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SUICIDE PREVENTION: A NEW APPROACH Julie Chodacki, PsyD LCDR, USPHS Scott AFB. DoD Suicides. On the rise – an average of 1 suicide every 36 hours* In AF 2/3 of suicides never had contact with MHC Increased publicity – newspapers, videos, websites
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SUICIDE PREVENTION: A NEW APPROACH Julie Chodacki, PsyD LCDR, USPHS Scott AFB
DoD Suicides • On the rise – an average of 1 suicide every 36 hours* • In AF 2/3 of suicides never had contact with MHC • Increased publicity – newspapers, videos, websites * 2009 DoD Task Force on Suicide Prevention
Coming up…. • Risk Factors • Protective Factors • Theoretical Model • Scott AFB Suicide Awareness & Prevention Field Day • Do try this at home
Suicide Risk Factors • Family history of suicide, child maltreatment • Previous suicide attempt(s) • History of mental disorders (clinical depression) • History of alcohol and substance abuse • Feelings of hopelessness • Impulsive or aggressive tendencies • Cultural and religious beliefs • Local epidemics of suicide
Risk Factors • Isolation, a feeling of being cut off from other people • Barriers to accessing mental health treatment • Loss (relational, social, work, or financial) • Physical illness • Easy access to lethal methods • Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or to suicidal thoughts CDC, 2010
New Military Reality • Separation from family, friends • Exposure to violence • Budget cuts/reduction in force • Losses (relational, social, work, or financial) • Physical/mental illness • Increased exposure to suicide
Suicide Research Acquired Capability Perceived Burdensomeness + Failed Belongingness Suicidal Ideation Serious Attempt or Death by Suicide Dr Thomas Joiner, Florida State University
Protective Factors • Effective clinical care for mental, physical, and substance abuse disorders • Easy access to a variety of clinical interventions and support for help seeking • Family and community support • Support from ongoing medical and mental health care relationships • Skills in problem solving, conflict resolution, and nonviolent way of handling disputes • Cultural and religious beliefs that discourage suicide and support instincts for self-preservation • (US Public Health Service 1999)
The “New Approach” Build a program that creates/strengthens protective factors
Awareness • Helping Agencies’ with risk factor game tables • No fliers, handouts, etc. -- prizes only! • Bingo card for completion of all games
Prevention • Units register at least one 4-person team • AMC funding obtains obstacle course (orange/blue) • One team member is “leader”; others are tied together • One team member is secretly handicapped • Two teams run course head-to-head • one orange, other blue • Track overall times • Orange wins more often – Why?
Prevention, continued • Orange leaders were secretly told of the handicap • Orange and Blue that compete together, debrief together • During debrief: • Complete evals • Inform of handicap – what changes? • Different if handicap was mental, not physical? • Felt isolated? (Orange? Blue?) Felt resentful? • Lesson: It’s not the limitation that impacts the mission; it’s not telling. Telling maintains connection, helps mission, helps individual
SUICIDE PREVENTION FIELD DAY Julie A Chodacki, PsyD, LCDR, USPHS & Connie M Burnett, MSW, Capt, USAF 375MDG, Scott Air Force Base, IL ComponentLoadingsColor-Word Interference Uncorrected Errors.78Trails Switching Set Loss Errors.74FAS Set-Loss Errors.56Design Fluency Set Loss Designs.67 Inconspicuously, a facilitator provided one of the tied team members with a note saying INTRODUCTION PREVENTION PROCESSING Immediately following the competition, paired teams competing on the Blue and Orange sides joined with a trained facilitator to be informed of their team member’s “injury”, to process their experiences, and to complete an evaluation. Facilitators were trained to inquire how having knowledge of a team member’s impairment changes their perception of that team member’s participation. They also discussed how the experience would have been different had the team member been depressed instead of having a broken arm. Scott AFB developed an innovative approach to suicide awareness and prevention. On September 23, 2010 educational games were set up and Airmen joined each other to challenge themselves in a professionally-facilitated obstacle course designed to promote protective factors. The event highlighted the importance of social support and belongingness; despite being educational, the 500 participants hailed it as “a lot of fun”. AWARENESS The Teams were divided into Blue and Orange Sides. Three members of a four person team were tied together with a rope. The fourth team member was assigned to be the team leader. Various helping agencies set up booths with educational games focused on raising suicide awareness and of available resources. Community partners donated food, music and prizes. Inconspicuously, a facilitator provided one of the tied team members on both sides with a note limiting the use of their dominate arm. OUTCOME The fastest team was from the Orange side and the top 4 out of 6 teams were also from the Orange side. As the obstacle course showed, knowing about a Wingman’s limitation actually helped the mission. It was not the limitation that impacted the mission; it was not knowing about it. Being informed ensured that the person with the limitation was part of the team, helped the mission and helped the individual. Only the Orange Team Leaders were informed of the team member’s limitation. They were told they could use this information to provide advice and support. Attendees visiting each game table received a stamp to fill their BINGO Card. Completed cards were entered into a drawing to win a prize. REFERENCES [1 Selby, Edward, Anestis, Michael, et al (2010). Overcoming the lethal injury: Evaluating suicidal behavior in the military through the lens of the Interpersonal-Psychological Theory of Suicide. Clinical Psychology Review, 30, 298-307. CORRESPONDENCE LCDR Chodacki/Capt Burnett, 375MDG, Scott AFB, IL 62225 E-mail: julie.chodacki@scott.af.mil/connie.burnett@scott.af.mil
Keys to Success • Commander support • Fun atmosphere • Free food
Do-It-Yourself • Group activity • Someone is handicapped; some leaders know, some don’t • Experienced facilitators