como indicadores de la opresión de género, pueden catalizar un intento de suicidio. Los riesgos son particularmente prominentes cuando la madre y la hija han sufrido una violencia que contradice los guiones culturales de género. Los resultados destacan la importancia de la participación de los padres y del análisis de las historias de violencia en el tratamiento de mujeres latinas que han intentado suicidarse. Las investigaciones futuras deberían incorporar los factores de riesgo de la opresión de género y de la violencia para comprender mejor el desarrollo de las tendencias suicidas entre las mujeres latinas.

Charting Directions for Research on Immigrant Children Affected by Undocumented Status.

Three groups of children from Mexico and Central America are vulnerable to effects of US immigration policies: 1) foreign-born children who entered the US with undocumented immigrant parents; 2) unaccompanied children who entered the US alone; and 3) U.S.-born citizen children of undocumented immigrant parents. Despite the recent demographic growth of these youth, scholarship on their strengths and challenges is under-theorized and isolated within specific disciplines. Hence, service providers, researchers, and policymakers have insufficient research to inform their efforts to support the children's wellbeing. A group of scholars and service-providers with expertise in immigrant children convened to establish consensus areas and identify gaps in knowledge of undocumented, unaccompanied, and citizen children of undocumented immigrant parents. The primary goal was to establish a research agenda that increases interdisciplinary collaborations, informs clinical practice, and influences policies. This report summarizes key issues and recommendations that emerged from the meeting.

Perceived discrimination and sexual precursor behaviors in Mexican American preadolescent girls: The role of psychological distress, sexual attitudes, and marianismo beliefs.

OBJECTIVES: This study explored the relation between perceived discrimination and sexual precursor behaviors among 205 Mexican American preadolescent middle school girls. In addition, this study examined whether psychological distress and sexual attitudes mediated and whether marianismo beliefs moderated this relation. METHOD: A categorical confirmatory factor analysis (CCFA) of the Marianismo Beliefs Scale (MBS) was conducted to test the factor structure with a preadolescent Mexican American population (ages 11-14). A path analysis of analytic models was then performed to examine the hypothesized relations between perceived discrimination, psychological distress, sexual attitudes, marianismo beliefs, and sexual precursor behaviors. RESULTS: Results of the CCFA did not support the original 5-factor structure of the MBS for preadolescent Latina girls. However, a revised version of the MBS indicated an acceptable model fit, and findings from the path analysis indicated that perceived discrimination was both directly and indirectly linked to sexual precursor behaviors via psychological distress. Marianismo was not found to moderate the relation between perceived discrimination and sexual risk behaviors, however certain marianismo pillars were significantly negatively linked with sexual attitudes and precursor behaviors. CONCLUSIONS: This study underscores the importance of psychological distress in the perceived discrimination and sexual precursor link as well as the compensatory aspects of marianismo against sexual precursor behaviors in Mexican American preadolescent girls. (PsycINFO Database Record

Illness representations and cultural practices play a role in patient-centered care in childhood asthma: experiences of Mexican mothers.

OBJECTIVE: Patients' cultural health beliefs and behaviors may conflict with biomedical healthcare values and practices potentially leading to non-adherence with asthma treatment regimens. To optimize shared decision-making, healthcare providers should understand and be sensitive to these cultural beliefs and behaviors and negotiate an asthma management plan acceptable to parents. The purpose of this study was to obtain the perspective of Mexican mothers regarding (1) their experiences of living with a child with asthma, (2) their understanding of the nature of asthma, and (3) how their cultural beliefs influence asthma management. METHODS: A qualitative, phenomenological study design was employed to assess mothers' lived experiences with and perceptions of their child's asthma. Individual in-depth interviews were conducted with a purposeful sample of 20 Mexican mothers of children ages 5-17 years with asthma. An inductive, theory-driven, phenomenological analysis approach was used to elicit thematic findings. RESULTS: Mothers expressed a symptomatic perception of asthma and limited understanding of the disease. Most believe the disease is present only when their child is symptomatic. Many are surprised and puzzled by the unpredictability of their child's asthma attacks, which they report as sometimes "silent". The inconsistency of triggers also leads to frustration and worry, which may reflect their concerns around daily controller medication use and preference for alternative illness management strategies. CONCLUSIONS: Our clinical encounters should be refocused to better understand the context of these families' lives and the cultural lens through which they view their child's asthma.

Examining the interplay among family, culture, and latina teen suicidal behavior.

In this article, we explore the relationships among culture, family, and attempted suicide by U.S. Latinas. We analyzed qualitative interviews conducted with Latina teen suicide attempters (n = 10) and their parents. We also incorporated data collected from adolescents with no reported history of self-harm (n = 10) and their parents to examine why some individuals turned to suicide under similar experiences of cultural conflict. Our results reveal that Latina teens who attempted suicide lacked the resources to forge meaningful social ties. Without the tools to bridge experiences of cultural contradiction, the girls in our study described feeling isolated and alone. Under such conditions, adolescents turned to behaviors aimed at self-destruction. Unlike their peers who attempted suicide, adolescent Latinas with no lifetime history of attempted suicide were able to mobilize resources in ways that balanced experiences of acculturative tension by creating supportive relationships with other individuals.

Well-being and contexts of development of U.S. citizen children in Mexico following parental deportation or voluntary relocation.

When undocumented immigrant parents are deported from the United States, they must decide whether or not to take their U.S.-born and undocumented immigrant children with them, often to countries the children have never visited or know little about. Other parents do not wait to be deported by the government and decide to relocate to their home countries with or without their children. Both sets of families experience relocation but under different circumstances. These differences deserve exploration to understand the psychological and emotional effects on children's well-being. In this cross-sectional study, we explored differences in self-concept, internalizing and externalizing behaviors, as well as the perception of the home, school, and neighborhood contexts of 178 U.S. citizen children (USCC) whose parents returned to Mexico forcibly and voluntarily. Through snowball sampling, we recruited the sample from two bordering Mexican states, Michoacán and the State of Mexico. Significant estimated marginal mean differences in internalizing and externalizing behavior problems, unhappiness, as well as parent-child conflict and support were found between USCC who relocated due to a parental deportation and those USCC whose parents relocated to Mexico voluntarily. Implications for clinicians in Mexico and the United States include recognizing the reasons, timing, decisions, events, and contexts of relocation. Findings can help inform immigration policies, practices, and future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Aspirations of Latina adolescent suicide attempters.

Parents' aspirations and expectations are communicated to their offspring. Children internalize their parents' aspirations and accept some of the expectations while rejecting others, all part of the developmental process and identity-consolidation. When the aspirations and expectations of youth and parents are incongruent, the outcomes in youths' behavior can be deleterious, such as when adolescents manifest suicidal behaviors. We examined aspirations expressed by 12 Latina adolescent suicide attempters and their parents and compared them to 12 non-suicidal Latinas and parents. Qualitative analyses revealed that incongruence of aspirations between girls and their parents were greater among suicidal teens. Suicidal and non-suicidal Latinas presented contrasting aspirations: the former on gaining independence and the latter on completing their education and pursuing careers. Findings may inform developmental research and ways in which clinicians and policymakers can help Latinas achieve their own and their parents' aspirations.

Challenges to quality assurance and improvement efforts in behavioral health organizations: a qualitative assessment.

Behavioral health organizations have been increasingly required to implement plans to monitor and improve service quality. This qualitative study explores challenges that quality assurance and improvement (QA/I) personnel experience in performing their job in those practice settings. Sixteen QA/I personnel from different agencies in St. Louis, Missouri, U.S.A., were interviewed face-to-face using a semi-structured instrument to capture challenges and a questionnaire to capture participant and agency characteristics. Data analysis followed a grounded theory approach. Challenges involved agency resources, agency buy-in, personnel training, competing demands, shifting standards, authority, and research capacity. Further research is needed to assess these challenges given expected outcomes.

Crisis Migration Adverse Childhood Events: A New Category of Youth Adversity for Crisis Migrant Children and Adolescents.

The present article proposes an extension of the concept of adverse childhood experiences (ACEs) to apply to crisis migration - where youth and families are fleeing armed conflicts, natural disasters, community violence, government repression, and other large-scale emergencies. We propose that adverse events occurring prior to, during, and following migration can be classified as crisis-migration-related ACEs, and that the developmental logic underlying ACEs can be extended to the new class of crisis-migration-related ACEs. Specifically, greater numbers, severity, and chronicity of crisis-migration-related ACEs would be expected to predict greater impairments in mental and physical health, poorer interpersonal relationships, and less job stability later on. We propose a research agenda centered around definitional clarity, rigorous measurement development, prospective longitudinal studies to establish predictive validity, and collaborations among researchers, practitioners, and policymakers.

US cultural involvement and its association with suicidal behavior among youths in the Dominican Republic.

OBJECTIVES: We examined how US cultural involvement related to suicide attempts among youths in the Dominican Republic. METHODS: We analyzed data from a nationally representative sample of youths attending high school in the Dominican Republic (n = 8446). The outcome of interest was a suicide attempt during the past year. The US cultural involvement indicators included time spent living in the United States, number of friends who had lived in the United States, English proficiency, and use of US electronic media and language. RESULTS: Time lived in the United States, US electronic media and language, and number of friends who had lived in the United States had robust positive relationships with suicide attempts among youths residing in the Dominican Republic. CONCLUSIONS: Our results are consistent with previous research that found increased risk for suicide or suicide attempts among Latino youths with greater US cultural involvement. Our study adds to this research by finding similar results in a nonimmigrant Latin American sample. Our results also indicate that suicide attempts are a major public health problem among youths in the Dominican Republic.

Co-occurring risk behaviors among White, Black, and Hispanic US high school adolescents with suicide attempts requiring medical attention, 1999-2007: implications for future prevention initiatives.

PURPOSE: To identify subtypes of adolescent suicide attempters by examining risk profiles related to substance use, violent behavior, and depressive symptoms. To examine the relationship between these subtypes and having had two or more suicide attempts during the past year. To explore race and gender differences across subtypes of suicide attempters. METHODS: Data were combined from five nationally representative cohorts of the US Youth Risk Behavior Surveillance System (YRBSS) and focused on a subpopulation of youth who reported a suicide attempt requiring medical attention. Latent class analysis was used to identify subtypes of suicide attempters. RESULTS: Analysis yielded three classes of youth who attempted suicide, distinguishable by their levels of substance use and violent behaviors: low substance use and violent behaviors, high substance use and violent behaviors, and extreme substance use and violent behaviors. All three classes had a high propensity for endorsing depressive symptoms. The proportion of youth with two or more suicide attempts during the past year increased across subgroup of attempters with higher levels of substance use and violent behaviors. Racial and gender differences were found across subtypes of suicide attempters. CONCLUSIONS: Preventing and treating the co-occurrence of substance use and violent behaviors may serve as essential strategies for reducing suicide attempts, especially among male youth. The use of public health strategies for suicide prevention should take into account the different needs of youth at risk for suicide.

Student objectives and learning experiences in a global health elective.

International health electives offer unique experiences for medical students to develop clinical skills and cultural competencies in unique and diverse environments. Medical students have been increasingly pursuing these learning opportunities despite the challenges. However, their goals in pursuing these opportunities and the relation between their learning objectives and actual experiences have not been studied adequately. It is important to assess these programs based on student objectives and whether those objectives are met. Thirty-seven medical students from five cohorts at a US medical school completed pre-post questionnaires regarding their global health elective objectives and learning experiences. The questionnaires included mostly open-ended questions and a Likert-scale rating of their overall experience. Qualitative thematic analysis involved inductive coding and followed a content-driven immersion-crystallization approach. Quantitative program evaluation measures yielded descriptive statistics. Five general objectives and four types of learning experiences were identified. Student objectives were: (1) to observe the practice and organization of health care in another country; (2) improve medical/surgical skills; (3) improve language skills; (4) learn about another culture; and (5) deepen knowledge of infectious diseases. All of their objectives were achieved. Moreover, one learning theme, "self-reflection and personal growth," was not a student objective. Quantitative assessment showed that most students had a favorable elective experience. Program challenges were also identified. Students in a global health elective were able to fulfill self-identified learning objectives, while also gaining other unexpected yet important lessons. Students' learning objectives also should be considered in evaluating learning experiences in international health electives.

Means, Intent, Lethality, Behaviors, and Psychiatric Diagnosis in Latina Adolescent Suicide Attempters.

This article describes the means, intent, lethality, behavioral profile, and psychiatric diagnosis of adolescent Latina suicide attempters. From a large mixed-methods project studying the sociocultural processes of Latina suicide attempts, we selected 76 subjects for this report. In addition to quantitative research data, medical records were available for all 76 subjects and qualitative data from in-depth interviews for 34 of them. Using the qualitative and quantitative research data, we explored the intent and behavioral profile of the suicidal adolescents. Medical records provided additional information about the means the adolescents used in their attempts and about their psychiatric diagnosis. The lethality of suicide attempts was coded using the LSARS and the LSARS-II. Findings showed that Latina adolescent suicide attempts are of low lethality. Consistent with the literature, most adolescents reported that they attempted by using means available in their homes (cutting and overdosing with medications were the predominant methods). Interesting discrepancies emerged when comparing adolescents' self-reported behavioral profiles with clinicians' psychiatric diagnoses. This report has implications for diagnosis and treatment approaches for both inpatient and outpatient service providers.

System Dynamics of Cognitive Vulnerabilities and Family Support Among Latina Children and Adolescents.

The paper describes an approach to developing a data-driven development of a feedback theory of cognitive vulnerabilities and family support focused on understanding the dynamics experienced among Latina children, adolescents, and families. Family support is understood to be a response to avoidant and maladaptive behaviors that may be characteristic of cognitive vulnerabilities commonly associated depression and suicidal ideation. A formal feedback theory is developed, appraised, and analyzed using a combination of secondary analysis of qualitative interviews (N = 30) and quantitative analysis using system dynamics modeling and simulation. Implications for prevention practice, treatment, and future research are discussed.

Knowledge and use of ethnomedical treatments for asthma among Puerto Ricans in an urban community.

PURPOSE: Puerto Ricans have higher lifetime and current asthma prevalence than other racial and ethnic groups in the United States. A great many Hispanics use ethnomedical therapies for asthma. This study elicited participant knowledge of ethnomedical therapies, developed a typology of the therapies, and considered whether some types are used or deemed efficacious based, in part, on information source. METHODS: Eligible participants were randomly selected from the medical records of an inner-city primary care clinic serving a predominantly Hispanic community in Buffalo, New York. Thirty adult Puerto Ricans who had asthma or were care-givers of children with asthma were interviewed in person using a semistructured instrument. Qualitative data analysis followed a content-driven immersion-crystallization approach. Outcome measures were ethnomedical treatments for asthma known to participants, whether these treatments were used or perceived effective, and the participant's information source about the treatment. RESULTS: Participants identified 75 ethnomedical treatments for asthma. Behavioral strategies were significantly more likely to be used or perceived effective compared with ingested and topical remedies (P <.001). Among information sources for ingested and topical remedies, those recommended by community members were significantly less likely to be used or perceived effective (P <.001) compared with other sources. CONCLUSIONS: This sample of Puerto Ricans with a regular source of medical care was significantly more likely to use or perceive as effective behavioral strategies compared with ingested and topical remedies. Allopathic clinicians should ask Puerto Rican patients about their use of ethnomedical therapies for asthma to better understand their health beliefs and to integrate ethnomedical therapies with allopathic medicine.

Family Relationships and Latina Teen Suicide Attempts: Reciprocity, Asymmetry, and Detachment.

Using qualitative data collected from adolescent Latinas and their parents, this article describes ways in which family relationships are organized within low-income Latino families (n = 24) with and without a daughter who attempted suicide. Based on a family-level analysis approach, we present a framework that categorizes relationships as reciprocal, asymmetrical, or detached. Clear differences are identified: Families of non-attempters primarily cluster in reciprocal families, whereas families with an adolescent suicide attempter exhibit characteristics of asymmetrical or detached families. Our results highlight the need for detailed clinical attention to family communication patterns, especially in Latino families. Clinicians may reduce the likelihood of an attempt or repeated attempts by raising mutual, reciprocal exchanges of words and support between parents and daughter.