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Suicide in US Army-PUBH430

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Regina Lewellyn

on 21 April 2013

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Transcript of Suicide in US Army-PUBH430

The Numbers Army Demographics In 2011, there were 1,127,801 total Army members including Reserve, Guard and
Active Duty:
By gender:
Males: 84.4%
Females: 15.6%
By race:
White: 64.7%
Black: 18.3%
Hispanic: 10.7%
Asian: 3.7%
Other: 2.6%
Age:
Average enlistment age is 21.3 for RA
20.7 for Army Reserve Current Research & Measures 2008: Army began publishing annual reports on suicide deaths

2009 - 2014: Army STARRS
Study to Assess Risk and Resilience in Servicemembers

Current Army 3 Phase Prevention Strategy S.T.A.R.R.S. Administered by NIMH
Consists of teams from the Uniformed Services University of the Health Sciences (USUHS), the University of California, San Diego, University of Michigan, Harvard Medical School, and NIMH
The largest study of mental health risk and resilience ever conducted among military personnel
5 components... Suicide is the eleventh most common cause of death in the US in general population
White males at highest risk
From 2011 to 2012 the US Military (includes all branches) saw a 16% increase in suicides
From 2004 to 2008 the Army saw an 80% increase in suicides
Suicide by firearms most common method in Army
Most astounding figure... Suicide in US Army Regina Lewellyn
4/16/2013 Preliminary Data
Suicide rate among those currently deployed =
18.3 per 100,000 deaths
Rate after deployment =
15.9 per 100,000 deaths
Rate of accidental death also increased among those never deployed but not among those currently or previously deployed
Women:
Suicide rate increased more so (5.1 to 15.2 per 100,000) than men (14.8 to 21.1) when comparing soldiers never deployed to those currently deployed
Ethncities:
Rates highest among soldiers of Asian ethnicity in currently deployed, previously deployed and never deployed
Asian soldiers also had higher rates of accidental deaths regardless of deployment status Components of S.T.A.R.R.S.
Historical Data Study:
De-identified historical health & administrative records of 1.6 million who were on active duty from 2004 to 2009;
Purpose is to detect risk & protective factors related to psychological resilience, mental health, risky behaviors and suicide Soldier Health Outcomes Study B
Psychological Autopsy component of S.T.A.R.R.S.
To find the risk and protective factors for suicide deaths among Army soldiers:
presence and accumulations of mental disorders
receipt of psychological treatment
developmental history and medical family history
the experience of specific military or general life stressors
recent experiences/state of mind prior to death
Unique part of S.T.A.R.R.S. as it reveals new data

The Process:
Recruit 2 informants for each soldier that has died (a next of kin and an Army supervisor)
Recruit 2 control Army Soldiers who are healthy with similiar backgrounds and 2 informants for each of the control soldiers

Full reports due out in 2014, but reports of SI and other risks reported immediately throughout study and individuals referred to mental health professionals Army Suicide Prevention Program Three Phases: Prevention, Intervention, "Postvention"

Prevention:
Prevent normal life "stressors" from becoming life crises
Coping skills for soldier, family members & Army civilians
Early screening to establish baseline mental health
Offer programs before dysfunction behavior occurs
Training leaders to be caring and proactive taking the time to get to know their subordinates and to evaluate the member's ability to handle stress
Increased mindfulness of changes in behavior SHOS-B Study Overview Statistical Data
Army Demographics
Current Research Findings
Prevention Strategies
Prevention
Intervention
"Postvention"
Resources http://nation.time.com/2013/03/19/military-mental-healths-wins-and-losses-since-the-iraq-invasion/ Intervention Attempts to prevent a life crisis or mental disorder from leading to thoughts of suicide
Helps soldier manage suicidal thoughts & take action when suicide seems imminent
Includes alteration of situation that led to crisis, treatment of psychiatric disorder(s) & follow-up care to monitor problem resolution
Controlling the environment, i.e. removing means
Utilize the Battle Buddies Program Responsibility of Commanding Officer (CO) to assess the situation & determine if threat as been fully resolved
EARLY INVOLVEMENT IS CRUCIAL! Battle Buddies Ensures that every soldier has a soldier who works with or is aware of their daily life and any possible life stressors that may be affecting them on a personal level
Battle Buddy is responsible for promoting Army Values and notifying CO when another soldier is in danger of misconduct or behavior that is harmful to oneself or another soldier
COs and 1SGTs required to match up soldiers regardless of rank; provide card with name and phone number of buddy
Follow up to ensure that Battle Buddy cards are being used
WATCH OUT, PROTECT AND INTERVENE 24/7 Components of S.T.A.R.R.S (cntd.) The All Army Study:
voluntary surveys given to active duty Army Soldiers including Reservists/National Guard members deployed;
assesses psychological and physical health; experiences during training, combat, & non-combat operations; life & work experiences across all phases of Army service;
used to determine how these various factors affect Soldiers’ psychological resilience, mental health, & risk for self-harm. “We are deeply concerned about suicide in the military, which is one of the most urgent problems facing the department. Our most valuable resource within the department is our people. We are committed to taking care of our people, and that includes doing everything possible to prevent suicides in the military.”
~DoD Spokeswoman Cynthia O. Smith S.T.A.R.R.S. Components (cntd.) The New Soldier Study (2011):
Invitation to all new Army soldiers to participate in study using a survey, neurocognitive tests & blood collections to assess the health personal characteristics & prior experiences as they begin their Army service In 2012, 187 Army members died by their own hands vs. 176 who were killed in combat Components of S.T.A.R.R.S. (cntd.) Special Studies Pre/Post Deployment Study:
The effects of deployment to combat zones
Assess physical/biological changes, risk & resilience of suicidality & related mental health disorders
Clinical Calibration Study:
Clinical interviews will be used to calibrate the diagnostic accuracy of S.T.A.R.R.S. questionnaires Review of Research Individuals die
Each suicide is complex in nature
No set of predictors guarantee or prevent suicide
Importance of multi-dimensional research and prevention "Postvention" Resources for Families Know the Signs:
Thinking about hurting or killing him or herself
Talking or writing about death, dying or suicide
Unable to sleep or oversleeping
Withdrawing from friends, family or society
Increasing alcohol or drug use
Engaging in reckless or risky behavior
Experiencing excessive rage, anger or desire for revenge
Having feelings of anxiety, agitation or hopelessness
Reliving past stressful experiences
Experiencing dramatic changes in mood Military Crisis Line: 800-273-TALK (8255)
ACE: Ask, Care, Escort
Military OneSource: 800-342-9647
http://www.armyg1.army.mil/hr/suicide/default.asp
http://www.behavioralhealth.army.mil/families/index.html Resources www.armystarrs.org
http://www.armyg1.army.mil/hr/docs/demographics/FY11_ARMY_PROFILE.pdfhttp://www.nimh.nih.gov/science-news/2011/army-starrs-preliminary-data-reveal-some-potential-predictive-factors-for-suicide.shtml http://www.nlm.nih.gov/medlineplus/suicide.html
http://www.nimh.nih.gov/about/director/2010/army-suicide-study-kicks-into-gear.shtml
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538499/
http://web.ebscohost.com.proxy.lib.utk.edu:90/ehost/pdfviewer/pdfviewer?sid=0147e476-ec7e-45ce-9f4d-7f79ce5a5cee%40sessionmgr114&vid=2&hid=128
http://www.carson.army.mil/IG/policy/Safety%20Policy%2003%20-%20Fort%20Carson%20Battle%20Buddy%20Program%20%285%20Aug%2009%29.pdf
http://armypubs.army.mil/epubs/pdf/r600_63.pdf
http://usnews.nbcnews.com/_news/2013/01/14/16510852-military-suicide-rate-hit-record-high-in-2012?lite
http://www.usarec.army.mil/support/faqs.htm#age
http://www.realwarriors.net/family/support/preventsuicide.php
http://usnews.nbcnews.com/_news/2013/01/03/16309351-the-enemy-within-soldier-suicides-outpaced-combat-deaths-in-2012?lite
http://usnews.nbcnews.com/_news/2012/12/10/15761391-fewer-homeless-vets-this-year-but-advocacy-group-sees-alarming-rise-in-younger-ex-service-members?lite Taking these things into consideration what does the soldier who completes suicide look like? Required when an individual has attempted or completed suicide
Steps to secure & protect such individuals before they can harm themselves and/or others
Also includes unit-level interventions after a completed suicide to prevent and reduce potential for suicide contagion, minimize psychological reactions to event, strengthen unit cohesion, & promote continued mission readiness Operation Military Kids
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