A UCLA-led study published in April found that current national reporting underestimates the presence of emotional distress, known as “emotional dysregulation,” before suicides in the United States.
Researchers said that signs of significant emotional distress may be present in up to 90% of suicide cases, but are often missed by existing methods. The team used large language models to analyze emergency response and law enforcement reports, identifying patterns not captured by traditional clinical diagnoses. They suggest these tools could help prevent future suicides through earlier intervention.
“Suicide is a major contributor to early mortality, particularly among those 15 to 45 years of age; it is the second leading cause of death for men and fourth for women in the United States,” said Vickie Mays, clinical psychologist and UCLA professor. “Yet estimates drawn from the nation’s major tracking source for violent death suggest that perhaps less than half of suicide victims have a mental health disorder at the time of their death, and less than a third are described as being known to have been depressed before they commit suicide.”
The peer-reviewed study appears in JAMA Network and analyzed data from over 72,000 suicides using records from the National Violent Death Reporting System. Susan Cochran, co-author and psychologist with UCLA Fielding School of Public Health, said: “We used a large language model to detect emotional dysregulation among people who die by suicide… current methods… are undercounting the problem because they rely on people having diagnosed mental health disorders, and these disorders are very much undertreated.” Bruce Cuthbert added: “What we found is that using the RDoC framework provided better information than focusing on clinical diagnosis alone. The approach used here observed more dysfunction among suicide decedents than that captured by the currently employed NVDRS measures of mental health.”
The research identified risk factors including being male (80% of deaths), non-Hispanic white (79%), middle-aged (average age 46), lack of partnership (58%), living in southern states (32%), or military veteran status among men (19%). Evidence showed only 44% had any mental disorder recorded; problematic alcohol or drug use was noted in 27%, while just 28% were classified as depressed at time of death.
Alina Arseniev-Koehler said: “Females are more likely than males to have a mental health problem, and males are more likely to have an alcohol and/or drug use problem… females were no more likely than males to be depressed according to NVDRS coding… which overall reinforces the concept that mental health diagnoses alone don’t bring out the full picture.” Mays concluded: “This is a research project… We’d like to grow this into a pilot project focused on high-risk populations, to see if these methods can be used to prevent someone from doing harm to themselves.”
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