With a $15 million grant from the National Institute of Mental Health, researchers from Brown University, Michigan State University and Henry Ford Health in Detroit are collaborating to reduce the national suicide rate by establishing a multi-institution suicide prevention research center. Suicide is a leading cause of death in the United States, with about one death reported every 11 minutes, according to the U.S. Centers for Disease Control and Prevention.
The researchers say the new center, called the National Center for Health and Justice Integration for Suicide Prevention, is an innovative program that will use contact with justice system entities — such as police, prison and courts — as a novel marker for suicide risk.
“The COVID-19 pandemic and social justice movements of the past several years have brought significant attention to the multitude of inequities faced within the U.S., and particularly how these have contributed to disparities in those who come into contact with the criminal justice system,” said Lauren Weinstock, a professor of psychiatry and human behavior at Brown University and one of three principal investigators on the grant.
“Amidst calls for decarceration and diversion to mental health and substance use treatment, we need systems in place to effectively identify those who are at greatest risk and connect them to services,” Weinstock said. “With the establishment of this new center, we aim to address the all-too-frequent problem in which vulnerable individuals find themselves falling through the cracks between the health and justice systems, and to connect people to needed care.”
People who have interactions with the criminal justice system account for a significant proportion of suicides annually, according to the researchers: One in three men and one in eight women who die by suicide have spent at least one night in jail in their lifetimes. Crises, such as criminal or legal problems, can increase immediate risk. Individuals who come into contact with the justice system also have high rates of other suicide risk factors, including mental health problems, substance use, financial challenges, loss of housing, relationship struggles, exposure to violence and access to lethal means such as firearms, vehicles or drugs.
Unfortunately, Weinstock said, justice and police settings have limited mental health intervention capacity, and health systems are typically unaware of their patients’ justice involvement.
Given that contact with the justice system is a significant risk factor for suicide, linking data between the disparate systems of health care and justice can allow health care professionals to intervene at critical moments in patient care.
“One of the main problems in suicide prevention is finding people at risk for suicide who are not well-connected to health care,” said Jennifer Johnson, a professor of public health at the Michigan State University College of Human Medicine. “It turns out that many such individuals are in contact with the justice system, including police, courts and local jails. The challenge with connecting individuals in jail with community services is that it is resource-intensive and difficult to do at scale. Our approach solves both problems.”
The center will leverage research recently completed by Weinstock and Johnson, which focused on suicide prevention among individuals around the time of pre-trial jail detention, following them for up to one year after they return to the community. The results of that study are forthcoming, Weinstock said.
NCHATS, the new center, will include more than 100 stakeholders, 30 investigators and 15 institutions. By bringing together jails, police, health systems/plans, court judges and correctional facilities, NCHATS will integrate and expand the public health response to suicide prevention. The new suicide prevention center will examine the effectiveness, cost-effectiveness and scalability of suicide prevention activities.
“This is an important area to explore as a society and as leaders in suicide prevention,” said Brian Ahmedani, director of the center for health policy and health services research and director of psychiatry research at Henry Ford Health. “Suicide is a serious public health problem that affects all ages and walks of life. While the goal of this valuable award from the National Institutes of Health is to prevent suicide in justice-involved individuals and improve the overall health and well-being of them and their families, the research and practices that come from it can also be a source of knowledge when it comes to suicide prevention in other populations."
In addition to Brown, Michigan State and Henry Ford Health, the award includes funding for researchers at the Addiction Policy Forum, Butler Hospital, CareSource Ohio, Cambridge Health Alliance, Columbia University, George Mason University, HealthPartners Institute, Mount Auburn Hospital, Pacific Institute for Research, Wayne State University, Education Development Center and University of Pennsylvania.
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