Journal of Youth and Adolescence

, Volume 41, Issue 10, pp 1312–1324 | Cite as

Associations Between Suicidal High School Students’ Help-Seeking and Their Attitudes and Perceptions of Social Environment

  • Anthony R. PisaniEmail author
  • Karen Schmeelk-Cone
  • Douglas Gunzler
  • Mariya Petrova
  • David B. Goldston
  • Xin Tu
  • Peter A. Wyman
Empirical Research


Suicide is a leading cause of death among adolescents, many of whom fail to disclose suicide concerns to adults who might help. This study examined patterns and predictors of help-seeking behavior among adolescents who seriously considered suicide in the past year. 2,737 students (50.9 % female, 46.9 % male; racial distribution 79.5 % Caucasian, 11.9 % Hispanic/Latino, and 3.6 % Black/African-American) from 12 high schools in rural/underserviced communities were surveyed to assess serious suicide ideation (SI) in the past year, disclosure of SI to adults and peers, attempts to get help, attitudes about help-seeking, perceptions of school engagement, and coping support. Help-seeking was defined as both disclosing SI to an adult and perceiving oneself as seeking help. The relationship between adolescents’ help-seeking disclosure and (1) help-seeking attitudes and (2) perceptions of social resources was examined among suicidal help-seeking youth, suicidal non-help-seeking youth, and non-suicidal youth. Of the 381 (14 %) students reporting SI, only 23 % told an adult, 29 % sought adult help, and 15 % did both. Suicidal help-seekers were similar to non-suicidal peers on all measures of help-seeking attitudes and social environment perceptions. Positive attitudes about help-seeking from adults at school, perceptions that adults would respond to suicide concerns, willingness to overcome peer secrecy requests, and greater coping support and engagement with the school were associated with students’ increased disclosure of SI and help-seeking. This study supports prevention strategies that change student norms, attitudes and social environments to promote help-seeking among adolescents with SI. Promising intervention targets include increasing students’ perceptions of the availability and capability of adults to help them, and strengthening students’ understanding of how existing resources can help them cope.


Youth suicide Help-seeking Prevention Youth–adult relationships Attitudes Social support 



The authors wish to thank Emily Hurley for her help in preparing this manuscript. We gratefully acknowledge support from the Center for Mental Health Services, SAMHSA (SM-05-019), New York State-Office of Mental Health, Locker Family Fund, National Institute of Mental Health (T32MH20061 and K24 MH066252), and the University of Rochester CTSA award KL2 RR024136 from the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Anthony R. Pisani
    • 2
    • 3
    • 1
    Email author
  • Karen Schmeelk-Cone
    • 2
  • Douglas Gunzler
    • 4
  • Mariya Petrova
    • 2
  • David B. Goldston
    • 5
  • Xin Tu
    • 2
    • 6
  • Peter A. Wyman
    • 2
  1. 1.Department of PsychiatrySchool of Medicine and Dentistry, University of Rochester Medical CenterRochesterUSA
  2. 2.Department of PsychiatryUniversity of RochesterRochesterUSA
  3. 3.Department of PediatricsUniversity of RochesterRochesterUSA
  4. 4.Center for Health Care Research & Policy, MetroHealth Medical Center, School of MedicineCase Western Reserve UniversityClevelandUSA
  5. 5.Department of Psychiatry & Behavioral SciencesDuke University School of MedicineDurhamUSA
  6. 6.Department of Biostatistics and Computational BiologyUniversity of RochesterRochesterUSA

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