This Sunday kicks off National Suicide Prevention Week. Nearly all of us in uniform have known someone who has taken their own life. I'm sure we have all been given ACE cards and see the pushup challenge in our feed... but how much do you know? Some quick IPB (a long thread)

Stats are from the 2019 DoD Report. Disclaimer: I'm not a mental health expert, data scientist, or trained interventionist. I'm just a leader who is exhausted from putting good men and women in the ground. I am in constant search of data & real TTPs we can use. Please pile on.

Service members who die by suicide are primarily enlisted (mostly E1-E4), less than 30 years of age, male, and use a firearm. This demographic makes up 46% of the military population but accounts for 60% of military suicides.

In 2018 we lost 541 service members to suicide (325 Active, 81 Reserve, 135 National Guard). That's roughly 1.5 per day. These rates have been fairly consistent since 2013. Thankfully it isn't getting worse- but it is not getting better either.

The most common methods of suicide death in the DoD is firearms (60%), followed by hanging(28%). Less than 3% of of suicide deaths are attributable to drugs/and or alcohol (alone). Research shows that it only takes 5-10 minutes for a suicidal person to go from thinking to acting.

When lethal means are made less available or less deadly, suicide rates decrease. In other words, people contemplating suicide will not generally just "find another way." So called "means" interventions have been shown to reduce suicide more than clinical interventions.

Even in homes that have firearms, four critical factors prevent suicide: 1) using gun locks, 2) keeping firearms unloaded, 3)storing ammunition separately, and 4) storing firearms away from the home altogether. KNOW which of your troops have firearms and HAVE this candid talk.

While it is well established that men in the service have nearly four times higher the risk of suicide death than women, this is generally because men make up nearly 85% of the military. Women veterans (prior svc) are 1.8 TIMES MORE LIKELY THAN CIVILIAN WOMEN TO COMMIT SUICIDE.

In the military, failed or failing relationships in the 90 days prior to death were reported in 36.9% of suicides. Other most significant contributing factors (sometimes combinations) are financial difficulties (7.4%) and admin/legal difficulties (30%).

How do we prevent suicide, far left of an intervention?
1) Strengthen economic support (i.e. help service members achieve financial readiness.
2) Strengthen access to care: THE GREATEST BARRIER TO RECEIVING CARE REMAINS STIGMA. If you are a leader you must crush it.

3) Create protective environments (see discussion on firearms above)
4) Promoting connectedness. STRONG SOCIAL CONNECTIONS protect against suicide. See also: ENGAGED LEADERSHIP.

5) Teaching coping and problem solving skills, particularly to our youngest population. These soldiers have stressful life events they are often unable to "adjust" or cope with, exacerbating their vulnerability to suicide.

6) Identifying and supporting people at risk. If you are a leader, read up on the latest Question, Persuade, Refer (QPR)frameworks (ACE for the Army). Service Member Gatekeeper and Leadership Interventions WORK. Lastly, study how to recognize the signs of suicide on social media.

Lastly, some common misconceptions.
1) The military suicide rate is not (much) higher than the U.S. general population
2) Being deployed (including combat) is not associated with suicide risk among service members (41.7% have no history of deployment). However,

Some factors related to deployment affect risk; such as repeated deployments with short breaks in between, or deploying soon after joining the military. TBI, PTSD, and insomnia also have substantial links to suicide- which could fill an entire separate thread.

3) The majority of service members who die by suicide do not have a mental illness or mental health diagnosis (50.8%).
4) If you remove access to one lethal method, someone at risk will just replace it (generally not true).

5) Talking about suicide will not lead to suicide. In fact, talking about suicide REDUCES the stigma, allows individuals to seek help, rethink options, and share their story with others. Most people who attempt or die by suicide have communicated such to at least one person.

If you are still here, I implore you to this or similar data & TTPs within your formations to attack suicide. Don't depend on an hour of ACE training per year to give you the tools you need. Read, research, try new ways to drive the number to zero.

Lastly, giving out your number to the formation and begging them to reach out is fine; but it probably isn't enough. Soldiers in distress need active prevention & intervention. Be positively intrusive, look for the indicators & warnings, and take action. Embrace NOT IN MY SQUAD!

Apologies, but one huge miss: ALCOHOL was a factor in 30% of successful suicides and 45% of suicide attempts. YOUNG SOLDIERS + ALCOHOL + FIREARMS is, by far, the most deadly combination.