Dr. Tucker Looks at “Nudges” to Aid in Suicide Prevention

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Dr. Raymond Tucker is again at the forefront of new research for suicide prevention. Last month he and collaborators authored “A Nudge in a New Direction: Integrating Behavioral Economic Strategies Into Suicide Prevention Work,” published in Clinical Psychological Science.

Dr. Tucker is Assistant Professor of Psychology, Louisiana State University (LSU), and Clinical Assistant Professor of Psychiatry, Louisiana State University Health Sciences Center /Our Lady of the Lake.

In the “Nudge” research, Tucker and co-authors looked at how behavioral economic strategies––using psychological phenomena to improve decision-making–– could improve efforts in suicide prevention. The strategies included nudges where social norms are tweaked, slight changes in question framing are applied, and adjusting item counts, are used to gently shape individual’s decision toward positive outcomes.

“Our research demonstrated that simply, how we advertise online suicide prevention materials can increase public awareness about suicide,” Dr. Tucker said. “College students asked to interact with an online suicide prevention program to help their loved ones cope with suicidal thoughts were 167% more likely to use the resource compared to those asked to click on the resource to help themselves navigate thoughts of suicide they may have in the future.”

“Although this change in wording may seem small, the theory of messaging resources this way is backed by work in behavioral economics and nudge messaging,” Tucker explained. “Specifically, most adults show an ‘optimism bias’ or a belief that negative things are less likely to happen to themselves in the future compared to others. Thus, a ‘nudge’ or change in wording to market mental health materials as helping others, not oneself, can help offset the optimism bias.”

Dr. Tucker’s research broadly focuses on the enhancement of theoretical models of suicide and suicide risk assessment tools, and he has published over 50 peer reviewed academic publications regarding suicide risk and resilience. He is a former member of the board of directors of the American Association of Suicidology and is a consulting editor for the academic journals Suicide and Life-Threatening Behavior and Archives of Suicide Research.

“As suicide prevention continues to extend outside of the therapy office to include public health approaches,” he said, “such as reducing access to lethal means such as firearms, the way suicide prevention resources are communicated to the public will benefit from lessons learned from decades of behavioral economics research.”

Tucker also serves as a consultant for Collaborative Assessment and Management of Suicidality (CAMS) Care and provides trainings in the evidencebased suicide prevention framework to behavioral health providers across the country. He was named the Outstanding Psychology Trainee throughout the VA healthcare system by Division 18 of the American Psychological Association.

What does he think are the most important issues in suicide prevention that psychologists should know about? Two stand out for him.

“There is an evidence base for providing suicide specific care,” he said, compared to treatment as usual where a practitioner treats mental health concerns while managing suicide risk. He explained that just recently a large review and metaanalysis, the Collaborative Assessment and Management of Suicidality or Cognitive Behavioral Therapy for Suicide Prevention,
compared treatment as usual to specific care.

“This meta-analysis demonstrated that these suicide-specific interventions, ones that few are trained on, enhance protection against suicidal thoughts and behaviors above standard psychotherapy for mental health concerns. Thus, suicide-specific care may help prevent suicide in patient populations.”

“The second point that stands out is that we are not likely to make meaningful changes in the countries suicide rate by providing better mental healthcare,” he said. “Suicide has increased by 30% since 1999 and over this time, research has clearly indicated that suicide is not just a manifestation of an untreated mental health disorder. Access to firearms, social and economic inequality, and even a state’s minimum wage systematically relates to suicide death at the state level. Scholars in suicide prevention argue that adequate mental healthcare is part of, but not the only piece of, reducing the alarming increase in suicide in the U.S.”

At LSU Dr. Tucker leads the Mitigation of Suicidal Behavior (MOSB) laboratory, where he and his students conduct research to guide suicide prevention efforts. “The MOSB lab is a community-based research program that uses research to enhance theoretical models of why people die by suicide as well as interventions and assessment methods based on these models. The MOSB lab is part of suicide prevention efforts on LSU’s campus as well as the department of psychiatry at Our Lady of the Lake.

“We also are involved in the National Suicidology Training Center (NSTC) housed at Baton Rouge the Crisis Intervention Center to improve healthcare provider training in suicide prevention. Across these partnerships, the lab has tested militaryspecific risk factors for suicide in Army soldiers and Veterans, how people’s stories about surviving a suicide attempt may increase help-seeking for mental health concerns, and how the Collaborative Assessment and Management of Suicidality can be used in medical settings to enhance suicide risk assessment and treatment.

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