Both the World Health Association and the U.S. Surgeon General have made clear that suicide is preventable. Because suicide is a preventable outcome, it is associated with many other public health challenges, such as gun violence (60% of gun deaths are suicides), mental illness including substance abuse (substance dependence is one of the greatest risk factors for suicide), and trauma. Similarly, the paths to suicide prevention come from many directions and are driven by a diverse group of specialists. We are bringing together an interdisciplinary and collaborative community of scholars and practitioners from the Johns Hopkins community to lead the effort for preventing as many suicide deaths as possible and helping build brighter futures.
Our research is aimed at developing a more nuanced understanding of suicide risk and developing programs of prevention and support. As researchers and clinicians, we are continuing to develop community, hospital-based, and applied programs of prevention targeting children and adults. These include screening and educational initiatives, studies of the biological underpinnings of suicide, epidemiological surveys of at-risk groups, and developing trainees in this important field.
Adaptation and Pilot Test of a Universal School-Based Suicide Prevention Program
This pilot study examines feasibility and acceptability of the proposed recruitment methods, research design, intervention, assessment methods and training program in a school system with a majority African American population by matching 7th and 8th grade classrooms by school and randomizing classrooms to YAM or to the wait-list control condition. The primary outcomes are suicidal ideation and mood symptoms in the three months after YAM implementation. (NIH Reporter)
Early Intervention for Suicide Risk among Immigrant Youth
This study focuses on developing and testing a family-based preventive intervention for suicide risk through three interrelated projects. These are: 1) Conducting longitudinal analyses of two existing datasets to identify how social support assets (e.g., experiences of family, peer, and community support) buffer suicide risk for adolescents at high risk of suicidal behavior, and examining how these associations may vary by gender and racial/ethnic group; 2) Utilizing intervention mapping and qualitative data to develop and refine a new preventive intervention, the Early Intervention for Suicide Risk among Immigrant Youth; and 3) Pilot testing the early intervention with first and second generation immigrant Latino/a adolescents screening positive for suicide risk and their families. (NIH Reporter)
An Evaluation Of Suicide Prevention Practices And Preferences In The Pediatric Emergency Department
Although firearm access is one of the most important risk factors for suicide in youth, pediatric emergency rooms do not consistently screen for firearm access during youth mental health emergency visits. This study evaluates the frequency of such screening at a major urban pediatric emergency department via medical record review, provider survey, and patient/guardian interviews. In addition to assessing the prevalence of screening, we are collecting information on patient preferences regarding being screened and best practices which will be acceptable by patients and providers alike.
Harmonizing Multiple Data Sources And Psychological Autopsy To Characterize Suicides Among Opioid-Related Deaths
Many of the individuals who die by suicide are not clearly identified as such by Medical Examiners, and their causes of death are often categorized as undetermined with implications for state and national statistics of suicide and for understanding of the causes of suicide and accidental death. The proposed study aims to improve detection of suicide deaths by using large linked data sets, latent class analysis and psychological autopsy to better distinguish suicide among decedents whose cause of death is currently categorized as “undetermined” and to pinpoint variables that can be used to better identify such cases. In addition to improving the statistics of suicide at state and national level and identifying characteristics that will aid Medical Examiners in identifying suicide and accidental overdose deaths, the study will contribute to a better understanding of real world relationship between drug use and suicide and their impact on individuals, families, peers and society, as highlighted in NIDA’s current Strategic Plan. (NIH Reporter)
Firearm Suicide in Youth: Tracing Methods of Firearm Access used in Fatal Suicides
Most firearm deaths are suicides, and firearms remain the most common method of suicide in the US. Young people in Maryland are theoretically prohibited from owning firearms, and yet they are able to access them tragically often for use in suicide. In this study, Dr. Nestadt and his team undertake extended interviews with the families and other collateral informants following a youth firearm suicide in order to better understand risk factors for suicide, missed points of intervention which may have saved the life, and the pathways that the decedent took to access the firearm in order to inform policies and other measures which may prevent these fatal incidents. This is done in partnership with the Maryland Office of the Chief Medical Examiner.
Improving screening and follow-up for suicidal ideation and behaviors among Latinx youth in primary care
The objective of this proposal is to develop and pilot a systems-level strategy in pediatric primary care to enhance identification and management of suicidal ideation and behavior in Latinx youth, particularly those in immigrant families with parents who have limited English proficiency (LEP). We will focus on the use of trained community health workers (CHWs) to increase clinic capacity and quality of suicide risk screening and early intervention, with a focus on safety planning, parent psychoeducation and care coordination. (NIH Reporter)
Intersectional Stigma, Belongingness, and Suicide: A Novel Approach for Minority Mental Health
Past evidence from minority stress theory suggests strong associations between identity-based stigma and suicide. However, minority stress theory lacks an intersectional stigma perspective incorporating multiple minority identities. Adapting this theory to include intersectional stigma enhances its applicability to racial/ethnic minorities, many of whom identify with multiple stigmatized subgroups. Moreover, merging the interpersonal theory of suicide to minority stress allows scientists to investigate the pathway of belongingness to suicide from an intersectional stigma perspective. The proposed study signifies a pressing research opportunity to uncover new insights on understanding suicide through this innovative theoretical framework in a subgroup of Asians. This will be implemented in a pilot study using a novel study design integrating complex methods from multi-level national, community, and individual data. (NIH Reporter)
Maryland Suicide Prevention Warehouse
In 2018, NIMH funded the development of the Maryland Suicide Data Warehouse (MSDW). The aim of developing MSDW was to link a diverse set of data sources and use various layers of risk factors to predict suicide death on a generalizable population. Currently, MSDW includes data on ~5+ million Maryland residents spanning from 2012 to 2017. MSDW contains hospital and emergency discharges, health information exchange (HIE) data, commercial insurance claims, medical examiner data, electronic health record (EHR) data from 5 select health systems, and place-based social determinants of health data covering various domains such as housing, employment, education, income and crime. This study will leverage the unique data types linked by MSDW to improve suicide death predictions among generalizable patient populations. Our proposed study will further expand the underlying data and develop cutting-edge use cases of MSDW. The study aims to achieve a number of outcomes: (1) Acquire refreshed data from all existing MSDW data sources; (2) Use the wide array of data sources stored in MSDW to advance the prediction of suicide mortality, while controlling for data quality and potential model bias; (3) Explore various uses cases of the MSDW such as unsupervised clustering of suicide mortality cases; and, (4) Collaborate with external investigators to validate the MSDW-derived predictive models of suicide death. (NIH Reporter)
Netting prevention intervention butterfly effects
An integrative data analysis investigating the long-term and cross-over effects of randomized, school-based prevention programs on adult mental health: Our objective is to link and harmonize data from six randomized controlled trials with preventive interventions focused on reducing disruptive and aggressive behavior in early childhood to understand the long-term impacts of universal prevention programs on key outcomes in early adulthood including suicidal behaviors, depression and anxiety symptoms and diagnoses, and psychosis symptoms. Data will be utilized from the Fast Track Project (Bierman et al., 2004), the Good Behavior Game trials (Kellam et al., 2008; Ialongo et al., 1999; Ialongo et al., 2019), the SAFEChildren Trial (Tolan et al., 2004), and the Linking the Interests of Families and Teachers Study (LIFT; Eddy et al., 2000; Reid et al., 1999). Our hypothesis is that with a harmonized dataset, there will be sufficient power to identify prevention program impacts into adulthood and as such we will find impacts of these programs beyond what was originally targeted. Our rationale is that with at least 10,000 participants across all studies, linkage and harmonizing data will allow for more complex, multifactorial, multi-level analyses to explore intervention impact on suicidal behaviors, depression and anxiety symptoms and diagnoses, and psychosis symptoms as well as potential mediators and moderators of impact. (NIH Reporter)
Preventing Suicidal Behavior with Diverse High-Risk Youth in Acute Care Settings
The study will compare the effectiveness of two relatively brief and scalable evidence-based interventions: the Safety Planning Intervention with follow-up contacts (SPI+), a suicide-specific intervention that helps people prevent suicidal crises from escalating, and Interpersonal Psychotherapy for Adolescents Ultra Short Crisis Intervention (IPT-A SCI), a psychotherapeutic crisis intervention treatment for suicidal adolescents that teaches youth skills to prevent suicidal crises and addresses interpersonal problems that lead to suicidal crises. The results will inform the future standard of care for youth at risk for suicide presenting in the ED setting. (PCORI)
Southwest Hub for American Indian Youth Suicide Prevention Research
The overall goal of the Southwest Hub for American Indian Youth Suicide Prevention Research (Southwest Hub) is to establish a collaborative network of tribal leaders, investigators, interventionists, service providers and service users in the Southwest region that will be managed by trusted scientific partner--Johns Hopkins Center for American Indian Health (CAIH)--to pool intellectual resources, cultural assets and experience to overcome American Indian and Alaska Native (AIAN) youth suicide disparity. Primary goals are to: 1) develop and test preventive strategies that can sustainably reduce the burden of youth suicide and promote resilience in Native communities; 2) conduct outreach and dissemination to promote additional tribal community engagement in research activities; and, 3) enable tribal leaders, providers and policy makers to used science-based information to formulate mental health policies and programs to reduce suicide. (NIH Reporter)
Sustainment of suicide prevention programs in American Indian Settings
The overall goal of this K01 Mentored Research Career Development Award is to broaden the candidate’s expertise in the science of sustainment. Through coursework, structured mentorship activities and applied learning, the candidate will develop new competencies in (1) Dissemination and Implementation (D&I) science with a focus on sustainment; (2) American Indian health research; (3) use of innovative methodologic approaches, including mixed-methods and systems dynamic approaches; and (4) professional development, to become an independent NIMH-funded investigator. (NIH Reporter)
Uncovering proximal antecedents to Black male suicide using real-time approaches
Digital phenotyping platforms offers an innovative opportunity to collect real-time data associated with race-related stressors by integrating active (e.g. ecological momentary assessment-EMA) and passive (e.g. GPS, accelerometer, etc.) data using smartphones. Refined digital phenotyping platforms may provide more granular insights towards Black male youth's proximal suicide risk by assessing time-varying factors as they naturally occur. Specifically, the candidate plans to address the following specific aims: (1) Modify a culturally-adapted digital phenotyping protocol for appropriate use among Black male youth; (2) Conduct a pilot digital phenotyping study among a re-contacted and newly recruited psychiatric sample of Black male youth to determine feasibility and acceptability of real-time assessments of suicidology in the study population. (NIH Reporter)
The Suicide Prevention Research group explores multidisciplinary approaches to preventing suicide. The goal is to collaboratively create, disseminate, and sustain the implementation of evidence-based suicide prevention interventions within community and healthcare settings. We have generated over 25 million dollars in external grants. When not collaborating on a grant proposal or working to influence local or national policy, members provide feedback and insight on individual projects to further strengthen the studies and outputs by Johns Hopkins faculty members and trainees in the group. We ultimately aim to create a suicide prevention research and training center at Johns Hopkins that functions as a national resource for the field. View other awardees.
The Johns Hopkins Bloomberg School of Public Health has a long tradition and a firm commitment to instruction of the highest quality. Excellence in teaching stimulates intellectual curiosity in students and prepares them to address the most challenging public health problems facing the world today. Each term, students recognize through their course evaluations the faculty who have contributed significantly to the intellectual life of the School through their excellence in teaching. The Suicide as a Public Health Problem course has received the Excellence in Teaching award for Outstanding Overall Course and Overall Instructor Ratings.
Suicide As a Public Health Problem
Racism and Public Mental Health
Methods in Implementation Science
Mental Health in American Indian Communities
Population Health Informatics