Illinois Institute of Technology, USA.
University of Ulm, Germany.
Soc Sci Med. 2019 Feb;223:16-23. doi: 10.1016/j.socscimed.2019.01.023. Epub 2019 Jan 21.
Individuals who attempt suicide are often subject to stigma and may feel ashamed to talk openly about their experiences with suicide. However, failure to disclose could interfere with care-seeking, increase distress, and limit social support. While research on other concealable stigmatized conditions (e.g. mental illness and HIV) has identified the complexities of disclosure decisions, little is known about disclosure for suicide attempt survivors.
Given the lack of research in this area, this study aimed to explore suicide attempt survivor perspectives on risks and benefits of suicide disclosure.
Academic researchers partnered with a community-based participatory research team to develop and conduct the research. The team conducted group and individual interviews with U.S. suicide attempt survivors (n = 40), using thematic analysis to code responses into themes for benefits (n = 12) and risks/barriers (n = 10) of disclosing.
Participants collectively identified how disclosure could benefit them (n = 9) through enhanced social support, strengthening of personal relationships, access to treatment, and opportunities for self-reflection. Participants described how disclosure could benefit others (n = 3) by reducing stigma, allowing attempt survivors to help peers who are currently struggling with suicidal ideation, and by providing psychoeducation on suicidality. Participants also described ways that disclosure could put them at risk (n = 8), in terms of stigma, unsupportive reactions, unwanted treatment, or loss of privacy. Participants were concerned that disclosure could put confidants at risk (n = 2) of being overburdened or triggered.
While the study methodology did not allow for an exploration of which benefits or risks may be most salient for suicide attempt survivors, this study lays groundwork for future research on disclosure of suicidal thoughts and behaviors. Furthermore, these results can be used by service providers to support suicide attempt survivors in strategic disclosure decisions that maximize benefits and reduce risks.
尝试自杀的个体往往会受到污名化的影响，可能会因为难以启齿而羞于公开谈论自己的自杀经历。然而，隐瞒可能会干扰寻求帮助的机会，增加痛苦，并限制社会支持。虽然针对其他可隐瞒的污名化状况（例如精神疾病和 HIV）的研究已经确定了披露决定的复杂性，但对于自杀未遂幸存者的披露情况却知之甚少。
鉴于该领域研究的缺乏，本研究旨在探讨自杀未遂幸存者对披露自杀企图的风险和益处的看法。
学术研究人员与一个基于社区的参与式研究团队合作，开发并开展了这项研究。该团队对美国自杀未遂幸存者（n=40）进行了小组和个人访谈，使用主题分析将回答编码为披露的益处（n=12）和风险/障碍（n=10）主题。
参与者共同确定了披露如何使他们受益（n=9），例如通过增强社会支持、加强人际关系、获得治疗和自我反思的机会。参与者描述了披露如何使他人受益（n=3），例如减少污名化、使尝试自杀的幸存者能够帮助目前正在与自杀意念作斗争的同龄人，并提供有关自杀倾向的心理健康教育。参与者还描述了披露如何使他们面临风险（n=8）的方式，例如污名化、不支持的反应、不必要的治疗或隐私丧失。参与者担心披露可能会使他们的密友（n=2）面临负担过重或被触发的风险。
虽然研究方法不允许探讨哪些益处或风险对自杀未遂幸存者可能最为重要，但本研究为未来研究自杀想法和行为的披露奠定了基础。此外，这些结果可被服务提供者用于支持自杀未遂幸存者做出战略披露决策，以最大限度地提高益处并降低风险。
