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Squadron Commander’s Suicide Prevention Education

Squadron Commander’s Suicide Prevention Education. Introduction. USAF Suicide Awareness Policy and Guidance. AFI 44-154, Suicide and Violence Awareness Education and Training directs (under revision) Annual community awareness education requirements

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Squadron Commander’s Suicide Prevention Education

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  1. Squadron Commander’s Suicide Prevention Education

  2. Introduction

  3. USAF Suicide Awareness Policy and Guidance • AFI 44-154, Suicide and Violence Awareness Education and Training directs (under revision) • Annual community awareness education requirements • Leader awareness education and training (Squadron Commander Courses and other PME) • Tracking of training completion • Suicide Event Surveillance System • Suicide Awareness Community Education Program Curriculum Guide

  4. USAF Suicide Prevention Program and Associated Policy • AFPAM 44-160 The Air Force Suicide Prevention Program (Apr 01) • AFI 44-109 Mental Health, Confidentiality, and Military Law (Mar 00) • AFI 44-153, Critical Incident Stress Management (Jul 99) • AFI 90-500, Community Action Information Board (CAIB) (Unpublished)

  5. General Background Information

  6. Evaluate Impact and Modify Interventions Implement Interventions Develop and Test Interventions Identify “Causes” and Protective Factors Define the Problem Community Approach • Applying Public Health Model to Suicide

  7. Increase - Protective Factors - Decrease Decrease - Risk Factors - Increase Disease Perfect Health Average Health Goals • Reduce adverse outcomes • Increase function and improve the health-related quality of life • Prolong healthy life

  8. Strategies • Modify community norms • Establish and enforce policies • Establish incentives for change • Enhance knowledge and skills • Monitor impact and adjust strategies

  9. Implementing Intervention • Define intervention objectives • Utilize multiple strategies • Change underlying community norms • Key to widespread and long-term health • Incorporate target population(s) in intervention development

  10. Identifying the Problem • Factors directly or indirectly associated with suicide: • Risk factors that increase the probability of suicide are: • Severe, prolonged, or unmanageable stress • Major life transitions (relationship problems) • Alcohol abuse • Legal problems • Others • Protective factors that decrease the probability of suicide are: • Optimistic outlook • Sense of belonging to a group and/or organization • Others

  11. Examples of Modifiable andNon-Modifiable Factors

  12. Balance Protective Factors Strengths And Competencies “Resilience” Risk Factors Vulnerabilities Problems Develop Protective Factors Keep Risk Factors In Balance Increased Probability Of Suicide Decreased Probability Of Suicide

  13. The Air Force Community “We have a responsibility to our active duty members and their families to provide a safety net of support services that ensures a healthy and fit force and assistance to those in need. This is the foundation underlying the Air Force Suicide Prevention Program. Now more than ever, we need to remind ourselves that our Air Force is only as strong as those who serve.” General John Jumper Air Force Chief of Staff

  14. Squadron Commander’s Suicide EducationProgram

  15. Unit 1 Identify actions and attitudes that encourage others to seek help Identify advantages and consequences of seeking help

  16. Unit 1: Actions and Attitudes that Encourage Others to Seek Help • Self-Referral • Best option • Individual maintains control • Increased motivation for change • Focus on resolving the problem • AFI 44-109, Mental Health, Confidentiality, and Military Law • Air Force policy to encourage seeking help • Commander/supervisor should encourage

  17. Unit 1: Referrals • Commander-Directed Evaluation (AFI 44-109) • Only commander directs • Commander consults with SJA to review the facts and the law • Commander consults with mental health • Mental Health provider determines appropriateness • Evaluates member’s mental health status, fitness for duty, and suitability for service • Rights of command referred airman • Legal counsel/IG; congressional etc. • Protected from reprisal • Not a tool for punishment • Two duty days written notice (except in emergencies)

  18. Unit 1: Advantages and Consequences of Seeking Help Type of Referral to Mental Health and Whether Confidentiality was Maintained Reference: Demographic, Clinical, and Military Factors Related to Military Mental Health Referral Patterns, Capt. Rowan, USAF BSC, Military Medicine Vol. 16, June 1996, page 324. Note: This study examined 693 cases of active duty members from all service branches seen in an Air Force outpatient mental health clinic over a 3-year period, 74% Air Force, 18% Army, 9% Navy and Marines.

  19. Unit 2 Understand the Limits of Confidentiality

  20. Unit 2: Confidentiality • AFI 44-109, Mental Health, Confidentiality, and Military Law • Psychotherapist-Patient Confidentiality • Communications between a patient and psychotherapist are confidential and shall be protected from unauthorized disclosure • Confidential communications will be disclosed to persons or agencies with a proper and legitimate need

  21. Unit 2: Limited Privilege Suicide Prevention Program (LPSP) • AFI 44-109, Mental Health, Confidentiality, and Military Law • Objective is to identify and treat those who pose a genuine risk of suicide because of impending disciplinary action under the UCMJ • Eligibility • Initiation • Duration • Limited Protection • Disclosing Case File Information

  22. Unit 3 Know the source for Air Force suicide demographic and epidemiological data Be familiar with Air Force suicide demographic and epidemiological information

  23. Unit 3: Source for AF Suicide Data • Suicide Event Surveillance System (SESS) (under revision) • Central surveillance database for fatal and nonfatal self-injuries • OPR: AFIERA/RSRH 2513 KENNEDY CIRCLE BROOKS AFB, TX 78235-5123 DSN: 240-3471

  24. Unit 3: Information on Air Force Suicides, CY 2000 • Of the 350,000 ADAF there were 128 deaths • Thirty were due to suicide • Suicide is the second leading manner of death • Second to unintentional injury • Suicide rate was 8.7/100,000

  25. Unit 3: More Facts About ADAF Suicides For CY 2000 • Males have a suicide rate that is twice that of females • Individuals separated, divorced or widowed are significantly more likely to commit suicide • No statistical difference in suicide rates among: • Rank groups • Age groups

  26. Unit 4 Know how to identify someone who may be at very high risk for suicide Know how to implement policies and procedures that are necessary to use for getting immediate help when someone is at very high risk for suicide

  27. Unit 4: Warning Signs forVery High-Risk Individuals • Current suicide ideation • Detailed plan • Lethal means • Easy access to lethal means • Intent to act on plan • Consider evidence of risk to others

  28. Unit 4: Very High RiskWhat to Do • Consult the Life Skills Support Center provider (mental health provider) • Do not leave them unattended • Have member transported and evaluated in emergency room or acute care clinic immediately • KEEP THEM SAFE!

  29. Unit 5 Understand the role and functions of the Integrated Delivery System (IDS) and identify resources and sources of information available within the IDS Know what the Critical Incident Stress Management policies are and how to obtain this assistance

  30. Family Support Unique Mission Family Advocacy Unique Mission HAWC Unique Mission Life Skills (Mental Health) Unique Mission Child and Youth Unique Mission Chaplains Unique Mission Integrated Delivery System for Preventive Services AFI 90-500 (Unpublished) Unit 5: Role and Functions of the Integrated Delivery System

  31. Unit 5: Critical Incident Stress Management • AFI 44-153 establishes a multidisciplinary Critical Incident Stress Team (CIST) at each base • It is intended for people experiencing NORMAL stress associated with potentially traumatic events • In the event of a critical incident local command post notifies CISTs team chief

  32. Final Thoughts Despite everyone’s best efforts, someone may still take their life “In a sense, no one deserves to be blamed for something that cannot ultimately be controlled – the volition and act of another autonomous human being” David A. Jobes, et al, Comprehensive Textbook of Suicidology Our goal is to do all we can to encourage the choice to live

  33. A healthy and fit forceincreases resiliency toovercome adversity

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