Non-disclosing youth: a cross sectional study to understand why young people do not disclose suicidal thoughts to their mental health professional
By Lauren McGillivray, Demee Rheinberger, Jessica Wang, Alexander Burnett & Michelle Torok
Published 4 January 2022
Context
Prevalence of suicidal ideation increases rapidly in adolescence, and many choose not to seek help and disclose their ideation. Young people who do disclose suicidal ideation prefer to do so with peers and family compared to mental health professionals, who are best placed to provide evidence-based treatment. This study aimed to identify key factors associated with young people’s decision to, or not to disclose suicidal thoughts to their mental health practitioner.
Research and findings
A community-based sample of young Australians (16-25 years), who had experienced suicidal ideation and engaged with a mental health professional, completed an online questionnaire. The questionnaire assessed whether or not the young person had disclosed their suicidal ideation to their mental health care professional, as well as demographic characteristics, severity of depression, anxiety, psychological distress, and suicidal ideation, previous suicide attempt, exposure to suicide loss, personal suicide stigma, prioritisation of mental health issues, and therapeutic alliance. Logistic regression analyses were used to identify factors associated with disclosure.
All 513 survey respondents had engaged in therapy, but 39% had never disclosed suicidal ideation to their clinician. Those who had disclosed were more likely to report:
- Greater therapeutic alliance
- Personal suicide stigma
- Prioritisation of suicidal ideation
- Lifetime history of suicide attempt.
The most common reason for not disclosing was concern that it would not remain confidential.
Implications
This study identified some of the factors related to why almost 40% of young people chose not to disclose suicidal ideation, even though they had access to a mental health care professional. Gaining a young person’s trust, explaining why disclosing is important and limits of confidentiality are aspects of clinical care that may assist in supporting young people to disclose, as well as improving clinicians’ ability to feel comfortable routinely asking or screening for suicide risk.