(PS9-C60) Is Disclosure Actually Helpful?: An Exploration of Changes in Emotions, Suicidality, and Help-seeking After First Disclosure of Suicidality

Background
Non-disclosure of suicidal thoughts and behaviors (STBs) has been linked to critical outcomes such as increased suicide severity (Apter et al., 2001). While few studies have begun to explore the benefits of disclosure (Sheehan et al., 2019), little is known about the perceived benefits, or utility, of disclosing STBs. Understanding individuals’ perception of positive outcomes following a disclosure is critical to informing prevention protocols. Therefore, the present study sought to explore changes in socioemotional states, severity of suicidality, and help-seeking following an initial STB disclosure among adults.

Method
Participants recruited via Amazon Mechanical Turk (MTurk) completed an online survey in service of a larger study on STB disclosure patterns. Eligible participants completed self-report measures on their demographic characteristics (i.e., race, ethnicity, age, etc.), history of STBs, and their initial STB disclosure experiences. Participants included 365 adults, aged 19 to 68 (M=36.3, SD=10.3), with a history of suicide ideation and previous STB disclosure. The sample identified as majority White (62%), non-Hispanic (62%), male (67%), and heterosexual (58%).

Results
Participants reported a diverse range of initial STB disclosure experiences – 41% voluntarily disclosed, 31.8% disclosed following solicitation, and 27.1% had a third-party disclose their STB. Overall, 76.2% first disclosed to an informal source (i.e., friend, partner, family), whereas only 9.7% first disclosed to a mental health/crisis provider. Furthermore, majority (54.7%) disclosed within a month of first experiencing STBs.

Participants felt a significant increase in closeness to the disclosure recipient following their first disclosure, t(363)=-6.62, p< .001, Cohen’s d=1.22. Majority of participants reported an increase in their positive socioemotional states following their initial disclosure. Specifically, 85.5% felt supported, 83.4% thought the disclosure was helpful, 83.4% found the disclosure comforting, and 79.8% reported the disclosure was encouraging. Similarly, most participants reported a decrease in socioemotional distress following the disclosure: 67% reported a decrease in anxiety, 61.3% a decrease in shame, 62.4% a decrease in feeling like they don’t belong, 59.8% a decrease in feeling like a burden, and 69.7% a decrease in hopelessness. Moreover, 75.8% reported a decrease in suicidality severity. Only 44.3% of adults sought help after disclosing despite the majority (57.6%) reporting that their disclosure recipient encouraged them to seek professional help. However, a greater proportion of people whose recipient told them to seek help went on to do so following disclosure, χ²(2=1)=69.9, p< .001. 

Conclusions
These findings are among the first to elucidate the perceived benefits of initial STB disclosures among adults at risk for suicide. This further magnifies the importance of disclosure and provides evidence for intervention strategies aimed at encouraging STB disclosures.