A Grandpa's Notebook · Chapter 8Part Five Lore, Myths and Memoirs (4)
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Many government and private sector employers already had in-house programs for stress management. They also had employees who, although lay persons, had been trained and qualified to give emergency CPR and other forms of first aid at the work site. So why not someone in the shop or office who was basically trained in suicide prevention and crisis intervention? As with other on-site emergency services, this person, who would have been trained and qualified to recognize discernible and professionally recognized signs that might precede a suicide attempt, would consult with a supervisor, and exercise his/her judgment in getting the person-in-distress ASAP to professional help.
Community suicide prevention programs (certified SP Centers, informal hotlines, Community Mental Health Centers, etc.) had by that time become a fact of life: they existed, and were part of the system, organized or ad hoc. Proactive 'suicide prevention,' would generate its own force for being: it would not get canceled like an aircraft, ship, or construction program, to the contrary. With oversight by reasonable and conscientious leaders, managers, and supporters, suicide prevention would become ingrained, omnipresent, and a way of life in which everyone would play a vital role. Naive? Maybe, maybe not.
What is vital to sustain 'suicide prevention' is to spread the idea, and make it 'everybody's business.' Making the idea acceptable as 'everybody's business' would be 'everybody's job.' The 'everybody' would include parents and teachers and counselors of children and youth, police officers and rescue workers on the street, and supervisors, staff, and union officials in the workplace. It would be where people played, in their neighborhoods, and go along with each age group to where they would spend their retirement years.
For the elderly (among whom depression and suicide rates are very high) crisis intervention resources, and suicide prevention and risk- reduction depends on leaders and staff of health care institutions, administrators and staff in retirement residence and convalescent communities, senior centers, AARP chapters, and anywhere the elderly gather. The reality would also depend on the elderly themselves, individually and collectively, e.g., to get past the long history they inherited of bigotry, superstition, and ignorance when it comes to mental health, suicide, and helping survivors of suicide. Emphasis on adult education, support group discussions, and motivational training can help to reduce such barriers among middle year's adults (parents of school age children) as well as the elderly.
An article I wrote in 1984 Suicide Prevention Must Be Everybody's Business was published in the January 14, 1985 issue of the Army, Navy and Air Force Times. It advocated an organized suicide prevention program within the military which would include training and involvement of all active duty military, not confined to those in the medical and mental health fields. I posed the questions:
'a. Does your base have a program whereby supervisors and co-workers who might be confronted with suicidal people are trained to recognize the warning signs and refer potential suicides to professionals?
'b. Are any base personnel, especially security police, social actions or family support workers, trained in crisis intervention techniques? Are any of them volunteer workers in the local community's suicide prevention program?
'c. Does your base have any sort of arrangement with local suicide prevention centers or hotlines so that a civilian crisis worker can contact the base for information or assistance? Do civilian volunteers know exactly whom to call for help when a military person or dependent threatens suicide?
'd. Do your base officials routinely check with local crisis clinics to find out the number and types of distress calls being received from military people? Is this information analyzed to determine trends or patterns?
'e. Do your base mental health workers give talks to active duty and dependents' groups on this subject? Are civilian experts in suicide prevention brought on base to explain their services?'
The following month (February 22, 1985), the Secretary of the Army and the Chief of Staff issued a Memorandum for Major Commands and Staff Agencies which stated in part, 'The Department of the Army has developed a Suicide Prevention Strategy designed to help commanders deal with this problem. Commanders must use this plan and complement it with initiatives tailored to specific needs.' Over the following months the Army issued implementing Departmental, major command, and subordinate level Regulations, programs, and guides.
Later that same year (1985), I secured copies of studies, plans, directives, motivational guides and other documents published by NIMH, the American Association of Suicidology (AAS), and the Army on their in- house suicide prevention programs and which they provided to me in response to my appeals. I published in book form the material that I received, and marketed it on a not-for-profit basis to cover my printing and related costs. My initial report, printed on Feb 26, 1971 (during Viet Nam) was 'Summary and Commentary on the Institute in Suicidology in Los Angeles January 23-27 1971' and had limited distribution within the Air Force, and the next compilation was in June 1985, 'Military-Civilian Teamwork in Suicide Prevention.' A subsequent update was published in 1988 'Suicide Prevention Programs in the Department of Defense', and the last update, in 1994, returned to the original title 'Military-Civilian Teamwork in Suicide Prevention.'
My intent, in collecting and disseminating to the general public the suicide prevention programs and practices of the Armed Forces, NIMH, and other contributors was to join the many lay persons like myself who had become involved. Wide distribution might also promote cross feed and disclose conflicting policies and procedures. The process, itself, I felt, would encourage collaboration among professionals, paraprofessionals, and administrators and directors of suicide prevention entities in neighboring civilian communities. Further, I hoped that publicizing the Armed Forces' plans and procedures for suicide prevention and crisis intervention would encourage other government entities to explore their need for comparable programs, and that potentially beneficial methodologies might spin off to the private sector.
My continuing interest in proactive and organized suicide prevention efforts in the Armed Forces led me to write to then Secretary of Defense Les Aspin, and to Senator Sam Nunn and Congressman Ronald Dellums in their responsibilities as Senate and House chairmen, respectively, of committees charged with the oversight of military affairs. A copy of my letter to and the response from the Office of the Secretary of Defense is attached.
Programs
A monumental medical and social advance was made in suicide prevention by the original U S Army Suicide Prevention Plan, (Feb 1985) prepared by the Directorate of Human Resources, Office of the Deputy Chief of Staff for Personnel. The Plan called on each U S Army base to develop and publish an installation Suicide Prevention Plan. The plan was to provide for active duty units, Army families, the Army Community, and civilian employees of the Army. Among its many initiatives were several concerned with collaboration with civilian communities and other public and private sector mental health and crisis intervention resources.
The Navy issued its program in 1987, and the Air Force issued formal policy guidance in 1997 on implementing their suicide prevention program. Since the USAF 1997-policy statement follows my dated copies of the Army and Navy programs by about a decade, I assume that it conforms to more recent DoD medical policies on the subject and perhaps even reviewed and commented upon by the other Services. The following is from the USAF Policy Letter Digest December 1997 (Source: World Wide Web, search title: 'Air Force Policy Letter Digest').