Decisions to Disclose Suicide Attempt History: A Qualitative Study.

Individuals with a history of suicide attempt may face complex decisions about whether, when, and how to disclose their suicidal behavior history. However, little is known about how they navigate these decisions within family, social, and mental health care contexts. This qualitative study examined disclosure decision-making among biological mothers with a documented history of suicide attempt whose children aged 5-17 years had received behavioral health services. Structured clinical and demographic assessments were used to characterize the sample, followed by semi-structured qualitative interviews. Eleven audio-recorded interviews were included in the qualitative analysis. Mothers described disclosure decisions within the context of prior experiences of judgment and dismissal, stigma surrounding mental health and suicide, distrust of mental health care, structural and family stressors, and discomfort with vulnerability. Mothers also described conditions that facilitated disclosure, including close relationships with trust and open communication, and pro-mental health care attitudes. Findings suggest that disclosure of suicide attempt history is a context-dependent decision shaped by experiences across interpersonal, social, structural, and individual contexts. Rather than supporting disclosure as uniformly beneficial or harmful, these findings highlight the need for individualized, developmentally appropriate support for individuals considering whether, when, and how to discuss a suicide attempt history.