Serious Mental Illness and the Decision to Share Suicidal Thoughts

Gatekeeper training for people in whom seriously mental ill people are likely to confide may help prevent suicide, according to the authors of a study on this high risk population. The research revealed that people with schizophrenia, bipolar disorder, or major depressive disorder are more likely to disclose suicidal thoughts to people who provide them with social support and in whom they have previously confided. People were found to be more open to disclosing thoughts of suicide to mental health professionals than to family members.

Eighty percent of the sample reported that they had disclosed suicidal thoughts to someone in the past. Almost 100 percent of the sample reported that they would be willing to disclose suicidal thoughts to someone in the future. The authors suggested that these findings “indicate a promising low rate of completely ‘hidden ideators’ in this small but high-risk sample.”

The authors also suggested that these results had implications for targeted gatekeeper training as well as safety planning. People with serious mental illness change their choices of confidants over time—possibly because of negative reactions from people in whom they previously confided. Thus, identifying and preparing potential confidants for revelations about suicidal ideation, as well as helping people with serious mental illness expand the network of people on whom they rely for social support and in whom they can confide, may be a productive approach. In addition, assessing the helpfulness of individuals in whom a person at risk has previously confided may be an important step in safety planning.

The research revealed that although people disclosed their serious mental illness to 90 percent of their social network, they identified less than 25 percent of their network as people to whom they would disclose suicidal ideation, which the authors saw as evidence of the need to reduce the stigma associated with suicidal thoughts.

Fulginiti, A., Pahwa, R., Frey, L. M., Rice, E., & Brekke, J. S. (2015). What factors influence the decision to share suicidal thoughts? A multilevel social network analysis of disclosure among individuals with serious mental illness. Suicide and Life-Threatening Behavior. Advance online publication. doi:10.1111/sltb.12224