Non-disclosing youth: a cross sectional study to understand why young people do not disclose suicidal thoughts to their mental health professional.
Abstract Background 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. Methods 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 (N = 513) which assessed demographic characteristics, severity of depression, anxiety, psychological distress, and suicidal ideation, lifetime suicide attempts, 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. Results Though the full sample had engaged in therapy, 39% had never disclosed suicidal ideation to their clinician. Those who had disclosed were more likely to report greater prioritisation of suicidal ideation (OR = 4.07, 95% CI = 2.34–7.09), therapeutic alliance (OR = 1.04, 95% CI = 1.02–1.06), and personal suicide stigma (OR = 1.04, 95% CI = 1.01–1.06). The most common reason for not disclosing was concern that it would not remain confidential. Conclusion These findings provide new insights into why young people may not seek help for suicidal ideation, despite being engaged with a mental health professional, and establish evidence to inform practice decisions and the development of prevention strategies to support young people for suicide.