In addition to addressing the research priorities identified by the National Action Alliance for Suicide Prevention, our 2021 Grants cover one or more of the following six content categories:
Focus Grants are targeted, novel and potentially high-impact studies focusing on designated areas of study.
Massachusetts General Hospital
Ketamine rapidly decreases depression and suicidal ideation. However, its effects on suicidal behaviors are unclear. Patients admitted to the hospital for suicidal ideation and behavior are at high risk for attempting suicide after discharge. This study will investigate the effectiveness of maintenance treatment with intravenous ketamine for 6 months. Outcomes will be compared with standard care for patients admitted to inpatient units for suicidal ideation and behavior and with a historical comparison group with no suicidal ideation or behavior.
Yale School of Medicine
To address irregularities in sleep and other daily rhythms - which are robust suicide risk factors - Brain Emotion Circuitry Targeted Self-Monitoring and Regulation Therapy for Daily Rhythms (BE-SMART-DR) will be administered via telehealth to adolescents and young adults with mood disorders at high risk for suicide. State-of-the-art digital technology (wearable and smartphone) real-time data on behaviors and symptoms, and neuroimaging on brain functioning, will provide unique opportunities to identify early indicators and brain mechanisms of risk reduction.
Through the funding of Innovation Grants, AFSP supports pioneering work that will increase our understanding of suicide with an array of promising new areas of research.
Washington University
Washington University
University of Oregon
Little is known about the daily social interactions that children have that might increase risk or protect from suicidal thoughts and behaviors (STB). In a group of children who expressed suicidal thoughts and behaviors in early childhood, we will study cell phone communications and activity patterns to investigate if, and how, they might be related to expressions of STB. We will also explore whether exposure to certain types of media impacts these mental states.
University of Oregon
University of Utah
Pregnancy and motherhood are often viewed as protective factors against self-injurious thoughts and behaviors. However, suicide accounts for 20-30% of perinatal deaths the year after birth. We will interview women who experience suicidal ideation during the 3rd trimester and then again at 6 weeks and 4 months postpartum. We will learn about suicidal thoughts or experiences and about risk and protective factors during the transition to motherhood.
Centre for Addiction and Mental Health
(Canada)
Genes play a role in how one manages stress and may relate to suicidal ideation and behavior. This study will investigate molecular mechanisms that mediate the effect of stress exposure in contributing to suicidal ideation in patients with schizophrenia. The main outcome of this grant would be to learn about the molecular mechanisms that link stress to suicidal ideation. Our proposed study will highlight novel and potentially treatable molecular targets for the treatment of suicidal ideation in people with schizophrenia.
University of Texas at Austin
Brain regions that are sensitive to stress—and regulate physiological responses to stress—are implicated in suicide behavior. In bipolar disorder, greater sensitivity to stress and changes in brain regions that underlie stress response emerge over adolescence. How the brain responds to stress could contribute to risk for suicidal thoughts and behavior. This study investigates neurophysiological responses to stress as a risk factor for suicide in youth with bipolar disorder to inform suicide prevention efforts.
Erasmus Medical Center
(Netherlands)
Access to firearms increases risk of death by suicide, yet little is known about how voluntary divestment from firearms may reduce suicide risk. Building upon prior work supported by AFSP examining how personal divestment affects handgun owners’ own risk, the goal in this study is to learn more about how divestment may also affect the suicide risk for other household members, beyond gun owners.
Uniformed Services University for the Health Sciences
Suicide is the leading cause of death for women during pregnancy and in the first year postpartum. Using data from a population of women enrolled in Oregon Medicaid for low-income families and individuals with disabilities, we plan to investigate the impact of perinatal opioid use on suicide attempt and death. We also examine whether a unique value-based health care system implemented in Oregon Medicaid, known as Coordinated Care Organizations, may contribute to preventing maternal opioid misuse and suicide attempt and death.
University of North Carolina, Chapel Hill
Transgender teens are at heightened risk for suicide ideation. Self-compassion, linked to lower depression and anxiety, can be cultivated through interventions that teach teens skills to treat themselves with greater kindness and acceptance. This study will test the feasibility of an online self-compassion program tailored to the unique needs of transgender adolescents that is targeted to reduce suicide ideation. We will also explore whether specific transgender characteristics, such as being transmale, transfemale, or non-binary, influence outcomes.
University of Ottawa (Canada)
Although low- and middle-income countries account for much of the global suicide burden, factors linked with suicidal ideation and behavior are understudied in these countries. The aim of this project is to identify factors that increase or reduce the association between adversity and suicidal ideation and behavior by studying a cohort of Brazilians followed since their birth in 1993. This research will help identify potential interventions based on modifiable factors associated with reduction of suicidal ideation and behavior appropriate for a lower-income setting.
Virginia Commonwealth University
Non-suicidal self-injury (NSSI) and suicidal behaviors are correlated, but distinct outcomes and how they are related remains unclear. This study aims to assess how a range of sociodemographic, behavioral, and environmental predictors are similarly or differentially related to NSSI and suicidal attempt in a large, population-based study. We will further assess the contributions of aggregate or combined genetic risk for related outcomes such as substance misuse, major depression, personality.
Massachusetts General Hospital / Harvard Medical School
Mentor: Lisa Fortuna, Ph.D., MPH
University of California, San Francisco
Immigrant-origin youth experience barriers to mental health treatment and specific risk and protective factors for suicidal behavior. Community health workers (public health workers who are often part of the community they serve) are uniquely positioned to provide accessible and culturally responsive suicide prevention programming to families. In this project, clinician-researchers and community partners will collaborate to adapt and pilot-test a youth suicide prevention program for delivery by community health workers to Latinx immigrant parents.
National Institute of Mental Health
Mentor: Carlos Zarate, M.D.
National Institute of Mental Health
The week after psychiatric hospitalization is a high-risk time for suicidal behavior. However, clinicians have few treatments with rapid onset. Ketamine has been associated with rapid changes in suicidal thoughts within hours to days, but the impact on suicide attempts or behavior is unknown. This project will use magnetoencephalography (MEG) to measure brain function before and after ketamine administration to understand the relationship of ketamine to the desire to make a suicide attempt.
University of Pittsburgh
Mentor: Tina Goldstein, Ph.D.
University of Pittsburgh
Cyberbullying can impact youth in many ways, the most serious of which is an increased risk for suicidal thoughts and behaviors. Sexual and gender minority (SGM) youth particularly experience high rates of cyberbullying and suicidal thoughts and behaviors. We will develop a digital intervention to aid coping in the moment that SGM youth experience cyberbullying to prevent increased suicidal risk. If effective, this intervention could fill a critical gap in suicide prevention services for SGM youth.
Icahn School of Medicine
at Mount Sinai
Mentor: Igor Galynker, M.D.
Icahn School of Medicine
at Mount Sinai
Over the last couple of years, the rates of child and adolescent suicide continue to rise, especially among ethnic, racial, and sexual minorities. The study will assess the effectiveness of a novel clinician training tool, the Virtual Human Interaction (VHI), to enhance clinical training in the assessment of imminent suicidal risk among diverse adolescent populations.
Pacific University
Mentor: Kimberly Van Orden, Ph.D.
University of Rochester School of Medicine
Aging is associated with increased risks for suicide and dementia. Suicide risk is high during early stages of dementia, but the reason for this is unknown. We will assess suicide risk factors, examine attitudes toward hastening death, and test a method to measure daily changes in suicidal thoughts among older people who are at risk for dementia because they experience cognitive problems. Findings will inform risk assessment and suicide prevention approaches for older adults with cognitive decline.
University of Texas, Houston
Mentor: Jair Soares, M.D., Ph.D.
University of Texas, Houston
People diagnosed with bipolar disorder are at a significantly higher risk of suicide attempts and deaths. This study will investigate changes in the expression of genes in neuronal cells and the role of genetic risk for both suicide attempts and bipolar disorder. Identifying biological changes associated with suicidal behavior in this population will help pinpoint targets for prevention and better treatment.
Yale School of Medicine
Mentor: John Krystal, M.D.
Yale School of Medicine
The majority of epidemiologic studies have shown PTSD is associated with an increased risk of suicide. However, the molecular determinants of both traits are not well understood and predictive biomarker discovery as well as therapeutic development in this area is still in its infancy. The goal of this project is to elucidate the molecular determinants that contribute to the development of PTSD and suicidal behavior using single cell genomics in postmortem brain tissue.
University of Minnesota Medical School
Mentor: Daniel Dickstein, M.D.
Harvard Medical School
Brain-based mechanisms of suicidal thoughts and behaviors remain poorly understood. Preliminary research suggests that adolescents with suicidal thoughts have altered neurochemistry in brain regions involved in emotional regulation, self-perception, and implicit thoughts. This project will use magnetic resonance spectroscopy, a brain imaging technique, to measure brain chemicals that excite and inhibit other neurotransmitters in youth with and without suicidal behavior. We will also examine how differences in brain chemistry correspond to the strength of adolescents’ implicit thoughts about death and suicide.
Centerstone Research Institute
Mentor: Anthony Pisani, Ph.D.
University of Rochester Medical School
Crisis Stabilization Centers (CSCs) have a unique role to play in Emergency Department diversion and suicide-specific care. However, brief interventions tailored for CSC settings are needed. This study will examine a new, 60-minute, narrative, technology-based, recovery-oriented intervention called THRIVE. THRIVE may help people make meaning of their suicide crisis, reduce suicidal ideation, and increase their recovery compared to usual care. If effective, THRIVE will help CSCs deliver better recovery-focused care.
Columbia University
Mentor: Ramin Parsey, M.D., Ph.D.
Stony Brook University
Patients with suicidal thoughts and behaviors (STBs) often report suicide-related imagery during a crisis. Mounting evidence suggests that brain function and connections between the frontal and visual parts of the brain are disrupted in patients with STBs. There is growing interest in the use of Transcranial Magnetic Stimulation (TMS) as a treatment for STBs. We aim to test a new TMS treatment, targeting the fronto-visual pathway in patients with treatment resistant depression and active STBs to relieve suicidal ideation and behavior.
McGill University (Canada)
Mentor: Annette Erlangsen, Ph.D.
Psychiatric Center Copenhagen
For women who are pregnant, events occurring during the intrauterine and perinatal periods may have profound impacts on neurodevelopment, in turn increasing later susceptibility to suicide. This project will investigate associations between adverse in-utero and perinatal events (including maternal infections and obstetric complications) and suicidal behavior in the lifespan using population-based data from the Danish nationwide registers. Our findings will advance knowledge of the developmental origins of suicide and may ultimately open new avenues of preventing suicidal behavior early in life.
Research Foundation for Mental Hygiene
Mentor: Randy Auerbach, Ph.D.
Research Foundation for Mental Hygiene
Adolescent suicidal thoughts and behaviors are a public health crisis and definitive brain-based markers of risk have not been identified. We will test how alterations in three brain systems (midbrain dopamine, social processing, and inhibitory control) contribute to suicide risk in the face of social stress. Magnetic resonance imaging (MRI) will be combined with smartphone and interview measures of stress to predict longer-term risk for suicidal behaviors among high-risk adolescents.
University of Washington
Mentor: Marian Betz, M.D., MPH
University of Colorado
Serious health concerns are a known risk factor for suicide, and dementia is a major source of health-related disability among older adults. Little is known about suicidal desires and behaviors among older adults with dementia or cognitive impairment. We do know that many deaths by suicide among older Americans involve firearms. Using qualitative interviews of patients, family caregivers and health care providers, we will learn about decision-making needs to support the development of a firearm safe storage decision-making tool for use in a clinical setting.
Ohio State University
Mentor: Craig Bryan, Psy.D.
Ohio State University
Individuals with psychotic disorders are at increased risk for suicide and little is known about the mechanisms that contribute to this risk. Ecological momentary assessment (daily surveys using a smartphone application) will be used to examine emotion regulation as a mechanism for suicidal ideation among individuals with psychosis. This work has the potential to advance efforts to predict the acute onset of suicidal thoughts and develop novel preventative interventions for this high-risk population.
Schneider Children’s Medical Center (Israel)
Mentor: Alan Apter, M.D.
Schneider Children’s Medical Center
There has been an alarming increase in the rates of adolescents presenting to Emergency Departments with suicidal thoughts and behaviors. This project aims to test an instrument for the assessment of near-term suicide risk among youth. This assessment instrument is designed to capture a mental state preceding suicidal behaviors termed “The Suicide Crisis Syndrome.” The study combines multiinformant reports by youth, parents, and clinicians to improve clinical decision-making in the Emergency Departments.
Massachusetts General Hospital
Mentor: Richard Liu, Ph.D.
Massachusetts General Hospital
A history of prior self-injury is the strongest predictor of future suicidal behavior, with evidence suggesting that the more severe such behaviors are, the greater the risk for future self-injury. This study will use computer vision and machine learning approaches to analyze images of self-injury to develop an objective means of assessing whether severity of prior self-injury can predict future suicidal behavior. Results from this work may help in the development of a clinical decision-support tool for use in medical care settings.
University of Toledo
Mentor: Cheryl McCullumsmith, M.D., Ph.D.
University of Toledo
The adenosine system regulates basic functions of the body such as sleep, by slowing down the nervous system. Disruption of the adenosine system is associated with many risk factors for suicide, including severe mental illness and impulsivity, but its specific role has yet to be explained. This study will determine how the adenosine system is dysregulated in people with depression who died by suicide. Understanding how the adenosine system is altered in different cell-types in the brain will provide insight into the neurobiology underlying suicide.
Baylor College of Medicine
Mentor: Ramiro Salas, Ph.D.
Baylor College of Medicine
Suicide by opioid overdose is a significant problem, especially during the opioid epidemic. Identifying the brain biology underlying increased risk for suicide in problematic opioid users is of public health relevance. This study will examine the link between opioid use and suicide risk using Transcranial Magnetic Stimulation (TMS) as a treatment and brain imaging using fMRI to investigate therapeutic efficacy of TMS in opioid-using suicidal patients. Findings will provide a step forward in developing neural-circuit based brain treatments for people using opioids and at risk for suicide.
Simmons University
Mentor: Anthony Spirito, Ph.D.
Brown University
Suicide and substance use are often interrelated and worsen each other. Adolescents with problematic substance use typically receive outpatient substance use treatment, where suicidal thoughts and behaviors are rarely fully addressed. A comprehensive, integrated suicide and substance use intervention for outpatient substance use treatment will be developed collaboratively with clinicians and patients. Next, the intervention will be assessed for feasibility, acceptability, and preliminary effects on suicide and substance-related outcomes.
University of Pittsburgh School of Medicine
Mentor: Nadine Melhem, Ph.D.
University of Pittsburgh School of Medicine
Transgender adolescents have high risk for suicidal behavior, and elevated rates of suicidal ideation and behavior in this population likely result from disproportionate experiences of psychosocial stress endured by transgender youth. We will examine the biology of risk for suicidal behavior over time among transgender youth, including how psychosocial stressors and biological dysregulation in the hypothalamic-pituitary-adrenal (HPA) axis and inflammatory pathways contribute to risk for suicidal behavior within this vulnerable population.
University of Pennsylvania
Mentor: Rinad Beidas, Ph.D.
University of Pennsylvania
Suicide rates in Black youth are rising, and evidence-based interventions that center on health equity are urgently needed. This study leverages a large implementation trial in Michigan and Colorado to examine if implementation of an evidence-based safe firearm storage program as a universal suicide prevention strategy in pediatric primary care differs across racial groups, as well as factors that may moderate potential disparities. This study will also explore Black parents’ experiences with program receipt and firearm storage decision-making processes.
Babcock University (Nigeria)
Adolescent suicidal ideation, though prevalent in low and middleincome countries (LMICs), is grossly under-researched. This study will identify and compare psychometric properties such as the reliability and validity of suicidal ideation tools to promote more accurate identification of suicidal thoughts in non-clinical contexts. The research seeks to clarify the risk factors, while investigating factors that could be protective in a holistic manner. These data are essential to provide evidence for awareness creation, advocacy, policy, planning, and implantation of interventions.
Bloomberg School of Public Health
Suicide is a leading cause of death among Black Americans. This study explores suicide risk and protective factors among Black Marylanders. We will explore individual, family, and community differences between Black suicide decedents and White suicide decedents and Black Marylanders who died by other manners. We will also explore the association between historical events (the killing of Freddie Gray, the COVID-19 pandemic, and the 2020 racial injustice protests) and suicide rates among Black Marylanders.
University of Southern Mississippi
Nudges are behavioral economic interventions used in marketing to subtly alter decision-making environments to use mental shortcuts and ultimately influence behaviors without restricting autonomy. However, certain nudges work better for different people, and using nudges that work best for the majority excludes underrepresented populations. This study examines if tailoring mental health nudges by identifying specific groups from the data increases engagement with crisis resources on popular social media platforms. Further, this study will produce cost-benefit estimates for using personalized nudges versus a one-size-fits-all approach.
Ohio State University
People with physical disabilities report higher rates of suicidal ideation and suicide attempts when compared to the general population. However, no current interventions for suicide prevention are specifically designed to address the psychosocial and access needs of this population. The effectiveness of telehealth-administered Brief Cognitive Behavioral Therapy for Suicide Prevention, adapted for people with physical disabilities (BCBT-PWD), will be evaluated, and stakeholder feedback will be used to improve the accessibility and content of the intervention.
University of Michigan
Many individuals who attempt suicide have received a mental-health diagnosis, obtained treatment, appeared in emergency rooms, or received prior clinical care for other types of self-harm behavior. These are crucial prevention opportunities, but it is difficult to accurately predict suicide risk using traditional clinical methods. To improve assessment of risk for suicide attempt and self-harm, statistical computational-modeling approaches will be applied to a broad range of health and social variables obtained from nationwide, linked administrative records.