PLOS Medicine Author Interview: Daiane Machado, PhD

Below, Senior Editor Richard Turner interviews Daiane Machado, PhD, co-author of a research article investigating the association between rates of suicide and the Bolsa Familia cash transfer program in the 100 Million Brazilian Cohort.

Please start off by telling us a little more about yourself – what’s your current role, where are you based, and what led you to a career in research?

I am a research associate at the Center for Data and Knowledge Integration for Health (CIDACS/FIOCRUZ) in Brazil and a research fellow at Harvard Medical School, working with Professors Mauricio Barreto and Vikram Patel, currently based in Boston, United States.

In the past, I have done clinical work as a psychologist and also volunteered at Samaritans, a counselling service, assisting people at risk of suicide in Brazil. I chose to move into research because, beyond treating people already at risk of suicide, I was interested in understanding the contributory factors so as to try to reduce suicide risk.

What are your scientific interests and what led you to investigate suicide in Brazil and the role of the Bolsa Familia cash-transfer program?

My research has been focused on understanding and evaluating the effects of social determinants, poverty relief and mental health (MH) interventions on suicide and MH-related outcomes in Brazil. I have been applying quasi-experimental impact evaluation methods for ‘big data’ on the associated outcomes, to support evidence-based policymaking.

While there is a long tradition of addressing mental illness with clinical treatment, there had been limited evidence on the impact of socioeconomic interventions to reduce the suicide rate and we addressed this gap in our study in PLOS Medicine.

What is the most important take-home message from your study?

The most important message is that targeting social determinants using cash transfer programmes could be important in limiting suicide and this is especially important in the current world scenario, where suicide is predicted to rise with the economic difficulties and anticipated recession consequent to the COVID-19 pandemic and war in Ukraine. 

What are the clinical and global implications of your work?

I think our findings may help to advance the global debate on economic responses to the pandemic, and in times of economic crises more generally. If cash transfers are associated with reduced suicide, they could have a dramatic impact on saving lives.

While poverty is challenging to address and may even be seen as impossible to resolve worldwide, a practical measure (i.e., transferring money) could potentially save lives. If this can be implemented in other low- and middle-income countries, it may be valuable in other parts of the world that have more resources than Brazil. Implementation would depend more on political decisions than financial limitations. 

What’s next? What are the most interesting or exciting developments in your field?

My next step is to investigate the mechanisms that link cash transfers to reduced suicide and decreased hospitalization due to MH disorders. I am currently leading another project, “The impact of social drivers, conditional cash transfers and their mechanisms on mental health of the young: an integrated retrospective and forecasting approach using the 100 million Brazilian Cohort” funded by the US National Institutes of Health, which aims to investigate the link between poverty and cash transfers with suicide and MH outcomes.

I am excited to work on this, since the results of this project will be of vital importance in guiding policies and programs to improve MH and reduce MH-related hospitalizations and suicide in young people. It will provide information with the potential to improve the impact of these programs worldwide.

Also, if a cash transfer program is capable of preventing mental illness and suicide among young people, we should then consider the wider social and economic contexts (such as a person’s economic situation), while also treating MH problems. Therefore, policies should be impacted by the anticipated results, since they could be tailored to cover broader aspects of individuals’ lives (such as their economic situation, in addition to factors such as racial and gender inequalities), instead of exclusively addressing MH issues, in order to prevent mental illness and suicide.

What do you feel are the benefits of publishing with a journal that supports open science practices?

Open access publishing offers several benefits, which include providing greater visibility and achieving greater public engagement, since the content is available to those who cannot access subscription content, increasing citations and usage. It also increases interdisciplinary conversation across multiple disciplines, helps researchers connect more easily and enables them to conduct collaborative research on a global scale. Most importantly, it increases the chances of policymakers gaining access. Reliable information, produced from robust research, should be a fundamental basis for policies.

What do you like to do when you’re not working on your research?

I like to dance: I am Brazilian, and I grew up dancing from a very young age. This is our way of socializing and being happy. I miss this part of my culture while living in Boston. For Brazilians, there is no party without music and people dancing: not professionally, but I am talking about putting music on at gatherings, and you would see kids, grannies, all people, of all ages, dancing. I also love travelling, talking to people, visiting museums, and reading.