The Research Roundup is a regular update of recently published findings in suicide prevention research. AFSP-funded studies included in this roundup examined how…
- Nurses identified workplace stressors shaping mental health and suicide prevention needs
- Suicide risk may be best understood by integrating multiple theories
- People who die by suicide without prior documented suicidal thoughts or behaviors may still show distinct clinical indicators, and
- Latin American suicide genetic research needs larger, more representative research
Researcher: Bernadette Mazurek Melnyk, PhD
Institution: The Ohio State University
Grant Type: 2022 Focus Grant – $1,498,914
Grant Title: HEAR Plus MINDBODYSTRONG: A Mental Health Resiliency Intervention for Nurses
Nurses regularly work in emotionally demanding environments shaped by long hours, chronic understaffing, repeated exposure to trauma, and high levels of responsibility for patient care. Over time, these pressures can contribute to burnout, depression, anxiety, and suicide risk, particularly when workplace cultures make it difficult for healthcare workers to prioritize their own well-being or seek support. Research has also shown that many healthcare workers avoid mental health services because of perceived negative attitudes (stigma), time constraints, or fears about professional consequences. Understanding how nurses themselves describe these stressors, and what they believe would meaningfully improve their well-being, is critical for developing suicide prevention efforts that are responsive to the realities of healthcare work.
With her AFSP-funded work, Dr. Bernadette Mazurek Melnyk analyzed responses from 464 nurses identified as being at moderate-to-high risk for mental distress, including suicidal thoughts and behaviors. Nurses described a wide range of overlapping stressors, including deteriorating mental and physical health, suboptimal work environments, financial insecurity, and strain within personal and family relationships. A central theme that emerged was what the Dr. Melnyk described as “the price of caring,” where the identity and expectations associated with being a nurse blurred the boundaries between professional obligation and personal well-being. Participants frequently described feeling unable to fully disconnect from caregiving demands, leading to exhaustion, guilt, and emotional depletion. Nurses identified several changes they believed could improve mental health and reduce distress, including stronger workplace support, adequate staffing, flexible scheduling, protection from workplace violence, increased pay, opportunities for career transition, and access to mental health services and evidence-based coping programs. Some also emphasized the importance of rest, therapy, social support, mindfulness, exercise, and reclaiming time outside of work. Overall, the findings highlight the importance of suicide prevention efforts that address both individual mental health needs and the broader workplace and systemic conditions shaping nurse well-being.
Citation: Hsieh, A. P., Cooper, A., Mayfield, C., Bauernsmith, I., Brown, K., Tucker, S., Melnyk, B. M., & Davidson, J. E. (2026). Nurses At-Risk for Mental Health Distress and Suicidality Describe Stressors and Strategies for Healthcare System Change: A Thematic Analysis. The Journal of nursing administration, 56(3), 127–134. https://doi.org/10.1097/NNA.0000000000001696
Researcher: Matthew Nock, PhD
Institution: Harvard University
Grant Type: 2014 Focus Grant – $1,043,263
Grant Title: Development of a Novel Method for the Short-Term Prediction of Suicidal Behavior
Suicide research includes several major theories about why suicidal thoughts and behaviors emerge, but those theories emphasize different psychological pathways. Dr. Aaron Beck’s hopelessness theory highlights negative expectations about the future as a driver of suicidal behavior. The interpersonal theory of suicide proposes that suicide risk increases when people feel they don’t belong, perceive themselves as a burden, and become less fearful of death. Other models emphasize experiences such as entrapment, emotional pain, impulsivity, or difficulties regulating distress. While these theories have each contributed important insights, many of the psychological experiences they describe overlap in everyday life, making it difficult to determine which factors are most strongly connected to different stages of suicide risk. Clarifying these relationships may help researchers better understand how suicidal thoughts develop, intensify, and transition into suicidal behavior.
Dr. Matthew Nock used his AFSP research grant to study 1,412 emergency department patients presenting with psychiatric concerns, assessing psychological risk factors at baseline and then following participants one and six months later. Using network outcome analysis, a statistical approach designed to identify the unique contribution of overlapping risk factors, Dr. Nock found that different psychological factors were most strongly associated with different suicide-related outcomes. Lack of belongingness was most predictive of later suicidal ideation, fearlessness about death was most predictive of suicide planning, and hopelessness was most predictive of suicide attempts. Dr. Nock also found that a person’s explicit association with death (i.e., how strongly they consciously associated themselves with death-related concepts) predicted suicidal ideation, suicide planning, and suicide attempts across follow-up periods. Overall, the findings suggest that suicide risk may be best understood by integrating insights from multiple theories, with different psychological experiences becoming more relevant at different points along the pathway from suicidal thoughts to suicidal behavior.
Citation: Freichel, R., Nock, M.K. & O’Shea, B.A. A network outcome analysis of psychological risk factors driving suicide risk in emergency department patients. Nat. Mental Health 3, 346–353 (2025). https://doi.org/10.1038/s44220-025-00389-4
Researchers: Emily DiBlasi, PhD
Institution: University of Utah
Grant Type: 2019 Postdoctoral Fellowship – $112,000
Grant Title: Characterization of Rare Genetic Variants Involved in Risk of Death by Suicide
Suicide prevention often relies on known warning signs, including prior suicidal thoughts or nonfatal suicide attempts. These markers are important, but at the same time, many people who die by suicide may never disclose suicidal thoughts, seek mental health care, or have suicidal thoughts and behaviors (STB) documented in their medical record before their death. This presents a major challenge for prevention and risk detection, particularly in healthcare settings that rely heavily on known suicidal ideation or behavior to guide intervention. Understanding how people who die by suicide without prior documented STB differ from those with known suicidal thoughts or behaviors may help broaden how suicide risk is recognized across clinical settings.
With her AFSP-funded work, Dr. Emily DiBlasi analyzed electronic health record data from 4,000 suicide deaths and more than 26,000 living population controls in Utah matched by sex and birth year using diagnostic data and natural language processing of clinical notes to identify prior suicidal ideation or behavior. Dr. DiBlasi found that approximately 56% of people who died by suicide had evidence of prior nonfatal suicidal ideation or behavior documented in their medical records, while about 44% did not. Individuals without prior documented STB tended to be older and had fewer overall psychiatric and medical diagnoses than those with documented suicidal thoughts or behaviors. Mental health diagnoses were much more strongly associated with documented STB itself than with suicide death alone, while several physical health conditions, including chronic pain, injury-related conditions, neurological disorders, and disability-related conditions, showed stronger associations with suicide mortality. Overall, the findings suggest that suicide risk may emerge through multiple clinical pathways, and that many individuals who die by suicide may not present just by suicidal ideation and behavior alone, but do show established contributors to risk such as chronic health problems, pain, and disability. The study also highlights the importance of approaches that consider both mental and physical health patterns when identifying suicide risk.
Citation: Coon, H., Shabalin, A. A., DiBlasi, E., Monson, E. T., Han, S., Kaufman, E. A., Chen, D., Kious, B., Molina, N., Yu, Z., Staley, M. J., Crockett, D. K., Colbert, S. M., Mullins, N., Bakian, A. V., Docherty, A. R., & Keeshin, B. R. (2025). Absence of nonfatal suicidal behavior preceding suicide death reveals differences in clinical risks. Psychiatry research, 347, 116391. https://doi.org/10.1016/j.psychres.2025.116391
Researcher: Brenda Cabrera-Mendoza, MD, PhD
Institution: Yale University School of Medicine
Grant Type: 2022 Postdoctoral Fellowship – $132,900
Grant Title: Suicide-associated Loci Regulating Molecular Traits and Their Interaction With Environmental Factors
Suicide rates in parts of Latin America have increased in recent years, even as global suicide rates have declined overall. At the same time, Latin American and Hispanic/Latinx populations remain significantly underrepresented in genomic research (i.e., all genes) on suicidal thoughts and behaviors. This matters because most genomic studies of suicide risk have been conducted in populations of primarily European ancestry, limiting how well findings may generalize across populations with different genetic backgrounds, environmental exposures, and lived experiences. Latin American populations are also highly diverse and admixed, with varying Indigenous, African, and European ancestry, making it especially important for suicide genomics research to account for ancestry, culture, and regional context. Expanding this work could help create a more accurate and inclusive understanding of the biological and environmental factors that shape suicide risk across populations.
With her AFSP-funded work, Dr. Brenda Cabrera-Mendoza reviewed studies examining the biological and genetic factors linked to suicidal thoughts and behaviors in Latin American and Hispanic/Latinx populations. The review included 59 studies focused on suicidal ideation, suicide attempts, nonsuicidal self-injury, and suicide death, and found that this area of research remains relatively limited and fragmented. Many earlier studies focused on genes related to stress, mood, and serotonin signaling, but findings were often inconsistent across studies. More recent large-scale genetic studies showed some promising genetic patterns that may differ across ancestry groups, although researchers noted that small sample sizes and limited representation continue to make findings difficult to interpret with confidence. The review also identified possible links between suicide risk and biological systems involved in stress regulation, immune functioning, and brain development, though much more research is needed to confirm these findings. Overall, the paper highlights the importance of building larger, more collaborative, and more representative suicide research efforts in Latin American and Hispanic/Latinx populations so that future findings better reflect the diversity of the communities being studied.
Citation: Cabrera-Mendoza, B., Panzenhagen, A. C., de Anda-Jáuregui, G., He, J., Magalhaes, P. V. S., Martínez-Magaña, J. J., … Suicide Working Group from the Latin American Genomics Consortium. (2026). Genomic Studies of Suicidal Thoughts and Behaviors in Latin American Populations: A Systematic Review. Biol Psychiatry. https://doi.org/10.1016/j.biopsych.2025.12.009
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Learn more about the AFSP research grants featured in this monthly roundup, as well as others, here.
