Dr. Goldman-Mellor brings a public health perspective to the study of psychological disorder and suicidal behavior. Her work encompasses four primary areas:
- Emergency departments as a context for behavioral health surveillance and risk assessment. Emergency departments (EDs) are a common treatment setting for behavioral health and injury-related problems, but are under-utilized as sites for intervention and risk assessment. Much of my work in this area uses population-based ED data from California to identify risk factors for suicidal behavior and drug overdose, and to inform public mental health surveillance efforts. Findings from Dr. Goldman-Mellor's work show that suicide, poisoning, and natural-cause mortality rates among ED patients seen for mental and substance use problems are up to 100 times higher compared to the general population, underscoring their need for ED-based interventions and mortality surveillance. She has also identified multiple novel risk factors – observable in routine ED settings – for deliberate self-harm and suicidal behavior, and collaborated with mathematicians to use machine learning causal inference methods to assess how hospitalization after deliberate self-harm affects suicide risk.
- Social and economic determinants of mental health outcomes. Social adversity is thought to be a potent risk factor for incident mental disorder, but methodological challenges (e.g., potential for reverse causation and selection bias, problems with drawing inference at the individual vs. population levels) have plagued this field. Dr. Goldman-Mellor's empirical work in this area includes several studies using linked census data, crime data, and population-representative survey data to examine whether exposure to neighborhood-level violent crime and rurality are related to mental health. She has also published several systematic reviews of the association between economic adversity and individual- and population-level risk of depression, anxiety, and suicidal behavior.
- Maternal morbidity and mortality due to mental health problems, drug use, and violence. Reducing maternal morbidity and mortality is a clinical and public health priority in the United States, and deaths due to drugs, suicide, and homicide are increasingly common among pregnant women and new mothers. Dr. Goldman-Mellor's work in this area has examined incidence of and inequities in pregnancy-associated mortality from these causes, and she is currently working on a new project examining risk factors for these devastating outcomes. She has also collaborated on studies examining the impact of the Affordable Care Act on perinatal mental health.
- Long-term outcomes of nonfatal suicidal behavior. Rates of suicidal behavior have risen dramatically in the US over the past 15 years. Understanding health and social outcomes among individuals engaging in suicidal behavior is important for public health prevention efforts, but their prognosis remains poorly understood. Dr. Goldman-Mellor's work in this area includes a seminal study examining long-term adverse physical health, socioeconomic, and violence-related sequelae associated with suicide attempt among a cohort of young New Zealanders. Her more recent work showed that deliberate self-harm is also associated with markedly excess mortality, healthcare utilization, and healthcare costs among adolescent and adult emergency department patients from the US.
You can find links to her recent publications on these topics on the Publications page.