ResearcH
suicide prevention in Military veterans
Much of my research is laser-focused on preventing suicide in veterans. I aim to address underlying causes like loneliness and evaluate interventions harness the support of veterans’ loved ones, all while being mindful of solutions that can be scaled up. Loneliness and social isolation have long been known as “upstream” risk factors but have had received relatively little focus in suicide prevention research. I have identified loneliness as a being closely associated with suicidal ideation and depression among veterans. I have been conducting randomized controlled trials of a brief, video-based suicide prevention training called VA S.A.V.E., which can be provided to friends and family of veterans. And I have adapted Caring Contacts, one of the only psychosocial interventions ever shown to reduce suicide mortality, to include a component of peer support for older veterans who have dropped out of VA care. I have been conducting a multisite, pragmatic trial of this intervention, which will be the first to attempt to determine whether loneliness is a mechanism by which Caring Contacts reduces suicide and/or other causes of mortality.
Hikikomori and social withdrawal across culture
As one way to understand how social relationships impact mental health, my work has examined an extreme variant of social withdrawal called hikikomori. My studies have helped to characterize hikikomori in different international contexts, establish a definition, and develop measurement tools. This work has been widely disseminated by national and international media, established my reputation as an international expert on hikikomori, and inspired interest amongst a new generation of researchers in the nascent field.
If you are interested in the the 25-item Hikikomori Questionnaire (HQ-25), click here to learn more.
USe of social media for mental health outreach and engagement
Within the broader area of mental health aspects of social media use, I have conducted research focusing on the examination of social media platforms as a contemporary vehicle for communication and social connection. My work in this area tries to identify opportunities to harness the positive role of social media while minimizing potential harms, with a specific goal of promoting enhanced mental health treatment engagement. Some of my research has studied whether and how Facebook can be used to reach otherwise hard-to-reach populations such as veterans at risk for suicide. Other studies have examined tendencies toward help-seeking and exchange of social support on social media platforms.
Social Support and Social Isolation in Psychiatric DisordersMy research has helped demonstrate the potent influence of social connection—including social support, loneliness, and social isolation—on the shape and course of major depression. This body of work has used quantitative data from longitudinal observations to demonstrate the beneficial impact of social support as well as the detrimental influence of insufficient social interactions. I have also used a qualitative approach to better understand patient perspectives in hopes of improving communication and treatments. Results have focused, in particular, on major depressive disorder and suicide risk. This work has been highlighted by national media multiple times.
Promoting engagement in healthcare through nudges
I have worked to apply nudge theory and behavioral insights (inspired by behavioral economics) to the development and testing of communication campaigns with the aim of increasing patient engagement in healthcare services. Some of this work has involved harnessing the social media platform Facebook to engage Veterans in health research studies. I am currently engaged in multiple studies in this area, including one project examining content of appointment reminders and another project examining an online training to encourage engagement with healthcare for those at risk of suicide. I have increased the impact of this area of work by focusing on interventions with potential to be highly scalable.
