Disclosure of gun access and suicidal thoughts and behaviors: An investigation of facilitators and barriers

Suicide risk assessment requires obtaining accurate information – and thus, accurate disclosure – about an individual’s history of suicidal thoughts and behaviors (STB) to inform risk categorization and appropriate intervention selection. However, research shows that accurate STB disclosure is challenged by barriers such as fear of involuntary hospitalization or other adverse consequences, perceived public stigma of suicide (i.e., beliefs that society or others hold negative judgments or stereotypes regarding suicide) and self-stigma (i.e., negative judgments or stereotypes one holds about their own experiences with suicide). Studies have found that participants also reported facilitators that increased honesty in responses to probing about suicidal thoughts. Some preliminary findings indicate that desire for support, trust in health care providers, and opportunity to access mental health treatment facilitate accurate STB disclosure. Therefore, even if barriers are not eliminated, enhancing facilitators may increase accurate disclosure and bolster suicide prevention efforts. 

There remain several gaps in the STB disclosure literature that this study hopes to address. Few studies have focused specifically on STB disclosure to a medical provider or mental health professional, who likely presents an increased opportunity to access appropriate treatment resources. Further, it is not well understood if accurate STB disclosure is more or less likely among those who may be at higher current risk for suicide, which may have implications for suicide risk assessment tools and procedures. Factors that influence firearm access disclosure have been even less studied. Some studies provide conflicting evidence showing that White respondents, older individuals, and those with more progun attitudes are more comfortable disclosing gun ownership, while others found no racial group difference and that older individuals and those with pro-gun attitudes are less likely to respond. This highlights the need to understand the barriers and facilitators to disclosing firearm access, and to explore whether firearm access disclosure may be more feasible than STB disclosure to facilitate lethal means counseling even without accurate STB disclosure. 

Funded By:
New Jersey Gun Violence Research Center

Project Status:
In progress

Principal Investigator (PI):
Joanne Kim, MS, Lauren Harnedy, BA

Faculty sponsors:
Edward Selby, PhD

Amount Awarded: