The Army’s Continuing Commitment To Suicide Prevention
March 16, 2009
According to the World Health Organization, more than one million people commit suicide each year. They go on to say that suicide is one of the leading causes of death among teenagers and adults under 35. There are also an estimated 10 to 20 million non-fatal attempted suicides every year worldwide.1 Those are pretty frightening statistics, when you think about it.
People commit suicide for many reasons, including depression, shame or guit, desperation, pain, financial problems, relationship problems and often other undesirable problems. The predominant view of modern medicine is that suicide is a mental health concern, associated with psychological factors such as the difficulty of coping with depression, inescapable suffering or fear, or other mental disorders and pressures. Suicide is sometimes interpreted as a “cry for help” and attention, or to express despair and the wish to escape, rather than a genuine intent to die. Most people who attempt suicide do not complete suicide on a first attempt; those who later gain a history of repetitions have a significantly higher probability of eventual completion of suicide.2
Recently, the number of suicides in the military has been increasing at an alarming level. So much so, that the Army and other branches of the military are taking proactive steps to decrease and hopefully eliminate suicide altogether. Because of the increased numbers in the Army, a suicide prevention campaign has been launched and a task force has been formed in address these very real issues. In a recent news release, US Army Forces Command talks about the steps the Army is taking towards the prevention of suicide.
U.S Army Forces Command
Directorate of Public Affairs, 1777 Hardee Ave SW,
Attn: AFCS-PA, Fort McPherson, Ga. 30330 1062, 404-464-6381,
Fax 404-464-5628, DSN 367-6381
ARMY LEADERS DEVELOP SUICIDE PREVENTION PROGRAMS
By Jessica Maxwell
FORSCOM Public Affairs
Considered an ongoing battle to decrease the Army’s suicide rates, commanders brainstormed how to reduce the rising numbers and push prevention training.
The number of suicides in 2008 totaled 128 confirmed cases from all Army components. This is the highest figure since the Army began tracking this alarming statistic.
The Army G1, which manages and develops Army personnel programs, is the proponent of the Army’s suicide prevention program and works as part of a joint effort with Installation Management Command (IMCOM), leaders of U.S. Army Forces Command (FORSCOM), mental health professionals from Medical Command (MEDCOM), and the Chief of Chaplains office.
To continuously track suicide data, FORSCOM G1 personnel chief, Brig. Gen. Eric Porter, formed a bi-monthly summit in October 2008. In addition to fostering communication between commands, the goal is to provide appropriate human resources to installations and forecast the needs of brigade combat teams post-deployment.
“Gen. Porter directed his staff to look into the circumstances around which the Soldiers committed suicide,” said CH (Col.) Brad Fipps, FORSCOM staff chaplain.
FORSCOM G1 is developing data that will show where in the deployment cycle suicides may be more likely to occur. Once these have been identified, commanders can apply mitigation strategies at key points to counter them through preventive training and reinforcement activities that promote resiliency.
“Soldiers and Families are remarkably resilient,” said Fipps. “Even though they are under tremendous stress from all the demands of current operations, including multiple deployments, most of them bounce back with incredible fortitude. With supportive emotional backing from their Families and friends, Soldiers are better able to withstand the emotional challenges, such as feelings of severe hopelessness and helplessness, which often lead to suicide,” he said.
Ongoing data from G1 shows that one-third of suicides occur during deployment, one-third occur a full year post-deployment, post-deployment, and a third of the Soldiers never deployed. However, Col. Mike Freville, a behavioral health officer at FORSCOM said, 70 percent of the suicides appear to be relationship-based. “It’s a mystery. Whether it’s in the civilian world or military, suicides are a mystery,” said Freville.
He added that commanders are dedicated to the battle and large amounts of energy and resources are being pooled to decrease the rates.
“Nothing is more important than the well-being of our Soldiers and Families,” said Gen. Charles C. Campbell, commanding general, FORSCOM. “We will do everything in our power to address the underlying causes that have contributed to the increase in suicide rates. We will make every effort to provide the necessary resources and training to help our units deal with this problem.”
On February 15, an Army stand-down began and continues through March 15. In a press conference Jan. 29, Vice Chief of Staff of the Army Gen. Peter Chiarelli said the stand-down allows commanders to take a direct approach to the issue. The stand-down teaches peer-to-peer recognition of suicide warning signs and is available to all Army components and Department of the Army civilians.
Phase I, an interactive video “Beyond the Front,” allows participants to choose options throughout the film, with the outcome based on their choices. The film illustrates to those in training that seemingly small, day-to-day decisions can have a large impact on the lives of their fellow Soldiers.
Phase II of the training, also a video, “Shoulder to Shoulder,” reinforces the Army credo of “No Soldier Left Behind” and ties it to helping a Soldier in need. Phase III focuses on sustainment of the concepts taught in Phases I and II.
The Chief of Chaplains office has been tasked with sustainment training. A yearly refresher course will be held for Soldiers and in every unit, a chaplain is on hand for intervention, if needed. In addition to the unit chaplain, a specially trained Family life chaplain recently started deploying with Soldiers (with one also stationed with the rear detachment at home station).
Fipps said the Family life chaplains are licensed counselors who can provide guidance to Families and Soldiers who face the stresses associated with frequent deployments.
One of the programs chaplains use is ACE, which stresses the “battle buddy” system. ACE, a mnemonic that represents the phrases, “Ask your buddy, Care for your buddy, Escort your buddy,” encourages Soldiers to continue watching each other’s backs for emotional problems. ACE cards, designed to look like a playing card, are distributed to each Soldier to carry in his or her wallet.
“The idea of ACE is to encourage Soldiers to help each other and protect each other from suicidal thoughts,” said Fipps.
Trained by chaplains at the unit level, ACE teaches Soldiers what to look for – anything ranging from unusual sadness to alcohol or drug use. If a “battle buddy” needs help, a fellow Soldier escorts him or her to the chaplain’s office and then if further help is needed, the chaplain enlists the help of a mental health professional.
“A Soldier keeps the card in his wallet and is reminded every time he opens his wallet. The idea is buddy care – it’s that battle buddy, Ranger buddy idea of care,” said Fipps. “If a Soldier watches your back in combat, then when you get back home, the expectation is that Soldier will continue to watch your back.”
Emphasis on suicide prevention continues with the ASIST (Applied Suicide Intervention Skills Training) program, which trains leaders on intervention and working with distressed Soldiers and Families. Army policy requires one ASIST-trained representative in every battalion. Additionally, all chaplains and their assistants, all behavioral health professionals, Army Community Service and other available instructors must attend ASIST. A certified ASIST individual provides immediate response to individuals who exhibit suicidal signs.
“We want to let them know we do care; not just chaplains, but Soldier-to-Soldier, everybody,” said Fipps.
Available at each unit, the Family Readiness Group (FRG) assists the commander in monitoring the stress level of Families and Soldiers throughout the deployment cycle.
For example, during the pre-deployment phase, the FRG works with spouses, parents and children and coaches them through anticipatory grief. Sometimes used as a coping method, anticipatory grief can manifest into bickering and fighting to make the initial separation with a deploying Soldier easier.
“We want healthy Soldiers, and part of that, a big part of that, are mentally healthy Soldiers and Families,” said Freville.
Additionally, the Army incorporates the BATTLEMIND training program into the Deployment Cycle Support (DCS) program. BATTLEMIND highlights the skills that Soldiers use in combat zones and uses them to create a smooth transition at home.
The acronym BATTLEMIND stands for: Buddies vs. Withdrawal from Family; Accountability vs. Controlling; Targeted Aggression vs. Inappropriate Aggression; Tactical Awareness vs. Hypervigilance; Lethally Armed vs. “Locked and Loaded” at Home; Emotional Control vs. Anger Detachment; Mission Operational Security vs. Secretiveness; Individual Responsibility vs. Guilt; Non-defensive Driving vs. Aggressive Driving; and Discipline and Order vs. Conflict.
“One of the goals in BATTLEMIND is to help Soldiers see how they can grow from trauma as opposed to being beaten down by it,” said Fipps.
The program expanded in 2007 to include a voluntary post-deployment session for spouses that teaches them to identify common areas of concern and conflict experienced during deployment and to identify cues of when to seek help and available resources. Overall, BATTLEMIND provides Families a strategy to strengthen resiliency after deployments and encourages turning perceived negatives into positives.
However, none of these programs will be effective if the stigma associated with asking for help remains intact.
“One of the major goals of all ongoing prevention efforts is to reduce the stigma of asking for help,” said Freville.
When asked about post-deployment assessments, Fipps said Soldiers often fear answering honestly. Because of the stigma of seeking emotional help, they worry the answers could affect their security clearance, their job or the next promotion. Reserve component Soldiers are often concerned that their responses may delay them getting home.
“We’re trying to let people know that we anticipate having some emotional concerns after seeing the things they see in combat,” said Fipps. “We want to help people learn how to break through the stigma and seek help if they need it.”
Fipps continued by saying that the stigma breaks as commanders and Soldiers begin to offer help, eliminate any mockery, and start developing sensitivity towards emotional injuries.
Freville added that some general officers have come forward to discuss their own battles with depression and suicidal thoughts.
“As excellent role models, they are really leading a perfect example at the highest levels,” said Freville.
By opening the subject for discussion, Freville said Soldiers should feel empowered in assisting their fellow Soldier, adding that immediacy is critical.
Fipps added that part of the holistic person is emotional health, and emotional health is a major part of unit readiness.
“Part of it is getting people to see that going to mental health professionals or going to see the chaplain is a sign of inner strength; it’s a courageous move,” said Fipps.
To learn more about the Army’s suicide prevention program, contact your unit chaplain or visit the Army G1’s Suicide Prevention website.
Suicide is a terrible problem throughout societies all around the world. It’s something that leaves many victims in it’s wake and many unanswered questions by those who are left behind. I’m impressed that the Army is taking this epidemic so seriously and aggressively finding ways to combat it. Please take some time to go to the Army’s Suicide Prevention website, read the literature there, and view the interactive video. Take this seriously!! Be aware of what’s going on around you, with your friends, family and co-workers and become involved. With awareness the number of suicides can be decreased.