research

Professors Receive $2.95M Grant to Study Health of Suicide Loss Survivors

AJ Rosellini and Jaimie Gradus will leverage Danish health records to document the mental and physical health outcomes experienced by family and friends of individuals who die by suicide.

The National Institute of Mental Health (NIMH) has awarded a $2.95 million grant to Boston University School of Public Health to investigate the mental and physical health outcomes experienced by family and friends of individuals who die by suicide, also known as suicide loss survivors.

Over the next four years, SPH researchers and their collaborators will leverage Denmark’s national data registries, analyzing 30 years of electronic medical records and sociodemographic information to identify people exposed to suicide deaths between 1994 and 2024 and document their mental and physical health following the loss.

Suicide is often understood to have a ripple effect, with prior research showing suicide loss survivors are at higher risk of developing major depression, post-traumatic stress disorder, and suicidal behavior themselves. One estimate suggests that for each suicide death, 135 additional people are exposed to the potential trauma of the loss. By developing a cohort of suicide loss survivors and two comparison cohorts of people exposed to loss via accidents and people from the general population, the project aims pinpoint health outcomes specific to suicide loss, laying a robust foundation for future epidemiological study.

“Suicide rates have increased over the past few decades, especially among teenagers and young adults. One very needed and appropriate consequence has been an increase in funding for [research] trying to identify how to prevent suicide. The other side of the coin though, is that with these increasing rates, that also means that there are more people that are exposed to suicide each year,” says AJ Rosellini, an associate professor in the Department of Epidemiology and co-principal investigator on the study alongside Jaimie Gradus, a professor also in the Department of Epidemiology.

“There has also been, appropriately, a big increase in focus on trauma and the impacts of trauma across the lifespan,” says Rosellini. “I think this project brings these two important fields together by looking at the trauma of suicide itself.”

Once the team has combed the records of suicide loss survivors to document health outcomes, they plan to analyze how those outcomes vary based on the amount of time to pass since a loss, the relationship of the survivor to the deceased (i.e., father, daughter, roommate, etc.), and the sex of the survivor. They will also examine the outcomes for patterns of comorbidities—diseases that present simultaneously.

Rosellini explains that further characterization of the health outcomes is important because while most medical research focuses on one disorder at a time, the reality is people often experience multiple conditions at once. Studying patterns of disease could enable the development of transdiagnostic treatments, which address multiple conditions through common underlying mechanisms. Ultimately, he hopes the research will lead to more targeted and effective suicide postventions, the support rendered to bereaved individuals in the wake of a suicide death.

Gradus (SPH‘09) and Rosellini (GRS‘13) have collaborated on mental health research on several prior occasions. A transplant from BU’s Charles River Campus, Rosellini joined the faculty at SPH last year. He completed his undergraduate and doctorate degrees in psychology at BU and later worked as a research assistant professor in the Department of Psychological and Brain Sciences and at the Center for Anxiety and Related Disorders, where he still holds an adjunct appointment. After earning her doctorate in epidemiology at SPH, Gradus studied for a second doctorate at Aarhus University in Denmark. The two BU alums now work together under the umbrella of SPH’s new Center for Trauma and Mental Health.

Rosellini says Gradus’s Danish connections have proven invaluable in supporting their growing portfolio of research on suicide. Most recently, the pair used Danish records to identify risk factors for suicide attempts among people with depression. Their work, published in the American Journal of Epidemiology earlier this month, mirrors efforts across the field to identify opportunities to intervene to prevent suicide.

“Suicide is known to be a public health problem. Accordingly, and rightfully so, much of the research to date has focused on understanding risk for suicide,” says Gradus. “I think this project is important because it highlights a part of the suicide public health problem that has received relatively less attention in the research literature—the health of people who experience suicide loss.”

Rounding out the research team are Amy Street, a professor in the Department of Psychiatry at the BU Chobanian and Avedisian School of Medicine; Henrik Toft Sørensen, a clinical professor and chair of the Departments of Clinical Medicine and Epidemiology at Aarhus University in Denmark; Julie Cerel, a professor in the College of Social Work at the University of Kentucky; and Tim Lash, a professor and chair in the Department of Epidemiology at the Rollins School of Public Health of Emory University.

The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. Call or text 988 for more information.

To learn more about related research and practice at SPH, visit the Center for Trauma and Mental Health (CTMH) website and subscribe to the CTMH newsletter.