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Innovations in Military and Veteran Suicide Prevention

  • Kathryn Maslowski
  • Kristen Vescera
  • Bruce Bongar
Chapter

Abstract

Protecting the 1% of the population that protects the rest is a top priority for the United States (US) Department of Defense (DoD) and political leaders alike. With the country at war for almost two decades, the USA is now seeing the impact those wars have had on veterans. After this epidemic came to light, the Department of Veterans Affairs (VA) and DoD implemented many suicide prevention programs and interventions. One of the changes is implementing mandatory training focused on identifying suicide risk factors for active duty veterans to better identify when their fellow veterans may need help. Additionally, in the past 5 years the DoD has attempted to decrease the stigma associated with receiving mental health treatment by emboldening leaders to be open about their own troubles while encouraging the people they lead to seek help. However, the stigma of receiving or seeking mental health is still a major issue in the military, especially in the Special Forces community where 49 operators have killed themselves in the last few years. Another point is increasing treatment availability and possible interventions offered through the VA. An increased focus on the VA within the past 5 years has been due to a lack of service provision and hardships associated with seeking mental health treatment. New social programs such as Rubicon, Wounded Warrior, and other veteran services and their effect on suicide and overall mental health of veterans should be considered. Lastly, studies have shown culture plays a large role in suicide risk. The military culture is one that uniquely traverses ethnicity, language, and country. Tailoring suicide prevention with military culture in mind and identifying risks could help decrease veteran suicide.

Keywords

Veteran suicide prevention Institution level suicide prevention Ask Care Escort (ACE) model Suicide distress Armed forces 

References

  1. Aseltine, R. J., & DeMartino, R. (2004). An outcome evaluation of the SOS Suicide Prevention Program. American Journal of Public Health, 94(3), 446–451.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Besterman-Dahan, K., Gibbons, S. W., Barnett, S. D., & Hickling, E. J. (2012). The role of military chaplains in mental health care of the deployed service member. Military Medicine, 177(9), 1028–1033.CrossRefPubMedGoogle Scholar
  3. Bongar, B., & Sullivan, G. (2013). The suicidal patient: Clinical and legal standards of care. Washington, D.C.: American Psychological Association.CrossRefGoogle Scholar
  4. Braswell, H., & Kushner, H. I. (2012). Suicide, social integration, and masculinity in the U.S. military. Social Science and Medicine, 74(4), 530–536.CrossRefPubMedGoogle Scholar
  5. Brooks, T. A. (2005). Ethnic identification level and mental health in a military environment. Dissertation Abstracts International Section A, 67(1-A), 103.Google Scholar
  6. Bruce, M. L. (2010). Suicide risk and prevention in veteran populations Bruce Suicide in veteran populations. Annals of the New York Academy of Sciences, 1208(1), 98–103.CrossRefPubMedGoogle Scholar
  7. Cardona, R. A., & Ritchie, E. C. (2007). U.S. Military enlisted accession mental health screening: History and current practice. Military Medicine, 172(1), 31–35.CrossRefPubMedGoogle Scholar
  8. Chu, J. P., Goldblum, P., Floyd, R., & Bongar, B. (2010). A cultural theory and model of suicide. Applied and Preventive Psychology, 14(1–4), 25–40.CrossRefGoogle Scholar
  9. Comprehensive Soldier and Family Fitness. (2010). Army health promotion risk reduction report 2010. Retrieved from http://csf.2.army.mil/downloads/HP-RR-SPReport2010.pdf.
  10. Cornum, R., Matthews, M. D., & Seligman, M. P. (2011). Comprehensive soldier fitness: Building resilience in a challenging institutional context. American Psychologist, 66(1), 4–9.CrossRefPubMedGoogle Scholar
  11. Department of Defense. (2013a) 2013 Demographics profile of the military community. Retrieved from http://www.militaryonesource.com.
  12. Department of Defense. (2013b). Mental health evaluations of members of the military services (DoD Instruction 6490.04). Washington, DC: Author.Google Scholar
  13. Department of the Air Force. (2014). Suicide prevention program (AFI90-505). Washington, DC: Author.Google Scholar
  14. Department of the Army. (2012). Army suicide prevention program: Annual guidance on suicide prevention training (ALARACT 079-12). Washington, DC: Author.Google Scholar
  15. Department of the Army. (2014). Comprehensive soldier and family fitness (Army Regulation 350-53). Washington, DC: Author.Google Scholar
  16. Department of the Army. (2015). Army health promotion (Army Regulation 600-63). Washington, DC: Author.Google Scholar
  17. Department of the Navy. (2009). Suicide prevention program (OPNAV Instruction 1720.4A). Washington, DC: Author.Google Scholar
  18. Department of the Navy. (2012). Marine corps suicide prevention program (MCO 1720.2). Washington, DC: Author.Google Scholar
  19. Department of the Navy. (2015). Operational stress control program (OPNAV Instruction 6520.1). Washington, DC: Author.Google Scholar
  20. DeViva, J. C., Sheerin, C. M., Southwick, S. M., Roy, A. M., Pietrzak, R. H., & Harpaz-Rotem, I. (2016). Correlates of VA mental health treatment utilization among OEF/OIF/OND veterans: Resilience, stigma, social support, personality, and beliefs about treatment. Psychological Trauma: Theory, Research, Practice, and Policy, 8(3), 310–318.CrossRefGoogle Scholar
  21. Franklin, K. (2015). Department of Defense quarterly suicide report calendar 2015 2nd quarter. Retrieved from Defense Suicide Prevention Office website: http://www.dspo.mil/Portals/113/Documents/DoD%20Quarterly%20Suicide%20Report%20CY2015%20Q2.pdf.
  22. Give an hour: General information. (n.d.). Retrieved from https://www.giveanhour.org/AboutUs.aspx.
  23. Greden, J. F., Valenstein, M., Spinner, J., Blow, A., Gorman, L. A., Dalack, G. W., … Kees, M. (2010). Buddy-to-Buddy, a citizen soldier peer support program to counteract stigma, PTSD, depression, and suicide Greden et al. Buddy-to-Buddy for citizen soldiers support. Annals of The New York Academy of Sciences, 1208(1), 90–97.Google Scholar
  24. Hall, B., & Gabor, P. (2004). Peer Suicide Prevention in a Prison. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 25(1), 19–26.CrossRefGoogle Scholar
  25. Hsu, J., & Ketchen, B. R. (2013). Working with veterans, social class, and counseling: Understanding the veteran population and implications for treatment. In W. Ming Liu (Ed.), The Oxford handbook of social class in counseling (pp. 164–184). New York, NY: Oxford University Press.Google Scholar
  26. Jones, E., Hyams, K. C., & Wessely, S. (2003). Screening for vulnerability to psychological disorders in the military: An historical survey. Journal of Medical Screening, 10(1), 40–46.CrossRefPubMedGoogle Scholar
  27. Kang, H. K., Bullman, T. A., Smolenski, D. J., Skopp, N. A., Gahm, G. A., & Reger, M. A. (2015). Suicide risk among 1.3 million veterans who were on active duty during the Iraq and Afghanistan wars. Annals of Epidemiology, 25(2), 96–100.CrossRefPubMedGoogle Scholar
  28. Kaplan, M. S., McFarland, B. H., Huguet, N., & Valenstein, M. (2012). Suicide risk and precipitating circumstances among young, middle-aged, and older male veterans. American Journal of Public Health, 102(S1), 131–137.CrossRefGoogle Scholar
  29. Kemp, J. & Bossarte, R. (2012a). Suicide data report 2012. Retrieved from Department of Veterans Affairs Mental Health Services Suicide Prevention Program website: http://www.va.gov/opa/docs/suicide-data-report-2012-final.pdf.
  30. Kemp, J., & Bossarte, R. M. (2012b). Surveillance of suicide and suicide attempts among veterans: Addressing a national imperative. American Journal of Public Health, 102(Suppl 1), e4–e5.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Lafleur, A. K., & White, B. J. (2010). Appreciating mentorship: the benefits of being a mentor. Professional Case Management, 15(6), 305–311.CrossRefPubMedGoogle Scholar
  32. Lambert, M. T., & Fowler, D. R. (1997). Suicide risk factors among veterans: Risk management in the changing culture of the Department of Veterans Affairs. Journal of Mental Health Administration, 24(3), 350–358.CrossRefPubMedGoogle Scholar
  33. Lester, P. B., McBride, S., & Cornum, R. L. (2013). Comprehensive soldier fitness: Underscoring the facts, dismantling the fiction. In R. R. Sinclair, T. W. Britt, R. R. Sinclair, & T. W. Britt (Eds.), Building psychological resilience in military personnel: Theory and practice (pp. 193–220). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  34. McCarthy, J. F., Blow, F. C., Ignacio, R. V., Ilgen, M. A., Austin, K. L., & Valenstein, M. (2012). Suicide among patients in the veterans affairs health system: Rural-urban differences in rates, risks, and methods. American Journal of Public Health, 102(S1), S111–S117.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Military One Source: Confidential Help. (2016). Retrieved from http://www.militaryonesource.mil/confidential-help/specialty-consultation?content_id=286144.
  36. Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA, 298(18), 2141–2148.CrossRefPubMedGoogle Scholar
  37. National Center for Telehealth & Technology, Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury. (2016). DoDSER Department of Defense suicide event report calendar year 2014 annual report. Retrieved from http://www.dspo.mil/Portals/113/Documents/CY%202014%20DoDSER%20Annual%20Report%20-%20Final.pdf.
  38. Nock, M. K., Deming, C. A., Fullerton, C. S., Gilman, S. E., Goldenberg, M., Kessler, R. C., … Ursano, R. J. (2013). Suicide among soldiers: A review of psychosocial risk and protective factors. Psychiatry, 76(2), 97–125.Google Scholar
  39. Peterson, C., Park, N., & Castro, C. A. (2011). Assessment for the U.S. Army Comprehensive Soldier Fitness program: The Global Assessment Tool. American Psychologist, 66(1), 10–18.CrossRefPubMedGoogle Scholar
  40. Pietrzak, R. H., Goldstein, M. B., Malley, J. C., Rivers, A. J., Johnson, D. C., & Southwick, S. M. (2010). Risk and protective factors associated with suicidal ideation in veterans of operations Enduring Freedom and Iraqi Freedom. Journal of Affective Disorders, 123(1–3), 102–107.CrossRefPubMedGoogle Scholar
  41. Ragins, B. R., & Scandura, T. A. (1999). Burden or blessing? Expected costs and benefits of being a mentor. Journal of Organizational Behavior, 20(4), 493–509.CrossRefGoogle Scholar
  42. Rynders, T., Sokolowski, J., & Williams, T. (2013). Suicide prevention in the army National Guard: Modeling effective strategies. Retrieved from U.S. Army War College website: www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA592978.
  43. Segall, D.O. (2004). Development and evaluation of the 1997 ASVAB score scale (Technical report no. 2004–002). Seaside, CA: Defense Manpower Data Center.Google Scholar
  44. Seligman, M. P., & Fowler, R. D. (2011). Comprehensive Soldier Fitness and the future of psychology. American Psychologist, 66(1), 82–86.CrossRefPubMedGoogle Scholar
  45. Sherman, M. D. (2003). The SAFE program: A family psychoeducational curriculum developed in a Veterans Affairs medical center. Professional Psychology: Research and Practice, 34(1), 42–48.CrossRefGoogle Scholar
  46. Sherman, M. D. (2008). Support and family education: Mental health facts for families. Retrieved May 22, 2016, from http://www.ouhsc.edu/safeprogram/.
  47. Stanley, B., & Brown, G. K. (2008). The safety plan treatment manual to reduce suicide risk: Veteran version. Washington, DC: United States Department of Veterans Affairs. Retrieved from http://www.mentalhealth.va.gov/docs/va_safety_planning_manual.pdf.
  48. Substance Abuse and Mental Health Services Administration (DHHS/PHS), R. S. (DHHS/PHS), Rockville, MD. Center for Mental Health Services. (2001). Mental Health: Culture, race, and ethnicity. A Supplement to “Mental Health: A Report of the Surgeon General.”. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK44243/.
  49. Sudak, H., Maxim, K., & Carpenter, M. (2008). Suicide and stigma: A review of the literature and personal reflections. Academic Psychiatry, 32(2), 136–142.CrossRefPubMedGoogle Scholar
  50. Team Rubicon (2014). 2014 Annual Report. Retrieved from Team Rubicon website: http://www.teamrubiconusa.org/wp-content/uploads/2016/03/2014_Annual_Report_24p_Mar2016.pdf.
  51. The Mission Continues. (2016). What we do. Retrieved from The Mission Continues website: https://www.missioncontinues.org/.
  52. Torres, J. (2015). Just what the doctor ordered. Philanthropy, 87, 38–44.Google Scholar
  53. U.S. Defense Manpower Data Center. (2015). Active Duty Military Strength by Service. DoD Personnel, Workforce Reports & Publications. Retrieved from https://www.dmdc.osd.mil/appj/dwp/dwp_reports.jsp.
  54. U.S. Department of Veterans Affairs. (2011). Profile of veterans: 2009 Data from the American Community Survey Retrieved from National Center for Veterans Analysis and Statistics http://www.va.gov/vetdata/docs/specialreports/profile_of_veterans_2009_final.pdf.
  55. U.S. Department of Veterans Affairs. (2014). Veteran population projection model 2014. Retrieved from the VA http://www.va.gov/vetdata/docs/Demographics/New_Vetpop_Model/VetPop2014_ExSum_093014_Final.pdf.
  56. Veterans Crisis Line. (n.d.). Retrieved from https://www.veteranscrisisline.net/.
  57. Vets 4 warriors: Unique features. (2015). Retrieved from http://www.vets4warriors.com/unique-features/index.html.
  58. Wood, J. (2011, December) Jake Wood: A new mission for veterans—disaster relief [Video file]. Retrieved from http://www.ted.com/talks/jake_wood_a_new_mission_for_veterans_disaster_relief.
  59. Wounded Warrior Project (2015). 2015 wounded warrior project survey: Report of findings. Retrieved from Wounded Warrior Project https://www.woundedwarriorproject.org/media/2118/2015_wwp_alumni_survey_full_report.pdf.
  60. Wyman, P. A., Brown, C. H., LoMurray, M., Schmeelk-Cone, K., Petrova, M., Yu, Q., … Wang, W. (2010). An outcome evaluation of the Sources of Strength suicide prevention program delivered by adolescent peer leaders in high schools. American Journal of Public Health, 100(9), 1653–1661.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2017

Authors and Affiliations

  • Kathryn Maslowski
    • 1
  • Kristen Vescera
    • 1
  • Bruce Bongar
    • 2
  1. 1.Graduate School of PsychologyPalo Alto UniversityPalo AltoUSA
  2. 2.Palo Alto UniversityPalo AltoUSA

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