Suicide prevention: Know the indicators
April 5, 2013
FORT BENNING, Ga. (April 3, 2013) -- Suicide is always a tragedy, but it is one with certain earmarks individuals can often spot in advance if they're attentive.
In the health-care industry, these are called suicide indicators.
"We're talking about things that are pretty much red flags that help us identify suicidal behavior," said Lt. Cmdr. Heather Boyce-James, U.S. Public Health Service officer for Martin Army Community Hospital. "Some red flags could be someone giving away possessions, someone behaving recklessly -- either with substance abuse or increased addictive behaviors. Or it could be someone with chronic pain (who) can't figure out a way to escape or lessen the pain. It could be someone who feels like they're a burden rather than an asset to others. Other red flags would be visiting people, giving away possessions and talking about death."
Many of these indicators, such as those mentioned above, are applicable to both civilians and military personnel.
Within the Army community, Boyce-James said, it's possible to look for more specific flags, such as losing a battle buddy or struggling with post-traumatic stress disorder.
Something like PTSD doesn't necessarily lead to suicide, but it can be a trigger, she said. If it becomes chronic, it could lead to destructive behavior, such as increased alcohol abuse, and when untreated, can have fatal consequences.
Last year, the Army had nearly 350 suicides in its ranks. That makes suicide awareness essential, Boyce-James said.
"When we talk about suicide prevention, we're talking about really a community effort that needs to surround that individual," she said.
That community is made up of unit leadership, Family, mental health providers, chaplains or ministers, local support agencies and battle buddies.
"It's not just left up to one person," Boyce-James said. "(It's) the individuals who are closest to that Soldier who can identify that something is just not right."
The Department of Behavioral Health at MACH uses a process called the "Four Ss" when it comes to prevention.
The first step is to screen an individual by asking questions. How is he doing? How does she feel today? The second is spotting.
"Look for those inconsistencies in behavior," Boyce-James said, "for those missed appointments or for that person who hasn't shown up for formation. You're looking for certain things that are not the normal pattern for that individual."
The third step is to secure the person -- it could mean asking for help, calling a crisis hotline or going to the hospital if needed.
Lastly, support. Give ongoing support, whether it's medication management or individual therapy.
That lets the person know there are other options, Boyce-James said.
"What's the biggest issue we have with getting through to our service members? The mental health stigma," she said. "Seeking help is a sign of effectively dealing with your problems. It's a strength to do that rather than a weakness. Getting through that mental health stigma is sometimes one of the bigger obstacles, so we're working on that."
Breaking that stigma and reducing the number of suicides is a priority for the staff at MACH, Boyce-James said.
Efforts in place include training staff and a range of services:
• an in-patient psychiatric unit,
• an outpatient mental health clinic,
• social work services,
• marital counseling,
• a battlemind clinic,
• an intensive outpatient program,
• an embedded behavioral health team,
• a traumatic brain injury clinic,
• a deployment cycle clinic and
• a community mental health clinic for basic trainees.
"So we're talking about a number of different areas that our goal is to get to the Soldier with red flags," Boyce-James said. "It's extremely important. We're seeing an increase in Soldiers who are committing suicide. This is something that not only ends the life of the Soldier, but it shatters the Family, it shatters the people who care about the Soldier, it shatters the unit the Soldier serves with. It is an emotional trauma. Our Soldiers go out and serve our country every day. I think we owe it to them that when they come back home, we show we care."