Two Reviews Put Common Suicide Prevention Assumptions to the Test

Some ideas about suicide prevention are widely held and rarely questioned. Two new papers led by Center Medical Director Dr. Paul Nestadt look closely at two of them and ask what the evidence actually supports.

Both papers grew out of collaboration with Rob and Terri Bogue of SuicideMyths.org, advocates who became involved in suicide prevention after their son, Alex, died by suicide. Both Bogues are co-authors.

Risk after psychiatric hospitalization

"Suicide Risk Following Psychiatric Hospitalization: A Narrative Review and Conceptual Synthesis" was published in the International Journal of Environmental Research and Public Health (van Gelderen, Marquard, Nasef, Bogue and Nestadt, 2026).

The review examines what is known about risk in the period after someone leaves inpatient psychiatric care, including the possibility that hospitalization itself can carry risks. Among the evidence it discusses: for patients with recent suicidal thoughts or a recent attempt, hospitalization did not reduce the risk of a later attempt after discharge. The takeaway is not that hospital care has no role, but that a hospital stay alone does not resolve risk. What happens after discharge matters.

The limits of universal screening

"Universal Suicide Screening: Myths and Misconceptions" was published in Crisis, Stress, and Human Resilience: An International Journal (Liu, Chen, Lenihan, Olson, Bogue and Nestadt, 2026).

This paper takes a critical look at screening all adults for suicide risk. The authors argue that universal screening "rests on flawed assumptions about prediction, disclosure, and healthcare system capacity." Suicide is rare enough that screening tools predict it poorly; many people do not disclose suicidal thoughts when asked; and health systems often lack the capacity to follow up with everyone who screens positive. The authors call for a more careful, evidence-based approach to identifying and reducing risk.

Why the two papers belong together

Both reviews make the same underlying point: prevention depends on what happens across a system of care, not on a single moment such as an admission or a screening question. Assumptions that feel reassuring can lead systems to invest in steps that do not change outcomes, while gaps elsewhere go unaddressed.

Limits

These are narrative reviews that synthesize existing research rather than new studies. The hospitalization review notes, for example, that the studies it draws on vary widely, which ruled out a formal pooled analysis.

The Center is grateful to the Bogues, and to the trainees and collaborators on both papers, for bringing these questions into the scientific literature.