July 6, 2022 - Podcast

Episode 285 — Predicting suicidality, and charitable giving in the U.S.

One person dies by suicide every 40 seconds worldwide. That's why IU School of Medicine researchers are working to prevent these tragedies. The researchers recently published findings about the effectiveness of a new suicidality risk assessment tool in the journal Discover Mental Health. Psychiatry Professor Alexander Niculescu says the study shows their tool is highly effective at predicting who is at risk of suicide and what can be done to decrease this risk in a personalized way. The assessment tool was first used four years ago on more than 400 patients in an Indianapolis hospital emergency department. The assessment is a simple 22-item yes/no questionnaire focusing on psycho-social risk factors. It can be taken on paper or in a digital format. Unlike current clinical screenings, the assessment does not ask about suicidal ideation and generates a quantitative risk score. Niculescu says that patients do not always want to answer questions specifically about suicidal ideation because they may be afraid of being hospitalized. Because this tool leaves out those questions, it is easier to deploy in any setting and can be a complementary questionnaire to use with current standard clinical screenings. The researchers found that at a four-year follow-up, the assessment was 80 percent predictive of future suicidality. The predictive ability increased to 90 percent when using artificial intelligence and machine-learning approaches. The study found top risk factors for suicide were feeling useless or not needed, a history of suicidality and social isolation. Niculescu says the results are exciting because many of these risk factors are addressable and correctable. With this tool, researchers can identify and track risk and help health care providers develop a personalized suicidality risk mitigation plan for their patients.

In other news, boosted by a strong year for stocks and swift economic growth, U.S. giving in 2021 totaled a near-record $485 billion. According to the latest annual Giving USA report from the Giving USA Foundation, which was released in partnership with the IU Lilly Family School of Philanthropy at IUPUI, individuals, foundations, estates and corporations gave more to charity in 2021 than before the pandemic. Giving was 0.7% below the inflation-adjusted all-time high of $488 billion in 2020 – when donors responded to the onset of the COVID-19 pandemic, the ensuing recession and an outpouring of concern over racial injustices. Two of the lead researchers on the report are IU's Anna Pruitt and Jon Bergdoll. They found that inflation changed how far each charitable dollar went in 2021. Inflation – the rate at which purchasing power for food, rent and energy costs declines – was higher in 2021 than it has been in recent years. When inflation heats up, charities need more money to keep up with rising costs. Household budgets can also become strained by rising costs of living. But charitable giving doesn’t automatically fall when inflation rates rise. With inflation running at a much faster clip in 2022 than 2021, the researchers are keeping an eye on any effects it may have on giving until rates subside. Pruitt and Bergdoll also found that a significant percentage of giving came from extremely large gifts. According to the report, individual donors gave $327 billion in 2021, or two-thirds of all charitable dollars. Ten gifts of $450 million or more, which totaled $15 billion, accounted for roughly 5% of all individual giving. The researchers also saw that many charities whose 2020 donations declined may have experienced a rebound. Giving to the arts, culture and humanities rose by 22% in 2021 as many museums, theaters, ballet companies and other arts groups resumed in-person events and found ways to continue to make use of hybrid events. That growth marked a sharp reversal from 2020, when those gifts fell 7%. Similarly, gifts related to health, a category that includes donations to hospitals, grew 2.9% in 2021 after a 6.9% decline a year earlier. Overall, giving in 2021 stayed well above pre-pandemic levels. The total donated was at least 5% higher than in 2019 for seven of the nine categories tracked by the report.