First-of-Its-Kind Surveillance System for Suicide Prevention

If you can’t measure it, you can’t prevent it. That’s the premise Melissa Young, MA, PsyD, a psychologist in Cincinnati Children’s Division of Behavioral Medicine and Clinical Psychology, and her team are working from as they strive to redefine how systems work to prevent suicide in the Greater Cincinnati region.

Within the Mental and Behavioral Health Institute, Young co-leads Zero Suicide, a prevention-based framework developed by the Education Development Center in collaboration with the National Action Alliance for Suicide Prevention. The Zero Suicide framework is built on the belief that every suicide is preventable and takes a system-wide, data-driven approach to strengthening suicide prevention efforts across healthcare institutions.

“Up until now, the data we’ve had access to in this space for non-fatal suicide attempts relies on billing codes that are notoriously unreliable and either over-inflate or under-inflate the scope of the problem—while data on suicide deaths can lag as much as three years behind,” Young says. “There isn’t nuance to the data.”

For example, a mental health emergency department (ED) visit could be for suicidal ideation or a non-fatal suicide attempt, but the current algorithms aggregate the billing codes together.

“By not having the specific information as to what’s occurring at the encounter level, we’re ill-equipping clinicians, and we’re also not able to directly target communities where there are increasing rates of non-fatal suicide attempts and deaths by suicide,” Young says.

An Opportunity To “Move the Needle”

To combat the problem, Young and her team worked with county coroner offices to obtain records of youth and young adults who died by suicide in the past 20 years. Now, they’re collaborating with county coroner offices and public health offices to launch a first-of-its-kind regional suicide surveillance system, with the goal of integrating social and policy drivers of well-being—such as economic inequality, healthcare access, discrimination and housing instability—at the individual and community levels.

“We want to capture data from unstructured notes in the medical record to define a population that’s never been defined before at a very nuanced level,” Young says. “Eventually, we hope to be able to drill down to certain ZIP codes and partner with local health offices on how to inform public health responses to increasing rates of non-fatal attempts and deaths in communities.”

As Young puts it, the goal is to basically flip the script on how to approach suicide prevention. Instead of starting with screenings and assessments at the individual patient level, Young and her team are attacking the problem at the population level.

“By focusing on screenings, assessments and processes at the individual level, we miss pivotal opportunities to get upstream,” she says. “I think people are starting to realize that the data systems we currently have are insufficient. There’s so much opportunity for growth, but we just need to be able to define what we’re doing.”

Eventually, Young and her team hope other healthcare systems across the country can leverage the surveillance system. “What’s exciting is that the work we’re doing could potentially change the outcomes for youth and young adults in our region, but also move the needle at a population level that is rarely seen in the United States,” she says.

“Most importantly, we just want to save lives,” Young says. “We know that what we’re doing currently isn’t enough, so we’re trying to think outside the box and lean into something innovative that goes against the grain to try to effect change.”

(Published January 2026)

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