What factors influence the decision to share suicidal thoughts? A multilevel social network analysis of disclosure among individuals with serious mental illness

Nondisclosure of suicidal thoughts limits suicide risk management. Consistent with disclosure models for other stigmatized statuses, understanding suicidal disclosure requires accounting for features of the discloser (individual factors) and the discloser-recipient relationship (relational factors). In a sample of 30 adults with schizophrenia, bipolar disorder, or major depressive disorder (Level 2) who nominated 436 social network […]

Disclosure of suicidal ideation and behaviours: A systematic review and meta-analysis of prevalence

Disclosure of suicidal ideation and behaviours, defined as thoughts, plans, or attempts, to other people provides opportunity for intervention and prevention. This study is the first to meta-analyze all available studies to estimate the prevalence of disclosure, to whom people disclose, and examine factors that influence disclosure. Databases were searched for studies reporting samples of […]

Suicidal ideation and behavior among youth victims of sex trafficking in Kentuckiana

Background: Youth experiencing homelessness are at risk for sex trafficking and mental health concerns. Aims: More information is needed to elucidate the prevalence and characteristics of suicidal ideation and behavior among youth experiencing sex trafficking. Method: The present study examined suicidal ideation and behavior in a convenience sample of 128 youths experiencing homelessness aged 12-25 years in metropolitan Louisville, Kentucky, […]

Moral injury and suicide ideation among combat veterans: The moderating role of self-disclosure

Background: Modern warfare in a civilian setting may expose combatants to severe moral challenges. Whereas most of these challenges are handled effectively, some potentially morally injurious events (PMIEs) may have deleterious psychological effects on the combatants, such as suicide ideation (SI). Self-disclosure, which includes sharing distressing thoughts and emotions, has been recognized as a protective factor against SI […]

Age differences in the associations between outness and suicidality among LGBTQ+ youth

Objective: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth are at increased risk for suicidality compared to their heterosexual and cisgender peers, and outness (the extent to which an individual is open about their LGBTQ+ identity to others) is an important correlate of suicidality. However, previous research has led to mixed findings regarding whether outness functions […]

Shame, depression, and complicated grief among suicide loss-survivors: The moderating role of self-disclosure

Background: Suicide-loss survivors (SLSs) are recognised as an at-risk population for several psychiatric complications, including complicated grief (CG) and depression (SI). However, whereas shame is known as one of the characteristics of this population, knowledge about possible psychological processes which may moderate the contribution of shame levels to CG and depression in the aftermath of suicide […]

Network-based prediction of the disclosure of ideation about self-harm and suicide in online counseling sessions

Background In psychological services, the transition to the disclosure of ideation about self-harm and suicide (ISS) is a critical point warranting attention. This study developed and tested a succinct descriptor to predict such transitions in an online synchronous text-based counseling service. Method We analyzed two years’ worth of counseling sessions (N = 49,770) from Open Up, a […]

School personnel experiences in notifying parents about their child’s risk for suicide: Lessons learned

BACKGROUND—Schools across the nation are increasingly implementing suicide prevention programs that involve training school staff and connecting students and their families to appropriate services. However, little is known about how parents are engaged in such efforts. METHODS—This qualitative study examined school staff perspectives on parent involvement in the implementation of a district-wide suicide prevention program […]

Social support mediates the association between disclosure of suicide attempt and depression, perceived burdensomeness, and thwarted belongingness

Objective Prior research has found disclosure of concealable stigmatized statuses, including suicide attempt survivorship, to be associated with positive mental health outcomes. This study sought to test the mediating effect of self-reported social support on the association between disclosure of suicide attempt and suicide risk factors in a sample of undergraduate college students. Method Data […]

Greater minority stress is associated with lower intentions to disclose suicidal thoughts among LGBTQ+ youth

Objective The current study examined suicide-related disclosure intentions in LGBTQ + youth, and the associations between reporting of lifetime experiences of minority stress and intentions to disclose suicidal thoughts. Method A sample of 592 LGBTQ + youth ages 12–24 (22.3% cisgender men, 33.1% cisgender women, 44.6% gender diverse, 75.3% white) who contacted an LGBTQ-specific crisis service, completed a survey. […]

Few do and to few: Disclosure of suicidal thoughts in friendship networks of young adults experiencing homelessness

Disclosure of one’s suicidal thoughts is a pivotal but under-investigated mechanism for preventing suicide among young adults experiencing homelessness (YAEH). In a sample of 527 YAEH, we adopted a multi-level perspective to assess patterns and correlates of disclosure in their friendship networks. Less than one-third of YAEH disclosed their suicidal thoughts—half of them doing so […]

Exploring adolescent experiences with disclosing self-injurious thoughts and behaviors across settings

Disclosure of self-injurious thoughts and behaviors (SITBs) is critical to current treatment and prevention programs. Limited research has examined patterns of and barriers to SITB disclosure in adolescents. This work is critical given the limits of confidentiality in this population. Over 1,000 adolescents aged 13–17 with a history of mental health treatment and SITBs were […]

Disclosure and nondisclosure of suicidality to romantic partners: Understanding the decision-making process

The stigmatization of suicidal thoughts and behaviors often prevents disclosure to others, including romantic partners. Minimal research has examined the disclosure or withholding of this stigmatized identity, resulting in a lack of knowledge about the benefits or consequences of informing others. Participants (n = 61) were recruited from Reddit and completed open-ended questions about their prior […]

An initial investigation of suicide attempt disclosures among US veterans

Background: Patient disclosure of prior suicidal behaviors is critical for effectively managing suicide risk; however, many attempts go undisclosed. Aims: The current study explored how responses following a suicide attempt disclosure may relate to help-seeking outcomes. Method: Participants included 37 veterans with a previous suicide attempt receiving inpatient psychiatric treatment. Veterans reported on their most and least helpful experiences disclosing […]

Suicide-related disclosure: Implications for inclusion and recovery

Purpose People who have lived experiences with suicide often struggle with concealable stigmatized identities that threaten their inclusion and recovery. While disclosure of a stigmatized identity can promote support and recovery and therefore prevent suicide, it may also present distinct risks. The purpose of this paper is to summarize key issues in suicide-related disclosure, suggest […]

“I feel like I know them”: The positive effect of celebrity self-disclosure of mental illness

The media is often perceived as portraying psychiatric illness in a negative, stigmatizing, and even dangerous fashion [1]. In the case of suicide, it has long been documented that media reporting of celebrity suicides can lead to an augmentation in copycat suicides, a phenomenon historically known as the Werther effect [2]. After the highly publicized […]

“Nobody hears a silent cry for help”: Suicide attempt survivors’ experiences of disclosing during and after a crisis

Suicide remains an important public health issue across the globe. Until recently the medically dominated field of suicide prevention has neglected first-hand accounts of suicidal thoughts and behaviors from those who have survived prior suicide attempts. This qualitative research provides insight into the experience of suicide attempt, highlighting difficulties with disclosure of suicidal thinking prior […]

Suicidality disclosed online: Using a simulated Facebook task to identify predictors of support giving to friends at risk of self-harm

Although peer support in response to online disclosures of suicidality may be imperative for suicide prevention efforts, little is known as to how often support is provided or what predicts giving support. This study addresses this issue by investigating the odds of providing peer support in response to simulated online disclosures of suicidality. While interacting […]

Suicidal disclosures among friends: Using social network data to understand suicide contagion

A robust literature suggests that suicide is socially contagious; however, we know little about how and why suicide spreads. Using network data from the National Longitudinal Study of Adolescent to Adult Health, we examine the effects of alter’s (1) disclosed and (2) undisclosed suicide attempts, (3) suicide ideation, and (4) emotional distress on ego’s mental […]

Predicting status along the continuum of suicidal thoughts and behavior among those with a history of nonsuicidal self-injury

Nonsuicidal self-injury (NSSI) and suicidal thoughts and behavior often co-occur, representing a growing public health concern. Despite extensive research examining suicidal thoughts and behavior among those who engage in NSSI, there is a lack of research investigating factors that, when considered together, can differentiate individuals along the continuum of suicidal thoughts and behavior (no history, […]

Understanding why patients may not report suicidal ideation at a health care visit prior to a suicide attempt: A qualitative study

Objective: The authors sought to understand why patients may not report suicidal ideation at a health care visit prior to a suicide attempt. Methods: Electronic health record data from Kaiser Permanente Washington were used to identify patients who reported having no suicidal ideation on question 9 of the nine-item Patient Health Questionnaire and who subsequently […]

“Are you having thoughts of suicide?”: Examining experiences with disclosing and denying suicidal ideation

Objective To characterize individuals’ prior experiences with being asked whether they are having thoughts of suicide and to understand factors that affected their response accuracy. Method Undergraduates (N = 306) reporting a lifetime history of suicidal ideation completed a web‐based survey about their experiences being probed about suicidal thoughts. Results Nearly two‐thirds of participants (63.1%) reported […]

Exploring suicide-related disclosure motivation and the impact on mechanisms linked to suicide

Suicide-related disclosure enables improved risk management but disclosure motivations are understudied. This study identified reasons for and against disclosing suicidal thoughts and examined their link to future disclosure and interpersonal needs among 44 people receiving psychiatric care. The most endorsed reasons for disclosure (approach-motivations) included help-seeking, shared background, and catharsis. The most endorsed reasons against […]