Neuropsychiatric Disease and Treatment Open Access Full Text Article Adolescent mental health: Challenges with maternal noncompliance Dovepress open access to scientific and medical research C A S E R E P O R T Vicki A Nejtek Sarah Hardy Scott Winter University of North Texas Health Science Center, Fort Worth, TX, USA Correspondence: Vicki A Nejtek University of North Texas Health Science Center at Fort Worth, Department of Psychiatry and Behavioral Health, 3500 Camp Bowie Blvd., PCC 4.462, Fort Worth, TX 76107, USA Tel +1 817 735 0640 Fax +1 817 735 0643 Email vnejtek@hsc.unt.edu submit your manuscript | www.dovepress.com Dovepress Abstract: The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal–child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient’s mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother’s actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness. Keywords: adolescent, suicide, maternal treatment noncompliance, maternal neglect Over the last few years in the United States, childhood neglect and abuse has increased from ∼92% to almost 94%. National statistics show extremely high rates of childhood neglect (34.1%) and abuse (26.4%) perpetrated most often by single mothers (25.5%).1 During the last 50 years, attachment theory research clearly shows that maternal neglect and abuse is a fundamental trigger of childhood mental illness that lasts a lifetime.2–4 While the etiology of psychiatric disorders arising from maternal-child dysfunction is well-documented, prevention resources to halt the rise of victimization of offspring are seriously lacking. Here, we report maternal neglect and possible abuse as described in a case of treatment noncompliance for a mentally ill and suicidal adolescent inpatient. The mother of a 15-year-old biracial male with a history of attention deficit hyperactivity disorder brought her son to the psychiatric emergency room for suicidal ideation. She reported that her son had threatened to kill himself with a gun and that she found bullets in his possession. The son denied suicidal ideation, but admitted to sadness, chronic frustration, and fear while living with his mother and two sisters. He described an altercation with his sisters that precipitated his suicidal threats which consequently led to his psychiatric emergency room admission. Neuropsychiatric Disease and Treatment 2010:6 67–69 © 2010 Nejtek et al, publisher and licensee Dove Medical Press Ltd.This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. 67