Content note: This story discusses suicide. If you or someone you know needs help, please call, text or chat the Suicide and Crisis Lifeline at 988.
A suicide prevention program tested by researchers from Michigan State University and Brown University reduced suicide attempts by more than half among people recently released from pretrial jail detention, according to a new study published in JAMA Network Open.
This study provides the first evidence-based suicide prevention approach in this population.
The federally funded trial, Suicide Prevention for at-Risk Individuals in Transition, or SPIRIT, evaluated a Safety Planning Intervention for people detained in jail. The program combined an in-jail safety planning session with follow-up phone calls after release to help individuals stay connected, navigate life stressors and access care.
“Too often, people leaving jail fall through the cracks at one of the most vulnerable points in their lives,” said Jennifer Johnson, the Charles Stewart Mott Endowed Professor of Public Health at Michigan State University and founding chair of the MSU College of Human Medicine’s Department of Public Health. “This study shows that even a brief intervention can have a profound impact. The Safety Planning Intervention reduced suicide attempts by more than half in the year after release from pretrial jail detention. This matters because 1 in 5 adults in the United States who die by suicide have spent a night in jail in the past year. We identified the first effective approach to prevent these suicides.”
The study followed 800 at-risk individuals across two jail sites — the Genesee County Jail in Michigan and the Rhode Island Department of Corrections — and tracked outcomes for a year after release. Participants who received the intervention showed a 55% reduction in suicide attempts and a 42% decrease in overall suicide-related events, compared with those receiving standard post-release care.
The study was co-led by Lauren Weinstock, professor of psychiatry and human behavior at Brown University, with collaborators that include the late psychologist Barbara Stanley from Columbia University as well as Greg Brown at the University of Pennsylvania, who had developed an intervention for suicide prevention that had been used in hospital emergency departments.
“People we recruited were under a tremendous amount of stress and strain,” Weinstock said. “They had high rates of prior suicide attempts, substance use and trauma exposure, with people sharing stories of very difficult life circumstances. This was a population at an extremely high risk for suicide, so it was informative to see how effective this intervention could be with this group.”
Nearly all participants reported suicidal thoughts in the month before arrest and some were arrested after a suicide attempt. Half had made their first attempt by age 13. Researchers used the arrest as a point of identification and intervention for those at the highest risk.
The team now is evaluating cost-effectiveness and developing implementation approaches to help correctional and community mental health systems adopt the approach on a wider scale, including through its National Center for Health and Justice Integration for Suicide Prevention, or NCHATS.
NCHATS is an innovative, practice-focused suicide prevention research center funded by a $15 million grant from the National Institute of Mental Health. Then center recognizes that contact with police, emergency services, courts or jails can be a marker for suicide risk and demonstrates ways to connect people to suicide prevention services at scale. It brings together dozens of investigators across multiple institutions — including MSU, Brown University and Henry Ford Health — as well as national organizations representing jails, police, crisis services, courts and health systems to expand public health approaches to suicide prevention for people in the community who have had contact with criminal and legal systems.
The SPIRIT trial was funded by the National Institute of Mental Health, with additional support from the National Institutes of Health Office of Behavioral and Social Sciences Suicide Prevention Research and the National Institute of Justice to MSU.
This story originally appeared on the Charles Stewart Mott Department of Public Health website.
