When should confidentiality be broken in conversations about suicidality?

• A. When the youth asks for privacy
• B. Only when there is a safety concern
• C. Confidentiality is never breached
• D. When the youth is not truthful

Answer: (B)

In conversations about suicidality, the priority is the youth’s safety. Confidentiality isn’t absolute—when there is a real safety concern, you must involve others to prevent harm. If there is imminent risk—clear intent, a plan, and means to carry it out—you break confidentiality to connect the youth with help, which often means contacting guardians, a supervisor, or emergency services so they can be protected or treated promptly. If there’s no immediate danger, you keep the information confidential and continue a safety-focused conversation.

That's why the best approach is to breach only when there’s a safety concern. Privacy should be preserved when there’s no imminent risk. The other options miss that balance: asking for privacy doesn’t override safety, confidentiality isn’t never breached, and risk isn’t determined by honesty alone.