In the United States, someone commits suicide every ten minutes. It is a public health epidemic that has grown steadily over the past 15 years and has resulted in more than $ 70 billion in medical costs and lost productivity. In the aftermath of an individual’s suicide, it has become all too common to hear family, friends, colleagues – even the media – say, “If only we had known how bad things were. “
As a beneficiary of National Institutes of Health (NIH) Director New Innovator Award 2021, John R. Blosnich, assistant professor at USC Suzanne Dworak-Peck School of Social Work, aims to address this problem by challenging the traditional concept of health suicide prevention research and intervention. and not related to health. The price is part of the High risk, high return research program, which funds highly innovative, high-impact biomedical or behavioral research conducted by exceptionally creative scientists.
Funding for the Director’s Awards comes from the NIH Common Fund, the National Institute of General Medical Sciences (NIGMS), the National Institute of Mental Health (NIMH), and the National Institute of Neurological Disorders and Stroke (NINDS). Blosnich received a $ 1.4 million grant from NIMH for his project Changing the paradigms of suicide prevention: looking beyond clinical parameters.
Blosnich proposes a paradigm shift in suicide research by prioritizing social determinants to develop public health research and prevention through broad, but strategic partnerships with industries outside of mental health and care. health. The NIMH-funded grant will be applied in a two-pronged approach. The first is Life Events Prior to Suicide Death (LEADS) and will apply an atypical method to examine and assess the social context of people who die by suicide.
“We take what is being hailed as the gold standard research methodology to examine suicide and reverse it – well, actually far from the head, ”said Blosnich. “What is called a psychological autopsy is generally applied and we make it more of a social autopsy.”
During the psychological autopsy, researchers contact the next of kin or close contacts of the deceased and reconstruct the events that led to the suicide. It is more focused on psychological symptoms and mental health treatments and medications, and based on an understanding of life stressors that the individual may have experienced prior to suicide.
“When we think of typical life events that occur before someone experiences a period of acute distress – loss of employment, divorce, expulsion for example – social service agencies can have a unique role during these stressful times, ”said Blosnich. “The LEADS social autopsy will interview individuals to understand their connection to social services and will really focus on the life events that cause distress and less on the mental health component. We want to know as much as possible about the potential connections a person had beyond clinical mental health services.
The second study is Charting Upstream Suicide Prevention (CUSP) which will focus on surveying those who work in three specific industries related to life disruption: family law, mortgage foreclosure and bankruptcy, and unemployment and unemployment services. professional training. The CUSP will interview employees of agencies that provide these services to determine what happens when a client shows signs of distress or in fact conveys that he may be feeling suicidal.
“The traditional approach was just to recommend mental health services, and that’s clearly important and life-saving, but some people never get through mental health treatment,” Blosnich said. “Much of the work that I have done on suicide prevention has focused on the social stressors that I am convinced lead to suicide, and I think social work has a huge role to play in it. this regard. “
Addressing the issue of suicide prevention is not just one thing, Blosnich emphasizes. It is about really understanding the individual, his course and that it is not necessarily defined by a period of his life.
“Suicide is different from other causes of death. It’s incredibly complex, ”said Blosnich. “Years ago, the CDC’s one-word suicide prevention campaign was ‘connection’. Not “pills” or “therapy”. It was a ‘connection’, and I think that inherently calls for social solutions. I’m not saying clinical solutions aren’t important – they clearly are. But I think we have invested so much and focused on the individual level, that we have lost the context. What we do to each other matters so much to what we do to ourselves.
Blosnich has leveraged surveys and administrative datasets to fill knowledge gaps in much of his suicide prevention research. The social determinants of suicide risk among military personnel and veterans have been at the center of his research. He has spent the last ten years working with the United States Department of Veterans Affairs (VA), first with the VISN2 Center of Excellence for Suicide Prevention in New York and now with the Center for Health Equity Research and Promotion in Pennsylvania.
His recent study “Differences in childhood adversity, suicidal ideation and suicide attempts among veterans and non-veterans, “Posted in American psychologist, was a nationally representative sample of veterans of the conflicts in Iraq and Afghanistan, which includes the most recent cohort of veterans in the United States. ), and their association with recent suicidal ideation and attempts among this new generation of veterans. The study showed that TEPs, events that occurred before the age of 18 and enlisting in the military, were very important to even recent suicidal thoughts and attempts.
“It starts with the issue of cumulative trauma history, then knowing the population patterns of these negative events, and then moving back to primary prevention,” Blosnich said. “Veterans didn’t just start their lives suddenly when they enlisted. They were at least 18 years old before they found their way into military service, and for some of them those times could have been very difficult and could be relevant if a soldier or veteran is in difficulty right now. Again, I think that context – in this case, historical context – is crucial to understanding an individual’s risk of suicide.
When Blosnich arrived at USC in January 2020, he immediately became involved with the Center for LGBTQ + Health Equity at the Suzanne Dworak-Peck School of Social Work. His most notable study with the Center, published in the American Journal of Public Health, found that LGBTQ + people who underwent conversion therapy were almost twice as likely to attempt suicide as LGBTQ + people who had not experienced conversion therapy.
In September 2021, he was appointed director of the Center, which aims to raise the profile of LGBTQ + health issues across the university. Under Blosnich’s leadership, the focus will be on increasing transdisciplinary and inter-campus participation.
“My vision for the Center is to create a hub for LGBTQ + health work across the university, collaborating with different disciplines and engaging students and faculty who wish to pursue research in this area,” said Blosnich.
The Center will begin hosting a series of discussions on the first Tuesday of the month to inform about its work and foster continued university-wide collaboration. Blosnich’s work on suicide risk and prevention, as well as topics such as collecting data on sex and gender across the lifespan, are a few examples of topics to explore.
“I want to democratize LGBTQ + research at the Center so that it is not limited to social work,” said Blosnich. “As with my project in the High Risk, High Yield Research Program, I want to take issues that have traditionally been addressed in a clinical setting and see how law, business or education sees them. One of the guiding principles of social work is to see the person in context, which requires the ability to work in all areas to meet a person’s needs. So, I couldn’t think of a better place to do the kind of work I want to do.