Suicide Risk Screening in Jails: Protocol for a Pilot Study Leveraging the Mental Health Research Network Algorithm and Health Care Data
BackgroundSuicide in local jails occurs at a higher rate than in the general population, requiring improvements to risk screening methods. Current suicide risk screening practices in jails are insufficient: They are commonly not conducted using validated screening instruments...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-06-01
|
| Series: | JMIR Research Protocols |
| Online Access: | https://www.researchprotocols.org/2025/1/e68517 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850164647051657216 |
|---|---|
| author | Erin B Comartin Grant Victor Athena Kheibari Brian K Ahmedani Bethany Hedden-Clayton Richard N Jones Ted R Miller Jennifer E Johnson Lauren M Weinstock Sheryl Kubiak |
| author_facet | Erin B Comartin Grant Victor Athena Kheibari Brian K Ahmedani Bethany Hedden-Clayton Richard N Jones Ted R Miller Jennifer E Johnson Lauren M Weinstock Sheryl Kubiak |
| author_sort | Erin B Comartin |
| collection | DOAJ |
| description |
BackgroundSuicide in local jails occurs at a higher rate than in the general population, requiring improvements to risk screening methods. Current suicide risk screening practices in jails are insufficient: They are commonly not conducted using validated screening instruments, not collected by clinically trained professionals, and unlikely to capture honest responses due to the chaotic nature of booking areas. Therefore, new technologies could improve such practices. Several studies have indicated that machine learning (ML) models considerably improve accuracy and have positive predictive value in detecting suicide risk compared with practice as usual (PAU). This study will use administrative data and ML modeling to improve suicide risk detection at jail booking.
ObjectiveThis study is primarily focused on gathering preliminary information about the feasibility and practicality of using administrative data and ML modeling for suicide risk detection but also incorporates elements of hypothesis testing pertaining to clinical outcomes.
MethodsThe study uniquely contributes to our understanding of suicide risk by further validating an existing ML model developed and previously validated by the Mental Health Research Network using Medicaid outpatient health care claims data. This validation uses complete claims data on a sample of approximately 6000 individuals booked into 2 diverse jails in a midwestern state. This model validation uses 313 unique demographic and clinical characteristics from 5 years of historical health care data. It detects suicide risk in jails and postrelease by using merged jail, Medicaid, and vital records data. The study will use jail administrative data for September 1, 2021, through February 28, 2022; Medicaid records data for September 1, 2016, through March 31, 2023; and vital records data for March 1, 2022, through March 31, 2023.
ResultsFirst, the algorithm will be validated on the data gathered for the jail sample using the C-statistic and area under the receiver operating characteristic curve. Second, the resulting model will be compared with the jails’ suicide identification PAU to assess risk and detection of identified suicide attempts and deaths from intake through 120 days and 13 months after jail release. The funding timeline for this project is August 1, 2022, through July 31, 2025. The algorithm’s predictions and actual event incidence will be linked and validated in the spring of 2025, with results ready for publication in the fall of 2025.
ConclusionsThe study will also investigate implementation factors, such as feasibility, acceptability, and appropriateness, to optimize jail uptake. Interview data on the implementation factors will be gathered in the summer of 2025, with expected dissemination in 2026. We hypothesize that a combination of intake screening PAU and the ML model will be the optimal approach, in that the combination will be more accurate and can have practical application in this context.
International Registered Report Identifier (IRRID)DERR1-10.2196/68517 |
| format | Article |
| id | doaj-art-e580b9a7bac946ab9e56df7f3f83cdf5 |
| institution | OA Journals |
| issn | 1929-0748 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Research Protocols |
| spelling | doaj-art-e580b9a7bac946ab9e56df7f3f83cdf52025-08-20T02:21:57ZengJMIR PublicationsJMIR Research Protocols1929-07482025-06-0114e6851710.2196/68517Suicide Risk Screening in Jails: Protocol for a Pilot Study Leveraging the Mental Health Research Network Algorithm and Health Care DataErin B Comartinhttps://orcid.org/0000-0002-4132-7670Grant Victorhttps://orcid.org/0000-0003-1654-5294Athena Kheibarihttps://orcid.org/0000-0002-1084-0738Brian K Ahmedanihttps://orcid.org/0000-0003-4291-4516Bethany Hedden-Claytonhttps://orcid.org/0000-0003-4734-7506Richard N Joneshttps://orcid.org/0000-0002-1049-218XTed R Millerhttps://orcid.org/0000-0002-0958-2639Jennifer E Johnsonhttps://orcid.org/0000-0003-2540-7213Lauren M Weinstockhttps://orcid.org/0000-0001-9970-235XSheryl Kubiakhttps://orcid.org/0009-0002-9142-5882 BackgroundSuicide in local jails occurs at a higher rate than in the general population, requiring improvements to risk screening methods. Current suicide risk screening practices in jails are insufficient: They are commonly not conducted using validated screening instruments, not collected by clinically trained professionals, and unlikely to capture honest responses due to the chaotic nature of booking areas. Therefore, new technologies could improve such practices. Several studies have indicated that machine learning (ML) models considerably improve accuracy and have positive predictive value in detecting suicide risk compared with practice as usual (PAU). This study will use administrative data and ML modeling to improve suicide risk detection at jail booking. ObjectiveThis study is primarily focused on gathering preliminary information about the feasibility and practicality of using administrative data and ML modeling for suicide risk detection but also incorporates elements of hypothesis testing pertaining to clinical outcomes. MethodsThe study uniquely contributes to our understanding of suicide risk by further validating an existing ML model developed and previously validated by the Mental Health Research Network using Medicaid outpatient health care claims data. This validation uses complete claims data on a sample of approximately 6000 individuals booked into 2 diverse jails in a midwestern state. This model validation uses 313 unique demographic and clinical characteristics from 5 years of historical health care data. It detects suicide risk in jails and postrelease by using merged jail, Medicaid, and vital records data. The study will use jail administrative data for September 1, 2021, through February 28, 2022; Medicaid records data for September 1, 2016, through March 31, 2023; and vital records data for March 1, 2022, through March 31, 2023. ResultsFirst, the algorithm will be validated on the data gathered for the jail sample using the C-statistic and area under the receiver operating characteristic curve. Second, the resulting model will be compared with the jails’ suicide identification PAU to assess risk and detection of identified suicide attempts and deaths from intake through 120 days and 13 months after jail release. The funding timeline for this project is August 1, 2022, through July 31, 2025. The algorithm’s predictions and actual event incidence will be linked and validated in the spring of 2025, with results ready for publication in the fall of 2025. ConclusionsThe study will also investigate implementation factors, such as feasibility, acceptability, and appropriateness, to optimize jail uptake. Interview data on the implementation factors will be gathered in the summer of 2025, with expected dissemination in 2026. We hypothesize that a combination of intake screening PAU and the ML model will be the optimal approach, in that the combination will be more accurate and can have practical application in this context. International Registered Report Identifier (IRRID)DERR1-10.2196/68517https://www.researchprotocols.org/2025/1/e68517 |
| spellingShingle | Erin B Comartin Grant Victor Athena Kheibari Brian K Ahmedani Bethany Hedden-Clayton Richard N Jones Ted R Miller Jennifer E Johnson Lauren M Weinstock Sheryl Kubiak Suicide Risk Screening in Jails: Protocol for a Pilot Study Leveraging the Mental Health Research Network Algorithm and Health Care Data JMIR Research Protocols |
| title | Suicide Risk Screening in Jails: Protocol for a Pilot Study Leveraging the Mental Health Research Network Algorithm and Health Care Data |
| title_full | Suicide Risk Screening in Jails: Protocol for a Pilot Study Leveraging the Mental Health Research Network Algorithm and Health Care Data |
| title_fullStr | Suicide Risk Screening in Jails: Protocol for a Pilot Study Leveraging the Mental Health Research Network Algorithm and Health Care Data |
| title_full_unstemmed | Suicide Risk Screening in Jails: Protocol for a Pilot Study Leveraging the Mental Health Research Network Algorithm and Health Care Data |
| title_short | Suicide Risk Screening in Jails: Protocol for a Pilot Study Leveraging the Mental Health Research Network Algorithm and Health Care Data |
| title_sort | suicide risk screening in jails protocol for a pilot study leveraging the mental health research network algorithm and health care data |
| url | https://www.researchprotocols.org/2025/1/e68517 |
| work_keys_str_mv | AT erinbcomartin suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata AT grantvictor suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata AT athenakheibari suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata AT briankahmedani suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata AT bethanyheddenclayton suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata AT richardnjones suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata AT tedrmiller suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata AT jenniferejohnson suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata AT laurenmweinstock suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata AT sherylkubiak suicideriskscreeninginjailsprotocolforapilotstudyleveragingthementalhealthresearchnetworkalgorithmandhealthcaredata |