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Suicide Prevention

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And how action is taken to reduce the possibility of suicide by referring the ... Active, mobilized reserves (RC) soldiers, deployed civilians and their families ... – PowerPoint PPT presentation

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Title: Suicide Prevention


1
Suicide Prevention
  • CH (MAJ) Kenneth Williams

2
Terminal Learning Objective
  • ACTION Identify elements of a unit suicide
    prevention program, to include warning signs
    precipitating events emotional disturbances and
    methods for addressing.
  •  Conditions In a classroom
  •  Standard Understand the seven step procedure is
    used to identify whether a soldier needs to be
    referred for professional help or not. And how
    action is taken to reduce the possibility of
    suicide by referring the individual to
    professional help.

3
Administrative Data
Safety Considerations None Risk Assessment
Level Low Environmental Considerations
None Evaluation Foundations Exam
4
Primary References
  • AR 600-63, Army Health Promotion Program
  • DA Pam 600-24, Suicide Prevention and
    Psychological Autopsy
  • DA Pam 600-70, United States Army Guide to
    the Prevention of Suicide and
    Self-Destructive Behavior

5
References, cont.
  • American Association of Suicidology
    (http//www.suicidology.org)
  • U.S. National Objectives in the area of suicide
    prevention (http//www.mentalhealth.
    org/suicideprevention/)
  • American Foundation for Suicide Prevention
    (http//www.afsp.org)

6
Can Suicide be Prevented?
  • CHALLENGES Soldiers who complete suicide
  • Rarely seek help through the chain of command,
    Chaplaincy or Behavioral Health
    (lt 1/5 of all completed
    suicides have seen BH).
  • Often dont show classic warning signs of
    suicide in the unit.
  • Frequently choose very lethal means and act
    privately, precluding rescue.

7
Army Active Duty Suicides (Includes USAR /ARNG)
Completed Suicides
Calendar Years
8
Army Suicide Rates(AC Only)
U.S. Adjusted Rate 19.8
Rates per 100k
Calendar Years
9
CY 03 Suicides Rates(Rank - AC Only)
AC Rate
10
CY 03 Suicides Rates(Age - AC Only)
AC Rate
11
CY 03 AD Suicides (Gender)
In US - 80 of all suicides committed by
males (Official 2001 data provided by AAS)
12
CY 03 AD Suicides (Race)

In US 90 of all suicides were white (Official
2001 data provided by AAS)
African
White American Hispanic Other Confirmed
50 9 6 6 Army
Rates 13.7 5.9 10.2 US
Rates 11.9 5.3 5.0
13
CY 03 Suicides Rates(MOS - AC Only)
AC Rate
14
Army U.S. Monthly Suicide Comparison
15
Suicide is a symptom, not a disorder
gt 90 of people who complete suicide have
depression or another diagnosable mental or
substance abuse disorder.
16
Suicide Analysis
  • Youth Suicides
  • Tend to be impulsive
  • Poor life coping skills
  • Substance abuse
  • Middle Age Suicides
  • Usually premeditated
  • Facing major transition
  • Relationship failure
  • Alcohol dependence
  • Major depression
  • Training just on recognizing warning signs
    doesnt target younger cohort who tend to be more
    impulsive
  • Need specialists trained in risk estimation
    skills readily available to advise the commander
    and to initiate the intervention process

17
Suicide Strategies
Developing Life Coping Skills - Behavioral
Development - Mentors
  • Youth Suicides
  • Tend to be impulsive
  • Poor life coping skills
  • Substance abuse
  • Middle Age Suicides
  • Premeditated
  • Facing major transition
  • Relationship failure
  • Alcohol dependence
  • Major depression

Encouraging Help- seeking Behavior - Stigma
Reduction - Confidentiality
18
Understanding Dysfunctional Health-Risk Behaviors
Visible to Command
Behaviors
NOT Visible to Command
Stressors
Current Environment
Developmental History
Genetic Vulnerability to Psychiatric Illness
The best predictor of future behavior is past
behavior.
19
Consider our Inputs
  • approx. 40 self-report having been raised in
    homes where they were physically /or sexually
    abused /or neglected
  • gt 40 come from non-traditional homes without 2
    consistent parenting figures
  • gt 20 of HS students had seriously considered
    attempting suicide during a 12 month period
  • 8 of HS students reported making a suicide
    attempt in the preceding 12 month period

data from Naval Health Research
Center-Report 95-26 Pre-enlistment Maltreatment
Histories of US Navy Basic Trainees Prevalence
of Abusive Behavior data from Zill
Robinson, The Generation X, American
Demographics, April 1995, pp. 24-33 data from
Centers for Disease Control(CDC) Youth Risk
Behavior Surveillance 2000 data from National
Strategy for Suicide Prevention, US Public Health
Surgeon General, May 2001
20
Psychological Reasons for Suicide
  • Death as retaliatory abandonment
  • Killing self to get back at person who
    abandoned you.
  • Death as self-punishment
  • Torturing/Killing self to atone for guilt/shame.

21
Potential Triggers
Based upon psychological autopsies
22
DoD Survey of Health Related Behavior
Stigma
Army Perceived
Need for Mental Health Counseling 17.8 Rec
eipt of Mental Health Counseling from military
Mental Health Professional 5.6 Perceived
Damage to Career Definitely Will 17.7
May or May Not 58.1 Definitely Will
Not 24.2
1996 Data
23
Commanders/1SGs CSMs
  • Conduct OPDs and NCOPDs that focus on some
    aspect of mental health
  • Watch out for the first-line supervisors
  • Promote life-coping skills development
    help-seeking behaviors
  • Develop well-defined procedures for storing
    P.O.W.s
  • Promote use of Army One-Source
  • Ensure your UMT members other designated
    trusted agents are ASIST qualified

24
Army One Source
  • Assistance and information live 24/7 x 365, via a
    toll free number and Internet access
  • Active, mobilized reserves (RC) soldiers,
    deployed civilians and their families worldwide
    are eligible
  • Specialized teams conduct customized research to
    answer all your questions
  • Comprehensive array of prepaid educational
    materials
  • Nationwide network of licensed clinical social
    workers, licensed marital and family counselors,
    and licensed psychologists
  • Privacy
  • Quality assurance via mutually agreed upon
    follow-up by caller and consultant, access to
    ACS, COR

25
Army One Source Access
  • By phone
  • From the United States
  • 1-800-464-8107
  • From outside the United States ONLY
  • Toll free The OCONUS number is (access code)
    800-464-81077
  • (please dial all 11 digits)
  • TTY/TDD
  • 800-346-9188

Or call collect 484-530-5889
  • En Español
  • 888-732-9020

26
Army One Source Online
Online access
  • LifeWorkshop Moderated Chat

Army One Source
Army One Source
  • Self-Assessment Tool

My Army One Source
My Army One Source
  • Calculators
  • Online Locators

Army One Source
  • Resource Rooms
  • Other Military Resources
  • Educational Materials
  • Passwordonesource

Online access
  • Userid Army
  • URL
  • http//www.armyonesource.com

10 of 11
27
First Line Supervisors
  • Get to know your soldiers
  • Find out about your soldiers developmental
    history
  • Assess solders life-coping skills
  • Know when your soldiers are experiencing a life
    crisis
  • Anticipate dysfunctional behavior
  • Know potential suicide triggers warning signs
    for mental illness
  • - especially alcohol and drug abuse
  • Promote help-seeking behavior
  • Encourage use of Army One-Source
  • Assist in reducing stigma regarding mental health
  • Set the example - take advantage of helping
    services

28
All Soldiers
  • Know suicidal danger and warning signs and
    leading causes for suicides
  • Become aware of local helping services
  • Take immediate action when suspecting someone is
    at risk for suicide
  • Never ostracize any member of your team
  • REMAIN VIGILANT!

29
STATES WITH THE HIGHEST SUICIDE RATE (2001)
  • 1. Nevada 22.3
  • 2. Wyoming 20.4
  • 3. Montana 18.4
  • 4. New Mexico 18.3
  • 5. Arizona 16.0
  • 6. Alaska 15.5
  • 7. Oklahoma 14.7
  • 8. Idaho 14.5
  • 9. Oregon 14.4
  • 10. Colorado/Washington 14.2

30
STATES WITH THE LOWEST SUICIDE RATE (1999)
  • 1. District of Columbia 5.8
  • 2. New York 6.6
  • 3. New Jersey 6.9
  • 4. Massachusetts 7.0
  • 5. Connecticut 8.3
  • 6. Illinois 8.4
  • 7. Maryland 8.4
  • 8. Minnesota 9.2
  • 9. California 9.3
  • 10. Rhode Island 9.7

31
Summary
  • Suicide is substantially preventable in the Army,
    IF
  • we target those at risk of or currently suffering
    from treatable mental/behavioral disorders
    (primarily substance abuse/mood dz)
  • we minimize stigma associated with accessing
    mental health care
  • leaders know and care about their peers
    subordinate soldiers
  • leaders constructively intervene early on in
    their soldiers problems
  • leaders pay close attention provide
    constructive interventions to those small s of
    peers and subordinates facing major losses from
    legal, marital, occupational or financial
    problems

32
QUESTIONS
33
CONCLUSION
  • SUICIDE IS A PERMANENT SOLUTION TO A TEMPORARY
    PROBLEM.

34
CONCLUSION, cont.
  • The one thing that will save a human life is a
    human relationship.
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