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NIH grant 1R01CE003866-01: Preventing Suicide Among Adolescents Who Use Substances: How School Responses to Substance Use Incidents Influence Suicide Risk
Institute: {'code': 'CE', 'abbreviation': 'NCIPC', 'name': 'National Center for Injury Prevention and Control', 'admin_org_id': '12501083', 'admin_funding_url': ''}. PI: Mohammad S. Jalali. Award: $399920.
Start: 2026-09-30T00:00:00.
Project Summary/Abstract
Adolescents who use substances represent a large population disproportionately burdened by suicide risk and
one that can be reached through targeted prevention efforts. When substance use incidents come to the
attention of schools, particularly those involving commonly used substances such as alcohol, cannabis, and
nicotine, they create an immediate opportunity for suicide prevention by bringing high-risk students into contact
with trusted adults and support services. However, to date, most schools have relied on exclusionary discipline
to respond to substance use infractions, disconnecting at-risk students from learning and support. Recognition
of the limitations and potential harms of exclusionary discipline has prompted schools, districts, and states to
increasingly adopt restorative, diversionary, and health-centered alternatives. Yet schools vary in how they
respond to substance use incidents, and little is known about which approaches are associated with lower
suicide risk, through what mechanisms, or under what conditions they can be implemented.
This project will generate evidence on whether and how school responses to substance use incidents can help
reduce suicide risk among students who use substances, focusing on suicidal ideation, planning, and attempts.
By reaching high-risk students when substance use incidents come to the attention of schools, approaches
associated with lower suicide risk could be translated into policy and practice at scale. Leveraging longstanding
partnerships with school districts and state agencies in Massachusetts, we will integrate school policy reviews,
survey data, and stakeholder interviews. With major variation in school responses to substance use incidents,
the state provides an ideal setting. Our statewide network provides access to longitudinal data from 104 middle
and high schools on suicide risk, mental health, substance use, help-seeking, disciplinary experiences, and
school connectedness, creating a resource rarely available at this scale.
Aim 1 will develop the School Response Systems framework and associated measures to systematically
characterize variation in school responses to student substance use incidents, providing the foundation for
evaluating the effects of school responses on suicide outcomes. Aim 2 will estimate the effects of school
responses on suicide outcomes among adolescents who use substances, with exploratory analyses of
pathways involving school connectedness, substance use, mental health symptoms, and help-seeking. Aim 3
will use stakeholder interviews and systems science methods to identify organizational, resource, and
contextual conditions that shape school responses to substance use incidents.
The team spans three centers with expertise in suicide prevention, substance use, causal inference, and
systems science. The study design maximizes relevance and feasibility through partnerships with schools and
policymakers. By identifying responses associated with lower suicide risk and conditions supporting
implementation, the study will generate evidence for schools, districts, and state agencies nationwide.document fetched 2026-10-14 02:50