LAUSR

OBJECTIVE It is sometimes stated that most people who die by suicide deny suicidal thoughts before their deaths. This narrative review examines the empirical basis for this assertion. METHODS Studies from 2000 to 2021 that examined the prevalence of the denial of suicidal thoughts among ideators in general, denial before suicide, and denial before and immediately after a suicide attempt were reviewed. Twenty-two papers met the inclusion criteria. RESULTS About 50% of ideators denied suicidal ideation (SI) during interviews. In addition, about half of decedents denied SI in the previous week or month before suicide, whereas about 30% denied SI in the previous week or month before a suicide attempt. CONCLUSIONS The denial of SI among ideators, attempters, and suicide decedents is an alarmingly common occurrence. Findings support the clinical wisdom that denial of SI is, by itself, an inadequate indicator of suicide risk.