By Reginald Rogers, Paraglide
FORT BRAGG, N.C. -- Last year, the Army's suicide rate peaked to astronomical levels, as the service reported more than 320 suicides. The increase in the number of reported suicides set off various alarms with the Army's senior leadership, and prompted the service to take a closer look at its suicide prevention program.
To ensure that those numbers are decreased in 2013, the Army has worked to ensure that all leaders are familiar with the resources available to at-risk Soldiers and other community members.
According to Lt. Col. Kevin Willis, manager, XVIII Airborne Corps Suicide Prevention Program, the goal of the Fort Bragg program, as directly related to the Army Suicide Prevention Program, is to prevent suicide among Soldiers, family members and civilians.
Willis pointed out that in accordance with ARMY DA PAM 600-24: Health Promotion, Risk Reduction, and Suicide Prevention, suicide prevention is described as a continuum of awareness, intervention, and postvention to help save lives. Ultimately, the goal of prevention is to develop healthy, resilient Soldiers to the point where suicide is not an option.
He said it is important to establish a culture that reinforces help-seeking behavior as an appropriate and widely accepted part of being responsible.
"Intervention is also key since the goal is to prevent a life crisis or mental disorder from leading to suicidal behavior and includes managing suicidal thoughts that may arise," Willis said.
He explained that at its most basic level, intervention may simply be listening, showing empathy, and escorting a person to a helping agency. This is something that can be done by any Soldier, family member or civilian with minimal training at the unit level. Army approved training for this level includes Center for Health Promotion and Preventive Medicine, or CHPPM, suicide prevention training programs for Soldiers, leaders, families and civilians.
Intervention and training go hand-in-hand, when is comes to suicide prevention, Willis said.
He pointed out that intervention may also include the use of more advanced skills by trained personnel who are capable of providing a greater level of crisis intervention, screening, care and referral. Junior leaders may receive training in peer-to-peer intervention that will give added skills, knowledge, and confidence to intervene in a crisis. This training can take many forms from specified suicide intervention training to broader, crisis intervention training.
The approved Army program for peer suicide intervention training is the three-hour, Ask Care Escort, or ACE, Peer Suicide Intervention Training developed by CHPPM. An even greater level of intervention is provided by formally-trained gatekeepers.
Primary gatekeepers can be chaplains, family advocacy program workers and medical providers, whose primary duties involve assisting people who are more susceptible to suicidal ideation.
Secondary gatekeepers are personnel who by the nature of their job, may come in contact with an at-risk person. These can include military police, inspector general personnel, Red Cross staff members, and first-line supervisors/leaders applied suicide intervention skills training is the Army-approved training for gatekeepers.
"Other products reinforcing the use of ACE include 'Beyond the Front,' interactive video simulation," he said in an e-mail interview.
Training can be provided to improve intervention skills, increase knowledge and build confidence in Soldiers to respond appropriately to a suicidal threat. Specific training modules are being developed for military medics and medical personnel focusing on the review of clinical protocols for responding to crisis situations.
Another key factor in preventing suicides is building resiliency.
"Resiliency-building programs help Soldiers and families develop life skills and directly impact the success of suicide prevention efforts by enhancing protective factors and mitigating stressors at the earliest stages," Willis said. "Life skills are available on a wide variety of subjects to include couples communication, child rearing, money management, stress management, conflict resolution, anger management, and problem solving."
Soldier resiliency is a combination of factors including a sense of belonging in the unit, having inner strength to face adversity and fears, connecting with buddies, maintaining caring and supportive relationships within and outside the family, Willis said.
Also important is to maintain a positive view of self, have confidence in strengths and abilities to function as a Soldier, and be able to manage strong feelings and impulses, he said.
Willis, who explained that his information comes directly from DA Pamphlet 600-24, said there are other things that community members can do to mitigate the negative effects of trauma, adversity and emotional stress. Some of them include:
-- Attending life skills or related training.
-- Seek out a mentor in which to confide.
-- Actively and frequently participate in unit activities.
-- Join social support groups, faith-based organizations, and self-help groups.
-- Recognize, accept, and face fears.
-- Nurture good relationships with family and close friends which may include counseling.
-- Learn to regulate your emotions and avoid impulsive behavior.
-- Maintain realistic optimism, and, believe in your ability to survive and function as a Soldier.
-- Recognize that no one has the resources to manage all personal problems alone, practice help seeking behavior as a sign of strength.
-- Commit to practices that maintain good physical and behavioral health.
-- Avoid isolation when faced with stressors.
-- Develop and maintain spiritual fitness.
He also added that it was important for leaders to become familiar with the available resources, which include:
-- Comprehensive Soldier and Family Fitness
-- Wellness programs, - Family program and Family assistance centers
-- Army Substance Abuse Program, Yellow Ribbon Program/deployment cycle support
-- Prevention relationship enhancement program (prep) for couples and singles
-- Army Emergency Relief fund
-- Warrior Transition units
-- Life skills training
Peer-to-peer programs to ensure that XVIII Airborne Corps Soldiers and community members remain resilient, and to filter ready and resilient efforts down to the lowest level, Willis said.
Lt. Gen. Daniel B. Allyn, XVIII Airborne Corps and Fort Bragg's senior commander, directed that every brigade level unit residing on Fort Bragg create and host a brigade-level council named the brigade health promotion team, or BHPT, no later than March 31.
"One of the greatest barriers to preventing suicides is a culture that shames Soldiers into believing it is not safe to seek help/assistance. Stigma can render suicide prevention and intervention efforts ineffective unless elements are incorporated into the program to counter these destructive attitudes," Willis said.
"Stigma is a cultural issue that will take a deliberate and focused effort to combat. The key to stigma reduction is leadership emphasis at all levels," he said.
Leaders can accomplish this by eliminating policies that discriminate against Soldiers who receive mental health counseling; supporting confidentiality between the Soldier and his/her mental health care provider; reviewing policies and procedures that could preclude soldiers from receiving all necessary and available assistance, Willis said.
Other means of combating suicides include educating all Soldiers, family members, and DA civilians about anxiety, stress, depression, post traumatic stress disorder, and treatment; increasing behavioral health visibility and presence in Soldier areas. It's important to encourage individuals to get help from mental health providers that precludes treatment, similar to critical incident stress debriefings; and, reinforce the 'power' of buddy system as a support system/mechanism in times of crisis, he said.