Understanding Suicidal Behavior: Exciting New Opportunities in Research Infrastructure
Innovative research strategies and emerging research infrastructures have the potential to lead to breakthrough discoveries in our understanding of suicidal behavior.
To further advance suicide research in the U.S., The National Action Alliance for Suicide Prevention’s Prioritized Research Agenda recommended nine actions to improve our nation’s ability to understand suicidal behavior. Below, we explore four of these recommendations with implications and opportunities for behavioral health systems and providers.
1) Develop standard definitions and common data elements for suicidal behavior.
Does your organization have a standardized system for defining suicidal behavior? Below are two resources related to definitions and data elements to consider as references for suicidal behavior:
The limited supply of human tissues available for research slows progress in understanding the biology of both healthy individuals and those who may have experienced psychiatric and neurological disorders, including suicidal behavior. NIH has created a centralized resource, the NIH Neurobiobank, which allows the research community to coordinate brain and other tissue sharing (e.g., brain tissue banks, genetic repositories).
3) Develop patient registries.
Patient registries give researchers the ability to analyze (de-identified) data from patient health care records and link them to mortality registries to examine the role of health conditions and health services for suicide risk.
One example of using patient registries for research was Valenstein’s study in the VA. The study examined suicide risk in a patient registry of more than 887,000 VA patients with depression. The study confirmed that following discharge from psychiatric hospitalizations and during any medication transitions (including start-up), patients are at extremely high risk for suicidal behavior.
4) Expand data sharing and warehousing
Data sharing is critical for suicide research as suicide is a relatively rare event. Large data sources are needed to identify and accurately study suicidal behaviors.
The Mental Health Research Network (MHRN) is an example of one attempt to share data to improve research and practice within care systems. Using electronic health records from 13 different health systems, researchers were able to detect a six-fold increase for suicide attempt if someone responded “every day” to item nine on the PHQ-9 questionnaire, which asks, “Over the past two weeks, how often have you been bothered by thoughts that you would be better off dead, or hurting yourself in some way?”
Behavioral health systems have the opportunity to collaborate and share data from multiple sites, helping ensure there are sufficient data points to provide statistical power to determine effects on suicidal behavior.
In addition to research, data surveillance infrastructure is critical to our understanding of suicidal behavior, including determining the scope of the problem and whether or not current programs and interventions are working.
Current public health surveillance systems tracking suicidal behavior (i.e., deaths, attempts and ideation) include WISQARS (fatal and non-fatal injury data), the youth risk behavior surveillance system, the National Electronic Injury Surveillance System (NEISS) and the National Violent Death Reporting System to name a few.
To explore this topic further, view the National Action Alliance for Suicide Prevention’s Prioritized Research Agenda.
Recordings of all six webinars in the National Action Alliance for Suicide Prevention webinar series can be found in the National Council for Behavioral Health’s webinar archives.
The National Action Alliance for Suicide Prevention is the public-private partnership advancing the National Strategy for Suicide Prevention (NSSP). This is achieved by catalyzing implementation of high priority NSSP objectives. One such example is the Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives. This groundbreaking document advances NSSP objective 12.1- Develop a national suicide prevention research agenda with comprehensive input from multiple stakeholders.