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September marks Suicide Prevention Awareness Month; University of Michigan researchers are using new methods that go beyond the numbers to shape understanding and prevention.

Every September, Suicide Prevention Awareness Month asks Americans to talk more openly about a leading cause of death that claims tens of thousands of lives each year in the U.S. At the University of Michigan, that conversation is being reshaped by social scientists whose novel research looks beyond the numbers — into the life transitions, communities and lived experiences behind them.

Briana Mezuk, Lisa Wexler, and Kara Zivin– affiliates of the Research Center for Group Dynamics and the Population Studies Center at the Institute for Social Research (ISR)– are scholars taking distinct approaches– spanning epidemiology, social work, and memoir– to understand suicide in context, using community and personal narrative as essential tools for building better responses and prevent mental health crises.

Reading the Story Behind the Statistic: Briana Mezuk’s Pandemic Study

When COVID-19 upended American life in 2020, public health officials braced for a surge in suicide deaths that did not materialize in the way that many expected. A research team led by Briana Mezuk, professor of epidemiology at the School of Public Health and co-director of the Eisenberg Family Depression Center’s Data and Design Core, wanted to know what the aggregate numbers were missing.

In what is believed to be the first study of its kind, the interdisciplinary research team dug into narrative reports from coroners, medical examiners and police contained in the CDC’s National Violent Death Reporting System, moving beyond counts to read the actual circumstances behind each death.

“To understand the role of the pandemic in these lost lives, we felt it was important to delve into the narratives of these deaths, rather than using numbers alone,” Mezuk said.

The study published in PLOS ONE in 2024 revealed that about 7 percent of suicide deaths in 2020 explicitly referenced some aspect of the pandemic, and those cases were more likely to also have circumstances related to financial strain than deaths unrelated to the pandemic.  Beyond these findings, the study demonstrated the possibility of contextualizing suicide mortality to inform mental health promotion efforts during periods of crisis, and demonstrated the need for “empathetic mental health.”

Lisa Wexler’s Community-Led Model

Nearly 2,500 miles from Ann Arbor, in five remote Alaska Native communities, Lisa Wexler, professor of social work and research professor at ISR’s Research Center for Group Dynamics, has spent decades showing how suicide prevention can move outside of the clinical setting to build resilience in the everyday lives of communities at risk.

A recent study by Wexler and collaborators, published last year in BMC Public Health, and involving nearly 400 participants, found that everyday community members — teachers, coaches, pastors, family and friends — can meaningfully reduce youth suicide risk simply by building on strengths and connection within the community. The study identified three predictors of whether someone takes action to prevent suicide: confidence in promoting wellness, confidence in preventing suicide, and participation in a “community of practice” — a network of people learning together. Those factors predicted real prevention behaviors, from restricting access to lethal means to supporting someone in distress to helping a community heal after a loss.

“If we’re serious about equipping people to reduce the risk of suicide in everyday settings, we need everyone who’s already part of young people’s lives to be involved,” Wexler said. “We need structures where people can learn from each other and build solutions to solve really complicated issues.”

Wexler’s model, called PC CARES (Promoting Community Conversations About Research to End Suicide), grew out her dissertation research in Northwest Alaska and now has a place on the Suicide Prevention Best Practices Registry. Its “learning circles” dedicate time for sharing research in small, digestible pieces so that educators, law enforcement, community leaders, and caregivers can discuss how they can use their learning in their lives. That translational work has recently expanded to new topics, like addressing substance use, and into new places, like Michigan, where Wexler and collaborator Elizabeth Evans have partnered with Tribes and American Indian Health and Family Services to adapt the curriculum for urban and rural  Indigenous communities. 

When the Researcher Becomes the Story: Kara Zivin’s Memoir

Fifteen years before she stood at a podium in Kahn Auditorium to launch her memoir, Kara Zivin was hospitalized less than half a mile away. Her severe perinatal depression culminated in an overdose late in pregnancy, a week-long inpatient psychiatric stay, a preterm birth she does not remember, and postpartum electroconvulsive therapy that erased months of memory.

For decades, Zivin’s lived experiences have driven her agenda as a scholar of public health and psychiatry and expert on maternal mental health. A co-PI with Mezuk on the COVID study, she has also spent her career demonstrating that perinatal mood and anxiety disorders are common, expensive, and inconsistently treated. Her data expose systemic gaps and point to opportunities for policy to support parents– but her personal story has a different power to both convey urgency and ignite hope.

“We need both story and data to achieve meaningful results,” Zivin writes in Persevered: A Maternal Mental Health Memoir (Swallow Press/Ohio University Press, 2026). Storytelling makes a population-level problem visible as something that happens to individual people who could have been helped sooner.

Already a PhD with a string of credentials, Zivin, the Marcia A. Valenstein Collegiate Professorship in Psychiatry, completed an MFA at Vermont College in order to craft the hybrid memoir: A personal narrative interleaved with medical records, journals, interviews, and peer-reviewed literature that is a call to action.

The data behind that call are stark. Perinatal depression is the most underdiagnosed obstetric complication in America, Zivin reports. Depression rates among pregnant and postpartum women range from 5 to 25 percent, reaching 40 to 60 percent in low-income populations, and diagnoses of perinatal mood and anxiety disorders among privately insured Americans rose 93.3 percent between 2008 and 2020. 

The annual U.S. cost of untreated perinatal mood and anxiety disorders is roughly $14 billion — a figure Zivin cites reluctantly, noting that the field is repeatedly asked to justify mental health care on cost-effectiveness grounds in ways rarely demanded of other specialties. She argues we should care because it is the right thing to do. 

“Sometimes I wonder why more people do not scream about this public health crisis,” she writes, “and demand that we do more to help one another.”

That instinct to tell a story beyond what the numbers convey unites the work of ISR researchers recognizing that prevention requires more than surveillance and statistics. 

“It is easy to lose sight of the fact that each person had a story,” says Zivin. “There was a coroner’s report, a police report, a family, and a set of circumstances.” 

Paths forward lie in listening more closely to the histories, relationships and circumstances that underlie personal crises.

As Zivin writes, “Data makes you credible, stories make you memorable.”

This article was written by Tevah Platt, communications manager for the Research Center for Group Dynamics and Population Studies Center at the Institute for Social Research. ISR affiliates Viktoryia Kalesnikava and Sarah Burgard also contributed to the pandemic study, which was previously featured by Michigan News.

Support is available 24/7. The 988 Suicide and Crisis Lifeline can be reached by calling or texting 988. Support for perinatal mental health is available through the National Maternal Mental Health Hotline at 1-833-852-6262.