ADDRESSING SUICIDE PREVENTION

FROM:  U.S. DEFENSE DEPARTMENT 
Suicide Prevention Remains Ongoing Battle, Senior Official Says
By Terri Moon Cronk
American Forces Press Service

WASHINGTON, Sept. 13, 2013 - The Defense Department and the military services have made inroads in suicide prevention, but work remains to be done, the vice director of the Joint Staff, told an audience of military chaplains here this week.

Army Maj. Gen. Frederick S. Rudesheim addressed the Chaplains' Resilience and Suicide Prevention Forum at the Pentagon on Sept. 10 to mark the observance of World Suicide Prevention Day.

"All the services are focused and engaged on preventing suicide and enhancing resilience, and have been for a while," Rudesheim said. "And we continually try to think of new and better ways to improve on our efforts. But I think there are a few things that haven't changed over the years. We've been working this a long time."

Many decisions can be made at the policy level, and programs can be executed, but ultimately, he said, "it's at the very lowest level where we're making a difference -- or not."

An important factor to remember in suicide prevention is that it's personal, Rudesheim told the chaplains. "It's [about] knowing the soldiers, airmen, sailors, Marines, civilians, ... and chaplains are great at that," he said. "Chaplains know their folks. You build rapport beforehand.

The general said he appreciates chaplains for their immediate and direct contact with troops.

"As I've come up in the ranks, I've always gone to the chaplains to figure out how things are going in the unit," Rudesheim said. "The chaplains will tell me straight, and tell me what's on soldiers' minds, what's going right, and what's going wrong."

But suicide prevention is a longstanding effort in the military, he said. "It is not going to end. There's "no finish to it," he said. "There is no 'We finally beat this.' I don't mean to be a negative force, but I'm telling you we can drive down percentages, we can work this as hard as possible, and we need to."

Suicide prevention is not an issue that calls for a surge, but rather is something that is done as a matter of course, Rudesheim said.

"This is something we have to do as part of who we are, ... because it's going to be with us," he added. "There are external factors that drive things up and down, [and] ... there will be setbacks and challenges, but the fact of the matter is we're in the fight all the time.

"It's a constant effort and something we grow up knowing," he continued. "If we don't, there's something wrong with our upbringing -- and I'm talking about professional growth as leaders."

Rudesheim told the chaplains that suicide prevention must reach down to individuals directly and "grab them" on a personal level.

"We've made inroads. Some of the services have brought down their numbers," the general said. "But there's no declaring victory. There is just the fight, because it's what we owe our soldiers, airmen, [sailors] and Marines."

SECRETARY HAGEL EMPHASISES DEFENSE DEPARTMENTS RESOLVE IN PREVENTING MILITARY SUICIDES

FROM:  U.S. DEFENSE DEPARTMENT 
Hagel Emphasizes Department's Resolve in Suicide Prevention
American Forces Press Service

WASHINGTON, Sept. 3, 2013 - As the nation observes Suicide Prevention Month, Defense Secretary Chuck Hagel issued a message to the men and women of the Defense Department today, emphasizing the department's collective resolve in its efforts to prevent military suicides.

Here is the secretary's message:

The Department of Defense has no more important responsibility than supporting and protecting those who defend our country and that means we must do everything possible to prevent military suicide. As we observe Suicide Prevention Month, the entire DoD community – Service members, civilians, members of our families and leaders at every level – must demonstrate our collective resolve to prevent suicide, to promote greater knowledge of its causes and to encourage those in need to seek support. No one who serves this country in uniform should ever feel they have nowhere to turn.

The Department of Defense has invested more than $100 million into research on the diagnosis and treatment of depression, bipolar disorder and substance abuse, as well as interventions for relationship, financial and legal issues – all of which can be associated with suicide. We are working to reduce drug and alcohol abuse and we are steadily increasing the number of mental health professionals and peer support counselors.

Effective suicide prevention training is critical to all these efforts and we are instructing our leaders on how to recognize the signs and symptoms of crisis and encourage service members to seek support. We are also reaching out to military families and the broader community to enlist their support in this cause.

Seeking behavioral health care is a choice that embodies moral courage, honor and integrity. Those values are at the foundation of what that we stand for and what we defend. The Military Crisis Line is there for all who need it. I encourage anyone in need to call 1-800-273-8255 and press one to speak to a trained professional, 24 hours a day, 365 days a year. This service is confidential and available to all service members and their families.

Always remember that our most valuable resource is each other. When one of us faces a challenge, we all must stand together. By fighting as one team, we can – and we will – help prevent suicide. Thank you.

VETERANS AFFAIRS AND DEPARTMENT ON DEFENSE WORK TO PREVENT SUICIDE

FROM:  AMERICAN FORCES PRESS SERVICE

DOD, VA Partner to Help Prevent Suicide

By Cheryl Pellerin

WASHINGTON, June 20, 2012 - Veterans Affairs Secretary Eric K. Shinseki said his agency is working with the Defense Department to end veteran homelessness and to identify possible contributors to service member and veteran suicide.

On the first day of the June 20-22 Annual DOD/VA Suicide Prevention Conference here, Shinseki -- a retired Army general, former Army chief of staff and a combat-wounded Vietnam veteran -- took the stage to a standing ovation from hundreds of mental health professionals, clinicians and military leaders.

"Suicide is a national concern. The Centers for Disease Control's annual report on the top 10 leading causes of death ... lists suicide as one of the top four causes of death in Americans ages 10 to 54," Shinseki said.

Suicide is the second-highest cause of death for young people ages 25 to 34, he added.

"These also happen to be the recruiting years," the secretary said. "Should we be surprised that recruits out of such a population bearing some level of increased stress for much of the past decade would experience suicides at some elevated level, or that the suicide rate among male veterans appears to be almost twice that of the general population?"

Shinseki said intervention, or the act of interrupting a potential suicide, primarily is a reactive response.

"We have demonstrated that we can react well," the secretary told the audience, "but is that good enough for the long term?"

To aggressively tackle some potential precursors of suicide, officials said, the VA is focusing on veteran homelessness and on creating a "warm handoff" for service members who transition from the military to the VA.

Three years ago, Shinseki said, the VA made ending veterans homelessness by 2015 one of its key priorities "because homeless veterans are evidence, no matter how good we think we are at this, that we have gaps in our system of care and benefits."

The VA team decided to challenge all of its assumptions about homelessness to find and close those gaps, he said.

"Many experts on homelessness felt then that the primary contributor to homelessness was mental illness. Today, after nearly three years of work, they've concluded that the leading contributor to veteran homelessness is more specifically substance abuse. That gives us a target to go after."

He added, "My question to this audience is, have we made similar assumptions about suicides over time? Do we know causes, cures and measures of effectiveness in our treatment regimens for those vulnerable to suicide? Do we have sufficient tools to prevent as well as rescue when dealing with those at risk? Are we asking the right questions to challenge all of our assumptions about suicide ideation?"

Veterans suffer disproportionately from depression and substance abuse, and they are high on the list for joblessness as well, Shinseki said. All of these factors, he added, contribute both to homelessness and suicide.

Another focus at VA is the transition of the service member to veteran, and how that process works for those who may be vulnerable to suicide or its precursors.

"At VA we know that when we diagnose and treat, people get better. This is reflected in our suicide treatment data that shows a declining trend between 2001 and 2009, the last year for which we have verifiable data," the secretary said.

"But we also know that veterans who commit suicide, perhaps as many as two out of three, are not enrolled in the VA health care system," he added. "So as good as we think our programs are -- we don't even get a shot at these veterans."

To narrow this gap, Shinseki said, efforts at the VA must focus on aggressive outreach to veterans and families, and the provision of high-quality and cutting-edge mental health treatments to those in need.

"We do this best with 'warm handoffs' between [DOD and VA]," he added, referring to a fledgling process through which a health care liaison is tasked to collect transitioning service members' medical records, make initial appointments in an appropriate VA medical center, and facilitate a personal handoff to the new facility.

"VA will continue to work closely with DOD to strengthen our collaboration on behalf of veterans leaving the service and reservists returning from operational deployments," Shinseki added. "We simply must transition them better."

He added, "There are folks still not convinced that warm handoffs are key to preventing suicides."

In May, Shinseki and Defense Secretary Leon E. Panetta met in Chicago to announce the goal of creating a fully operational integrated electronic health record that seamlessly will be able to move from DOD to VA by 2017.

"A significant challenge," Shinseki said, "but without it these warm handoffs are just more difficult."

Shinseki said VA investments in mental health programs increased from $4.4 billion in 2009 to $5.9 billion in 2012.

"Our funding specifically for suicide prevention has doubled, from $35.8 million in 2009 to $72.8 million in our 2013 budget request, with $6.2 billion requested for 2013 for overall mental health," he said.

As DOD anticipates growth in its mental health patient load, Shinseki said, the VA will pace its own growth accordingly.

"But that takes warm hand offs or else we're stuck in that primarily reactive response of rescuing [those who attempt suicide] during crisis, he added.

"Secretary Panetta's leadership and close partnership on behalf of those who wear the uniform today and those who have worn the uniform in times past has been monumental," Shinseki said. "As a result, we've brought our two very large departments much closer together than they've ever been before."

COPING WITH STRESS

FROM:  USA.GOV
Alleviate Stress: Help Coping with Life’s Tensions
It’s easy to let the little stresses of life pile up and overwhelm you all at once. With so many ongoing activities and events at work and at home, it’s easy to feel anxiety build up – usually at the worst moment. USA.gov can help put things in perspective with these helpful resources:

Constantly being on the go can be an added stress to an already busy day. The National Center for Telehealth and Technology has a free app, Breathe2Relax, available on androids and iPhones. The app includes instructions and practice exercises to help you conquer stress management. Breathing exercises have proven to help improve moods and lessen anxiety.

Stress can come in all different forms, and can affect you on many levels. Physically, you may notice a faster heart beat, rapid breathing, trembling and more. While certain life events like starting a new job or moving are typical stressful events, learn when it is time to contact a medical professional. Panic attacks and thoughts of fears you cannot control are critical moments to reach out to a medical professional.
Having some everyday stress is normal, and even healthy. But too much stress can lead to other unhealthy behaviors and lifestyles. Take the quick “Stress-o-meter” quiz to get your personal stress profile and make sure you aren’t letting life’s little tensions build up to an unhealthy level.

If you or someone you know is having thoughts of suicide or severe emotional distress, call 1-800-273- TALK (1-800-273-8255), or if it is a medical emergency, call 911. USA.gov offers many resources on specific mental health conditions as well as substance abuse effects on mental health. You can learn about particular disorders and mental health topics from information across the federal government.


MILITARY ENLISTED LEADERS DISCUSS SUICIDE PREVENTION

American Forces Press Service

Enlisted Leaders Focus on Suicide Prevention

By Army Sgt. 1st Class Tyrone C. Marshall Jr.

WASHINGTON, March 29, 2012 - The most senior enlisted leaders from each branch of service and the combatant commands focused on the health of the force, and specifically on suicide prevention, during a conference here this week, the military's top enlisted member said today.

Marine Corps Sgt. Maj. Bryan B. Battaglia, senior enlisted advisor to the chairman of the Joint Chiefs of Staff, said he and the other enlisted leaders collaborated on issues pertaining to the health, welfare and wellness of service members and their families.

Battaglia highlighted his "NOW" initiative, designed to reach younger service members.

"The audience that I really wanted to reach is the 18- to 24-year-olds," he said. The suicide issue seems to be most prevalent with younger service members, he said, but "it's also important to educate the leadership too, so the audience wasn't restricted to simply the young [troops]."

The sergeant major broke down the initiative's three-letter acronym.

"The 'N' meaning there is never a problem too big that one would have to resort to suicide as a course of action to solve a problem," he said. "If it is a problem, bring the problem to us, and we can solve it together, if he or she can't solve it alone.

"The 'O' is simply outreach – an outreach that is literally a fingertip away," Battaglia continued. "Troops can outreach by pressing the button on a phone, knocking on someone's door, or by texting a team leader, but help is readily available."

Battaglia said the final letter, "W," represents "we," as in the one-team concept of all leaders, service members and their families.

"[It's] just to remind them -- even though I think that all of our troops and families know we care, and I say we collectively, again -- it's one team, and it's a universal problem, so we're going to find a universal solution for this," he said.

During the conference, Battaglia said, he brought in a subject-matter expert to shed more light on suicide and further educate senior leadership. The military still has "a lot of work to do" in preventing suicides, he acknowledged.

"And we just have to burn the midnight oil to try to crack this code as to why folks are not coming to get help and using suicide as an option," Battaglia said.

Battaglia said he believes the conference was "a great networking opportunity."

"It afforded us the opportunity to build relationships between the services and the combatant commands," he said. "It's all about relationships."