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Study Aims to Reduce Suicide after Prison

woman in jail cell

A Michigan State University public health researcher is embarking on a first-of-a-kind study that will look to reduce suicides among recently released jail detainees.

Jennifer Johnson

Jennifer Johnson

Jennifer Johnson, with the College of Human Medicine, has been awarded a $6.8 million grant from the National Institute of Mental Health and National Institute of Justice to keep those who serve jail time from taking their own lives. Currently, it’s estimated that 10 percent of all suicides involve legal issues such as an arrest or jailing and half of all those who commit suicide aren’t in treatment.

“Suicide prevention efforts need to find those at risk and intervene where they are,” Johnson said, who is a C.S. Mott Endowed Professor of Public Health. “Right now, there’s a critical gap for those who are transitioning back into the community from jail and we’re looking to fill that void.”

She will be conducting the study with co-investigator Lauren Weinstock, associate professor of psychiatry and human behavior at Brown University and psychologist at Butler Hospital.

The four-year study, known as the SPIRIT Trial, or Suicide Prevention Intervention for at-Risk Individuals in Transition, will follow 800 recently released detainees from the Genesee County Jail in Flint, Michigan, and the Department of Corrections in Cranston, Rhode Island. Each participant will be randomly assigned to today’s standard care or to a newer intervention method for one year after release.

Researchers will then track the mental health of all participants, including any improvements in suicidal behaviors, psychiatric symptoms, hospitalization and overall functioning, and compare the results between the two intervention strategies.

“With almost 12 million admissions a year in jails across the country, facilities have a difficult job because more than half of people detained have mental health and substance use problems,” Johnson said. “Jail catches people who are at risk.”

The standard level of care offered now in the justice system only provides assistance to those while in jail and very little when released.

But according to Johnson, there will be some monitoring of participants who are assigned to this type of care throughout the study, and if needed, emergency help will be provided.

The newer method involves a prioritized list, or safety plan, written by the participant that identifies coping strategies and support mechanisms that can be used before or during suicidal crises.

“Recently released inmates are four times more likely to attempt suicide than those in jail,” Johnson said. “Right now, the three largest mental health treatment providers in the country are jails. The problem is the need for help is much greater than the available budget dollars and legislators don’t tend to campaign on better health care services for this population.”

Johnson also said that people don’t realize the role jails play in public health and likely think of those in these facilities as separate from their families and communities. But the reality is the opposite. Jails pick up many of the most vulnerable people at a low point in their lives and offer population-level services that will benefit the entire community.

“One in 34 people in the United States are currently involved with the justice system,” she said. “So chances are…they could be your neighbors. Offering them a chance to succeed is important.”

This is the National Institute of Mental Health’s first major investment in suicide prevention research within the justice system. Other researchers involved in the study include Sheryl Kubiak, a criminology professor at MSU, Danis Russell, CEO of the Genesee Health System, and Genesee County Undersheriff Chris Swanson.

Last year, the Charles Stewart Mott Foundation created a $9 million endowment for the expansion of MSU’s College of Human Medicine Flint campus and recruitment of leading public health researchers from across the country. This endowment supports Johnson’s position.

– Sarina Gleason, Jennifer Johnson, Geri Kelley via MSU Today

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