Characteristics Associated with Non-Disclosure of Suicidal Ideation in Adults

Abstract

Suicide prevention efforts often depend on the willingness or ability of people to disclose current suicidal behavior. The aim of this study is to identify characteristics that are associated with non-disclosure of suicidal ideation. Data from the Dutch cross-sectional survey Health Monitor 2016 were used, resulting in 14,322 respondents (age 19+). Multiple logistic regression analyses were conducted to assess the strength of the associations between demographics and health-related characteristics as independent variables, and non-disclosure of suicidal ideation as the dependent variable. The mean age of the respondents was 60 years (SD 16.7) and 45% were male. Of these adults, 5% (n = 719) reported suicidal ideation in the past year, nearly half of which (48%) did not disclose suicidal ideation. Non-disclosure was significantly associated with social loneliness (OR = 1.29). Inverse significant associations were found for age (35–49 years, OR = 0.53), poor health status (OR = 0.63), frequent suicidal ideation (OR = 0.48), and severe psychological distress (OR = 0.63). The accuracy of this model was fair (AUC = 0.73). To conclude, non-disclosure is a substantial problem in adults experiencing suicidal ideation. Adults who do not disclose suicidal ideation are more likely to have few social contacts, while they are less likely to experience poor (mental) health and frequent suicidal thoughts.

Suicide Risk and Mental Disorders

“…Suicide prevention efforts often depend on the disclosure of suicidal ideation (SI), an early step in the suicidal process. Data from the Dutch cross-sectional survey Health Monitor 2016 was used in one study [ 10 ]. Of the adult participants, 5% reported SI and nearly half of those had not disclosed their SI.…”

Characteristics of suicide attempts associated with lethality and method: A latent class analysis of the Military Suicide Research Consortium

“…Although promising from a risk-detection perspective, findings suggest disclosure is not necessarily protective against attempt lethality. In fact, frequency of suicide disclosure is often positively associated with severity of psychological symptoms, including suicid al ideation (Calear & Batterham, 2019;Mérelle et al, 2018). Additionally, to whom a person disclosed suicide risk was not measured in the present study (e.g., family member, healthcare providers), raising questions of whether disclosure patterns may differentiate groups even if overall disclosure frequency did not.…”

“…For example, suicide attempts of individuals with greater intent tend to involve more lethal methods, require more serious medical attention, and are more likely to result in death than individuals with ambivalent intent (Hasley et al, 2008). Also, frequency of suicide risk disclosure is associated with greater suicidal ideation severity (Calear & Batterham, 2019;Mérelle et al, 2018). Veterans are typically less likely than civilians to disclose suicide intent (Ganzini et al, 2013;Horwitz et al, 2019;Monteith et al, 2020;Wood et al, 2020), with one study estimating 85% of veterans who died by suicide had denied ideation during the week before death (Smith et al, 2013).…”

Harassment and its association with depressive symptoms and suicidal behavior: The role of perceived stigma and nondisclosure.

“…Willingness to disclose personal information, especially of distressing nature, is a necessary precondition to seek help (Heffren & Hausdorf, 2016; Nam et al, 2013) and nondisclosure of mental health problems is related to not receiving support and treatment (Reavley et al, 2018). Nondisclosure of mental health problems or of a somatic illness is further related to several predictors of suicidal behavior (Kleiman et al, 2014; Klonsky & May, 2015; McGee et al, 2001), such as loneliness, lower perceived social support, and poorer self-esteem (Mérelle et al, 2018; Zea et al, 2005). Further, concealing emotional meaningful information from others can be distressing (Pachankis, 2007) and could contribute to suicidal behavior as the exposure to aversive conditions might become unmanageable once individuals fail to communicate these conditions (Levi et al, 2008).…”

“…In another longitudinal study on military deployment, discomfort in disclosing deployment experiences was associated with an increased risk for developing symptoms after deployment (Koenen et al, 2003). Nondisclosure of mental health problems as well as nondisclosing of a somatic illness have further been related to increased loneliness, poorer self-esteem, and higher depressive symptoms (Mérelle et al, 2018; Zea et al, 2005). Moreover, reduced disclosure of personal information and experiences is related to suicide attempts (Levi et al, 2008).…”