Suicide prevention month comes to a close Published Sept. 30, 2016 By Staff Sgt. Kia Atkins 7th Bomb Wing Public Affairs DYESS AIR FORCE BASE, Texas -- Although, the end of September may signify the end of suicide prevention month, it is important to keep an eye on your fellow Wingmen year-round. The vigilance it takes to maintain healthy mental resiliency is a year-round duty for all Airmen. Suicide prevention is the responsibility of every individual in the Air Force. “I know we always talk about wingmanship and looking out for your fellow Wingmen or Airmen, but it really is important,” said Capt. James Salas, 7th Medical Operations Squadron family advocacy officer and suicide prevention program manager. “Many times when we are walking down a hallway or just passing by one another, we ask the courtesy question ‘how are you doing?’ Sometimes we wait for a response, sometimes we don’t or sometimes we just kind of keep on walking, but we really shouldn’t do that. We need to pay attention to our co-workers. If you see someone that might be having a hard time or notice that something is wrong, ask them.” Recent information from the Air Force Medical service about suicide indicates there are several factors that can combine to put an individual at risk for committing suicide. The presence of these factors does not guarantee suicidal ideations, however, individuals with these factors may warrant close monitoring. These risk factors include: • Current/pending disciplinary or legal action • Relationship problems • Substance abuse • Financial problems • Work related problems • Transitions (retirement, PCS, separation from service, etc.) • A serious medical problem, such as chronic pain or terminal illness • Significant loss, such as, but not limited to through death or divorce • Setbacks (academic, career, or personal) • Stress that is severe, prolonged, and/that a person thinks they cannot • A sense of powerlessness, helplessness, and/or hopelessness • A sense of being a burden to others • Presence of a weapon in the home • History of previous suicide attempts or self-injurious behavior such as cutting or burning “A lot of times, you’ll be around a coworker and start noticing that they are acting a little differently,” said Salas. “They’ll seem down, depressed or maybe just irritable, so you’ll ask them how they are doing and they will say ‘Oh, I’m fine’ or ‘I’m okay. You shouldn’t just leave it at that; it’s important to dig a little bit deeper. Really ask them what’s going on. You’ll be surprised how many people will acknowledge that they are having a difficult time.” If you know an individual who exhibits several of these risk factors, it’s important to be able to recognize distress in the individual associated with those risk factors. Close coworkers, family and friends are more likely to recognize behavioral changes in the individual. It is integral to discuss these changes with the individual and to provide support and care. Some changes that may be exhibited are: • Mood • Concentration • Sleep • Energy • Appetite • Substance use • Impulse control • Reduced capacity for enjoyment • Helplessness or hopelessness • Peer relations (withdrawal or arguments) • Work performance • Military bearing • Personal hygiene and grooming • Ineffective problem-solving In addition, Wingmen must be vigilant when someone shows: • An inability to see a future without pain • A view of themselves as worthless or burdensome to others • An absence of control over their life or life circumstances • Feeling alone • Excessive guilt or shame • An inability to stop negative thinking • Pessimism and a belief that there is no solution to life's problems • Constant/frequent thoughts about death, dying and weapons • Challenging people in an aggressive manner • Giving away possessions • Excessive sorrow for past behaviors If the individual reports thoughts of suicide, discusses a suicide plan, discloses a recent suicide attempt or has self-harming behavior such as cutting or burning themselves seek immediate assistance from the Mental Health Clinic. “Sometimes all of those stressors start adding up and the individual feels like their only option is to take their own life,” said Salas. “Again, it’s important to ask questions when you see someone starting to act a little differently.” As a Wingman, you can more effectively help an individual if you know what is going on. Your Wingman may or may not be having suicidal thoughts, but asking questions will help determine the level of help they may need. The ACE model is recommended for discussing suicide. • Ask: Ask directly about thoughts of suicide without being judgmental (e.g., "Have you had any thoughts of hurting or killing yourself?"). Never promise to keep thoughts of suicide a secret or criticize someone's thoughts or feelings. Always take indicators of suicide risk seriously. Accept distressed thoughts/feelings as an indication of the person's distress and need for help. • Care: Express care and concern for the distress the person is feeling, along with a desire to help. Accept their thoughts and feelings without being judgmental, express your desire to get them help and support them through a difficult time. • Escort: Escort the person to help. Don't leave them alone; get them to a medical facility, chaplain, Commander or other authority that can help. Don't ignore the problem or expect the situation to improve; act immediately to get them to help. “Let’s say that person says that they are serious about harming themselves or that they are having suicidal thoughts,” said Salas. “You should walk them to the Mental Health Clinic. We are open Monday through Friday, 7:30 a.m. to 4:30 p.m. and you can just walk them right in. We take walk-ins all the time. But what do you do after hours? You call 9-1-1, never leave that person alone and contact their supervisor, their first sergeant, their commander. Take them to the E.R. Just never leave that person alone.” Salas went on to say there have been cases where individuals who have expressed suicidal ideations have been referred to the Mental Health Clinic, but have then been left alone. “We definitely don’t want any adverse outcomes, it’s important to never leave that person alone,” said Salas. “The Mental Health Clinic is always here to help, but we aren’t the only ones out there to assist an individual in need. There’s the Airman and Family Readiness Center. There are military family life consultants that are housed over at the Airman and Family Readiness Center. You also have the chaplains, which are a great resource and they are 100 percent confidential and talking to a supervisor, coworker, friend or family member is always a possible source of assistance.” Some Airmen believe there is a stigma attached to being seen at the Mental Health Clinic or that it could adversely affect their career, but Salas says that is not the case. “The percentage of people that come in to seek mental health treatment, and have that situation negatively impact their career is very small,” said Salas “Less than maybe two or three percent of what we see here at the Mental Health Clinic has some sort of career impact. Most of the time people do get better when they come in for treatment.” Although you may be put on a profile that prevents you from deploying or going to a temporary duty location, it is only temporary. “If the individual is put on some sort of medication we do put a profile in place, but that profile is not to hinder their career at all,,” said Salas. “We just want to make sure that they’re doing okay, and that they don’t go somewhere that there’s no medical provider that can help them. If they are doing well, we remove the profile and there is minimal impact.” If you or someone you know is experiencing suicidal thoughts, please contact the Mental Health Clinic at (325) 696-5380. If it is after hours, on a holiday or during the weekend, please contact 9-1-1, take them to the emergency room, notify their chain of command and never leave your Wingman alone.