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Background: Many adolescents with mental illness (MI) struggle with the decision whether to disclose their condition. They may decide to keep their MI secret, whether due to fear of public stigma or due to self-stigma and shame. Secrecy may protect against discrimination, but has often negative long-term consequences such as social isolation., Aim: To explore personal views of adolescents with MI on secrecy and disclosure of their MI., Method: Six focus groups consisting of 39 adolescents with MI were recorded, transcribed, and analyzed by qualitative content analysis to identify major themes deductively and inductively., Results: Participants described MI as a stigmatized condition and stressed both the benefits and risks of secrecy. Disadvantages included fear of stigma and loss of friendships, benefits included emotional support and relief. Adolescents underlined the importance of individual disclosure decisions (DDs). The majority preferred selective disclosure. Additionally, the role of other adolescents with and without MI was emphasized., Conclusions: DDs are individual and depend on social factors since stigma and fear of discrimination remain significant concerns for adolescents with MI. Implications for future interventions to support adolescents with MI are discussed.

Background: The burden of mental illness (MI) is exacerbated when adolescents with MI are confronted with stigma and social exclusion. Adolescents face the difficult decision whether or not to disclose their MI. Focus groups (FGs) were conducted with parents of adolescents with MI as well as with teachers, mental health professionals (MHPs) and adolescents without MI., Aim: To collect information from relevant stakeholders on secrecy versus disclosure of MI among adolescents., Methods: Thirteen FG sessions with 87 participants were recorded, transcribed and analyzed using qualitative content analysis to identify major themes., Results: Selective disclosure and social media as a potential way of disclosure emerged as dominant themes. Negative aspects of disclosure on social media were discussed. Stigma and labeling were seen as disadvantages of disclosure. Social support was perceived as one advantage of disclosure. Distinctive features of adolescence, such as self-discovery, appeared as specific problems. Parents, teachers, MHPs and adolescents without MI were considered important for disclosure. Participants discussed how to help adolescents with their dilemma between disclosure and secrecy., Conclusions: The findings suggest that disclosure decisions are personal and influenced by the individual's environment. Implications for interventions that aim to support adolescents with MI in this regard are discussed.