Predicting professional help-seeking intentions and behaviors from suicidal ideation disclosure among nurses: A nationwide one-year cohort study.

BACKGROUND

Suicidal ideation (SI) is a major mental health concern among nurses. Disclosure of SI is considered a key step toward accessing care, but limited research has explored how SI disclosure influences future help-seeking behaviors, especially in nurses. This study aims to examine whether SI disclosure predicts nurses' professional help-seeking intentions and behaviors at a one-year follow-up.

METHODS

This nationwide one-year cohort study used data from 5075 Chinese nurses who endorsed SI via PHQ-9 from the Nurses' Mental Health Study. SI disclosure was defined using responses to a direct question on SI and PHQ-9 item 9. Logistic regression models examined whether SI disclosure predicted professional help-seeking intentions and behaviors at follow-up, adjusting for sociodemographic, psychosocial, and clinical covariates. Interaction terms and stratified models explored moderation by sex, age, and depression status. Two sensitivity analyses tested the robustness of findings.

RESULTS

Only 46 % of nurses disclosed SI, indicating that more than half of nurses with SI did not acknowledge their ideation directly despite reporting it on a validated symptom measure. Compared to non-disclosers, disclosers had significantly higher odds of endorsing professional help-seeking intentions (AOR = 1.17, 95 % CI: 1.04-1.31) and engaging in professional support (AOR = 1.18, 95 % CI: 1.01-1.37). These associations were significant for both mental health service use and participation in promotion programs. Age significantly moderated these associations, which were only observed among nurses aged ≤35 years. Sensitivity analyses confirmed the primary findings.

CONCLUSIONS

SI disclosure significantly predicts subsequent professional help-seeking among Chinese nurses, particularly in younger adults. Ambiguous responses, such as "Prefer not to answer," should not be overlooked in suicide prevention. These findings underscore the importance of improving early detection and reducing barriers to care for nurses experiencing SI.