What Factors Influence the Decision to Share Suicidal Thoughts? A Multilevel Social Network Analysis of Disclosure Among Individuals with Serious Mental Illness

Anthony Fulginiti, Rohini Pahwa, Laura M. Frey, Eric Rice, John S. Brekke

Research output: Contribution to journalArticlepeer-review

Abstract

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 members (Level 1), we examined disclosure patterns and identified individual and relational correlates of disclosure intent. Most individuals disclosed in the past (77%; n = 23) and all intended on disclosing (100%; n = 30). Disclosure was highly selective, with 14% (n = 62) of network members identified as prior confidants and 23% (n = 99) identified as intended confidants. Multilevel modeling indicated that relational factors were more central to disclosure than individual factors. Network members who were prior confidants and who provided social support were attractive targets for intended disclosure. Our findings suggest that "targeted" gatekeeper training may be a promising strategy and reveal relational characteristics to identify "high-probability confidants."

Original languageEnglish (US)
Pages (from-to)398-412
Number of pages15
JournalSuicide & life-threatening behavior
Volume46
Issue number4
DOIs
StatePublished - Aug 1 2016

ASJC Scopus subject areas

  • Clinical Psychology
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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