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Suicide Prevention

adaptation of materials to prevent suicide among soldiers

carolyn holecek

on 27 September 2012

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Transcript of Suicide Prevention

Resilience Risk Factors and Warning Signs Tip Even though the Army has worked hard
to reduce the degree of stigma experienced by all members of the Army Family, stigma still exists and we must continue to work to reduce and eliminate it. You just saw several Soldiers, DA Civilians, and Family members who got help to deal with stress and other issues that were overwhelming them. With the right help, most people can resolve problems with depression, stress, and anger, build their resilience, and get on with their lives. Discussion -What is stigma, and why does it sometimes keep Soldiers and members
of the Army Family from seeking help?

-In the video, DA Civilian Aaron says, “There are many people who think if they have suicidal thoughts, and tell anybody about it, it’s the end of their career; which is simply not true.” Do you agree with that statement?

-Do you feel there is a stigma associated with taking medications for depression, anxiety, etc.? Would you take medications for depression and anxiety if you needed them? Spark One of the greatest barriers to preventing suicides is a culture that shames Soldiers into believing it is not safe to seek help. Stigma can render suicide prevention efforts ineffective unless elements are incorporated into the program to counter these destructive attitudes Army leadership has been seeking ways to reduce the stigma that has been associated with seeking behavioral health care. What are some of the things you know about that the Army has done? What are some of the things leaders can do to help Soldiers, DA Civilians, and Army Family members who have these fears so they feel comfortable seeking help? How many of you would be reluctant to get help if you needed it? Why? We must all continue to work on reducing the stigma associated with getting help so that everyone feels comfortable asking for help. Seeking help is not a sign of weakness. It takes courage and, in fact, is a sign of strength. Encourage unit activities that let people get to know each other and let you know them.

Offer your Soldiers positive reinforcement; recognize them appropriately when they do good things. y Create a unit climate that does not allow hazing or stigmatizing others. Treat everyone fairly.

Be approachable.

Let everyone know they can call you 24/7. Different
perspectives What can leaders do? Walk around every day to see how things are going.
Know your people. Don’t just talk about work; ask about their personal lives. What the DoD and Army Are Doing to Reduce Stigma Stigma Reduction Campaign Plan. Both the Department of Defense and the Army are in the process of developing a stigma reduction campaign plan that synchronizes efforts across agencies and leverages DoD’s existing Real Warriors Campaign that was launched in 2009 to encourage help-seeking behavior among Service members and veterans. Behavioral Health (BH) Providers. The Army has increased the number of BH providers, embedded them with brigade combat teams in theater, and is co-locating them with primary health care physicians to provide comprehensive medical treatment and share treatment plans. Rapid Action Revision of AR 600-63, Army Health Promotion. This regulation underwent a four-month review by the Army Suicide Prevention Task Force (ASPTF) and a rapid revision to incorporate a number of policy changes, including replacingthe term “mental health” with “behavioral health”; requiring commanders to refer Soldiers who are undergoing disciplinary action and have multiple risk factors present to appropriate services to mitigate risk; mandating that commanders publish a suicide prevention policy (e.g., full-participation in behavioral health screenings, importance of reducing stigma, and unit program elements) and implement health promotion, risk reduction, and suicide prevention programs and encourage participation in behavioral health screenings and treatment. NIMH Army STARRS. The Army provided funding for the National Institute of Mental Health Army Study to Assess Risk and Resilience in Service members (NIMH Army STARRS). This is the largest study ever undertaken on suicide and mental health among military personnel. Army STARRS will identify, as rapidly as possible, modifiable risk and protective factors related to mental health and suicide. It also will support the Army’s ongoing efforts to prevent suicide and improve Soldiers’ overall well-being. Body Suicide Prevention Awareness and Training. The Army has increased emphasis on suicide prevention awareness and training, with a number of programs. Revision of DA PAM 600-24, Health Promotion, Risk Reduction, and Suicide Prevention. This revision made a number of changes, including outlining the commander’s responsibility to reduce stigma associated with needing or seeking behavioral health treatment, and building a command climate that encourages self-care and help-seeking behaviors. A common misconception is that most suicides are directly caused by the stress of combat or deployment. It’s not that simple. The total Active Duty Suicides for calendar years 2001-2010 was 1,026. Of those suicides, 419 Soldiers (41%) were never deployed, 227 Soldiers (22%) died during deployment, and 380 Soldiers (37%) died post deployment. Even in cases where combat stress was a factor, it was not the ONLY factor. Risk factors are personal factors or life events that increase stress for people especially when multiple risk factors are involved. People experiencing these events may need increased support or counseling to deal with them. For a few people these increased stresses may lead to depression and the potential for suicide. - Family reintegration and changes in roles after deployment
-Financial problems (debt, uncontrolled spending, etc.)
-Work or unit or mission challenges
-Other types of work stress like changing jobs or changes of leadership
-Balancing the demands of work and home life-Legal issues
-Family issues, such as pressures as care-givers, dealing with a spouse who is deployed, or reintegrating after deployment
-Relationship issues (pregnancy, divorce, infidelity, etc.) What are some of the other risk factors that you have observed or have heard about? Leaders must know their people well in order to recognize the risk factor they are experiencing and warning signs of suicide and act appropriately. Warning Signs -Increased alcohol and/or drug use or abuse
-Isolation and withdrawal from social situations
- Giving away possessions
-Expressing feelings of sadness, hopelessness, anxiety -Making a will or otherwise finalizing personal affairs
-Sudden or impulsive purchase of a firearm or obtaining other means of killing oneself such as poisons, medications Go Don't Unnoticed know the -Noticeable changes in eating/sleeping habits and personal hygiene

-Talking or hinting about suicide, expressing a strong wish to die or a desire to kill someone else
-Obsession with death (e.g., in music, poetry, artwork, letters)

-Change in mood (e.g., depression, irritability, rage, anger) Many stress factors can increase the risk of suicide. They include:
-Failed intimate relationship or relationship strain
-Previous suicide attempts
-Family history of suicide, suicide attempts, or depression
-History of depression or other psychological illness
-Significant loss (death of loved one, loss due to natural disasters, etc.) -Poor social skills, difficulty interacting with others
-Drug or alcohol abuse
-Violence in the home or social environment
-Access to means of suicide (particularly handguns in the home)
-Disciplinary or legal actions (Article 15, UCMJ)-Serious medical problems or physical illness
-Work-related problems
-Excessive debt and other financial problems-Severe, prolonged, and/or perceived unmanageable stress The previous factors can be complicated by intense feelings or emotions. Some individuals consider drastic measures to stop these feelings. Strategies to lower the risk of suicide should address risk factors as well as the intense reactions, which may include:
-Loneliness, a feeling of being alienated. Loneliness can also stem from a feeling of being disconnected from a higher power. Connections with other people and with a higher power can reduce stress and disappointment.
-Worthlessness, a feeling of not being valued.
- Hopelessness, a feeling that the future holds no escape from negative circumstances. Awareness of resources can alleviate hopelessness.
-Helplessness, a feeling of having no control over a situation.
-Shame, which may follow a negative legal or judicial action. In the Army, first-line leaders have the responsibility to:

-Foster a climate of trust and support

-Minimize the stigma of seeking help by
demonstrating by attitude, words, and actions that they tolerateand encourage help-seeking behavior

-Take a personal interest in each subordinate Soldier’s personal life and provide support as needed

-Understand their responsibilities regarding suicide prevention, intervention, and postvention

-Teach suicide prevention to all personnel assigned

-Establish, publicize, and enforce a no-tolerance policy for belittling, shaming, hazing, or otherwise humiliating those who need or seek help

-Encourage the battle buddy system, fostering a sense of active concern and support for each other

-Make sure that all personnel understand the ACE (Ask, Care, Escort) method of peer-to-peer intervention

-Encourage activities that promote resilience in Soldiers, DA Civilians, and Family members Questions?
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