Mental illness disclosure decision making.

Abstract

Disclosure related to mental illness has been linked to various positive outcomes, including better mental health. However, many individuals with serious mental illness (SMI) continue to practice non-disclosure. Even though disclosure inherently occurs within the context of one's social relationships, research has generally conceptualized mental illness disclosure as an individual level phenomenon and neglected to consider preferences concerning to whom an individual discloses and the factors that influence this decision. The current study uses the disclosure decision-making model (DD-MM) by Greene (2009) to better understand the processes of mental illness disclosure preference and selective disclosure for individuals with SMI (n = 60) using multivariate random intercept logistic regression with an emphasis on the constituent factors of disclosure preference at both individual and relational levels. The majority of participants were found to practice selective disclosure, with 68% of the participants identifying at least 1 network member to whom they could disclose. Family members and friends were central to the selective disclosure process, comprising the greatest proportion of network members who, both were and were not identified as preferred confidants. Women were found to show higher odds of preference for mental illness disclosure than men. Having lower perceived social support was associated with lower odds of disclosure preference. Among relational factors, greater relationship availability and lower dyadic tangible social support were associated with lower odds of disclosure preference. Practice and research implications of using social network analysis to get a deeper understanding of disclosure and disclosure preference are discussed, including implications for future interventions targeting stigma reduction. (PsycINFO Database Record

Barriers to accessing support for mental health issues at university

“…Indeed, with greater disclosure, participants were more likely to seek help from informal sources, but disclosure did not predict help-seeking from formal sources. This supports prior research that family and friends are more often recipients of disclosure than professionals for those with suicidal ideation (Husky et al 2016) and severe mental illnesses, with higher levels of disclosure associated with higher perceived social support (Pahwa et al 2017).…”

The impact of disability type and visibility on self‐concept and body image: Implications for mental health nursing

“…While previous research found that the visibility might have a negative impact on self‐concept of people with physical disabilities (Tam et al, ), the present study that compared two different types of disabilities (physical vs. psychiatric) indicated that the disability visibility might play a protective role for persons with physical disabilities compared to persons with psychiatric disabilities. People with visible physical disabilities who cannot hide their impairment have to actively cope with others' reactions, while people with invisible psychiatric disabilities constantly face the question of disclosure, which may negatively affect their psychological well‐being (Pachankis, ; Pahwa, Fulginiti, Brekke, & Rice, ).…”

Suicide Attempt Survivorship and Designation as a Concealable Stigmatized Identity

“…Responses were reverse coded and we calculated the proportion of family members who had not been told about the attempt (i.e., nondisclosure/concealment). This approach has been similarly used in other network CSI research (Pahwa et al, 2017).…”

“…An emphasis on kin networks may be of added value with attempt survivors given that family members are often the first and last line of defense in suicidal crises and tasked with more responsibilities for their relatives’ immediate welfare (i.e., maintain their loved ones’ safety) than other CSI statuses. Some network research has investigated dyadic concealment and stigma of mental illness (e.g., Pahwa, Fulginiti, Brekke, & Rice, 2017) but did not include any measures of identity. Notably, none of these studies have sought to assess all three components of a CSI, concentrated on family networks, or focused on suicide attempt survivor status.…”