Patterns of suicidal ideation disclosure among acute psychiatric inpatients

Prior literature has explored disclosure of suicidality to formal and informal sources, identifying reasons for nondisclosure (e.g., fear of rejection, shame, and hospitalization); however, existing research is limited to retrospective data, often collected months or years after suicide attempts have occurred. The present study seeks to address this gap by identifying patterns of nondisclosure among recent suicide attempters within a one-week period following the attempt, shortening the temporal distance from event to recall. Adult psychiatric inpatients (N = 39, 38.5% female, 61.5% White) who had attempted suicide within the past seven days were recruited from a large urban hospital system in New York. At intake, patients completed a self-report questionnaire, which included two questions on suicidal ideation (SI) disclosure. Consensual Qualitative Research (CQR) methodology was used to extract and categorize reasons for nondisclosure. Nearly half of the patients (46.2%) reported not disclosing their suicidal intentions prior to their suicide attempt. Four key themes emerged as reasons for nondisclosure: fear of stigma (27.8%), fear of consequences such as involuntary hospitalization (22.3%), social isolation and lack of confidants (22.3%), and impulsivity (16.7%). Future research should examine targeted interventions to improve disclosure and explore how different disclosure patterns influence treatment outcomes.