Before the Crisis: Reimagining Suicide Prevention | 25th Annual Bennett Lecture in Prevention Science

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Suicide prevention efforts in the United States and worldwide have focused largely on individual risk and on healthcare settings, yet suicide rates have not declined. Approximately 60% of youth who die by suicide never see a mental health professional, and most suicidal people will never receive an evidence-based practice. Healthcare settings are essential, but a public health approach is urgently needed to reach people where they are: in schools, workplaces, and communities, and on social media and AI chatbots. It must also close the global gap between what we know works and what is actually put into practice.

This lecture makes the case for greater emphasis on “upstream” strategies that shift the whole population’s risk downward rather than only treating people in crisis. It will review evidence that childhood programs targeting aggression, impulsivity, and behavior problems, including the Good Behavior Game, Seattle Social Development Project, Fast Track, and Family Check-Up, also reduce later suicidal behavior, and that some offer very high returns on investment (Washington State Institute for Public Policy estimates of roughly $64 and $226 per dollar for the Good Behavior Game and Family Check-Up). A harmonized analysis of five early-intervention trials found a 42% reduction in the odds of suicide attempts among male students and no clear effect among female students, underscoring the need to understand who benefits and why.

The lecture will also address the policy and data infrastructure that population-level prevention depends on, including lethal means safety policies such as extreme risk protection orders and child access prevention laws, and data linkage to strengthen surveillance and research. It will close with implications for researchers, health officials, and policymakers seeking to move prevention evidence into action.

About the Speaker

Dr. Holly Wilcox is a Professor in the Department of Mental Health and the director and founder of the Center for Suicide Prevention at the Johns Hopkins Bloomberg School of Public Health. She holds joint appointments in the Department of Health Policy and Management, as well as at the Johns Hopkins Schools of Medicine and Education. Holly’s research focuses on advancing public health approaches to suicide prevention, including policies, early intervention, and chain-of-care approaches. Holly is the past President of the International Academy of Suicide Research (IASR), chair of the Scientific Council and a member of the Board of Directors of the American Foundation for Suicide Prevention (AFSP), a suicide prevention consultant for the World Health Organization, and an Affiliate Investigator at the Centre for Research Excellence in Suicide Prevention at the Black Dog Institute in Australia.

Dr. Wilcox has a focus on population-based research on preventing suicidal behaviors. Her work evaluates the impact of community-based universal prevention programs targeting suicidal behaviors and leverages data linkage strategies to inform effective suicide prevention. Dr. Wilcox’s research extends to diverse settings, including schools, universities, social media platforms, and emergency departments. She has won the Johns Hopkins Advising, Mentoring, and Teaching Recognition Award three times.

Throughout her career, Dr. Wilcox has been an advocate for a public health-oriented suicide prevention agenda, collaborating with national and international organizations such as the National Institutes of Health, World Health Organization/UNICEF, and Pan American Health Organization. She has secured competitive research grants from various agencies and has published over 190 research articles.

Dr. Wilcox has worked to adapt and implement school-based interventions in the United States and make research findings accessible to people working in various roles in the community including mental health professionals and suicide bereaved individuals. Her major research interests include population-based prospective studies of suicidal behaviors, effectiveness studies of prevention programs, data linkage for suicide prevention, and intergenerational studies of suicide risk.

About the Bennett Lecture

The Bennett Lecture in Prevention Science is an annual fall event to honor worldwide leaders in prevention research. The lecture includes a week of activities with the most prominent scholars in the field. The featured speaker also provides a second lecture, co-sponsored with the Child Study Center, on a related topic. The Lectureship was created through an endowment, established in 1999 by Edna Bennett Pierce ’53 HEc, which also provides a comprehensive portfolio of enhancements to the Center.