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Gen Goldfein

General Goldfein

"We in the Air Force are committed to optimizing Airman Culture. It is the personal engagement, the social connection and the sense of purpose that comes from being part of something greater than ourselves which sustains us in the face of adversity."

Gen. David L. Goldfein
Air Force Chief of Staff

Ask Care Escort

If you have identified an airman that may be considering suicide, it’s important to Ask your Wingman directly about what’s going on. This will help you determine what needs to be done next. Ask about issues early rather than waiting for things to escalate to the point of crisis. Take all comments about suicide seriously. Be an active listener and let your Wingman tell you about their challenges. Although it can be awkward, it’s important to ask the tough questions about whether or not your Wingman is thinking about harming or killing himself. If the answer is yes, or if you even suspect that the answer is yes, don’t leave the person alone.

Care for your Wingman by calmly listening and expressing concern. Don’t be judgmental or promise secrecy. If your Wingman is having thoughts of suicide, you need to act. Remove anything he could use to hurt himself and immediately seek help.

The final step is to Escort your Wingman immediately to the nearest emergency room, Mental Health Clinic, chaplain, or primary care clinic, and contact the supervisor or chain of command. If a distressed Airman refuses help or you're not sure what to do, call your supervisor or 911 for help. Never leave an Airman who is having thoughts of suicide alone, even to go to the bathroom.

Ask Your

Wingman

  • Have the courage to ask the question, but stay calm
  • Ask the question directly: Are you thinking of killing yourself?

Care For Your

Wingman

  • Calmly control the situation; do not use force; be safe
  • Actively listen to show under­standing and produce relief
  • Remove any means that could be used for self-injury

Escort Your

Wingman

  • Never leave your buddy alone

Family Resources

Compassionate Friends

Provides highly personal comfort, hope, and support to every family experiencing the death of a son or a daughter, a brother or a sister, or a grandchild, and helps others better assist the grieving family
http://www.compassionatefriends.org/home.aspx

The Dougy Center for Grieving Children & Families

Provides support in a safe place where children, teens, young adults, and their families grieving a death can share their experiences. Provides support and training locally, nationally, and internationally to individuals and organizations seeking to assist children in grief.
http://www.dougy.org

National Alliance on Mental Illness (NAMI)

NAMI, is dedicated to building better lives for the millions of Americans affected by mental illness. Advocates for access to services, treatment, supports and research and is steadfast in its commitment to raising awareness and building a community of hope for all of those in need.
http://www.nami.org/

Parents of Suicide

A mailing list provides that provides a supportive environment for parents whose children have died of suicide. It is intended to provide a place where parents can discuss the lives and deaths of their children with other parents whose children have died by suicide.
http://www.parentsofsuicide.com/parents.html

SiblingSurvivors.com

Share stories of surviving sibling suicide and continue supporting the need for open dialog and community amongst those affected by the loss of a sibling.
http://www.siblingsurvivors.com

Suicide: Finding Hope

http://www.suicidefindinghope.com/home

Tragedy Assistance Program for Survivors (TAPS)

TAPS provides immediate and long-term emotional help, hope, and healing to all who are grieving the death of a loved one in military service to America. TAPS meets its mission by providing peer-based emotional support, grief and trauma resources, casework assistance, and connections to community-based care.
http://www.taps.org/

Helping Resources

There are many resources available to airmen, their families, and friends pertaining to the subject of suicide prevention.

Veterans/Military Crisis Line

The purpose of the Veterans/Military Crisis Line is to connect service-members, their families, and their friends to a qualified Department of Defense responder in a time of crisis. The VCL/MCL can be reached by phone at 1-800-273-8255, by text at 838255, or via online chat.

National Organizations Providing Suicide Prevention Information

American Association of Suicidology (AAS)

AAS is a membership organization for all those involved in suicide prevention and intervention, or touched by suicide. AAS is a leader in the advancement of scientific and programmatic efforts in suicide prevention through research, education and training, the development of standards and resources, and survivor support services.
https://www.suicidology.org/

American Association of Suicidology (AAS) Clinician Survivor Task Force

Under the auspices of the American Association of Suicidology, the task force will provide consultation, support and education to psychotherapists and other mental health professionals to assist them in understanding and responding to their personal/professional loss resulting from the suicide death of a patient/client.
http://mypage.iu.edu/~jmcintos/therapists_mainpg.htm

American Foundation for Suicide Prevention (AFSP)

Not-for-profit organization exclusively dedicated to understanding and preventing suicide through research, education and advocacy, and to reaching out to people with mental disorders and those impacted by suicide.
http://www.afsp.org/

American Psychiatric Association

The American Psychiatric Association is the world's largest psychiatric organization. It is a medical specialty society representing more than 33,000 psychiatric physicians from the United States and around the world. Its member physicians work together to ensure humane care and effective treatment for all persons with mental disorders, including intellectual developmental disorders and substance use disorders.
http://www.psychiatry.org/suicide

American Psychological Association

The American Psychological Association is the largest scientific and professional organization representing psychology in the United States. APA is the world's largest association of psychologists, with more than 137,000 researchers, educators, clinicians, consultants and students as its members.
www.apa.org/topics/suicide/index.aspx

Link Counseling Center's National Resource Center

The Link's NRC is a leading resource in the country for suicide prevention and aftercare. It is dedicated to reaching out to those whose lives have been impacted by suicide and connecting them to available resources. Families who have experienced a loss through suicide receive unparalleled support while they grieve.
https://www.thelink.org/

Make the Connection

A public awareness campaign by the U.S. Department of Veteran Affairs (VA) that provides personal testimonials and resources to help Veterans discover ways to improve their lives.
http://maketheconnection.net/conditions/suicide#

Mental Health America

Dedicated to promoting mental health, preventing mental and substance use conditions and achieving victory over mental illnesses and additions through advocacy, education, research and service.
http://www.nmha.org/go/suicide

National Institute of Mental Health (NIMH)

The mission of NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure.
http://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml

SAVE: Suicide Awareness Voices of Education

Their mission is to prevent suicide through public awareness and education, reduce stigma and serve as a resource to those touched by suicide.
http://www.save.org

24/7 Resources And Information For Service Members And Families:

DoD/VA Suicide Outreach: DCoE Outreach Center (with Link to Chat)

Provides psychological health information and connects service members/families with resources.
1-866-966-1020

Military One Source

Free service provided by the DoD to service members and their families to help with a broad range of concerns including money management, spouse employment and education, parenting and child care, relocation, deployment, reunion, and the particular concerns of families with special-needs members.

They can also include more complex issues like relationships, stress, and grief. Services are available 24 hours a day -- by telephone and online.
(Available 24/7) 1-800-342-9647
http://www.militaryonesource.com/skins/MOS/home.aspx

Warning Signs

Warning Signs for suicide are different than Risk Factors. They are more observable, and should be responded to immediately. A common theme for Warning Signs is change. This is why friends, relatives, and coworkers are critical in detecting early Warning Signs of distress.

Many people who are at risk for suicide show changes in their mood such as hopelessness, depression, or anxiety. Other emotional and behavioral changes include agitation, anger, or irritability.

Changes in daily activities, for example changes in appetite or sleep, can be Warning Signs. These can include eating or sleeping significantly more or less than usual. Unusual or sudden changes in behavior, isolation, withdrawal, a loss of interest in work, or change in work performance are also Warning Signs. Even a positive mood change can be a Warning Sign if someone has been down for a while. It’s important to ask about the reasons behind the change.

And, finally, one very important Warning Sign is talking or communicating about death or suicide. All Airmen should be alert to these behaviors in others and be prepared to intervene.

The behaviors listed below may be signs that someone is thinking about suicide.

  • Talking about wanting to die or wanting to kill themselves
  • Talking about feeling empty, hopeless, or having no reason to live
  • Making a plan or looking for a way to kill themselves, such as searching online, stockpiling pills, or buying a gun
  • Talking about great guilt or shame
  • Talking about feeling trapped or feeling that there are no solutions
  • Feeling unbearable pain (emotional pain or physical pain)
  • Talking about being a burden to others
  • Using alcohol or drugs more often
  • Acting anxious or agitated
  • Withdrawing from family and friends
  • Changing eating and/or sleeping habits
  • Showing rage or talking about seeking revenge
  • Taking great risks that could lead to death, such as driving extremely fast
  • Talking or thinking about death often
  • Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
  • Giving away important possessions
  • Saying goodbye to friends and family
  • Putting affairs in order, making a will

If these warning signs apply to you or someone you know, get help as soon as possible, particularly if the behavior is new or has increased recently. One resource is the VETERANS/MILITARY CRISIS LINE, 1-800-273-TALK (8255). The crisis line is available 24 hours a day, 7 days a week. The deaf and hard of hearing can contact the crisis line via TTY at 1-800-799-4889.

Protective Factors

The Air Force recommends maintaining a balanced lifestyle through Comprehensive Airman Fitness, or CAF. CAF encourages taking care of each other and ourselves through wellness in four domains – mental, physical, social, and spiritual. CAF can help instill or strengthen existing Protective Factors to help you cope with stress or challenges in positive ways.

Because everyone faces stress, it’s important to continually assess and strengthen those factors in your life that help you effectively cope with and overcome challenges. Protective Factors are positive behaviors and supportive connections that protect against stress. They are also an important element of suicide prevention. They include:

  • Positive relationships with family, friends, and coworkers, as well as a sense of belonging
  • Coping skills such as effective problem solving, goal setting, and knowing when to seek help
  • And practicing positive thinking or beliefs such as:
    • Acknowledging the positive aspects of a situation
    • Maintaining positive expectations for the future
    • Recognizing your ability to influence that future
    • Believing things will get better even when they are going wrong
    • Sustaining a sense of purpose or meaning in your life, and
    • Holding religious or spiritual beliefs

11 Elements of the Air Force Suicide Prevention Program:

The AF Suicide Prevention Program is built on 11 overlapping core elements stressing leadership and community involvement in the prevention of suicides.

  1. Leadership Involvement: AF leaders actively support the entire spectrum of suicide prevention initiatives in the community.
  2. Addressing Suicide Prevention through Professional Military Education: PME provides periodic and targeted Suicide Prevention training for Airmen, specifically oriented to the individual's rank and level of responsibility.
  3. Guidelines for Commanders: Use of Mental Health Services: Commanders receive training on how and when to use mental health services and guidance on their role in encouraging early help seeking behavior.
  4. Unit-based Preventive Services: Helping-agency professionals partner with unit leaders to provide services at the work site to increase access, encourage help-seeking, and promote familiarity, rapport, and trust with Airmen and families.
  5. Wingman Culture: Wingmen practice healthy behaviors and make responsible choices and encourage others to do the same. Wingmen foster a culture of early help-seeking. Wingmen recognize the risk factors and warning signs of distress in themselves and others and take protective action.
  6. Investigative Interview Policy: Following any investigative interview, the investigator is required to 'hand-off' the individual directly to the commander, first sergeant, or supervisor. The unit representative is then responsible for assessing the individual's emotional state and contacting a mental health provider if any question about the possibility of suicide exists.
  7. Post Suicide Response (Postvention): Suicide impacts coworkers, families, and friends. Offering support early is associated with increased help-seeking behavior.
  8. Integrated Delivery System (IDS) and Community Action Information Board (CAIB): At the Air Force, MAJCOM, and base levels, the CAIB and IDS provide a forum for the cross-organizational review and resolution of individual, family, installation, and community issues that impact the force readiness and the quality of life.
  9. Limited Privilege Suicide Prevention Program: Patients undergoing legal action who are at risk for suicide are afforded increased confidentiality when seen by mental health providers.
  10. Commanders Consultation Assessment Tool: Commanders use a variety of assessments (e.g., Unit Climate Assessment, Air force Community Assessment Survey, Airman Comprehensive Asessment) recommended by appropriate agencies, to gain insight into unit strengths and areas of vulnerability.
  11. Suicide Event Tracking and Analysis: Information on all AF suicides and suicide attempts are entered into a central database, currently the Department of Defense Suicide Event Report (DoDSER), to identify suicide risk factors and trends.

Government Resources

There are many national agencies and organizations that are involved in suicide prevention efforts. These agencies provide valuable information, and some offer funding opportunities, training, technical assistance, and additional resources.

U.S. Substance Abuse And Mental Health Services Administration:

The U.S Substance Abuse and Mental Health Services Administrations (SAMHSA) provides suicide prevention information and other helpful resources to behavioral health professionals, the general public, and people at risk. SAMHSA is committed to continuing to work with its federal partners and private organizations to provide states, territories, tribal entities, communities, and the public with the assistance and prevention resources they need.

http://www.samhsa.gov/suicide-prevention

National Institute Of Mental Health:

The National Institute of Mental Health (NIMH) is an organization that conducts research on suicide, suicide prevention, and many other mental health topics. Their website offers information and resources on a wide array of topics.

https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml

National Center For Injury Prevention And Control:

The NCIPC is a division of the U.S. Centers for Disease Control and Prevention (CDC). The NCIPC website contains information on suicide such as statistics, prevention plans, and risk factors. It also includes links to statistical databases, such as WISQARS (Web-based Injury Statistics Query and Reporting System), YRBSS (Youth Risk Behavior Surveillance System), the National Violent Death Reporting System, and the National Vital Statistics System.

http://www.cdc.gov/ViolencePrevention/suicide/index.html

Indian Health Services:

Despite the strengths of American Indian and Alaska Native (AI/AN) families and communities, suicide remains a devastating and all too frequent event. Complex, interrelated factors contribute to an increased suicide risk among AI/AN people. Risk factors include mental health disorders, substance abuse, intergenerational trauma, and community-wide issues. Factors that protect AI/AN youth and young adults against suicidal behavior are a sense of belonging to one's culture, a strong tribal/spiritual bond, the opportunity to discuss problems with family or friends, feeling connected to family, and positive emotional health.

Cooperation among tribal, federal, and other partners is imperative to create a safety net of interconnected programming—health, education, law enforcement, public health and well-being, economic development, and physical and behavioral health—to maximize effectiveness of services and to protect individuals against suicide risk.

The Indian Health Service is partnering with tribal, federal, state, and community leadership to advance behavioral health and prevent suicide in AI/AN communities.

https://www.ihs.gov/suicideprevention/

Defense Suicide Prevention Office

The Defense Suicide Prevention Office (DSPO) provides advocacy, program oversight, and policy for Department of Defense suicide prevention, intervention and postvention efforts to reduce suicidal behaviors in Service members, civilians and their families.

http://www.dspo.mil/

Centers For Disease Control and Prevention: Violence Prevention

Violence is a serious public health problem. From infants to the elderly, it affects people in all stages of life. Many more survive violence and suffer physical, mental, and or emotional health problems throughout the rest of their lives. CDC is committed to stopping violence before it begins.

https://www.cdc.gov/violenceprevention/index.html

Be There

In any given year, over 40,000 Americans die by suicide, almost twice as many as are killed by homicide. The military is not exempt from the problem of suicide.

What do you need to know to effectively raise awareness about suicide prevention?

  • Daily connections can make a big impact on someone’s feeling of loneliness.
  • No special training is needed to show genuine concern for someone in crisis.
  • Suicide prevention is very much a leadership issue, which means leaders should create climates in which Service Members are encouraged to seek the help they need.
  • When members of the military get behavioral health care, they are protected against discrimination by law.
  • There are important signs of suicide risk that can be identified: Hopelessness, Anxiety, Self-destructive behavior (for example, alcohol and drug abuse, as well as talking about death)

Training

Wingman Online

A website full of resources pertaining to suicide prevention managed by the Air Force’s Center for Excellence in Medical Multimedia. Suicide prevention training programs, resilience trainings, a video library, and more resources can all be found at the Wingman Online Website.

Green Dot

Green Dot is an important step in arming Airmen for violence prevention using an evidence-based public health model. Green Dot prepares organizations to implement a strategy of violence prevention that reduces power-based interpersonal violence, which includes not only sexual violence, but also domestic violence, dating violence, stalking, child abuse, elder abuse, and bullying. The Air Force contracted the non-profit Green Dot organization to provide these violence prevention tools to the total Air Force over the next three years. The 1,500 Airman implementers completed training in March 2016. They returned to their units to train peer leader Airmen at each base followed by training for all Airmen.

Leader Resources

Limited Privilege Suicide Prevention Program:

The LPSP program is for Airmen who have been informed (verbally or in writing) that they are under investigations for possible UCMJ violations.

If an Airman is at risk for suicide, he/she may self refer or be referred to the program by any individual officially involved in the processing of the disciplinary action.

A mental health provider will determine if the Airman is at risk. If the mental health provider determines the member poses a risk of suicide he/she will: initiate treatment, explain the LPSP program, place the member in the program and document enrollment in the mental health notes.

The protection ends once the mental health provider determines the member no longer poses a risk of suicide. The LPSP protects what the Airman says in treatment with the mental health provider.

VCSAF Memo & CC Checklist 

Risk Factors

Military life can be both rewarding and challenging, and everyone deals with life stressors. Fortunately, most Airmen deal effectively with life stressors the majority of the time.

For some people, however, challenges can seem overwhelming, which may even lead to thoughts of suicide. Risk Factors for suicide include anything that makes it more likely that a person will attempt to take his or her own life, such as:

  • Relationship problems
  • Legal challenges
  • Financial issues
  • Medical problems
  • Sleep concerns
  • Workplace challenges, or
  • Family problems

These stressors may or may not be known to others. For this reason, it’s important to notice changes in those around you, and engage with anyone you are concerned about. Ask questions in order to understand what’s going on, and provide support. It’s also important to recognize Risk Factors in yourself as signs that you may need additional support.