4 - (IOP 24) Negative Beliefs of Suicide Disclosure: The Role of Culture and Identity Among Black Adults

Background:
Disclosure of suicidal thoughts and behaviors (STBs) is key to suicide risk detection and prevention. Anticipated disclosure consequences (e.g., hospitalization or firearm confiscation) may deter disclosure, yet the relationship with perceived barriers (e.g., shame in discussing STBs) to disclosure remains unknown. Also, it’s unclear what unique factors may play a role in the link between negative beliefs about, and barriers to, disclosure among a group least likely to disclose STBs – Black individuals. This study examined the moderating role of cultural factors on the relationship between negative beliefs about disclosure and the top barriers to STB disclosures among Black adults.

Methods:
Participants included 275 Black adults (Mage = 31.1), with a history of suicide ideation who had never disclosed their STBs. Participants were majority cis-gendered women (56.7%), and heterosexual (79.3%).They completed self-report measures of negative beliefs about STB disclosure (i.e., firearm confiscation, hospitalization, provider disinterest in the truth about STB presence, and others’ discomfort in discussing STBs), barriers to disclosure (i.e., shame/discomfort in discussing STBs, and belief in coping on their own), cultural sanctions for suicide, and public regard of Black identity.

Results:
The overall model including all negative beliefs was significantly associated with the barrier of shame/discomfort in discussing STBs, F(4,257)=8.27, p<.001, R2=.114. The negative belief that people are uncomfortable discussing suicide was a significant contributor, B=0.26, p= 002, 95% CI [0.09, 0.43]. Regarding the barrier of coping with STBs alone, the overall model with all negative beliefs was significant, F(4,257)=3.48, p=009, R2=.05, with the belief of firearm confiscation (B=.13, p=.03, 95% CI[.01-.24]) and provider’s disinterest in the truth of STB presence (B=.12, p=.04, 95% CI[.01-.23]) emerging as significant contributors to the model.

Public regard of Black identity moderated the relationship between the negative belief that people are uncomfortable discussing suicide and the barrier of shame/discomfort in discussing STBs, B=-.12, SE=.06, p<.05, 95% CI [-.25, -.00]. Public regard did not moderate the relationships between firearm ownership, nor provider’s disinterest in the truth of STB presence, on the barrier of wanting to cope with STBs on their own (ps=.51-.60). Cultural sanctions did not moderate the relationship between any significant negative belief on the two barriers tested (ps=.23-.42).


Conclusion:
Findings suggest that racial identity plays a stronger role in STB disclosure among Black adults than suicide-related cultural belief, emphasizing the need for culturally responsive care that affirms Black identity and also challenges harmful stigma around suicide disclosure.