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 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."
School of Social Work, University of Southern California, Los Angeles, CA, USA.
Anthony
A
Fulginiti
Silver School of Social Work, New York University, New York, NY, USA.
Rohini
R
Pahwa
Kent School of Social Work, University of Louisville, Louisville, KY, USA.
Laura M
LM
Frey
School of Social Work, University of Southern California, Los Angeles, CA, USA.
Eric
E
Rice
School of Social Work, University of Southern California, Los Angeles, CA, USA.
John S
JS
Brekke
D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology*; D030881:Disclosure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012565:Schizophrenic Psychology; D012944:Social Support; D059020:Suicidal Ideation