Multi-institution research effort to reduce the national suicide rate.
Brown University
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.
