An interview with Dr Marisa Marraccini

CW: This post references suicide

The MQ Foundation is very proud to be working with the American Foundation for Suicide Prevention to support the work of new MQ Fellow and researcher Dr. Marisa Marraccini from the University of North Carolina. 

We caught up with Marisa to ask her nine questions about her life and work.

What made you want to work in suicide/mental health research?

I’ve always been amazed by teenagers – especially their strengths as they face such a difficult time in development. They’re navigating the tension between societal and family expectations, with their need for independence; they’re developing more intense relationships with their peers, which are incredibly meaningful and can leave them feeling incredibly vulnerable; meanwhile, their brains and bodies are rapidly developing, making them prone to risky decisions and behaviours. All of this points to the urgency for improving the way we support teen mental health.

Once I began training as a school psychologist, it became really clear to me that we need to do better for our teens struggling with suicide-related crises. Adults can feel unsettled and nervous once a teen reports having suicidal thoughts, and this can lead adults to treat them differently. We may forget that teens having suicidal thoughts are still facing all the same issues as before. And there’s something about this particular tension – that when teens struggle the most, adults may respond poorly or pull away, instead of leaning in holistically to care for students – that really drew me to this issue.

Are there any common misconceptions about suicide?

There are many misconceptions about suicide.

A common one is the false belief that talking to youth about suicide or suicide-related behaviours will increase their likelihood of engaging in suicide-related behaviours. There are experimental studies refuting this. If you are worried about the possibility of someone being at risk for suicide, it’s really important to ask them if they are considering suicide directly. This can be the first step to getting that person help.

On the other hand, communications about a death due to suicide that are over simplified (suggesting only one thing caused a suicide), glamourised, or romanticised can encourage suicidal thoughts and behaviours in youth. It’s easy to get these two issues mixed-up, leaving people afraid to talk about suicide with youth – but it’s really important that we do.

Another misconception is the idea that means restriction (limiting access to means for harm) doesn’t work, and that kids who want to attempt suicide will simply find another way. But actually, means restriction is linked to reductions in suicide, and is a really important approach to take when we are concerned about a teen in crisis.

Why are some groups of young people at higher risk of suicide than others?

There is no single factor that can be attributed to risk for suicide. Rather, there are many converging factors that can lead to a state of hopelessness or despair that may lead to suicide. Although risk for suicide is unique to each individual, youth with shared identities may face some overlapping environmental risk factors. For example, LGBTQIA+ and Black and brown youth may face obstructions to health and mental health care, as well as pervasive discrimination, including homonegativity and racism. Unfortunately, family and parental rejection of LGBTQIA+ youth is common; and, in the United States, Black and brown youth are more likely to receive harsh disciplinary procedures in school. These are examples of some of the stressful experiences youth may have that can confer risk for suicide, which may provide some insight into why certain groups of young people may have heightened risk for suicide.

Why is it important that young people are able to practice coping skills before being discharged from hospital/returning to school?

Practicing coping strategies, before they are needed, is the best way to learn them. This way, when a difficult situation or stressor does arise, it’s easier to use the strategy. Although we need to do more so support youth recovery from mental health crises than simply reinforce their coping strategies (for example, they need ongoing evidence-based interventions, and a supportive, caring and safe environment to return to), helping to teach and reinforce the use of coping strategies is an important component of recovery and health and well-being.

What sparked the idea to use a Virtual reality programme?

This idea came from my research and clinical conversations with teens and school professionals, and my excitement about the potential of immersive virtual reality and its effectiveness for exposure therapy. Our qualitative research was focused on helping improve school reintegration experiences for youth following a psychiatric crisis. In addition to considering how to improve communication between schools, families, and hospitals, we started thinking about how to improve therapeutic interventions during hospitalization. Given how unlike the hospital setting is to real life, the idea of virtual reality practice opportunities for skill learning emerged.

How can we better support young people who are experiencing suicidal thoughts?

Even though they are struggling with suicidal thoughts, remember that they are still kids. This means considering steps to keep them safe, like connecting them to care and, in some cases, restricting their access to means. This also means listening to them, and asking them about what they need and want. Sometimes we can forget how much wisdom and insight young people have, so truly listening can go a long way.

Is there anything you have found in your research that has changed how you look after your own mental health?

As a parent, I can’t help but see my own kids in the data I pour over. My kids aren’t yet adolescents (I have a 6 year-old and a nearly 10 year-old), but I try to talk openly with them about their mental health, reinforce positive coping strategies, and explore issues that may be troubling them. I can’t say I’ve necessarily gotten it right, but hearing from so many teens about what is important to them is steering some of these conversations – and that’s been amazing. Of course, I suspect I’m in for plenty of surprises once they actually step into adolescence.

What does having this MQ Fellowship mean to you?

I am thrilled to have this fellowship. It’s pushing me out of the United States to think more globally, and it’s allowing me to move towards a more creative and human centred approach in this work. It’s incredibly humbling to read about the other awardees who are clearly making a mark on the field. I’m looking forward to learning – both from the other awardees’ research, and the co-designers contributing this project.

What are the big questions you hope that research can one day answer?

How can we improve the quality-of-care young people receive when they experience a mental health crisis? It is my hope that partnering with youth to co-design interventions will result in interventions that are both efficacious and engaging for youth, so they can receive high quality care that is meaningful to them.

How can we increase youth access to mental health care? In the future, I hope to identify and evaluate solutions to the barriers preventing youth from accessing care in their communities – through community-school partnerships and creative strategies, such as social media.

If you are struggling with your mental health and need someone to talk to please reach out to the Samaritans by calling 116 123 or e-mailing [email protected]