By 1st Lt. Tomas RofkahrAugust 22, 2011
BETHLEHEM, Penn. -- "You're a late night operator on a suicide hotline. The phone rings and when you answer it, you hear the sound of a gun going off," says Chaplain (Lt. Col.) Steve Langehough, the deputy command chaplain for the 200th Military Police Command as he slams a hardbound book onto the concrete floor of the drill hall. The report echoes and visibly startles his trainee audience.
"A voice on the other end of the line says to you: That was the first barrel of a double barrel shotgun. You have five minutes to convince me to not use the other barrel on myself." Langehough regards the trainees levelly, then looks at his watch.
Indecision grips the would-be caregivers.
Langehough looks around the class as the trainees struggle to come up with a response. There are a few false starts as one student or another tries to tackle the problem. Seconds tick past, Langehough smiles.
The training was called Applied Suicide Intervention Skills Training or ASIST. The trainees are a collection of volunteers, Soldiers and Family members from the Army Reserve's 200th Military Police Command.
The students quickly learned that ASIST training was very hands on and intense -- nothing at all like the yearly suicide awareness briefing most of them were used to.
Finally, one Soldier, Staff Sgt. Rachel Pitts, assigned to the Bethlehem, Penn.-based 744th MP Battalion, said, "So, you're telling me you want to use that shotgun to commit suicide."
The statement seems out of place, almost obvious, and the uncertain expression Pitts wore was mirrored on the faces of the assembled trainees. But for Langehough and the other ASIST trainers, Pitts' simple reflection of the situation was the right first step. She has made a connection with the at risk caller and for students of ASIST, that connection was the critical first step to providing aid.
"This is different," said Langehough. "We (the Army), have traditionally done a lot of support for suicide after the fact; ASIST is different, this is intervention, direct first aid for someone at risk."
As a scheduled two-day course, ASIST gives students the confidence and skills necessary to prevent suicides from happening. More than just awareness, they were taught how to recognize someone who's at risk and how to move them emotionally to a "safe place."
The coursework was hands on and for many of the aggressive and confident military policemen, more than a little frustrating.
"Don't immediately try to fix people. You're here to listen, to assess. Try to avoid questions that can be answered with a yes or a no," said Langehough. "Reflect what you're hearing back at the person you're talking to, let them lead."
The chaplain took a step and turned as if ballroom dancing.
"We are the followers in this dance, the person at risk is always in step, always in sync; we just have to keep up," said Langehough.
An integral part of what students learned in the course included the many myths associated with suicide and how their own views and beliefs can affect their ability to provide care.
The ASIST instructors then broke the classroom up into three areas.
One end of the classroom belonged to students who believed suicide was wrong. The other, belonged to those who believed suicide was something every person has a right to. The middle belonged to students who weren't sure or who claimed they believed the answer wasn't black and white.
While the majority of the students filtered toward the "suicide is wrong" side of the classroom, others aligned themselves in the middle or toward the "suicide is a right" side.
Regardless of where each stood, they realized that what they believed about suicide can affect how an at-risk person views them as a potential caregiver.
"The intent isn't to teach a student that what they believe is wrong, but to get them to understand both sides of the picture," said ASIST trainer, Sgt. 1st Class Merle Solomon. "What they perceive, and what the at-risk person believes."
Students in ASIST training were taught to pick up on "invitations" that were sent out by at risk individuals. Small, seemingly insignificant acts could often be signs that a fellow Soldier is at risk of suicide.
ASIST instructors trained caregivers to recognize these invitations and taught Soldiers how to engage the at-risk person in order to understand them, and to ultimately provide care.
"We're not doing therapy here," said Langehough. "We're doing crisis intervention. We're getting the at-risk person to a safe place until a full-time professional can get involved."
Therapy or not, the training was very hands on. Soldiers found themselves working through role-play scenarios with their instructors. The actual scenarios were grueling and every trainee found themselves struggling to "say the right thing."
For Pfc. Wayne Smith, who is assigned to the Ashley, Pa.-based 361st Military Police Company, the fear of making a mistake in an intervention was the hardest part.
"Saying the wrong thing would be rough," said Smith. "You're afraid you're going to say something that's going to put them over the edge."
While Soldiers struggled with the role-play interventions, Smith and several other Soldiers found themselves energized by the hands-on nature of the class.
"This training helps us put everything together," said Staff Sgt. Bob Ridgick of the 744th. "Any of us might recognize the signs (of suicide) but what do you do now? The class gave us a plan to work off of."
Soldiers spent the majority of the second day of training working through interventions, struggling to pick up on invitations and to make critical hand offs from one phase of the intervention to the next.
"There is no perfect intervention," said Langehough. "We have to remember that it's okay to get out of sync with the process. We just need to know how to back in."
For Soldier caregivers, the threat of suicide is one that has become more and more visible.
According to LivingWorks, the Canadian company that developed ASIST training, more than 6 percent of the entire population of the United States have had serious thoughts of suicide.
Four to 5 percent have actually attempted suicide.
As the suicide rates within the armed forces have grown to alarming rates, the need to change how the Army Reserve responds to the threat has grown.
"We're all aware of suicide, but now we're doing more than talking about it," said Lt. Col. Diane Wallace, an ASIST trainer from the Fort Totten, N.Y.-based 344th Combat Support Hospital and a registered nurse. "We're the pebble in the water that's making waves."
The continuing need for understanding and change was echoed by other Soldiers.
Several Soldiers felt that one of the most important questions to be addressed during the training was how the Army Reserve community was going to adapt and change in order to better understand and prevent suicide.
"Many hands make light work," said 1st Lt. Jason Small, 744th MP Bn. "The more we understand and the more personnel who receive training like ASIST is what it's going to take to turn the tide."
Sgt. Tonya Raymond of the 744th agreed. "The change is going to start with us."