Characterizing Silence: Adolescents' Nondisclosure of Their Suicidal Thoughts and Behaviors to Their Family and Peers.

Objective: Despite immense public concern around youth suicide, there remain countless young people whose suicide risk remain undetected. Some adolescents deliberately choose not to disclose suicide-related experiences, even to their family and peers who could play a key role in connecting them to clinical assessment and care. Studying this population is scientifically challenging, as those adolescents who are prone to nondisclosure are the exact individuals who may not typically opt into research studies. The current investigation explores the frequency, reasons for, and correlates of adolescents' nondisclosure tendencies. Method: We recruited 154 adolescents (aged 13-17 years; mean = 15.98; SD = 1.04) with a lifetime history of suicidal thoughts and/or behaviors from across the United States to participate in a study requiring only adolescent self-consent. Adolescents were predominantly female (92.21%), White (72.08%), and bisexual (35.06%). We administered a brief, Web-based, anonymous survey assessing lifetime history of suicidal thoughts and behaviors, and nondisclosure of such suicide-related experiences. Results: Other family members of suicidal adolescents were the most common primary confidant identified to whom adolescents deliberately chose not to disclose their suicide-related experiences, closely followed by parents. Adolescents tended not to disclose to certain confidants because of their fear of negative reactions and sense of self-reliance. Those adolescents who had never disclosed to anyone tended to experience more frequent suicidal thoughts, to be closer with their primary confidants, and to cite distinct reasons for nondisclosure. Conclusion: Some adolescents remain silent about their suicide-related experiences, either toward select confidants or all of the people in their life. Understanding the distinct profiles of and reasons for nondisclosure may inform ways to connect underserved youth to care. Diversity & Inclusion Statement: We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.