Applied Suicide Intervention Skills Training offered to Michigan National Guardsmen
May 15, 2014
BATTLE CREEK, Mich. - Depending on which national news source one listens to or reads, a person may obtain a varying understanding of the rate of suicides across the military community. A November 2013 Huffington Post article stated that the number of military personnel who died by suicide had dropped by 22 percent from the previous year. In April 2014, an online article written for USA Today stated that the rate of suicide in the military was slightly higher than reported due to an arithmetic error in the way the calculations were figured.
The Department of Defense recognizes that suicide is one of the most important issues facing the military and has established several initiatives in their commitment to prevent suicide by members of the Armed Forces. Seen from the senior leaders of the Michigan National Guard's foxhole, one Michigan Guard member who dies by suicide is egregious.
"We must work to ensure we are doing all we can to take care of every member of the Guard family to prevent another tragic loss of life," said Maj. Gen. Gregory Vadnais, the adjutant general for the Michigan National Guard.
In April 2014, Michigan Army National Guard Capt. Stephanie Boltrick and Chap. (Capt.) Paul Lepley administered the first of three suicide intervention workshops scheduled this year to train Michigan National Guard members in Applied Suicide Intervention Skills Training. Boltrick has a master's degree in social work, and is the Ready and Resilient Campaign program coordinator. She was tasked by Vadnais to guide the R2C efforts to promote resilience and reduce at-risk behaviors among troops. Lepley is chaplain with the Wyoming-based 126th Cavalry Squadron and has a master's degree in counseling. Together, the two officers taught the course in an interesting and impactful way through role-play, videos, and small group discussion. From the officers' vantage point, this program is vitally important to implement.
"As a chaplain, I've been called upon to conduct casualty notifications to families of service members who have died by suicide. I've seen firsthand the effects on family members when they hear the resounding words "an apparent self-inflicted gunshot wound" and have seen how their demeanors change from one of pure grief knowing they lost their son or daughter, to one of grief, confusion and sometimes disbelief as they ask "why" or "how could this have happened," said Lepley.
The ASIST program leads participants through a "Pathway for Assisting Life" model and trains Soldiers with advanced intervention skills. The suicide intervention model was created in the 1980s and is supported by evidence-based research.
"The Michigan National Guard is focusing on the way forward and intervention and awareness is a great way to start," stated Boltrick.
Although it can be difficult to predict who will attempt suicide there are a number of risk factors that increase the potential for suicide. According to the Air Force's yearly-required computer-based suicide prevention training, relationship problems are the single most common risk factor in Air Force suicides. The list of other key risk factors is lengthy and includes severe, prolonged or unmanageable stress, lack of social support, depression, anxiety, prior suicide attempts, legal problems, difficulties at work, a history of mental health problems, alcohol or drug abuse, or feelings of hopelessness.
"The R2C is working to move Michigan's Guardsmen into a healthier direction where Soldiers and Airmen bounce back from adversities and overcome mental health challenges. ASIST and the growth of our suicide prevention program are examples of this initiative," said Boltrick.
The Pathway for Assisting Life taught in the ASIST model has three phases, each with two objectives. The first phase it to connect with a person. This can happen through casual conversation. In this phase, one who is suicidal may exhibit behavior such as withdrawal from family, friends, school, etc., they may have a loss of interest in sport or other events, misuse alcohol, or demonstrate other behavior changes. They may express that their life is meaningless or other words to that effect. The objective is to explore signs of distress which invite help.
Suicide risk assessment is necessary and involves inquiring about suicide thoughts, planning and preparation, previous suicide attempts, and family history of suicide or mental illness. This may seem like a radical topic to introduce, but may be needed to bring someone out of the "fog" of suicidal thinking. The bottom-line message in phase one is to convey a sincere "I care" message to the member in distress.
The second phase is to help the member understand their choices. This requires active listening and non-judgmental interaction with the person if they say they had thought of ending their life. The gatekeeper is there to hear and to support with the message of "I understand."
"This program will help all people from all walks of life to notice risk factors and to be empathetic as they listen to an at-risk individual share why they want to die," said Lepley.
The goal of the third phase is to bring the member to a place where they arrive at a turning point and reject suicide. This may involve helping them problem-solve to find solutions to the main issue(s) that troubles them. This also involves helping them to be safe; i.e., if they have said how they intended to take their life, the gatekeeper asks them if they will agree to allow them to take away the method of self-harm or the helper calls 911 for additional help.
"I hope more service members will step up and request to go to this training so the number of these casualty notifications can go down. For those who are at risk, I hope they will raise their hand and say "I need help" so that those around them can see the distress and provide aid. Suicide is a lonely place and we, as the Guard, are one big family. Let's reach up and out and support each other in this battle against suicide," Lepley concluded.
In August and September 2014, two-day ASIST workshops are scheduled at Fort Custer Education Center (5-6 August) and at Camp Grayling (9-10 September). For more information contact Megan Williams, the Michigan National Guard suicide prevention program manager at 517-481-8359 or firstname.lastname@example.org.