The Impact of Varying Levels of Confidentiality on Disclosure of Suicidal Thoughts in a Sample of United States National Guard Personnel

Abstract

Objectives: Increasing rates of suicide in the military indicate current assessment approaches are not yielding accurate determinations of risk. Concern that endorsement of suicidal ideation may result in obstacles to career advancement may be resulting in nondisclosure.

Method: To test this, we recruited a sample of US National Guard personnel (n = 789; 81.7% male; 63.2% white) and administered two measures of current thoughts of suicide. One measure was integrated into our risk assessment protocol and soldiers were thus aware that answers could result in referral to on site military mental health professionals. The other measure was not integrated into the risk assessment protocol and soldiers were thus aware that results would not be reported to on site military mental health professionals.

Results: As hypothesized, a higher proportion of individuals reported current thoughts of suicide on the measure not integrated into the risk protocol (9.4%) than on the measure that was (6.0%). Also as hypothesized, a higher proportion of those willing to endorse current thoughts of suicide on the measure not integrated into the risk protocol denied current thoughts of suicide on the one that was (61.5%) than vice versa (39.0%). Limitations include cross-sectional self-report data and a lack of counter-balancing of measures.

Conclusions: The results indicate that increasing the confidentiality of risk assessments within the National Guard increases the likelihood of reporting of current thoughts of suicide.