Tag Archives: suicide risk

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.

#BeThere For The Holidays

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According to the Suicide Prevention Resource Center, it is a commonly-held misconception that suicides increase over the holidays. This is not the case. However, the holidays are an ideal time to strengthen your connections with shipmates and loved ones – a protective factor against suicide. Whether catching up via phone, social media or at a holiday gathering, pay attention to the subtle signs that may indicate someone is having difficulty navigating stress. Those signs may include expressing feelings of hopelessness or burdensomeness, increased substance use, withdrawal from usual activities and sudden mood changes. Even if it seems like they’re joking or being casual, if something seems out of the norm trust your gut and ACT (Ask Care Treat).

ACT is Navy’s call-to-action to encourage early intervention when a Sailor is experiencing difficulty navigating stress or may be at risk for suicide. All Sailors and members of the Navy community should be able to recognize the risk factors and warning signs that indicate a potential suicidal crisis, and should feel confident in their ability to ACT:

  • Ask – Ask directly: are you thinking of killing yourself?
  • Care – Listen without judgment. Show that you care.
  • Treat – Get the Sailor immediate assistance. Escort him or her to the nearest chaplain, trusted leader or medical professional for treatment.

Annual case reviews consistently reveal missed opportunities to “connect the dots” when a Sailor is experiencing the negative effects of stress, psychological health concerns or exhibiting uncharacteristic behavior. Active communication and ongoing dialogue about stress, psychological health and suicide can motivate positive action and open the door for help.

While the holiday season may be a busy time, remember that 1 Small ACT can make a difference. In addition to knowing the signs and when to intervene, encourage Sailors to get ahead of stress by practicing self-care this season, like eating a balanced diet, making time for exercise and getting adequate sleep. Like U.S. Navy Operational Stress Control on Facebook or follow @NavStress on Twitter for healthy holiday tips from the Every Sailor, Every Day campaign. For additional resources, messages and materials, download the FY-19 1 Small ACT Toolkit.

A Different Kind of Grief: How to Help Survivors of Suicide Loss

Walk for suicide prevention and awareness

International Survivors of Suicide Loss Day is November 17. When someone loses a colleague or loved one to suicide, grief can be compounded by feelings of guilt, confusion and even anger and embarrassment. How can you help?

What You Can Do

CAPT Tara Smith, Ph.D., clinical psychologist for Navy Suicide Prevention Branch, OPNAV N171, offers these tips to help someone who is dealing with the loss of a loved one by suicide:

1. Don’t be afraid to acknowledge the death. Extend your condolences, express your feelings of sorrow. Talking about the loss lets the person know you’re a safe and understanding per-son in whom they can confide.

2. Ask the survivor if and how you can help. Though they may not be ready to accept help, asking signifies that you are there—not avoiding or distancing during this tragic event. Be prepared to offer specific support, such as providing meals, offering childcare or a coffee break.

3. Encourage openness. Do your best to be non-judgmental and be prepared for a wide variety of emotional responses. There is no one way to grieve. Be accepting of however survivors need to express their feelings. It may be with silence, with sadness or even anger.

4. Be patient. Don’t set a time limit for a survivor’s grief. Complicated grief can take years to process. Moreover, don’t limit a survivor’s need to share and repeat stories, conversations or wishes. Repetition is a key factor in grief recovery.

5. Be a compassionate listener. This means resisting the urge to try to “fix” things. The greatest gift you can give someone you care about who has survived a suicide loss is your time, reassurance and love. It’s perfectly okay to not know what to say or do. Simply being present is often the best support.

Every Sailor, Every Day

Losing someone to suicide can feel very isolating, not just for the immediate family, but for members of the entire community. Be physically and emotionally present for the grieving person. Strong relationships built on trust are key principles of resilience that can promote recovery after experiencing loss.
Every member of the Navy community is responsible for contributing to a culture that supports psychological and physical health, encourages seeking help for challenges and promotes a constructive dialogue about stress and suicide.

Finding Support

There are many resources available on Navy Suicide Prevention’s website at www.suicide.navy.mil to help you communicate safely about psychological health and suicide, find support and more. Confidential help is available through the Military Crisis Line (call 800-273-TALK and Press 1 or text 838255) and your command chaplain. Additional resources for survivors of suicide loss are also available at:

Security clearances and mental health—Part 1: Judgment matters

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This article is courtesy of our partners at the Human Performance Resource Center (HPRC) and is the first in their series about mental health and security clearances.

One of the biggest reasons Warfighters hesitate to seek professional mental health care is the commonly held misunderstanding that getting such assistance could impact their security clearances. Here are some basics: The existence of a psychological diagnosis or disorder will not automatically disqualify you from getting or retaining a security clearance. Almost no one has lost a clearance for having a behavioral health diagnosis. Of those who have lost clearances, only 0.04% did so for solely psychological reasons. What’s more, the simple act of meeting with a mental health professional or obtaining mental health care will not automatically result in a loss of clearance. The issue of mental health and security clearance is complex, so it’s important to clear up some common misconceptions about how mental health can impact security clearance status.

HPRC provides a series of articles about mental health and security clearances, beginning with this one on how your good judgment favorably affects your clearance status.

Judgment Matters

The real factors that heavily influence clearance status are whether an individual is trustworthy, dependable, reliable, and shows good judgment. Indeed, the vast majority of revoked or denied clearances occur because the applicant demonstrated a history of poor judgment and questionable decision-making. Infractions such as running up a credit card, getting numerous speeding tickets, or drinking and driving negatively impact clearance status much more commonly. The clearest disqualifier is active involvement with illegal drugs, including medical marijuana, which remains illegal at the federal level. Drug use and risky behavior, for example, are symptoms of more serious underlying psychological issues that can indeed impact clearance status. Many people incorrectly attribute negative clearance status to the simple act of seeking help instead of poor judgment and behavior.

Seeking help when you face a problem—including a mental health problem—actually demonstrates trustworthiness, dependability, reliability, and good judgment—the very factors being vetted for a security clearance. Being forthcoming about what you experienced and how you dealt with it by obtaining help from a mental health professional shows mental clarity and self-awareness.

Debrief/Bottom line

Warfighters are expected to have the tactical skills and stamina required to perform at consistently high levels in stressful environments. However, even the strongest have moments in life that might require them to call for support. When you’re struggling, it takes courage to admit it and seek help. Doing so means you’re strong, and it means you have good judgment. Calling for support means that you can stay strong and be prepared for your teammates and your family, both of whom depend on you to stay on top of your game.

Obtaining mental health care when you need it demonstrates good judgment that can be favorably evaluated during a security clearance investigation. All Warfighters need maintenance, from time to time, of their physical and psychological health. Don’t let simple misconceptions about a complex process stand in the way of calling for mental health support. Be proud of yourself for seeking help and be candid during the clearance process. You’ll be glad you did.

References

Defense Human Resources Activity. Welcome to PERSEREC. Retrieved from http://www.dhra.mil/perserec/

U.S. Army Personnel Security. Information on Question 21. Retrieved from http://www.dami.army.pentagon.mil/site/PerSec/Q21.aspx

Under Secretary of Defense for Personnel and Readiness. (2014). Seeking Help is a Sign of Strength: Campaign Plan for Promoting Awareness of the Benefits of Help-seeking and Understanding. Question 21 of Standard Form 86. Retrieved from http://www.dami.army.pentagon.mil/site/PerSec/Q21.aspx

United States Office of Personnel Management, & Director of National Intelligence. (2013). Revised Instructions for Completing Question 21, Standard Form 86, “Questionnaire for National Security Positions”.  Washington, DC. Retrieved from https://nbib.opm.gov/hr-security-personnel/federal-investigations-notices/2013/fin-13-02.pdf