Mental illness disclosure decision making

Rohini Pahwa, Anthony Fulginiti, John S. Brekke, Eric Rice

Research output: Contribution to journalArticlepeer-review


Disclosure related to mental illness has been linked to various positive outcomes, including better mental health. However, many individuals with serious mental illness (SMI) continue to practice non-disclosure. Even though disclosure inherently occurs within the context of one's social relationships, research has generally conceptualized mental illness disclosure as an individual level phenomenon and neglected to consider preferences concerning to whom an individual discloses and the factors that influence this decision. The current study uses the disclosure decision-making model (DD-MM) by Greene (2009) to better understand the processes of mental illness disclosure preference and selective disclosure for individuals with SMI (n = 60) using multivariate random intercept logistic regression with an emphasis on the constituent factors of disclosure preference at both individual and relational levels. The majority of participants were found to practice selective disclosure, with 68% of the participants identifying at least 1 network member to whom they could disclose. Family members and friends were central to the selective disclosure process, comprising the greatest proportion of network members who, both were and were not identified as preferred confidants. Women were found to show higher odds of preference for mental illness disclosure than men. Having lower perceived social support was associated with lower odds of disclosure preference. Among relational factors, greater relationship availability and lower dyadic tangible social support were associated with lower odds of disclosure preference. Practice and research implications of using social network analysis to get a deeper understanding of disclosure and disclosure preference are discussed, including implications for future interventions targeting stigma reduction.

Original languageEnglish (US)
Pages (from-to)575-584
Number of pages10
JournalAmerican Journal of Orthopsychiatry
Issue number5
StatePublished - 2017


  • Disclosure preference
  • Mental illness
  • Social network analysis
  • Social support
  • Stigma
  • Decision Making
  • Humans
  • Middle Aged
  • Social Support
  • Male
  • Self Disclosure
  • Mental Disorders/psychology
  • Adult
  • Female
  • Social Stigma

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology
  • Arts and Humanities (miscellaneous)
  • Psychology (miscellaneous)


Dive into the research topics of 'Mental illness disclosure decision making'. Together they form a unique fingerprint.

Cite this