Air Force suicides drop 33% in wake of mandatory prevention program.

CHICAGO -- Communities and organizations could learn a lot about suicide prevention from the United States Air Force.

Data for 1990-2002 show that within 6 years of the USAF Suicide Prevention Program implementation, suicides among Air Force personnel were down 33%.

In addition, moderate and severe family violence were reduced 30% and 54%, respectively, and homicides were reduced 51%. An 18% increase in mild family violence over that time period may reflect increased reporting in the wake of educational programs that raised awareness about violence and suicide, Maj. Steven Pflanz, MC, USAF, said at the annual meeting of the Academy of Occupational and Organizational Psychiatry.

The USAF admittedly is a unique population, and the USAF was able to make the program mandatory for all personnel. Still, the outcomes suggest that a coordinated network of policy and community education initiatives is effective for decreasing suicide risk, said Dr. Pflanz, chief of the Air Force Suicide Prevention Program, Falls Church, Va.

He described the program as a community-based, population-oriented program built around an integrated system of important initiatives. The first five initiatives, which make up the "guts" of the program, include leadership involvement, suicide prevention in professional military education, guidelines on use of mental health services, community prevention services, and community education and training.

Others include an investigative interview policy, critical incident stress management, integrated delivery system, and suicide event surveillance.

Leadership involvement and support of the program were particularly crucial for success, he noted at the meeting, which was cosponsored by the American College of Occupational and Environmental Medicine.

Specific program goals included reducing the stigma associated with use of mental health services through education, and encouraging early help-seeking behaviors, because the program was predicated on the view that individuals at risk show warning signs, and that intervention at an early stage lowers risk.

The program also sought to create an atmosphere of responsibility and accountability by establishing new expectations about suicide prevention behaviors among individuals and leaders.

Dr. Pflanz's vision for the program is that at every level of the community, from citizen to provider, appropriate suicide prevention concepts be well known and put into practice, he said, stressing that suicide prevention is a community responsibility, and that early recognition and intervention require widespread community knowledge and skills.

The widespread recognition of 911 systems and the benefits of CPR are good examples of how ingrained in the community suicide prevention knowledge should be, he said.

To ensure implementation of program initiatives, quarterly reports are provided, and program implementation is monitored. Annual training is provided, as are workshops and guidelines for front-line supervisors and commanders.

The effectiveness of the program is tracked through study, and research on suicide risk factors specific to the Air Force is ongoing.

These principles could easily be adapted for use in organizations such as police and fire-fighting forces, government agencies, large corporations, schools, and universities, Dr. Pflanz said.

BY SHARON WORCESTER

Southeast Bureau