Suicide-related disclosure: implications for inclusion and recovery
| Date | 05 September 2019 |
| Pages | 162-168 |
| DOI | https://doi.org/10.1108/JPMH-01-2019-0012 |
| Published date | 05 September 2019 |
| Author | Lindsay Sheehan,Nathalie Oexle,Michael Bushman,Anthony Fulginiti,Laura M. Frey |
| Subject Matter | Health & social care |
Suicide-related disclosure: implications for
inclusion and recovery
Lindsay Sheehan, Nathalie Oexle, Michael Bushman, Anthony Fulginiti and Laura M. Frey
Abstract
Purpose –People who have lived experiences with suicide often struggle with concealable stigmatized
identities that threaten their inclusion and recovery. While disclosure of a stigmatized identity can promote
support and recovery and therefore prevent suicide, it may also present distinct risks. The purpose of this
paper is to summarize key issues in suicide-related disclosure, suggest theoretical models for describing
suicide-related disclosure and identify research needs.
Design/methodology/approach –This conceptual paper discusses the existing literature on disclosure of
concealable stigmatized identities, then explores research on disclosure of suicidal ideation, suicide attempt
and suicide loss. Theoretical models (disclosure processes model and interpersonal theory of suicide) that
can be employed in understanding suicide-related disclosure are explored. Finally, the paper suggests areas
for future research, including longitudinal research to identify strategic disclosure practices that can lead to
greater inclusion and recovery.
Findings –Research on suicide-related disclosure should differentiate between disclosure of past and
current suicidality, incorporate theoretical frameworks and examine approaches for preparing potential
confidants and disclosers for the disclosure process.
Originality/value –This paper highlights issues unique to the disclosure of suicidal thoughts and behaviors,
and to suicide loss.
Keywords Suicide attempt, Disclosure, Mental health, Suicide, Recovery, Suicide ideation
Paper type Conceptual paper
Suicide-related disclosure may have profound implications for people who experience current
suicidality, suicide attempt survivors and suicide loss survivors (Fulginiti et al., 2016; Oexle et al.,
2018; Sheehan et al., 2017). These three “lived experience”groups, which are already at
increased risk of dying by suicide (Gibb et al., 2005; Pitman et al., 2014), are imperiled by overt
prejudice and discrimination from society and/or shame and internalized stigma (Sheehan et al.,
2017). However, these three stakeholders groups often have the discretion to decide whether to
disclose those experiences to others. Suicide-related disclosure, defined broadly as the process
of communicating with others about personal experiences with suicide, is complex and involves
weighing the risks and benefits, to both discloser and confidant (Frey et al., in review).
Importantly, positive disclosure experiences (especially disclosure of current suicidality) have the
clear potential to prevent future suicides and improve access to care. In this paper, we explore
findings on disclosure of concealable stigmatized identity (CSI), with a focus on suicide-related
disclosure and implications for recovery and inclusion.
Disclosure of concealable stigmatized identity
CSI, a term used to describe individuals whose stigmatized identity (e.g. HIV and sexual minority)
can be hidden from others, has most recently been applied to suicide attempt survivors as well
(Fulginiti and Frey, 2018a). Research on the disclosure of a CSI unsurprisingly identifies stigma as
a barrier to disclosure (e.g. Chaudoir et al., 2011; Corrigan and Matthews, 2003). However,
individuals with a CSI also avoid disclosure to prevent interpersonal conflicts, because they are
averse to treatment options, out of privacy concerns or simply because they do not perceive a
need to disclose (Bell et al., 2011; Jones, 2011). On the other hand, positive outcomes of CSI
Received 21 January 2019
Revised 7 April 2019
Accepted 7 May 2019
Lindsay Sheehan is based at
the Illinois Institute of
Technology, Chicago,
Illinois, USA.
Nathalie Oexle is based at the
Ulm University and BKH
Gunzburg, Ulm, Germany.
Michael Bushman is based at
the Illinois Institute of
Technology, Chicago,
Illinois, USA.
Anthony Fulginiti is based at the
University of Denver, Denver,
Colorado, USA.
Laura M. Frey is based at the
University of Louisville,
Louisville, Kentucky, USA.
PAGE162
j
JOURNAL OF PUBLIC MENTAL HEALTH
j
VOL. 18 NO. 3 2019, pp. 162-168, © Emerald Publishing Limited, ISSN 1746-5729 DOI 10.1108/JPMH-01-2019-0012
To continue reading
Request your trial