It’s ‘Complicated’: Jamie Zelazny on Technology’s Role in Youth Suicide Prevention

As an assistant professor of nursing and psychiatry at the University of Pittsburgh, Jamie Zelazny has devoted her research to one overarching question: How can technology help identify and manage suicidal thoughts and behavior in youth?

New technologies—from ever-evolving social media platforms to artificial intelligence (AI) chatbots—carry risks and opportunities in the fight against suicide, the second leading cause of death among individuals between the ages of 10 and 24 in the United States, according to 2023 Centers for Disease Control and Prevention data. Zelazny tackles this issue from multiple angles, studying factors that can affect suicide risk and developing technological interventions that can help at-risk youth.

She has also raised awareness about mental health at Pitt and beyond. In May, she spoke at the Higher Education Suicide Prevention Coalition Conference—hosted at Pitt this year—about engaging university students in suicide prevention efforts. She is an active volunteer with the American Foundation for Suicide Prevention (AFSP) and coordinates the organization’s annual Out of the Darkness walks on Pitt’s campus, which raised nearly $30,000 this year.

Her influence also extends to the nursing profession at large. She led the American Psychiatric Nurses Association’s (APNA) efforts to develop a position paper outlining the role that nurses can play in screening, assessing risk and planning treatments for youth at risk of suicide. She has also served in various APNA leadership positions and received the organization’s Award for Excellence in Research and Scholarship in recognition of her impact on suicide prevention.

In a recent conversation with Pitt Nursing, Zelazny discussed her ongoing research, suicide prevention efforts, and the “complicated” links between youth mental health and technology.

What topics are you currently focusing on in your research?

I am the principal investigator or a co-investigator of several studies, including an active grant using mobile sensing to inform a behavioral activation intervention delivered by health coaches to encourage mood-boosting activities in at-risk adolescents, as well as an adaptive intervention for suicide safety planning in adolescents. We recently concluded a study examining social media as a predictor of youth suicide risk, and we are now analyzing that data and working to publish our results.

We also just received news from the AFSP’s research grants program that our team is slated to receive $450,000 for a new study: “Piloting a Next Generation Psychological Autopsy Study Including Digital and Contextual Exposures.” This will be a collaborative study with Johns Hopkins University and Georgia Tech that will explore events leading to death by suicide in children and adolescents. Our goal is to better understand the factors driving the continued high rates of suicide in young people, including evolving risk factors such as social media and AI experiences.

How can social media—and technology more broadly—predict and monitor mental health and suicidal risk in youth?

The relationship between social media and suicide risk is complicated. Social media use is associated with increased risk for suicide in some youth, but it can be protective for others. Problematic social media use is associated with a host of poor mental health problems, sleep disturbance and suicide risk. Digital techniques such as mobile sensing—using technology to passively collect data about human behavior from teens’ cell phones—gather large amounts of information in real-time, providing important insights into patterns and shifts associated with risk. Data analysis from my SMART2 study (Social Media as a Predictor of Proximal Risk in Youth Suicide Attempt) is in process, so we will know more soon.

In recent years, there have been several high-profile cases of youth suicides that are reportedly linked with AI chatbot use. How does AI factor into conversations surrounding the pros and cons of technology and mental health?

This is a very concerning trend and one that we will definitely address in our new psychological autopsy study. The use of AI is exponentially growing, and it is difficult for providers and parents to keep up with the technology. It is so important to ask youth directly about their AI and chatbot use. Teens are especially sensitive to the negative effects of social isolation, and unfortunately, some turn to AI chatbots for that social interaction. There is an urgent need for additional research in this area.

As with social media, research also has the power to use AI to better detect warning signs via suicide risk prediction algorithms that leverage electronic health record data. My colleagues in psychiatry are developing chatbots to aid youth experiencing cybervictimization in real-time. These examples are still experimental but showcase how technology can be harnessed to improve mental health outcomes.

What role can nurses play in helping to combat stigma and monitor and support mental health, particularly in adolescents?

The first step is to simply start the conversation. If we can normalize talking about mental health in the same way we talk about physical health, we can greatly reduce stigma. Nurses should be assessing youth for known risk factors associated with mental health distress and suicidal thoughts and behaviors. Routine screening is so important.

What are some ways that non-medical professionals can support loved ones or children who might be struggling?

As mentioned above, start the conversation. Let them know what you are noticing and that you are there for them and want to hear what they are experiencing. Resources are available—make appropriate referrals and make sure that loved ones know they can always dial the 988 Suicide & Crisis Lifeline for support.