Everyone Counts -- DoD Aims for Fewer Suicides

During an open forum Nov. 19 at the Marine Corps' Henderson Hall in Arlington, Va., Army, Air Force and Navy representatives joined a panel of mental health experts to begin planning a yearlong campaign aimed at reducing suicides in the military even further.

"Just because we've been successful doesn't mean we stop focusing on the problem," said Dr. (Lt. Col.) Rick Campise, suicide prevention manager and consultant to the Air Force Surgeon General. "If we become complacent, we're only inviting suicide rates to go back up again."

Army Dr. (Lt. Col.) Elspeth Ritchie, program director of Mental Health Policy and Women's Issues, Office of the Assistant Secretary of Defense for Health Affairs, said forum participants would analyze military suicide prevention programs and determine their effectiveness.

"The number of suicides have gone down because all the services have (been using) very aggressive suicide prevention programs," Ritchie said. "The focus of the forum will be to look at each service's programs and come up with a 'unified approach' to suicide prevention."

DoD statistics show the Air Force as having one of the more successful prevention programs among the services. Between calendar 1991 and 2001, the suicide rate among airmen fell from a high of 15.9 per 100,000 in 1994 to 5.6 per 100,000 in 1999 -- nearly a two-thirds decline.

Campise, who unveiled the Air Force's latest tool in preventing suicides, an interactive Web site, credited the decline in suicides among airmen to leadership and community involvement.

"Our program's success lies in the fact that every single person in the Air Force is a suicide-prevention manager," he explained. "From the chief of staff on down, the internal message is to take care of our people."

Navy Lt. Cmdr. Kevin Kennedy, behavioral health section head, Naval Personnel Command, Millington, Tenn., has seen similar success among Marines and midshipmen. He reported that the suicide rate among Navy personnel in 2001 was 10.4 per 100,000, the lowest in a decade.

(DoD statistics indicate the Marine Corps suicide rate between 1991 and 2001 ranged from a high of 20.9 per 100,000 in 1993 to a low of 11.7 per 100,000 in 1997. The 2001 rate was 16.2 per 100,000.)

"We can't say that our training has caused the low ratio, but we can say that it correlates with the low rate of suicide among our sailors and Marines. And that leads us to think we are doing something right," Kennedy said. He noted that the Navy's plan stresses the importance of getting help immediately, notifying command leaders, and individual responsibility.

"With increased emphasis on prevention, we feel our number of suicides will remain low," Kennedy said.

Meanwhile, the Army, working with John Hopkins University of Baltimore and Living Works Education, a Canadian-based public-service company, plans to extend its "Applied Suicide Intervention Skills Training," or ASIST, to all soldiers.

The training, which is being conducted in workshops Armywide, gives soldiers at risk for suicide the confidence and tools for immediate life-saving actions, said Army Lt. Col. Jerry Swanner, a suicide prevention program manager at the Pentagon.

"ASIST trains laypeople, professionals -- basically anyone -- in how to estimate the risk of suicide in an individual and then apply an intervention model when appropriate," Swanner explained. "We recognize that we will not prevent every suicide, however, our purpose is to minimize the risk."

Ritchie said the forum would also address how to provide suicide prevention and intervention for National Guard and Reserve members.

Regardless of the strategy, major parts of the campaign will focus on educating service members that suicide is preventable and to teaching them what signs and symptoms to look for, she said.

Those signs include depression, alcohol abuse, and family issues due to frequent deployments, retirement or loss of military careers, Ritchie remarked. Other warning signs to look for include decreased ability to concentrate, a change in appetite or sleep, irritability, loss of energy, and feelings of guilt, she added.

"The important thing for someone to do if he notices these factors is to ask, 'What's going on, what's wrong?' It's never hurts to ask," she said.

Ritchie noted the military's current high op-tempo in the war on terrorism, increased deployments and the threat of war seem to have no direct influence on military suicide rates.

"The rates have remained close to the same," she added. There has been a "small fluctuation" in the number of suicides in the past year, she said, but military suicides are still well below the national average.

"Our rates are lower than the civilian world, that's true. But irrespective of our rates being lower, they are still too high," Ritchie said. "Any suicide is going to have a major effect of the unit in terms of people feeling, 'What should I have done?'"

In terms of morale, she said, "Everybody is affected. Everybody hurts. So suicides really affect our military readiness as well."