Coon Lab, Utah Suicide Mortality Research Study

Despite major advances in treatments for mental illnesses thought to be associated with risk, suicide mortality in the U.S. has increased dramatically since the late 1990’s. Over the last two decades, Dr. Coon has worked to establish collaborations and to build a comprehensive research study to bridge this critical knowledge gap, including statewide demographic, genealogical, environmental, and clinical data. Importantly, this resource now also includes the world’s largest resource of biospecimens from suicide decedents, enabling genetic and other biomarker discoveries.

This resource, the Utah Suicide Mortality Research Study (USMRS; https://rge.utah.edu.usmrs.php), now supports a diverse group of collaborative investigators dedicated to improving our understanding of risks leading to suicide through studies of the complex interactions among these comprehensive data elements.

Work funded by the NIH through 2030 focuses on several important topics. First, evidence of suicidal thoughts or behaviors (STBs) are currently the most robust predictors of suicide mortality. But how do we determine risks leading to suicide mortality for individuals where there is no evidence of STBs? Roughly half of suicide deaths fall into this category based on USMRS data and other recent, large, population-based studies. Even for those who exhibit STBs, fewer than 10% go on to die by suicide, posing a challenging problem to determine which individuals may be most at risk. For those with no evidence of STBs, knowledge of risks is currently even more difficult.

USMRS data can begin to approach these difficult questions. Recent findings have shown that suicide decedents without evidence of prior STBs were dramatically clinically different from those with evidence of prior STBs, exhibiting significantly fewer diagnoses across the neuropsychiatric spectrum (https://pubmed.ncbi.nlm.nih.gov/40020535/). Subsequent work showed that these dramatic clinical differences were not attributable to poor access to healthcare. Rather, suicide decedents without prior STBs also showed significantly lower underlying polygenic liabilities to many neuropsychiatric conditions (https://pubmed.ncbi.nlm.nih.gov/40385453, now in press).This work represents a paradigm shift in our assumptions about suicide risk, broadening our scope of risk discovery beyond neuropsychiatric clinical / genetic risks to include other novel risks associated with physical health and increased attention on the important contributions of exposures.

Additional new work will focus on discovery of physiological and mechanistic aspects leading to risk of suicide mortality. Other NIH funding anticipated to start in early 2026 will use a strategy of analyzing homogeneous subtypes, including unique Utah genealogical data that allows ascertainment of extended families at high risk of suicide death where familial transmission of genetic variation leading to risk can follow the successful design of prior work in Utah that has led to genetic discoveries for cancer and heart diseases. Other subtypes will also be studied defined by extreme psychiatric risks, but also by dysregulated physiological stress responses, recognizing our other work that has suggested that risks go beyond neuropsychiatric vulnerabilities.

As part of her deep passion, Dr. Coon will also pursue work to help maintain the USMRS and to ensure its sustainability for future discoveries by many investigators. The USMRS, which is now partially supported by the University of Utah Office of the Vice President for Research, rests on strong, long-term collaborations with the Utah State Office of the Medical Examiner, the Utah Population Database, investigators at Intermountain Health, the University of Utah Clinical and Translational Science Institute, and the University of Utah Office for Research Integrity and Compliance.

Dr. Coon’s interests span other areas of complex disease. Her earlier work focused on neurodiversity, substance use, schizophrenia and bipolar disorder, pulmonary disorders, and cardiovascular disorders. These areas of work continue to influence her perspectives on analytical strategies and on the integration of studies across mental and physical health. She also retains a long-term interest in research ethics and has served for more than two decades on the University of Utah Institutional Review Board