The Decision-Making Process for Disclosing Suicidal Ideation and Behavior to Family and Friends

Objective: This study was designed to explore the decision-making processes for disclosing suicidal ideation and behavior. Background: Suicide attempt survivors are an invaluable resource that can provide essential information about suicidal behavior and related communication to family and friends. Because of the stigma associated with suicide and seeking help, many individuals choose to conceal their suicidal ideation or behavior or to disclose only to a few family and friends. Method: Semistructured, audio-only interviews were conducted with a convenience sample of 40 suicide-attempt survivors to develop a grounded theory of factors that influence the decision to disclose current and past suicidal behavior to family members and other individuals within one's social network. Results: Several motivations for disclosing (e.g., seeking help, sharing personal information, informing others) were identified, and a majority of the sample conducted an informal cost–benefit analysis before disclosing. The findings also elucidate the process of choosing a person with whom disclosure occurs, and the importance of having that family or friend with whom attempt survivors feel safe disclosing ideation as it occurs as well as subsequently processing the experience and seeking treatment. Conclusion: Decision-making processes for suicide-related disclosure include identifying motivations to disclose, an informal cost–benefit analysis, and the selection of a recipient to whom one will disclose. Implications: This emergent model identifies five tangible intervention strategies for increasing the likelihood of suicide disclosure. Future research should examine the internal resources that motivate individuals to engage in subsequent disclosure to individuals from whom they have previously experienced stigma.