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Medicine & Health

Who’s at Risk?
Researchers address high suicide rates with app-based tools and culturally aware interventions.

By Peder Schaefer ’22.5 / April–May 2024
April 5th, 2024

We are really good at saying what group of people is at higher risk for suicide, but we’re not great at determining what gets someone from thinking about suicide to actually acting,” says research psychologist Jennifer Primack. She’s one of many suicide-prevention researchers at Brown, thanks to an interdisciplinary faculty, partnerships with healthcare institutions, and focused investment on training and mentoring. U.S. suicide rates have increased by 35 percent in the last two decades—there’s one suicide death every 11 minutes—and 55 percent involve guns. Nearly 70 percent of victims are white men, but since Covid, the biggest rate increases are in Black, Latinx, and Indigenous people. Veterans, LGBTQ people, and adults over 75 are at particularly high risk. And tragically, suicide is the second leading cause of death for people aged 10 to 24. Many Brown researchers are responding with app-based interventions.

“It’s a lot of cross-pollination of ideas that have led to bigger ideas that have led to even bigger projects,” says Lauren Weinstock, a psychiatry professor who codirects a mentoring program for suicide prevention researchers and helps run a multi-university consortium on the topic.

Immediate intervention
Primack studies veterans, who are one and a half times more likely to die by suicide than other adults, using their smart phones to study sleep patterns, mood changes, and “context changes” such as job loss or a fight with a partner. Her team is investigating what takes suicide-prone people from ideation to action, with an eye to creating specific, rapid interventions.

“People like their phones and they like to use apps,” says research psychologist Heather Schatten, who is developing MAPS: the Mobile Application for the Prevention of Suicide. The app will measure mood, sleep, and other potential risk factors, while delivering interventions to those who need it.

This could help to address one of the biggest challenges in suicide prevention: managing acute risk—the ups and downs of daily life that could cause a suicidal event but aren’t always captured in weekly or bimonthly therapy sessions.

Schatten sees MAPS as an “adjunct” to therapy and a tool that could alert clinicians when patients need additional care. “There’s a lot of data suggesting that when people leave the hospital, for example, they don’t get immediately into mental health care,” she says. “This could help bridge the gap.”

Teen Apps
Ninety-five percent of teens have smart phones, so app-based interventions are particularly promising. Professor Anastacia Kudinova and her research team are developing an app that prompts teens to share how they are feeling and what they are doing multiple times a day, so clinicians can make critical interventions faster.

The app can also prompt teens to take steps to care for themselves, like pushing for self-compassion or seeking support in a time of crisis. “With this technology, you can start figuring out which aspects you can zero in on,” she says.

Nicole Nugent, who studies sleep patterns and mental health outcomes, collaborated on an app that tracks how teens interact with social media. “They’re not getting the sleep we know is so critical for mental health and our ability to learn and regulate our emotions,” she says. “If we see that certain patterns of social media use are impacting sleep, we could work with the team around these great interventions.”

While youth and teens have been the focus of suicide prevention research for a long time, the world has changed around them. “The social world for teenagers is so intense, and it’s becoming such a pressure cooker, especially after the loss from Covid,” Nugent says. “The ability to slow down and be present in the moment is hard. Even when they are with their peers, they are messaging all the time.”

Connecting dots
While finding better ways to collect data around suicide risk factors is key, so is making existing data more available. For example, Weinstock asks, “How do we best support people as they are moving between the criminal justice and healthcare systems?” People in jail often have many of the risk factors tied to suicide such as trauma history, mental health concerns, and substance abuse. Her group hopes to link publicly available release data and health records, “so people in the healthcare system know that a patient might have had a recent criminal-legal incident. Our research has really emphasized to us the high needs for this population.”

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Related Issue
April–May 2024