Injuries/Violence
Leveraging Legal Epidemiology for Suicide Prevention Research: An Interdisciplinary Approach to Systematically Assessing Policy Enactment Across the United States Anne E. Massey* Anne Massey Avery K. Druyon Sandra Roettgering Ali Rowhani-Rahbar
Legal epidemiology offers a standardized set of methods to conduct rigorous policy research, grounded in a public health framework. This approach addresses a historical gap in systematic methods available to directly apply public health science to policy research. We used these methods to identify all state-level policies across the United States related to training occupation groups in suicide prevention—an emerging but understudied strategy to decrease suicide rates. Our research team, including epidemiologists and law students, developed a standardized search protocol for this cross-sectional study. Using the protocol and Westlaw, a legal research database, we searched all 50 states and the District of Columbia for any policies related to suicide prevention training for occupation groups. To add rigor, each jurisdiction (n=51) was searched by two researchers. All polices identified were recorded in standardized templates to collect the citation, title, enacted date, effective date, and legal text for each policy. We met weekly to resolve any divergences in findings between the two researchers. Once data collection was complete, we reviewed all policies to remove any duplicates and collectively determine our final policy set. In total, we identified 823 policies that were effective as of July 1, 2022. There were an average of 10 policies per jurisdiction in our final policy set, with a minimum of one in Michigan and a maximum of 43 in Washington. This national assessment can be used by policy makers, advocacy groups, and researchers. It also generated a robust exposure dataset that can be used: 1) to subsequently evaluate the impact of these policies on suicide outcomes, and 2) by other researchers who want to access or update these data while maintaining consistent methodology across studies. Legal epidemiology can add significant rigor to policy research, has been underutilized in epidemiology, and is an advantageous tool for public health researchers.