Identifying Mechanisms and Predictors of Suicide Contagion and Exploring Postvention at US Colleges

Suicidal thoughts and behaviors (STB) have increased in recent years at an alarming pace among college students in the US. A key goal of postvention, an organized institutional response to a death by suicide, is to mitigate suicide contagion, the mechanism by which a death by suicide can lead to subsequent deaths by suicide. Unfortunately, the rise in STB means that US colleges are increasingly having to implement postvention measures. Guides and toolkits exist to help colleges develop a postvention response, however, we have little collective understanding of contagion and corresponding postvention practices at colleges in the US. The aims of this Early Career Researcher Grant will advance our knowledge of the mechanisms of contagion on college campuses and describe current postvention practices.

The first aim of the grant is to identify institutional, individual, and relational factors associated with vulnerability to contagion. We will use machine learning methods to analyze two years of data from the Healthy Minds Study (HMS) linked to data we will collect from directly from those institutions. The HMS is a large survey on mental health, sociodemographic, and academic characteristics and annually includes around 100,000 students from nearly 200 institutions across the US. Using this large dataset, our machine learning approach will be able to assess a broad range of institutional, individual, and relational factors associated with the outcome of making a past year suicide attempt among students who were aware of a suicide death in their institutional community. The second aim will investigate how institutional postvention plans associate with students’ perception of whether the institutional response is supportive of students’ mental well-being. We hypothesize that having and implementing an institutional postvention plan will be associated with increased prevalence of students perceiving the institutional response supported their mental well-being. We will use logistic regression to evaluate this relationship.

The third aim will describe college leaders’ perspectives on suicide postvention protocols at colleges in the US. This qualitative aim will interview leaders at HMS-enrolled institutions about their postvention plans and practices, particularly around communicating about the suicide death, screening to identify students at risk, and making their postvention plans available to the public. Leaders that do not have established plans will be asked about barriers to formalizing plans and how they might address communication, screening, and publicity.

Having a postvention strategy is becoming an increasingly pressing need at US college campuses. These Aims will use novel data linkage and innovative machine learning methods to better understand critical aspects of suicide contagion including factors that confer protection and vulnerability (Aim 1), the relationship between institutional postvention protocols and student perceptions of institutional prioritization of mental health (Aim 2), and attitudes and practices that influence postvention responses (Aim 3). Collectively, these aims can inform postvention practices on college campuses. Moreover, the research outlined in this project will lay the groundwork for subsequent, longitudinal studies that will refine our understanding of contagion and bolster our collective ability to implement effective postvention measures in the college context.