The Ontological Crisis in Suicide Prevention: Transcending Epistemological Silence through a Narrative Evidence Model

Current suicide prevention in the U.S. relies on checklist-based assessments that prioritize legal liability over patient experience, resulting in a staggering 0.01% predictive accuracy for suicide mortality. To effectively address the national crisis, the system must shift from these "silencing" clinical tools toward a human-centered model that values personal narrative and subjective distress.

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April 14, 2026

Inquiry-driven, this project may reflect personal views, aiming to enrich problem-related discourse.

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Madison Zeng

2026 Winter Fellow

Madison Zeng (she/her) is an undergraduate at the University of Rochester, studying psychology and public health and exploring how philosophy, behavioral health policy, and health equity intersect. Through her capstone with the Institute for Youth in Policy, Madison developed a federal legislative proposal, the Narrative-Centered Suicide Prevention and Epistemic Justice Act of 2026, which aims to reform suicide risk assessment standards in federally funded healthcare facilities and establish a national pipeline for imminent support personnel in behavioral health settings. She is committed to advancing policy frameworks that restore patients’ epistemic agency and center lived experience as a form of clinical expertise.

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