LEMURS (EXPLORATORY PROJECT): SUMMARY/ABSTRACT Significance: This project is significant in its bold approach to prevent suicide for college-aged individuals,4 for whom suicide is a leading cause of death. Identification, monitoring, and mitigating suicide risk can save lives,5–7 yet only a minority of college students with suicidal ideation receive care.8 This project overcomes barriers to traditional suicide risk screenings: (1) high student health center burden,9 (2) provider discomfort,10,11 (3) infrequent visits, and (4) poor patient recall.9 This project aims to establish the needs, acceptability, usability, and feasibility of our novel screening technology, as well as explore integrating it with suicide risk interventions. Investigators: The project team has extensive research experience with suicidal participants, college samples, microlongitudinal surveys (Project Co-Lead: Dixon-Gordon); health apps, technological development, computational modeling (Project Co-Lead: Rundensteiner); implementation science (Lemon); data analysis (Yang); machine learning (Agu); business development (Dunlap); economics (Singh); and ethics (Nebeker). Innovation: This study extends our team’s pioneering mobile health app Early Mental Health Uncovering (EMU12–16), which uses passively-obtained data streams from students’ smartphones (e.g., GPS, number/type of contacts, etc.) to screen for depression and suicidal ideation.13,14 Leveraging CAPES resources, we will assess an automated smartphone-powered strategy to increase the adoption and effectiveness of suicide risk screening, with resource needs assessment and stakeholder co-development for translation into practice. Approach: This project, Leveraging Early Mental Health Uncovering Risk for Suicide (LEMURS), extends our work on EMU, which uses passively-obtained data from participants’ smartphones to screen for distress and suicide ideation13,14 and extends this to LEMURS which will activate risk alerts in health provider-facing dashboards, and applies implementation science principles for integration and uptake in college health centers. The project has several aims to: (1) understand stakeholder needs and concerns for this technology via interviews with students, clinicians, and staff; (2) co-develop a provider-facing dashboard responsive to student preferences and clinician workflow needs via iterative interviews and prototype evaluations; (3) explore how LEMURS can integrate with suicide risk interventions; and (4) evaluate feasibility/barriers by deploying LEMURS in a college healthcare setting in 40 students (n=20 with high suicide risk) alongside daily surveys evaluating self-reported suicide risk. This project will explore system, clinician, and patient influences on implementation. Environment: UMass Amherst and Worcester Polytechnic Institute (WPI), along with CAPES collaborators, have proven their ability to support this bold study in their success with developing health-enabling technologies (e.g., EMU) and conducting numerous NIH-funded studies in self-injurious behaviors and interventions. Impact: Accelerated translation of LEMURS for suicide risk screening adoption in college health settings has the potential to ease the burden on health systems and reach thousands of at-risk students annually.

LEMURS (EXPLORATORY PROJECT): NARRATIVE See Project Narrative in the Overall component.