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NEWS | Sept. 19, 2011

Are You “All In”?

By Catherine Hallett JB Charleston ADAPT program manager

In 2009, a joint Secretary of the Air Force and Chief Sergeant Major of the Air Force letter to all Airmen addressed their deep concern about Airmen who commit suicide. The letter emphasized an "all in" approach for us to support each other in getting the necessary help to prevent suicide. Their stand of 'one suicide is too many' is meant to convey that we need to remain vigilant and must not let our guard down in order to prevent the next suicide. Preventing the next suicide requires each of us to be on the lookout for warning signs and then be willing to act accordingly using the ACE principle of Ask, Care, and Escort the person to the safety of mental health professionals.

Suicides in the military remain a concern. According to the Centers of Disease Control and Prevention, suicide is the fourth leading cause of death among 25 to 44-year-olds in the United States with a rate of 19.2 suicides per 100,000. Historically, the suicide rate has been lower in the military than among the general civilian population. However, that all changed in 2008 when the Army had 140 suicides at a rate of 20.2 suicides per 100,000 Soldiers. This trend was also seen in the Marine Corps which lost 41 Marines at a rate of 19 per 100,000. The Navy had 41 deaths at a rate of 11.6 per 100,000 and the Air Force reported 40 suicides at a rate of 12.4 per 100,000. In 2009, the Air Force reported 41 suicides but in 2010, suicides rose to an alarming 54, changing the rate of suicides to 16.2 per 100,000. These facts underscore just how serious a problem suicide is and should spark everyone to realize that if any suicide prevention program is going to be effective, it must involve all of us. The all in stance our leaders are promoting, that even one suicide is one too many, must be adopted by all Air Force members - active duty, civilian and contractors alike.

Two products that have been developed can be found at These useful tools are the Leader's Guide to Managing Personnel in Distress and the Frontline Supervisors Training. The Leader's Guide is designed to help unit leaders at all levels recognize distress-related behaviors, provide support to individuals within the unit and collaborate with helping agencies. The guide describes a broad range of supportive interventions, resources and strategies for supporting individuals in distress.

The Frontline Supervisors Training is a four-hour workshop that provides in-depth training on assisting personnel in distress as well as in suicide prevention. It can be taught by any experienced leader, educator or helping professional.

Commanders' calls and weekly roll calls are also an effective means to promote programs and services and encourage Airmen to get help.

Central to any suicide prevention program is recognizing distress-related behaviors, both in ourselves and others. We don't need to wait until a person has reached the threshold of debilitating distress before reaching out. We can't always tell when an Airman is having emotional difficulties. Anxiety, depression or problems with alcohol or other substances can often remain hidden from others. Angry outbursts at work, relationship problems, increased drinking, accidents and mishaps can sometimes be warning signs. Sometimes, a caring friend who will listen can make a difference.

Air Force and DoD senior leaders recognize that seeking help is a sign of strength and can assist people to function at their peak at work and at home. Everyone needs help with certain aspects of their lives and we should all seek help when needed and encourage others to do the same. We must eliminate the stigma attached to asking for help and realize there is no shame attached to offering or receiving mental health services. We need to recognize when an individual is clearly in distress and intervene.

The ACE model of Ask, Care, and Escort is easy to remember and act upon. Asking a person if they are suicidal shows concern. Caring about the individual enough to listen is being a responsible Wingman. And finally, stay with the person and Escort them to the mental health clinic or hospital. That just might make the difference between life and death.

The following is a personal account from a former ADAPT client who has asked to remain anonymous:

"I almost died! In fact I came so close to suicide, I'm surprised I'm still around. I had so many problems and felt I couldn't tell anyone how much pain I was in. Everyone thought I had it all together; when in fact, I hated my life. I kept getting more projects at work and with each additional duty I became increasingly worse. I tried to concentrate but lost focus. I was staying later and later at work and then going home every night and drinking until I fell asleep, often in the easy chair in front of the TV. My wife knew I was unhappy but she didn't know how bad I was. I couldn't tell her just how unmanageable my life had become. I became remote at work, distant to my family, an absent parent to my children and began having thoughts of killing myself. To this day, I don't know how I ended up in the Mental Health Clinic. I always believed that if you went to mental health your career was over. At the point when I thought I had nothing left to lose, I called to make an appointment.

"The counselor was incredibly kind, but made it clear to me that I needed to go to a hospital where my problems, especially with alcohol, could be addressed. She contacted my chain of command and my wife. My boss drove me to the hospital where I stayed for 28 days. It was there I learned so much about myself, my demons and how to cope with the day-to-day stressors of my life. "My leadership worked very closely with me. They reassured me my career was not over and that they had every confidence I would be back in top form.

"When I was released from the hospital, everyone worked with me to find the right balance between work and home. I accomplished more at work, had time to work out and had energy left over at the end of each day. I went to counseling and Alcoholics Anonymous regularly and soon felt better than I had in years. I began enjoying life again. I became a better Airman and leader, a more loving husband and father and most importantly, I am alive today."

The above reflection illustrates the importance of suicide prevention and how the "all in" approach saved a life. If you or someone you know is stressed, don't be afraid to ask for help. Call the Mental Health Clinic on the Air Base at 963-6852, or Navy Mental Health at 794-6450 at the Weapons Station, or Military One Source at 1-800-342-9647 for assistance. If you are suicidal, get help now.

The following numbers are also available 24-hours a day, seven days a week, and 365 days a year:

Military/Veterans Suicide Hotline at 1-800-273-8255 or 1-800-273-TALK
National Suicide Hotline at 1-800-784-2433

This article first appeared in the November/December 2009 Combat Edge Magazine and has been updated for use at Joint Base Charleston.