R01MH128269

Understanding Bystanders for Self-Directed Violence Prevention: A Prospective National Study Highlighting Marginalized Youth and Young Adults

Self-directed violence (SDV), defined as anything a person does intentionally that can cause injury to oneself, including death (i.e., suicide attempt, suicide ideation, non-suicidal self-injury), is a significant public health issue. A growing number of SDV prevention programs train adults and peers (termed "gatekeeper training") to be more active bystanders – to try to help when they see someone who may be at risk for self-injury. Such programs have demonstrated positive changes in knowledge and attitudes about suicide but have had less success in changing behaviors in real-world settings. Limited impact may be due to the absence of longitudinal research on how SDV bystander actions unfold and what attitudes and barriers influence bystanders' behavior.

A recent national survey of 1,031 youth and young adults conducted by this research team to inform the current proposal revealed that 83.1% have been exposed to SDV in their lifetimes. While this suggests great opportunity for interventions focused on bystanders, studies also document the mental health impact of those exposed to SDV (i.e., "bystanders"). Indeed, lifetime exposure to suicidal behavior is associated with past month trauma symptoms, suicide ideation, and thoughts of self-harm among youth. Also, we have surprisingly limited information about how these bystanders are impacted by the help they provide. In the interpersonal violence field, research suggests that the feelings of bystanders about their intervention are influenced by the way their actions were received by the other person. Given research on the contagion of SDV among young people, extending this research to SDV bystanders is critical.

Further, exposure to SDV may be amplifying existing mental health disparities experienced by sexual and gender minority (SGM) populations. Youth with SGM identities experience elevated rates of suicidal behavior and associated risk factors including depression, substance use, and peer victimization because of discrimination and structural inequalities. The negative impacts of SDV exposure noted above may amplify these disparities. New and innovative approaches are clearly needed to help narrow these gaps in SDV risk and exposures among SGM and other minority populations.

To address these gaps, we propose to conduct a national longitudinal study of youth, ages 13-22. Participants will be recruited via social media to facilitate a national reach and oversampling of SGM youth. Specific aims are informed by the research team's prior work, previous research about interpersonal violence bystander behavior, and guided by the Enhanced Social Cognitive Model for SDV (ESC-SDV). Specifically, we will:

1) Recruit and survey a cohort of 5,000 adolescents and young adults to identify the pathways through which attitudinal and contextual components of the ESC-SDV predict: a) opportunity to act, b) intent to act, and c) actual bystander behavior for SDV;
2) Survey these youth two more times, 12 months apart, to identify the impact of bystander behavior on the bystanders themselves; and
3) Examine how these trends are different for important subgroups of youth.

University System Of New Hampshire

THE MISSION OF THE NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH) IS TO TRANSFORM THE UNDERSTANDING AND TREATMENT OF MENTAL ILLNESSES THROUGH BASIC AND CLINICAL RESEARCH, PAVING THE WAY FOR PREVENTION, RECOVERY, AND CURE. WE FULFILL THIS MISSION BY SUPPORTING AND CONDUCTING RESEARCH ON MENTAL ILLNESSES, HEALTH SERVICES, AND THE UNDERLYING BASIC SCIENCE OF THE BRAIN AND BEHAVIOR; SUPPORTING THE TRAINING OF SCIENTISTS TO CARRY OUT BASIC AND CLINICAL MENTAL HEALTH RESEARCH; AND COMMUNICATING WITH SCIENTISTS, PATIENTS, PROVIDERS, AND THE PUBLIC ABOUT MENTAL HEALTH RESEARCH ADVANCES AND PRIORITIES. IN MAY 2024, NIMH RELEASED ITS STRATEGIC PLAN FOR RESEARCH. THE STRATEGIC PLAN BUILDS ON THE SUCCESSES OF PREVIOUS NIMH STRATEGIC PLANS BY PROVIDING A FRAMEWORK FOR SCIENTIFIC RESEARCH AND EXPLORATION, AND ADDRESSING NEW CHALLENGES IN MENTAL HEALTH.THE NEW STRATEGIC PLAN OUTLINES FOUR HIGH-LEVEL GOALS: GOAL 1: DEFINE THE BRAIN MECHANISMS UNDERLYING COMPLEX BEHAVIORS GOAL 2: EXAMINE MENTAL ILLNESS TRAJECTORIES ACROSS THE LIFESPAN GOAL 3: STRIVE FOR PREVENTION AND CURES GOAL 4: STRENGTHEN THE PUBLIC HEALTH IMPACT OF NIMH-SUPPORTED RESEARCH THESE FOUR GOALS FORM A BROAD ROADMAP FOR THE INSTITUTES RESEARCH PRIORITIES OVER THE NEXT FIVE YEARS, BEGINNING WITH THE FUNDAMENTAL SCIENCE OF THE BRAIN AND BEHAVIOR, AND EXTENDING THROUGH EVIDENCE-BASED SERVICES THAT IMPROVE PUBLIC HEALTH OUTCOMES.

93.242 - Mental Health Research Grants

National Institute of Mental Health (NIMH) [HHS - NIH]

New Hampshire United States

State-Wide

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)

Amendment Since initial award the End Date has been extended from 06/30/26 to 06/30/27 and the total obligations have increased 444% from $649,712 to $3,536,497.