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Headquarters U.S. Air ForceIntegrity - Service - Excellence Suicide Prevention Lt Gen C. Bruce Green Surgeon General 13 Oct 11 1
PSA: AF Family Suicide Risk Video Begins on ClickIntegrity - Service - Excellence 2
PSA: AF Family Suicide RiskIntegrity - Service - Excellence 3
The Suicidal MindSuicide is a behavior, not a disease How we think and communicate about it affects its rateUsually characterized by desperation, hopelessness Rage: anger and frustration - Impulse Avoidance: legal/financial concerns, guilt Mental illness: Depression, Bipolar IllnessSubstance use often fuels the fireTop risk factors Relationship problems Mental health history Legal/ administrative problems Integrity - Service - Excellence 4
Where We Left Off Last Year 120 AD Suicides ARC in Duty Status 24 110 ARC not in duty status Civilian Suicides 22 100 CY AD Rate Total Force Rate 20 90 18 80 16Number 70 14 Rate/100K 60 12 50 10 40 8 30 6 20 4 10 2 0 0 2004 2005 2006 2007 2008 2009 2010 Sense of Urgency: AF experienced more suicides in CY10 16.4/100K than any year since 1994 – 2011 Rate 14.4/100K *As of 3 Oct 11 Integrity - Service - Excellence 5
Gap Analysis Comprehensive gap analysis Volpe, RAND, with 11 AFSPP Elements Input from MAJCOM/ARC Mental Health Consultants and CAIB/IDS leaders Findings by Volpe & RAND Encompass 11 AFSPP Elements 23 AFSPP Gaps Identified Messaging (1) Standardization (3) Evaluation (2) Guidance (15) Application (2)“The Air Force suicide-prevention program could provide a model for the other Services.” – RAND, The War WithinTMT: 41111 Integrity - Service - Excellence 6
New Suicide Prevention Initiatives Point of Attack ProcessFrontline Supervisor Training for at-risk AFSCs Strategic Communication PlanSemiannual Wingman Days Shift to strengths-based messagingSecurity Forces/JAG initiatives RAND social media studyVCSAF Memos Improved weekly dashboard slide Face-to-face suicide prevention training Fort Hood Follow-on Review Unit Consultation Tools Response to DHB DoD TF on theComprehensive Post-Suicide Guidelines Prevention of Suicide by Military MembersPublic Affairs Guidance for Suicide 2011 Community AssessmentIncrease AD mental health providers by 25% Expanded use of multimedia tools Add 70 more to Primary Care CSAF/CMSAF PSAs“The Air Force’s pioneering suicide prevention program was producing the firstempirical evidence that a comprehensive, public health approach could, in fact, reduce suicide across a population.” – Volpe Report Integrity - Service - Excellence 7
Air Force Suicide Prevention Overview Suicide Rates (per 100,000/yr) AD Risk Factors/Stressors (%)10 year Pre-Program 13.5 Relationship Problems 54.210 year Post-Program 9.9 History of Any Mental Health 45.8CY10 Active Duty 16.4 DiagnosisCY11 Active Duty (Rolling Rate) 14.4 Legal/Admin Problems 33.9CY11 Q2-Q3 Active Duty 11.5 Seen by Mental Health in Past 18.6CY11 Total Force (Rolling Rate) 13.4 MonthCY11 Q2-Q3 Total Force 12.9By AD Career Group (CY 10-11) Alcohol in System at Death 17(per 100,000/yr)Security Forces (3P) 33.8 Deployed in the Past Year 12Aircraft Maintenance (2A) 21.8 Financial Problems 10.2Intelligence (1N) 0.0 Security Forces rate down 30% from Feb ‘11 peak Integrity - Service - Excellence 8
Prevent the Final Impulsive ActionIdentify those at riskKnow your AirmenCreate a culture of resilient AirmenACE: Ask, Care, EscortStress is Ubiquitous – Simple Adaptive Behaviors (Humor) are Effective Integrity - Service - Excellence 9
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Where Leaders Can Help Core Elements of Suicide Prevention Leadership Involvement#1 Leadership Involvement Conduct face-to-face training#2 Address Prevention through PME Encourage PME#3 Guidelines for Commanders: Use Leader’s Guide for Managing Personnel in Distress Use of Mental Health Services#4 Unit-Based Preventive Services Employ Resilience Elements (AFI 44-172, Mental Health)#5 Wingman Culture Plan semi-annual Wingman Days#6 Investigative Interview Policy Heighten vigilance for Airmen under investigation#7 Post Suicide Response Make use of Leaders’ Post-Suicide Checklist#8 IDS & CAIB Support your local CAIB/IDS#9 Limited Privilege SPP Know when to recommend privileged counseling#10 Commander Consultation Tools Collaborate with your IDS on unit assessments#11 Suicide Event Tracking and Analysis Support the completion of DoDSER database Help Improve Resilience & Destigmatize Mental Health Integrity - Service - Excellence 14
UNCLASSIFIED // FOUO Metric AF Active Duty and AF Total Force Suicides Status: Yellow Objective Track suicides over time to identify trends Metric Owner: AFMSA/SG3OQ Metric POC: Major Michael McCarthy Last Updated On: 30 Sep 11 Metric Definition: Suicide Rate= (Raw Number of Suicides Over the Last 12 Months/End Strength) x100,000 120 24 AD Suicides ARC in Duty Status ARC not in duty status 110 22 100 Civilian Suicides CY AD Rate Total Force Rate 20 CY10 DoD Rate 90 18 Rate/100K Red BoundaryNumber 80 16 70 60 * * Green Boundary 14 12 50 10 40 8 30 6 20 4 10 2 0 0 2004 2005 2006 2007 2008 2009 2010 2011 * 52 Week Rolling Rate Results Analysis CY10/CY11 #s * Rolling 12 Month Rate AD AF Suicides through 30 Sep: 38/32 14.4 Total Force Suicides through 30 Sep: 72/63 13.4 Improvement Actions/Next Steps - Update AFI 44-154, Suicide and Violence Prevention Education and Training - Suicide Prevention Program Evaluation Grant Proposal Integrity - Service - Excellence 15
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