Disclosure of Suicidal Ideation: A Scoping Review Examining the Extent to Which Young People Disclose Suicidal Ideation and Behaviour, Who They Disclose To and Its Impact

A scoping review of the literature on who young people disclose suicid

Young people's disclosure of suicidal thoughts and behavior: A scoping review

Background: Disclosure of suicidal ideation offers a significant opportunity for intervention and pathways to care. Family can be instrumental in young people accessing care. To date there is limited knowledge about the patterns of disclosure of suicidal ideation and behavior in young people, particularly to their family. Methods: A scoping review was conducted to identify studies of disclosure of suicidal ideation and behavior in young people (aged 12–25), to identify the rates of disclosure to informal supports, and the effects of that disclosure. Online databases PsycINFO, CINAHL, Web of Science, Embase, PubMed were searched for eligible articles. Results: Thirty-five studies used a quantitative method, seven reported on qualitative research and two used mixed methods. Studies were examined based on design, setting, sample, reported disclosure, target of disclosure and impact. Rates of suicidal ideation disclosure varied widely amongst community and clinical samples. Few studies reported on the impact of disclosure on either the young person and the target, how the young person perceived the reaction, and how that relates to future disclosure and help-seeking. Limitations: No quality analysis or meta-analyses were done; studies had to be in English, limiting representation. The measurement of suicidal ideation and its disclosure were inconsistent across studies. Conclusions: There is a need to understand how young people choose who they disclose suicidal ideation to and what impact the suicidal disclosure has on both parties. Understanding how disclosures to family members affect help-seeking longitudinally is important and may provide avenues for targeted clinical intervention

Mental Images Of Suicide: Theoretical Framework And Preliminary Findings In Youth

Suicide is the second leading cause of death in young people between 10 and 24 years old. There is a clear need to identify novel treatment targets in order to develop more effective strategies to reduce the massive impact of youth suicide. This paper discusses ‘suicidal flashforwards’ as a potential novel target. Suicidal flashforwards are vivid mental images of future death or suicide - a form of suicidal cognition that has received very little attention in both research and clinical practice to date. Here we present a brief review of relevant literature and propose potential clinical and cognitive factors associated with suicidal flashforwards, and the progression from suicidal flashforwards to suicidal behaviours (e.g., suicide attempt). In addition, we present data from our pilot study on suicidal flashforwards, which is the first study to examine this phenomenon in young people. Thirty-three young people (aged 16-25) with current or recent (in past 4 weeks) suicidal ideation, who received treatment at a local youth mental health clinic for a mood disorder participated in the study. Our findings suggest that suicidal flashforwards are very common in this population (reported by 97% of the sample), and are experienced as vivid, real, distressing and intrusive. Importantly, we found an association between higher ratings of distressing effects of suicidal flashforwards and the number of previous suicide attempts, while no associations with attempts were found for characteristics of verbal suicidal thoughts. These findings highlight the importance of suicidal flashforwards as a potential target for risk management and treatment strategies for suicide. Future larger studies that aim to understand the clinical, cognitive and biological mechanisms underlying suicidal flashforwards are needed to identify targets for appropriate preventions and interventions