Perceptions of Helpful and Unhelpful Responses to Disclosures of Suicidality in a Sample of Mobile App Users

Abstract

Objective

Assessment and management of suicide risk is dependent on the individual at risk disclosing their suicidal thoughts. This study analyzed self-reported data collected via Youper, a mental-health app, to explore user experiences with suicide-related disclosure.

Method

2,952 international users who endorsed suicidal ideation reported on experiences with suicide-related disclosure. Differences in experiences were examined according to age, gender, and symptoms of psychopathology.

Results

Just over half of users (56.17%) shared their suicidal thoughts. The primary reason for not sharing was thinking others would not understand. Of those who had disclosed their suicidal thoughts, 56.31% perceived the listener’s response to be helpful, with listening and expressing care identified as most helpful. More severe depression and generalized anxiety symptoms were associated with higher disclosure likelihood, whereas higher borderline-personality and social-anxiety symptoms were associated with lower disclosure likelihood. Perceptions of what users found helpful when they disclosed suicidality varied by gender. Lack of understanding was the most frequently reported unhelpful response universally.

Conclusion

Findings suggest that listening and expressing care should be prioritized to maximize suicidal individuals’ experiences of feeling supported. That said, gender and symptoms impact likelihoods of and experiences with disclosure, which should be considered when receiving suicide-related disclosure.

HIGHLIGHTS

• Nearly half of users shared suicidal thoughts and found listener responses helpful.

• Users most often endorsed listening as helpful and not understanding as unhelpful.

• Symptom severity and gender informed suicide-related disclosure experiences.

Keywords:

• Mental health
• suicide-related disclosure
• support

ACKNOWLEDGEMENTS

We thank Youper users for providing valuable data.

DISCLOSURE STATEMENT

Andrea Niles was a former employee of Youper and Jose Hamilton Vargas, Diego Dotta Couto, and Thiago Maragon are current employees of Youper. They are all shareholders in the company.

Notes

1 Users who shared as well as those who did not share about their experiences with suicidal ideation both scored in the moderately severe depression range and moderate anxiety symptom range according to PHQ-9 and GAD-7 scoring guides, respectively.

2 Users who perceived support as helpful as well as those who did not both scored in the moderately severe depression range, moderate anxiety symptom range, moderate social-anxiety symptom range, and comparable borderline personality disorder symptom severity according to PHQ-9, GAD-7, Social Phobia Inventory, and Borderline Evaluation of Severity over Time scoring guides, respectively.

Additional information

Notes on contributors

Allison V. Metts

Allison V. Metts, Department of Psychology, University of California, Los Angeles, CA 90095, USA

Meredith Sears

Meredith Sears, San Francisco VA Healthcare System, San Francisco, CA 94121-1593, USA

Jose Hamilton Vargas

Jose Hamilton Vargas, Thiago Marafon, Diego Dotta Couto, Andrea N. Niles, Youper, Inc., San Francisco, CA, USA.

Thiago Marafon

Jose Hamilton Vargas, Thiago Marafon, Diego Dotta Couto, Andrea N. Niles, Youper, Inc., San Francisco, CA, USA.

Diego Dotta Couto

Jose Hamilton Vargas, Thiago Marafon, Diego Dotta Couto, Andrea N. Niles, Youper, Inc., San Francisco, CA, USA.

Andrea N. Niles

Jose Hamilton Vargas, Thiago Marafon, Diego Dotta Couto, Andrea N. Niles, Youper, Inc., San Francisco, CA, USA.