(PS2-C67) Suicide-related Disclosure Among Adolescents from Racial and Ethnic Minorized Backgrounds

Introduction: Research on adolescents’ disclosure of their suicidal thoughts and behaviors (STBs) is scarce. Adolescents have been found to be most likely to disclose STBs when prompted by mental health providers, and even then, many actively denied and concealed STBs (Fox et al., 2022). Disclosure may be even lower among youth from racial and ethnic minoritized backgrounds (Morrison & Downey, 2000). The present study sought to fill the gap in research on adolescents’ suicide-related disclosure to understand when, why, and how adolescents disclose their STBs, along with the consequences of STB disclosure.

Methods: Adolescents (N = 126), ages 12-19, recruited primarily from a public hospital in New York City following suicide ideation (n = 80) or an attempt (n = 46) completed a detailed Adolescent Suicide Ideation Interview (Miranda et al., 2021) about their most recent suicide ideation or attempt. Over 90% of teens identified as racial/ethical minorities, primarily Hispanic/Latinx, 77% as female (assigned sex at birth), and > 50% as sexual minorities. Interviews included inquiries about adolescents’ disclosure of their suicide ideation or attempt, including to whom they disclosed, and when, why, and how they disclosed.

Results: Of those presenting with SI (n=80), 68 (85%) adolescents disclosed unprompted (i.e., were not directly asked). Forty-two adolescents disclosed to one person (62%), 17 (25%) disclosed to two people, and 9 (13%) participants disclosed to 3 or more people. The most common SI disclosure recipient was a mother or same-sex friend/sibling (endorsed by 20 participants), followed by mental health providers, opposite sex friend/sibling and school counselor or teacher, respectively. The least commonly reported suicide-related disclosure recipients were fathers, other adult family members, and romantic partners. Adolescents most commonly disclosed their ideation in-person (n = 45; 66%%), followed by text messages/emails (n = 12; 18%) and phone call/voicemail (n = 9; 13%), respectively. Only one adolescent disclosed over a social media post and one disclosed via a written note. The most frequent times of disclosure were in the afternoon (12-5PM; n = 22), morning (9AM-12PM; n = 15), and early morning (before 9am; n = 9). Only 12 participants reported disclosure after 5PM). The two most common reasons for disclosure were wanting help (n = 37) and wanting to be understood (n = 22). Only two adolescents reporting disclosure as a way to “threaten” someone in their social network. Among adolescents with a recent suicide attempt, 29 (63%) disclosed their attempt to someone, mainly to one person (52%), and the majority of those who disclosed their attempt (74%) did not request secrecy.

Discussion: The majority of adolescents receiving clinical care following suicide ideation or attempt are seen because they disclosed their ideation or attempt, unprompted. Our findings may inform interventions aimed at facilitating disclosure among adolescents as well as training others to provide the appropriate support and guarantee that the adolescents receive immediate care. These interventions should specifically target mothers, friends/siblings, and school personnel, who seem to be the main recipients of adolescents’ disclosure.