Researcher Q&A: Suicide Trends and Prevention in New Orleans

A RAND Gulf States study team is working with local partners to understand the reasons behind the increased suicide rates in New Orleans. In 2014 (the last year for which data is provided), there were 50 reported suicides in New Orleans. In 2013, the number was only half that.

Although this study is based in New Orleans, it aims to provide insight that can help address the prevalence of suicide all across the country. Through "psychological autopsies," RAND experts will better understand why some people choose suicide and what individuals and communities can do to help prevent it.

Below, Rajeev Ramchand, the principal investigator of this study, discusses more about the project and its early findings.

Can you tell us how this project came about?

I have been studying suicide since 2008. I took a three-day course in conducting psychological autopsies, sponsored by the American Association of Suicidology, and was interested in the role that firearms and firearm storage practices play in suicide. The director of the RAND Gulf States Policy Institute knew of my interest and told me about Dr. Rouse, the newly elected coroner for Orleans Parish. Dr. Rouse and I met; I was really impressed with his commitment to public health, and he was really open to our idea to conduct this type of study in New Orleans.

Why is RAND funding this study specifically?

Since 1996, research on firearms has been sparse in the United States, due largely to an essential moratorium on funding for this type of research. This is also a time period characterized by increases in suicides. Twice in 2013, the president announced executive actions to reduce gun violence, including more research on ways such violence can be prevented. Federal agencies are only slowly beginning to fund this work. By funding this work in New Orleans, RAND is helping to fill this gap.

What are the primary goals of this project?

Our primary objective is to better understand the epidemiology of suicide in New Orleans. We hope that, from this information, we can identify potential policies or practices that might minimize the risk of future suicides. This might include recommending better coordination of mental health care across parish agencies or media campaigns or policies that address firearm access and storage.

What is it like as a researcher to interview surviving families?

Talking to loss survivors is one of the most rewarding and critical activities in this research. We learned so much from them, and they often appreciate that their experience can be used to help prevent future suicide deaths. That said, because I am based in Washington, D.C., Enchanté Franklin is the lead interviewer. We're so lucky to have found Enchanté and have her as part of the team.

Do you have any preliminary findings that you can share?

We’re still working through the analysis. One of the things we learned initially is that we tried to reach out to loss survivors too soon—within six weeks of the death. This is what experts told us to do so that people would have really good memories about the person who died, but we had no luck recruiting them. We think that it was too early on in most peoples' grieving process to actually be interviewed. When we started inviting people who lost someone to suicide a year earlier, we had many more people who were interested. We found out that there is a timeline to grieving that really effects people’s ability or desire to talk about their loss.

Partnerships between RAND and other organizations are critical to this project. Can you tell us who is participating and explain their importance?

The ultimate partner is the Orleans Parish coroner's office, which has been awesome to work with. They understand our objectives and have been so willing to accommodate RAND staff when we need to have meetings, review files, or anything else. They are integral to our efforts. I also had meetings early on with people from the Louisiana Public Health Institute, who offered suggestions for recruiting interviewers and other ideas about doing work in New Orleans.

Why is this work important for the New Orleans region? Will the findings have implications for other places in the United States?

We envision a report geared specifically to the residents of New Orleans. During the past two years of visiting the city for this work, I have really fallen in love with it. I am even more committed that the work has direct relevance to the city. I want to tell the story of suicide in New Orleans but offer hope that we can work together—researchers, government, and advocates alike—to prevent these deaths.

By demonstrating our ability to conduct this research in Orleans Parish, we hope to generate future funding from external sources to expand this research to other parishes and counties, both within Louisiana and the other Gulf States to other areas of the country. I'd like to specifically adapt this study to the Mountain West, which suffers some of the highest rates of suicide in the United States.

How does this work relate to the work you've done on veteran suicide and other suicide-focused studies by RAND?

I have done lots of studies on military and veteran suicide and am now even conducting a study on suicide among law enforcement personnel. I continue to evolve and learn from each of these efforts and hope that I bring new knowledge with me to each project. But what I like most about this project is the personal touch. I have so much respect for the people we are interviewing—that they are willing to talk to us for up to two hours about such huge events in their lives. I learn so much from the stories they tell us, and adding that human dimension to the work is really moving and rewarding. It also keeps me passionate about pursuing work in this area well into the future.