Research Blog

A study from the Johns Hopkins Center for Suicide Prevention introduces a public health-oriented Cascade of Care (COC) model for suicide prevention, published in the American Journal of Preventive Medicine. The model builds on the success of public health frameworks used in other areas, such as HIV care, and provides a structured, population-level approach to reducing suicide rates. By conceptualizing population suicide rates as a challenge with gaps in care —the model aims to provide an overarching framework to advance prevention efforts.

The study emphasizes the urgent need for a public health response to suicide prevention that moves beyond traditional clinical settings. Data show that although many individuals who die by suicide have prior contact with healthcare or community systems, few receive consistent follow-up care. The COC model leverages public health principles to address these care gaps, emphasizing equitable access to resources and interventions that are culturally and contextually relevant. It also highlights the importance of upstream interventions, such as economic empowerment and community-based programs, to mitigate risk factors before crises occur.

The researchers call for widespread adoption of the COC model to guide public health efforts at local, state, and national levels. By integrating health equity and implementation science, the model seeks to address structural barriers and systemic inequities that disproportionately impact vulnerable populations. With its focus on continuity of care and scalability, the COC model provides a roadmap for creating sustainable, coordinated systems that can significantly reduce suicide rates and advance mental health equity across communities.

A new study from the Johns Hopkins Center for Suicide Prevention highlights the critical role of Child Access Prevention (CAP) laws in reducing youth firearm suicides and other firearm-related deaths. This comprehensive national evaluation, spanning three decades, found that CAP laws can cut youth firearm suicide rates by up to 14%, underscoring their importance in protecting children from tragic and preventable deaths.

The research examined two primary types of CAP laws: negligent firearm storage policies and reckless provision statutes. Laws requiring firearms to be stored unloaded and locked, especially for households with children under the age of 16, were the most effective. These policies were associated with significant reductions in firearm suicides and unintentional firearm injuries among youth, with no evidence that declines in firearm suicides led to increases in other suicide methods.

Conversely, laws targeting reckless provision of firearms to minors showed limited effectiveness, likely due to enforcement challenges and other contributing factors. This highlights the importance of enacting and enforcing stringent firearm storage regulations to reduce the availability of lethal means in moments of crisis.

“With youth firearm suicides rising by 68% among children aged 10 to 14 during the COVID-19 pandemic, these findings reveal how lifesaving CAP laws can be,” the study reports. “Requiring firearms to be stored unloaded and securely locked not only reduces firearm suicides by up to 14% but also helps prevent unintentional injuries and firearm homicides among children.”

As firearm ownership rates continue to climb, this research underscores the urgency for policymakers to implement or strengthen CAP laws. These regulations represent a vital step in suicide prevention and in reducing the devastating impact of firearm violence on families and communities.

A comprehensive meta-analysis conducted by researchers from the Johns Hopkins Center for Suicide Prevention reveals that substance use disorders (SUDs) are strongly associated with suicide mortality, increasing the risk by 5.58 times compared to non-users. The findings, based on 47 studies from 12 countries, provide critical insights into the elevated risks posed by specific substances such as alcohol, opioids, and cannabis, and call for enhanced public health interventions to address this significant suicide risk factor.

Key findings from the study include striking gender disparities, with substance misuse associated with a 12.37 times higher suicide risk for females compared to 5.21 times for males. Alcohol misuse was found to be particularly deadly, associated with a standardized mortality ratio (SMR) of 5.39, while amphetamines posed an even greater risk (SMR: 11.97). Tobacco use (SMR: 1.83), cannabis use (SMR: 3.31), and opioid misuse (SMR: 5.46) also showed significant associations with suicide mortality, emphasizing the broad and severe implications of substance misuse on mental health and safety.

The study also highlights the concerning lack of disaggregated data to explore health inequities across race, ethnicity, gender identity, and geography. Despite the well-documented disparities in both substance use and suicide, researchers noted an overrepresentation of European data and a critical need for more diverse and inclusive research.

"Substance misuse remains a significant, yet modifiable, risk factor for suicide," the authors state. They urge policymakers and healthcare providers to focus on both universal and targeted prevention strategies, such as increasing access to effective treatments for substance use disorders, expanding mental health support, and addressing health inequities.

This research underscores the urgency of integrating substance misuse prevention into suicide reduction strategies, particularly in light of rising substance use and global suicide rates.