The Wexner Center, where ARTEMIS research will be held. Credit: Daniel Bush | Campus Photo Editor
To continue Ohio State’s suicide prevention research, the university’s project ARTEMIS received $19.5 million from the National Institutes of Health (NIH) to study suicide risk factors and prediction.
The ARTEMIS project, which stands for Analyses to Reveal Trajectories and Early Markers of Imminent Shifts in Suicidal States, will use artificial intelligence and dynamic systems modeling to track participants’ risk of suicidal ideation or action, according to an Ohio State press release. This tracking mechanism will alert clinicians of potential suicidal crises, allowing them to identify and monitor high-risk patients at critical moments.
“What we’re trying to do is to really develop an approach that allows us or physicians or family or individuals to identify when [patients] are heading into a state of high risk for suicidal behavior or suicide attempt,” sais Jessica Turner, principal investigator in ARTEMIS and professor in the Department of Psychology and Behavioral Health.
This tool aims to address rapid shifts in mental states, which can be dangerous if left undetected, Melanie Bozzay, co-investigator in ARTEMIS and assistant professor in the Department of Psychology and Behavioral Health, said.
Some patients may rapidly develop suicide risk, which Bozzay said creates challenges for clinicians and healthcare providers.
“You might see a patient in your office on Monday and the patient is doing fine, and then on Thursday there is a significant life event or something that happened and suddenly the patient is experiencing an intense suicidal crisis,” Bozzay said. “What we’re trying to do is develop a tool to help healthcare providers specifically be able to identify when someone might be vulnerable to making a suicide attempt so that we can intervene earlier to be able to help those folks.”
Clinicians do have current tools in place for suicide screenings, however these tools sometimes fail to properly highlight the patients who are most in danger of a crisis due to the lack of available experienced providers, Bozzay said.
“I think one of the strengths of our approach is it is able to sort of winnow down the pool,” Bozzay said. “The hope is that this project will inform more effective strategies so that we can save lives and target treatments to the right person at the right time.”
ARTEMIS is currently in its initial planning stages as researchers organize its many moving parts, Turner said. The current plan is to start subject recruitment early next year, with various trials over the subsequent few years.
The recent $19.5 million NIH grant awarded to the project will also allow researchers to expand the project more broadly, Turner said.
“It opens up a huge number of avenues and directions that we can go,” Turner said. “The possibility for expansion is just really exciting.”
Though suicide prevention has been a subject of study for many years, this project looks at suicide prevention on a more individualized and incremental level than similar research, Turner said.
“There’s been a great deal of research in suicide prevention by many people over many many decades at this point, and there’s a lot known about who is at risk generally as a life-time measurement.,” Turner said. “We know some groups are at higher risk than others, but that doesn’t tell you anything about if my patient is safe for this weekend. We just don’t have that level of individual understanding, and that’s what we’re trying to get at.”
By condensing the timeline of analysis to days instead of years, researchers can closely focus on the fast-changing nature of mental health crises, Bozzay said.
“One of the things we have really realized in the field over the last few years is that suicide risk is highly dynamic and fluctuates a lot over brief periods of time — as short as hours, to minutes, to days,” Bozzay said.
The ARTEMIS project builds on the foundation of the Ohio State Wexner Medical Center’s current research, State of Ohio Adversity and Resilience (SOAR), which focuses on identifying the root causes of emotional distress, suicide and drug overdose. ARTEMIS aims to broaden the scope of current university suicide prevention research by expanding beyond Ohio’s borders, Turner said.
“We’ve pulled from a number of different approaches. SOAR used the same techniques in order to gather information,” Turner said. “What we’re doing in this case is really focusing on a wide range of factors for both resilience and suicide, and we’re taking it way outside of Ohio. SOAR is an Ohio-based project, and what we’re trying to do is go nationwide.”
Ohio State serves as the lead site of ARTEMIS, with collaborators at the University of Michigan, University of Indiana, the African American Male Wellness Agency and other participating research institutions.
By working with a range of different institutions, each with different locations and focus areas, researchers can utilize diverse skills and communities to broaden the range of the project and the populations it studies, Turner said.
This project is heavily informed by Turner and Bozzay’s prior psychology research, as well as Bozzay’s experience firsthand with high risk patients.
“I am a clinical psychologist and I have spent over a decade treating patients who are high risk for suicide, so this is an issue for me that’s just near and dear to my heart,” Bozzay said. “When I think back to the patients I treated over the years and some of the information that I wish I would have had to be able to make better decisions as a clinician, this tool for me addresses a lot of those things.”
As a clinician, she often makes difficult decisions in assessing patients’ safety and stability. ARTEMIS aims to clarify this uncertainty for future clinician-patient interactions, Bozzay said.
“Sometimes as a clinician, there’s sort of guesswork in trying to determine if the patient is safe to go home today. Is this person going to be okay over the weekend?” Bozzay said.
Though the project is focused towards improving clinician care in suicide prevention and prediction, there are potential expansions for this research beyond this field, Turner said.
ARTEMIS researchers hope that this project will create lasting change in suicide prediction and prevention research, Turner said.
“It’s the potential to do something that’s not just identifying underlying factors. It’s really identifying something that is clinically actionable almost immediately,” Turner said. “I’ve certainly, as many of us have, been touched by suicide and friends who have died by suicide. Anything we can do to move the needle on making suicide prevention better is well worth it.”
For anyone struggling with suicidal thoughts or actions, 988 offers 24/7 judgment-free support for mental health, substance use, and more. Text, call or chat 988 for help during a crisis.
