When Jennifer Johnson picked up the phone more than a decade ago, she had not yet moved to Flint, unpacked a box or even accepted a job offer from Michigan State University. What she did have was a research question combined with a willingness to call the Genesee County Sheriff’s Office to see if they could work together.

Warning: This story talks about suicide. If you or someone you know needs help, please call, text, or chat the Suicide and Crisis Lifeline at 988. You matter. You are important.

Johnson, then a professor at Brown University, had spent years studying how to help mental health among people involved in the justice system. She knew local jails were one of the largest and most overlooked points of contact for people at high risk of suicide. What she needed was a partner willing to open the doors. 

At the time, Chris Swanson was undersheriff, second in command at the Genesee County Sheriff’s Office. Johnson called to ask whether he would be interested in collaborating on a study and, almost as an aside, whether he knew where she might live if she moved to Flint. 

“The answer was yes,” Swanson said. “And after that conversation, she accepted Michigan State University’s offer and moved here.” 

Why This Matters

• Research: This randomized clinical trial, led by Michigan State University and Brown University and published in JAMA Network Open, provides the first rigorous evidence that a brief suicide prevention intervention delivered in jail can cut suicides by more than half after release.
• Community partnership: The collaboration among Genesee County Sheriff’s Office, Genesee Health System, and MSU demonstrates how partnerships between law enforcement, clinicians, and researchers can translate science into real-world action.

That call became the foundation of a partnership among the Michigan State University Charles Stewart Mott Department of Public Health, the Genesee County Sheriff’s Office, and Genesee Health System that has now produced nationally significant findings: a brief, jail-based intervention that cut suicide attempts by 55% in the year after people were released from jail. 

The randomized clinical trial, co-led by Johnson and Lauren Weinstock of Brown University, was published in JAMA Network Open, one of the nation’s top medical journals. 

For Swanson, the stakes were personal. 

“I remember my first violent death as an intern at Mott Community College,” he said. “It was a suicide. I was never the same after I saw it.” 

Pictured left to right: Marie Jones, Karena Mitchell, Jennifer Johnson, Sheriff Chris Swanson, and Dan Russell. All five participated in a townhall to discuss a research partnership between Michigan State University, the Genesee County Sheriff's Department, and Genesee Health System on February 9.

Support for People in Crisis 

Each year, about 8 million people pass through local jails in the United States. Most are there briefly as only about 1 in 17 go to prison. The rest return to their communities, often within days. 

What many people do not realize, Johnson said, is how closely jail involvement and suicide risk are connected. 

“One in five of all adult suicides in this country involves someone who spent at least one night in jail in the year before they died,” said Johnson, the Charles Stewart Mott Endowed Professor of Public Health at Michigan State University and founding chair of the MSU College of Human Medicine’s Department of Public Health. “People who end up in jails tend to already be experiencing crises in their lives.” 

Most people in the study were not suicidal because they were incarcerated.  Most had made suicide attempts before entering jail, including in the weeks and days before being arrested.  . 

“People don’t usually end up in jail when everything in their life is going great,” Johnson said. “They’re often already in crisis.” 

That crisis can take many forms, including job loss, substance use, relationship breakdowns, or other trauma, and sometimes leads people to behaviors that are both illegal and life-threatening, such as reckless driving or overdose. Law enforcement officers may not recognize those actions as suicide attempts, Johnson said, but they are often part of the same downward spiral. 

The study enrolled 800 people in Genesee County and Rhode Island who had recently attempted suicide or reported serious suicidal thoughts. Participants were randomly assigned either to receive usual care or a brief intervention known as the Safety Planning Intervention. 

Clinicians from Genesee Health System delivered the intervention inside the jail before release and followed up afterward. 

At its core, the intervention helps people create a written, step-by-step plan for moments of crisis. The plan includes identifying triggers, warning signs, coping strategies, people to contact, and professional resources. 

“It’s like writing the battle plan before you’re in the battle,” Swanson said. 

The results were striking. Participants who received the intervention had 55% fewer suicide attempts in the year after their release compared with those who did not. 

“This was the first randomized trial of suicide prevention in any justice setting,” Johnson said. “And it worked — even better than some people expected.” 

Collaboration Inside and Outside the Jail 

Delivering mental health interventions inside a jail is never simple, said Dan Russell, CEO of Genesee Health System. The project required careful coordination, additional staff time, and close adherence to jail protocols. 

“Our role was providing the clinical therapists who actually did the interventions,” Russell said. “There were a lot of moving pieces, and our staff took this on in addition to their regular work.” 

For Russell, the collaboration itself was one of the study’s most important lessons. 

“Getting an academic institution, a community mental health provider, and a law enforcement agency to work together on anything is a major accomplishment,” Russell said. “The fact that we worked so well together speaks to why partnerships like this matter.” 

Russell said Genesee Health System believed the intervention would help, but even he was surprised by the magnitude of the results. 

“We anticipated positive outcomes because we believe in treatment,” he said. “But I don’t think we were expecting them to be as positive as they were. It shows the treatment works and should be a blueprint going forward.” 

Johnson said the rigor of the study, including a yearlong follow-up and extensive safety protocols, was key to its acceptance by JAMA Network Open. 

“That level of publication means the research underwent intense scrutiny by experts across the country,” she said. “It means the evidence is solid.” 

If the approach were implemented nationwide, Johnson estimates it could save thousands of lives each year. 

“About 50,000 people die by suicide annually in the U.S.,” she said. “If one-fifth of them passed through jail and we cut attempts by 55%, that’s roughly 5,500 lives saved every year.” 

For Swanson, the numbers reinforce what he has seen firsthand. 

“This is a story of redemption and optimism,” Swanson said. “We gave people hope. We gave them a pathway.” 

The partners shared their findings with the community during a public town hall on February 9 at the MSU Department of Public Health. Representatives from MSU, the Genesee County Sheriff’s Office, and Genesee Health System participated and Karena Mitchell, who received the intervention, shared her story. Johnson hopes the conversation encourages other communities to see jails not just as places of detention, but as opportunities for prevention. 

“Suicide is often an impulsive but permanent decision,” she said. “Small, human interventions at the right moment can make a life-or-death difference.” 

February 9, 2026