Suicide Prevention: Each of us has an important role to play
Keita Franklin, director of the Defense Suicide Prevention Office
Every loss of a service member, veteran, or family member is a tragedy. There’s no simple reason why suicide occurs, nor a single approach for preventing it. Suicide is a complex issue with biological, cultural, economic, psychological, and social factors.
Interventions such as psychotherapy and prescription medication are critically important in helping to prevent suicide. But according to the 2015 Department of Defense Suicide Event Report, only about 30 percent of service members who died by suicide were previously seen by behavioral health providers. That’s why preventing suicide requires a public health approach that includes the entire community.
One strategy is to use the Columbia Suicide Severity Rating Scale, or C-SSRS, to identify individuals at risk for suicide. Based on more than 20 years of scientific research, C-SSRS is a series of questions anyone can use to evaluate whether someone is at risk for death by suicide. The questions cover whether and when a person has thought about suicide, what actions he or she may have taken to prepare, and if a previous suicide attempt was considered but then aborted because of a last-minute change of heart or an intervention.
The answers to these questions help to identify individuals who are at risk for suicide. They also gauge the level of intervention and support an individual may require.
C-SSRS is being used throughout the Military Health System. Army Medicine has incorporated the tool as part of the Behavioral Health Data Portal, and five Air Force military treatment facilities are using the tool as part of the Zero Suicide initiative. Zero Suicide is a program that was founded on the belief that suicides are 100 percent preventable. The program focuses on hospital-based leadership support for strategies such as screening at multiple points, education of the entire hospital system (not just mental health providers), and the use and monitoring of evidence-based practices as well as intensive follow-up after individuals receive care.
C-SSRS can be used in a variety of settings, either on its own or in combination with other interventions. This tool can also be used by a host of people who may encounter individuals at risk, including Sexual Harassment/Assault Response and Prevention (SHARP) victim advocates, chaplains, peers, and family members.
C-SSRS is suitable for use in all ages and populations, and it’s available in more than 100 languages. The scale and training are freewhen used in community and health care settings and in federally funded and nonprofit research.
The Defense Suicide Prevention office is also involved in research projects to prevent suicide. They include training military chaplains to help at-risk individuals, developing practices and policies centered on firearm safety, and teaching service members and peers to recognize and respond to the warning signs of suicide on social media.
While widespread use of the C-SSRS and other intervention efforts and initiatives demonstrate DoD’s commitment to preventing death by suicide, each of us individually has an important role to play, because one suicide is one too many.
Do you know someone who’s engaging in self-destructive behaviors or talking about harming him or herself? Reach out. Talk openly and plainly, and listen and respond nonjudgmentally. Don’t act shocked or dare someone to act, and perhaps most importantly, don’t promise not to tell anyone if you learn someone is at risk. Instead, seek help from peers or from people or agencies specializing in crisis and suicide prevention.
If you or anyone you know is thinking about harming themselves, contact the National Suicide Prevention Lifeline at 1-800-273-8255 and press 1. Another resource – specifically intended for service members and their families – is the BeThere Peer Support Call and Outreach Center for those seeking help with everyday life challenges. Call 1-844-357-7337, or visit www.betherepeersupport.org.
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