I n t e g r i t y - S e r v i c e - E x c e l l e n c e

Headquarters U.S. Air Force

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Suicide Prevention

Lt Gen C. Bruce GreenSurgeon General

13 Oct 11

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PSA: AF Family Suicide Risk

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PSA: AF Family Suicide Risk

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The Suicidal Mind

� Suicide is a behavior, not a disease� How we think and communicate about it affects its rate

� Usually characterized by desperation, hopelessness� Rage: anger and frustration - Impulse� Avoidance: legal/financial concerns, guilt� Mental illness: Depression, Bipolar Illness

� Substance use often fuels the fire

� Top risk factors� Relationship problems� Mental health history� Legal/ administrative problems

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AD Suicides ARC in Duty Status

ARC not in duty status Civilian Suicides

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Where We Left Off Last Year

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Sense of Urgency: AF experienced more suicides in CY1016.4/100K than any year since 1994 – 2011 Rate 14.4/100K

*As of 3 Oct 11

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Gap Analysis� Comprehensive gap analysis

� Volpe, RAND, with 11 AFSPP Elements� Input from MAJCOM/ARC Mental Health

Consultants and CAIB/IDS leaders

� Findings by Volpe & RAND� Encompass 11 AFSPP Elements� 23 AFSPP Gaps Identified

� Messaging (1)� Standardization (3)� Evaluation (2)� Guidance (15)� Application (2)

“The Air Force suicide-prevention program could provide amodel for the other Services.” – RAND, The War Within

TMT: 41111 6

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New Suicide PreventionInitiatives

Point of Attack

� Frontline Supervisor Training for at-risk AFSCs

� Semiannual Wingman Days

� Security Forces/JAG initiatives

� VCSAF Memos� Face-to-face suicide prevention training� Unit Consultation Tools

� Comprehensive Post-Suicide Guidelines

� Public Affairs Guidance for Suicide

� Increase AD mental health providers by 25%� Add 70 more to Primary Care

Process� Strategic Communication Plan

� Shift to strengths-based messaging

� RAND social media study

� Improved weekly dashboard slide

� Fort Hood Follow-on Review

� Response to DHB DoD TF on thePrevention of Suicide by MilitaryMembers

� 2011 Community Assessment� Expanded use of multimedia tools

� CSAF/CMSAF PSAs

“The Air Force’s pioneering suicide prevention program was producing the firstempirical evidence that a comprehensive, public health approach could, in fact,

reduce suicide across a population.” – Volpe Report

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Air Force SuicidePrevention Overview

Suicide Rates (per 100,000/yr) AD Risk Factors/Stressors (%)10 year Pre-Program 13.5 Relationship Problems 54.2

10 year Post-Program 9.9 History of Any Mental HealthDiagnosis

45.8CY10 Active Duty 16.4CY11 Active Duty (Rolling Rate) 14.4 Legal/Admin Problems 33.9CY11 Q2-Q3 Active Duty 11.5

Seen by Mental Health in PastMonth

18.6CY11 Total Force (Rolling Rate) 13.4CY11 Q2-Q3 Total Force 12.9By AD Career Group (CY 10-11)(per 100,000/yr)

Alcohol in System at Death 17

Security Forces (3P) 33.8 Deployed in the Past Year 12

Aircraft Maintenance (2A) 21.8Financial Problems 10.2Intelligence (1N) 0.0

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Security Forces rate down 30% from Feb ‘11 peak

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Prevent the Final ImpulsiveAction

� Identify those at risk

� Know your Airmen

� Create a culture of resilient Airmen

� ACE: Ask, Care, Escort

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Stress is Ubiquitous – Simple Adaptive Behaviors (Humor) are Effective

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Musical Stairs

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Musical Stairs

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“TRUSTED CARE ANYWHERE”

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BACK UP SLIDES

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Core Elements of Suicide Prevention

#1 Leadership Involvement

#2 Address Prevention through PME

#3 Guidelines for Commanders:Use of Mental Health Services

#4 Unit-Based Preventive Services

#5 Wingman Culture

#6 Investigative Interview Policy

#7 Post Suicide Response

#8 IDS & CAIB

#9 Limited Privilege SPP

#10 Commander Consultation Tools

#11 Suicide Event Tracking and Analysis

Where Leaders Can HelpLeadership Involvement

Conduct face-to-face training

Encourage PME

Use Leader’s Guide for Managing Personnel in Distress

Employ Resilience Elements (AFI 44-172, Mental Health)

Plan semi-annual Wingman Days

Heighten vigilance for Airmen under investigation

Make use of Leaders’ Post-Suicide Checklist

Support your local CAIB/IDS

Know when to recommend privileged counseling

Collaborate with your IDS on unit assessments

Support the completion of DoDSER database

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Help Improve Resilience & Destigmatize Mental Health

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* 52 Week Rolling RateResults Analysis

CY10/CY11 #s * Rolling 12 Month RateAD AF Suicides through 30 Sep: 38/32 14.4Total Force Suicides through 30 Sep: 72/63 13.4Improvement Actions/Next Steps- Update AFI 44-154, Suicide and Violence Prevention Education and Training- Suicide Prevention Program Evaluation Grant Proposal

Red Boundary

Metric AF Active Duty and AF Total Force Suicides Status: Yellow

Objective Track suicides over time to identify trends

Metric Owner: AFMSA/SG3OQ Metric POC: Major Michael McCarthy Last Updated On: 30 Sep 11

Green Boundary

Metric Definition: Suicide Rate= (Raw Number of Suicides Over the Last 12 Months/End Strength) x100,000

UNCLASSIFIED // FOUO

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CY10 DoD Rate

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