Tag Archives: suicide prevention

SAIL Referrals Decreasing during COVID-19

SAIL_logo (002)Last month, there was a significant decrease in the SAIL referral rate. There is concern that commands are not submitting referrals due to the COVID-19 crisis. Now more than ever, the Navy Suicide Prevention Program is encouraging commands and Suicide Prevention Coordinators (SPCs) to continue submitting SAIL referrals following instances of suicide-related behaviors (SRBs). SAIL services are critical during this crisis and commands must continue to submit referrals. Due to COVID-19 operations, caring contacts have transitioned from in-person contacts to telephonic contacts, but SAIL Case Managers are still standing by to assist Sailors.

Sailors sometimes do not speak up about their feelings of hopelessness or emotional distress prior to an SRB because they fear judgement and other negative perceptions. The Navy created the SAIL Program to provide a support network that assists Sailors in navigating resources. Participation in SAIL initiates a series of caring contacts during the first 90 days after an SRB to ensure the Sailor has ongoing resources and support. SAIL is not therapy and does not replace therapy or the care the Sailor may receive from medical and chaplains. It is risk assessment, safety planning and a link to all the additional resources that Fleet and Family Support Center (FFSC) offers to support our Sailors.

The SAIL Program launches into action when a command notifies their SPC when an SRB occurs. The SPC then contacts the Navy Suicide Prevention Program, which forwards the Sailor’s information to Commander, Navy Installations Command (CNIC). CNIC contacts the appropriate FFSC Case Manager, who first reaches out to the command, and then reaches out to the Sailor to offer SAIL. SAIL case managers help Sailors understand, choose and engage with resources they need. Sailors are empowered to strengthen their coping skills throughout the process.

Although risk factors associated with SRBs do not cause or predict suicide, several relate to social connection:

  • Lack of social support and sense of isolation
  • Loss of relationship or significant personal loss
  • Feeling like a burden to others, helplessness

If you hold a leadership position, be sure to actively listen to your Sailors with the intent to understand, not just respond. After someone experiences an SRB, one of the most important things they need is support. Support from leadership is critical at this time. Remaining transparent with others in discussing thoughts of suicide or other forms of self-harm openly promotes help-seeking behavior. Facilitating positive and ongoing dialogue around stress helps empower proactive self-care.

Psychological health is just as critical to readiness as physical health. Feeling connected to others can help reduce the isolation of suicidal thoughts, which often stem from a desire to stop intense pain rather than a desire to die. Leaders at all levels of the Navy contribute to their shipmates’ understanding of resources and command climate. Whether you’re a deckplate leader, front-line supervisor or commander, investing in relationships with your team through mentorship and other forms of social connection helps create an environment where all Sailors feel heard and valued. We all play a part in creating a supportive environment where those who need help have the courage to seek help and feel heard.

To learn more about the SAIL Program and access additional resources for leaders, visit this website.

If you or someone you know is in need of immediate assistance, the Military Crisis Line is available 24/7. Call 1-800-273-8255 (Option 1), text 838255 or visit http://www.militarycrisisline.net for free and confidential support.

Annual Department of Defense Suicide Prevention Outreach Recognition

41091343_1937693046269634_8563406773740896256_nThe Defense Suicide Prevention Office (DSPO) is  conducting its annual DoD Suicide Prevention Month Outreach Recognition to honor one exemplary installation from each of the services and one from either the Reserves or National Guard. This recognition honors the installations with the most dedicated and influential efforts commemorating Suicide Prevention Month. Recipients will be recognized for their efforts to be there for service members, their families and DoD civilians by educating, engaging and building community support for suicide prevention.

For recognition consideration, events must occur during the month of September 2019, though they may be sustained beyond that time to promote ongoing engagement. All Navy events must adhere to the safe messaging guidelines included in the FY-20 1 Small ACT Toolkit to ensure that they do not unintentionally place vulnerable individuals at increased risk and convey a positive narrative. Additionally, Navy events should promote one or more of the following “Every Sailor, Every Day” campaign concepts:

  • Educate on suicide risk factors, protective factors and warning signs;
  • Empower proactive self-care, early intervention and seeking help;
  • Promote open, positive and ongoing dialogue about stress, psychological health and suicide; and
  • Demonstrate practical applications of the “1 Small ACT,” “BeThere” and/or “Small Steps Save Lives” messages.

All nominations must be submitted via email to Navy Suicide Prevention Program at suicideprevention@navy.mil no later than November 1, 2019. To nominate your local efforts:

  • Provide no more than a 750-word narrative, using 12-point Times New Roman describing your installation’s event(s) and/or activity/activities throughout September 2019. Including pictures, fliers and other supporting material is encouraged.
  • Include SMART (specific, measurable, achievable, relevant, and timely) measures of effectiveness of each activity or event (i.e., qualitative or quantitative data demonstrating how the activity or event affected the community such as number of participants, populations participating, or survey outcomes, etc.).
  • The email subject line should read “2019 DoD Suicide Prevention Month Outreach Recognition _ installation name”. The file naming convention should read “2019SPM _ installation name”.
  • Coordinate with your homeport or installation’s public affairs office to ensure that only one nomination is submitted per installation.

How (and Why) to Develop a Self-Care Plan

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Sailors know that no military operation is undertaken without significant planning. Personal duties like a permanent change of station or even trips to the store are often accompanied by detailed checklists, too. However, planning to prioritize self-care may be a new idea. We think that self-care will just “happen,” but it’s easy to let your personal needs fall to the bottom of the list. Self-care is an important part of wellness that deserves the same thoughtfulness as any other important event. Building a self-care plan can help make sure we take care of ourselves, so we can take care of the mission and of others.

What Is a Self-Care Plan?

A self-care plan is a customizable tool and preventative measure to help you identify what you value and need as part of your daily life (maintenance self-care) and the strategies you can use if you face increased stress or a crisis (emergency self-care). There is no “one-size-fits-all,” but the plan should represent a commitment to attending to your physical, psychological and emotional health in ways that are meaningful to you. An effective self-care plan helps you take the guesswork out of how to direct your energy in positive ways.

How to Create a Self-Care Plan

When you begin writing your plan, you’ll need to do a little self-reflection. Think about the ways that you currently cope with stress in your life, and whether those ways are positive or negative. A self-care plan can include abstaining from negative behaviors, like overspending or overusing alcohol, as well as developing new and more productive strategies. Think about the things in your life that bring you joy and increase your well-being. Make a list of those positive activities. Come up with a reasonable amount of time per week that you’re able to dedicate to those activities, and then block that time off on your calendar in advance. Some activities may be easy to incorporate into your daily routine, like a walk with your dog. Some activities may fit in better on a weekly or monthly basis, like a manicure or massage. Find what’s right for you, and then make it a priority.

What to Consider

Customize your self-care plan to meet your needs, but also make sure you aren’t neglecting any part of your total wellness. A good self-care plan should include practices or activities related to a variety of health areas.

Physical – These are all the things that involve taking care of your physical health, like nutrition, preventive medical care and good sleep practices. Learn how to get a great workout without equipment in this blog post about minimalist fitness workouts designed for Sailors. Yoga offers a complete mind and body workout, and this article can help you start a yoga practice. If you turn to sugary foods as a coping mechanism, you can learn about the effects of sugar on your body and mind here. For tips on creating a sleep-friendly environment to recharge your resilience, check out this article.

Psychological – There are many ways to nurture your mind and mental health. This article from the Real Warriors Campaign describes stress reduction techniques that can help, especially for people in high-stress occupations. Information on specific breathing, meditation and relaxation tips can also be found here. Achieving work-life balance is an important part of psychological wellness, and this article offers help on finding that balance in the Navy.

Social/Relationships – Time alone is important, but relationships are one of the principles of resilience. Whether it’s relationships with friends, a spouse or other family members, or professional relationships and community ties, connectedness can have significant positive effects on a person’s well-being. Learn techniques on how to strengthen connections, whether in person or at a distance, here.

Self-care can be challenging to adopt or maintain, often due to demands on time, energy or putting the needs of others before your own. As you implement your plan, keep track of how you’re doing. Tracking your progress over time will help you understand and recognize your habits, successes and any difficulties you may not have originally anticipated. Remember, you can revise your plan as needed! Being there for others starts with being there for yourself. 1 Small ACT can make a difference and help you be there for every Sailor, every day.

Summer Safety: Suicide Prevention During the 101 Critical Days of Summer

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The 101 Critical Days of Summer are always a time to focus on safety – responsible drinking, boating safety, swimming safety and more – but suicide prevention efforts aren’t always included as a focus. The causes of suicide are complex, and while seasonality and weather are not significant risk factors, researchers have observed some associations between warm weather and suicide rates. Additionally, the stresses of military moves and accompanying separation from known support networks can be very difficult during this time of year. For these reasons and more, suicide prevention efforts are an important part of summer safety.

Use caution if drinking and watch out for your shipmates if they choose to drink. Alcohol abuse has been consistently associated with suicidal behavior, according to the National Institutes of Health. Consuming alcohol can lower inhibitions, increase impulsiveness and impair judgement. Alcohol abuse can also lead to social withdrawal, and all of these attributes can lead to greater suicide risk.

Understand how to reduce access to lethal means. Reducing access to lethal means of self-harm is key if a person is at risk of suicide, according to the Suicide Prevention Resource Center. Many suicide attempts happen during a short-term crisis, so reducing access to deadly medications or to firearms is important. Always store medications and firearms safely, or remove them from the area completely if you are concerned about those nearby.

Stay connected during times of change. Relationships play an invaluable role in our lives and are one of the Principles of Resilience. During the summer, when people are coming and going as a part of Navy life, it’s easy to feel disconnected. Check in on your friends who have left and reach out to new people in your community. Help create a feeling of belongingness in those around you and for yourself.

Suicide prevention is an all-hands, year-round responsibility. If you think a shipmate is having trouble navigating stress, ACT (Ask, Care, Treat):

  • Ask directly: Are you thinking of killing yourself?
  • Show that you care by listening without judgment and offering hope. Be there.
  • Help your friend connect with a support system immediately. Contact the Military Crisis Line (call 800-273-TALK and Press 1 or text 838255), escort them to the nearest chaplain, provider or leader, or call 911 if danger is imminent. Stay in contact with your friend throughout their treatment to promote a healthy recovery.

The idea that suicides occur more frequently during the holidays is a long-perpetuated myth and one that can be harmful to prevention efforts, according to the Centers for Disease Control and Prevention. A 2016 study in The Journal of Affective Disorders reviewed 29 science articles from 16 countries and found that suicide attempts were most frequent in spring and summer. Additionally, a 2016 study published in Environmental Health Perspectives found positive associations between warmer temperatures and suicide in three East Asian countries, regardless of country, age and gender. More recently, a 2018 study in the International Journal of Biometeorology examined nine major U.S. cities. Researchers found that there was a tendency toward late spring/summer peaks.

The Every Sailor, Every Day campaign has fact sheets, infographics, posters and magnets educating Sailors and families on key Operational Stress Control (OSC) concepts. Visit https://go.usa.gov/xyEBp to download materials, including the Principles of Resilience graphic and Lethal Means Safety graphics, or order them free of charge from the Naval Logistics Library.

Suicide Prevention and Supervisors: The Front Line When Things Get Tough

IWTC Virginia Beach Hosts Inaugural Hampton Roads Area Intelligence Symposium

Navy leaders have great influence and impact on their shipmates’ sense of connectedness. Front-line supervisors in particular can make a difference because of their unique position—the close quarters and long hours that characterize much of Navy life mean lots of day-to-day contact and many opportunities to really get to know your teammates. Supervisors are also knowledgeable about significant events Sailors are experiencing, such as promotion, deployment or family status.

Most Sailors who die by suicide were experiencing multiple stressors before their deaths, including relationship issues, transitions, and career or personal setbacks. Annual case reviews consistently reveal missed opportunities to “connect the dots” when a Sailor is experiencing negative effects of stress. Active communication is important, especially if a Sailor is alone and away from his or her support networks. Supervisors are key to this effort.

The Supervisor’s Role in Suicide Prevention

Though Sailors may compartmentalize their personal stressors to stay focused on the mission, if those stressors aren’t being adequately addressed or continue to pile up, they’re likely to spill over into their work performance. Taking the time to get to know your people can better enable you to notice when something seems off.  For example, a Sailor who used to be engaged and happy at work is becoming more withdrawn, is unable to focus or is easily agitated. These can be signals that a Sailor is in crisis and are opportunities for supportive conversation and ACTion. Consider reaching out to one of their peers who knows them well, as well as their family members who are more likely to have a more complete picture of what may be troubling the Sailor so that you can connect the dots and offer appropriate support.

It’s also imperative to reach out to the Sailor one-on-one and mention that you’ve noticed that they haven’t seemed like themselves lately. Ask directly “are you thinking about killing yourself?” You can follow up with questions like “do you have a plan to kill yourself?” Show them that you Care by listening without judgement and paying close attention to any additional warning signs, like statements about not wanting to live, feeling like a burden, feeling hopeless or discussion of lethal means. Help them get to Treatment immediately and escort them to a medical professional or Navy chaplain for safety. You can also call the Military Crisis Line with them.

Be there throughout the process, follow up and offer continued support, regardless of the level of care needed to help the Sailor bounce back. Ensure that they have ample time to attend appointments for any services they may need and help them overcome logistical barriers. For Sailors who have experienced a suicide-related behavior (SRB), remember that your suicide prevention coordinator (SPC) will need to initiate a referral to the Sailor Assistance and Intercept for Life (SAIL) program. SAIL provides caring contacts to Sailors in the 90 days after an SRB and keeps them connected to resources. Let the Sailor know that they’ll receive a call from a Fleet and Family Support Center (FFSC) SAIL Case Manager inviting them to receive these services to support their recovery. For more information on SAIL and key messages for leaders, visit https://go.usa.gov/xEE69.

Command Directed Mental Health Evaluations and Voluntary Storage of Firearms

Sometimes Sailors may be hesitant to seek treatment, even when it could be life-saving. A commander or supervisor may direct Sailors to undergo a mental health evaluation if they reasonably believe that a Sailor’s current mental health state places them at risk of hurting themselves or others. Command directed mental health evaluations are also appropriate when a Sailor has displayed marked changes in behavior or when the leader is concerned about a Sailor’s fitness for duty. Commanding Officers may consult with the nearest available mental health provider for guidance on the referral as well as necessary precautions such as escorts and removing access to lethal means.

As an added safety precaution during times of increased stress, Commanders must ask Sailors believed to be at-risk for suicide to voluntarily allow their privately-owned firearms to be stored for temporary safekeeping by the command per NAVADMIN 263/14. Leaders must work with base security and/or other local resources to proactively determine storage and safety protocol for local implementation of this DoD-wide policy. For more information, refer to DoD Instruction 6490.04.

Be There for Every Sailor, Every Day

Fostering communication and encouraging connectedness among team members are two strategies to increase protective factors against suicide that are recommended by the International Association for Suicide Prevention. Negative attitudes about mental illness can keep people from sharing their situation and reaching out for help. Lead by example and reassure your Sailors that mental health problems can happen to anyone and are treatable. Talk about mental health openly, honestly and supportively, just as you would about physical health. Encourage use of professional resources like medical providers and Navy’s Counseling Advocacy Program, as well as confidential support from a Navy chaplain or the Military Crisis Line.

Leaders should also share resources, contact information and educational materials regularly to foster a supportive command climate. Lifelink Newsletter includes articles that can be reproduced for your command’s blog or local publication, plan of the week notes and more. There are posters and other print resources available for download as well on the Every Sailor, Every Day campaign’s “Get Involved” webpage on http://www.suicide.navy.mil. Your support helps to reshape the negative perceptions about the impacts of seeking help on one’s career, especially when it comes to treatment from leaders and peers.

An All-Hands Responsibility

All Sailors, regardless of supervisory status, have specific responsibilities for suicide prevention which are outlined in the Navy’s latest Suicide Prevention Program Instruction, OPNAVINST 1720.4B​. In addition to the mandatory general military training (GMT) required for all Navy personnel and the specialized training for SPCs and Suicide Prevention Program Managers (SPPMs), Navy Suicide Prevention Brach also provides training resources for communities who have frequent contact with at-risk Sailors. Gatekeeper Training is available for legal defense personnel, transient personnel unit (TPU) staff, ombudsmen and medical staff. This training includes a facilitator guide, can be downloaded from www.suicide.navy.mil, and meets the Suicide Prevention GMT requirements. Additionally, the new Navigating Stress for Navy Families course provides practical tools and effective techniques to help spouses and families build resilience and navigate stress.

Resources to support locally-developed training can be found on the Navy Suicide Prevention Branch website, including facts and warning signs, informational materials, videos and statistics.