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
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
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
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
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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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
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
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
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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Civilian Suicides CY AD Rate Total Force Rate
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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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