The Journal of Primary Prevention

, Volume 37, Issue 3, pp 287–302 | Cite as

The Influence of Training, Reluctance, Efficacy, and Stigma on Suicide Intervention Behavior Among NCOs in the Army and Marine Corps

  • Lynsay Ayer
  • Rajeev Ramchand
  • Lily Geyer
  • Lane Burgette
  • Aaron Kofner
Original Paper


The Army and Marine Corps have consistently experienced the highest rates of suicide relative to the other services. In both the Army and Marine Corps, the service members responsible for identifying and referring individuals at risk for suicide are called “gatekeepers” and are typically noncommissioned officers (NCOs). We used structural equation modeling on survey responses from 1184 Army soldiers and 796 marines to estimate the relationships between training, intervention efficacy, reluctance, and mental health stigma on NCO intervention behaviors. Efficacy and reluctance were independently associated with intervention behaviors, and stigma was only associated with intervention behaviors among Army NCOs. Study results suggest that while quantity of training may help NCOs feel more confident about their ability to intervene, other efforts such as changing training content and delivery mode (e.g., interactive vs. didactic training) may be necessary in order to reduce reluctance and stigma to intervene with service members at risk for suicide.


Suicide Military Gatekeeper Stigma 



This research is sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (TBI) and conducted within the Forces and Resources Policy Center, part of the RAND National Defense Research Institute (NDRI). NDRI is a federal funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community. We also acknowledge individuals in the DoD, particularly our project sponsor Captain Janet Hawkins, and from the Army: Army Chaplain (Major General) Donald L. Rutherford, Army Chaplain (Colonel) Dallas Speight, Mr. Bruce Shabaz, Col. George Glaze, CDR Andrew Martin, LtCol Sean Stallard as well as the NCO cadre and their immediate leadership at each installation that were kind enough to allow us access into their training academies.

Compliance With Ethical Standards

Conflict of Interest

The authors have no conflict of interest.


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Copyright information

© RAND Corporation 2016

Authors and Affiliations

  • Lynsay Ayer
    • 1
  • Rajeev Ramchand
    • 1
  • Lily Geyer
    • 1
  • Lane Burgette
    • 1
  • Aaron Kofner
    • 1
  1. 1.RAND CorporationArlingtonUSA

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