Research Roundup March 2025: Recently Published Findings From AFSP-Funded Studies

The Research Roundup is a regular update of recently published findings in suicide prevention research. AFSP-funded studies included in this roundup examined how…

• Adolescent crisis line volunteers were affected by the experience providing peer support
• Individuals experiencing a suicidal crisis process their distress
• Pandemic-related factors played a part in suicide deaths in 2020, and
• Neuroinflammation, stress-related suicidal ideation, and negative mood relate in depression

Researcher: Catherine Glenn, PhD
Institution: Old Dominion University
Grant Type: 2022 Standard Research Grant – $100,000
Grant Title: Evaluating the Impact of Teen-to-teen Crisis Lines

Crisis lines play a vital role in suicide prevention, offering immediate support to individuals in distress. Teen-to-teen (t2t) crisis lines, where adolescent volunteers provide peer support, have emerged as a promising resource, particularly given that young people are often more comfortable confiding in peers than adults. While extensive research has examined the effectiveness of adult-staffed crisis lines, little is known about the experiences of youth volunteers who take on this emotionally demanding role. Understanding how these adolescents are affected – both positively and negatively – by their work is crucial for ensuring their well-being and improving the sustainability of t2t crisis services.

Dr. Catherine Glenn’s AFSP-funded pilot study examined the experiences of 20 t2t crisis line volunteers, ages 14–20, from two of the largest programs in the United States. Volunteers reported a strong motivation to help others and a sense of fulfillment from their work, citing benefits such as improved communication skills, greater empathy, and increased confidence. However, some also reported challenges, including emotional exhaustion and feeling pressure to support others. Notably, 90% of volunteers had handled high-risk suicide-related contacts, underscoring the intensity of their work. While most participants described their experience as overwhelmingly positive, the findings highlight the importance of providing structured support to safeguard the mental health of youth crisis responders. Further research is needed to explore the long-term impact of t2t crisis line work and optimize training and supervision practices.

Citation: Glenn, C. R., Kalgren, T., Dutta, S., Kandlur, R., Allison, K. K., Duan, A., Eskin, C. K., Leets, M., & Gould, M. S. (2024). Evaluating the Experience of Teen-to-Teen Crisis Line Volunteers: A Pilot Study. Community mental health journal, 60(7), 1422–1433. https://doi.org/10.1007/s10597-024-01298-z     

Researcher: Briana Mezuk, PhD
Institution: University of Michigan
Grant Type: 2020 Distinguished Investigator Grant – $124,880
Grant Title: Suicide Risk during Employment and Housing Transitions in Mid- and Late-Life

The COVID-19 pandemic introduced significant social and economic disruptions, leading to widespread concerns about mental health and suicide risk. While early predictions suggested that pandemic-related distress might lead to increased suicide rates, data on how specific pandemic-related stressors contributed to suicide deaths remained limited. Understanding the role of financial strain, social isolation, and health concerns in suicide deaths during this period is crucial for informing crisis response strategies in future public health emergencies. This study sought to clarify the impact of these factors by analyzing suicide deaths in 2020 compared to pre-pandemic years.

Using data from the National Violent Death Reporting System (NVDRS), Dr. Briana Mezuk examined over 31,000 suicide deaths in 2020, comparing them to cases from 2017–2018. Approximately 7% of 2020 suicide narratives explicitly referenced pandemic-related stressors, including financial struggles, job loss, and fear of infection. Decedents with pandemic-related circumstances were more likely to be older, highly educated, and unemployed. Their deaths were also more commonly associated with financial and mental health challenges but less so with substance use or interpersonal issues. These findings provide critical insights into the nuanced ways in which large-scale crises influence suicide risk, emphasizing the need for targeted mental health and economic interventions during future public health emergencies.

Citation: Mezuk, B., Kalesnikava, V., Ananthasubramaniam, A., Lane, A., Rodriguez-Putnam, A., Johns, L., Bagge, C., Burgard, S., & Zivin, K. (2024). Psychosocial and pandemic-related circumstances of suicide deaths in 2020: Evidence from the National Violent Death Reporting System. PloS one, 19(10), e0312027. https://doi.org/10.1371/journal.pone.0312027  

Researcher: Daniel Cox, PhD
Institution: University of British Columbia (Canada)
Grant Type: 2017 Young Investigator Grant – $82, 986
Grant Title: What Reduces Suicide Ideation in Online Crisis Chats? A Study of Crisis Counselor & Client Processes

Understanding how individuals experiencing a suicidal crisis process their distress is essential for improving crisis intervention efforts. Crisis theory suggests that when distress overwhelms coping abilities, individuals may feel their experience is intolerable and inescapable, increasing suicide risk. While previous research emphasizes the importance of distress awareness in reducing suicidal thoughts and behaviors, there is limited knowledge about how individuals in crisis actually process their distress. This study sought to develop and validate a distress-processing model that could enhance interventions by identifying stage-specific needs that could guide crisis counselors in tailoring their support.

Dr. Daniel Cox developed a five-stage distress-processing model based on transcripts from online crisis chats. The model begins with unengaged distress, where individuals either avoid discussing their distress or minimally engage. It progresses to distress awareness, where they acknowledge their distress, and then to distress clarity, where they begin connecting their emotions, thoughts, and experiences. In distress insight, individuals gain a deeper understanding of why they feel the way they do, leading to the final stage, applying distress insight, where they come up with ways to move forward. A follow-up validation study confirmed that distress processing occurs step-by-step and that greater progression through the stages was associated with improved outcomes. These findings offer a framework for understanding how individuals navigate suicidal crises, underscoring the importance of interventions that help people move through the stages of distress-processing and find solutions.

Citation: Mickelson, J. M., Cox, D. W., Young, R. A., & Kealy, D. (2024). A Distress-Processing Model for Clients in Suicidal Crisis. Crisis, 45(1), 18–25. https://doi.org/10.1027/0227-5910/a000907

Researcher: Nadine Melhem, PhD & J. John Mann, MD
Institution: University of Pittsburgh Medical Center & Research Foundation for Mental Hygiene
Grant Type: 2018 Linked Standard Research Grant – $300,000
Grant Title: Neuroinflammation and Imminent Risk for Suicidal Behavior in Young Adults

Inflammation is our body’s way of protecting ourselves from adverse forces, like viruses. This also occurs in the brain, which impacts the way we think and feel. While previous research has suggested that neuroinflammation may play a role in suicide risk, its connection to stress-related suicidal ideation and negative mood remains unclear. The translocator protein (TSPO), a marker of neuroinflammation, has been found to be higher in individuals with depression, but its relationship to acute stress and suicidal ideation is unclear. Understanding how neuroinflammatory processes interact with daily stressors may tell us more about suicide risk.

In their AFSP-funded grant, Dr. Nadine Melhem and Dr. J. John Mann examined 53 adults with major depressive disorder (MDD), using PET-scan brain imaging to measure TSPO binding in the brain. A subset of 21 participants also completed a seven-day ecological momentary assessment (EMA), to track daily stress, mood, and suicidal ideation throughout each day. Results showed that higher TSPO binding was associated with more suicidal ideation and negative affect during stressful periods, but not in non-stressful periods. However, TSPO binding was not significantly associated with a history of suicide attempts, suggesting it may be more indicative of acute suicide risk rather than long-term vulnerability. These findings suggest that neuroinflammation may play a role in stress-related suicidal thoughts.

Citation: Herzog, S., Bartlett, E. A., Zanderigo, F., Galfalvy, H. C., Burke, A., Mintz, A., Schmidt, M., Hauser, E., Huang, Y. Y., Melhem, N., Sublette, M. E., Miller, J. M., & Mann, J. J. (2025). Neuroinflammation, Stress-Related Suicidal Ideation, and Negative Mood in Depression. JAMA psychiatry, 82(1), 85–93. https://doi.org/10.1001/jamapsychiatry.2024.3543   

Learn more about the AFSP research grants featured in this monthly roundup, as well as others, here.