Page 142 - Journal of Special Operations Medicine - Spring 2016

from the
S
SEMAEMA

or this issue of the Journal of Spe- of sorts to help individuals take action
Fcial Operations Medicine (JSOM), I as leaders. The following is a very im-
feel compelled to talk briefly about sui- portant and useful list of suicidal risk
cide. Not only is this an important topic factors and warning signs:
within my command, but it is an issue
that all leaders and all Servicemembers • Life circumstances
should talk about. Suicide is a heart- o access to lethal means of self-harm
breaking event that goes against every- SGM F. Bowling o suicides within the family/community
thing that we espouse in the military. 18D, ATP o career setbacks or disciplinary ac-
tions, loss of a job
It is unfortunately true that suicide USSOCOM o loss of or conflict within a close
rates can increase when stories of sui- Senior Enlisted Medical Advisor relationship
cide appear in the media. There is also o financial problems
a stigma surrounding talking about suicide. It is therefore o readjustment difficulties following deployment
probably wise not to talk about certain aspects of sui- • Biopsychosocial issues
cide. For instance, the number of suicides is only im- o history of abuse, family violence, or trauma
1–4
portant if you are an epidemiologist; one suicide is too o medical or mental health problems (i.e., depression)
many. The method of suicide is not important; the loss is o prior suicide attempt
just as tragic regardless of the method. The mere fact that o impulsiveness, aggressiveness
the death was the result of suicide is far less important o alcohol and substance abuse (which can cause or
than the fact that a human being has died. It is sufficient exacerbate existing depression)
to say that someone died. It is not necessary to repeat that o severe or prolonged stress or combat-related psy-
someone committed suicide any more than it is important chological injuries
to repeat that someone has died. However, it is of para- o overwhelming grief from a loss (death of a loved
mount importance that we talk about the prevention of one, divorce, disabling injury, etc.)
suicide and risk factors. It is important to talk about how • Cultural issues
someone lived. It is important to talk about how preven- o limited access to health care
tion works. It is important to talk about how to spot the o religious beliefs that support suicide as a solution;
warning signs and prevention. The attached enclosure of negative attitudes toward getting help
counseling areas and leader actions from USSOCOM sui- o limited support
cide prevention policy offers a broad list for leaders to o Remember, risk factors do not mean that a person
take positive steps for counseling subordinates. will actually attempt suicide now or in the future.
When risk factors are present, however, think of
I have no doubt whatsoever that no one, Servicemem- them as reasons to consider the possibility of self-
ber or civilian, wants to let down the world by taking injury and learn the suicide warning signs and what
his or her own life. The fact that some of the strongest, you can do to prevent it.
most honorable people we know would choose to take • A different way to identify risk: You can also assess sui-
their own life is a testament to the deep suffering that cide risk by looking for three factors that Dr Thomas
they experience. Talking about this is a stigma we must Joiner identifies in his book Why People Die by Sui-
overcome. We continue to try to overcome the stigma cide as essential conditions for suicidal behavior. Each
5
of seeking help for posttraumatic stress disorder, and we of these factors has been seen in Servicemembers strug-
have made great strides in this area. However, the stigma gling with combat-related stress injuries or with read-
of talking about suicide and suicidal ideation still lingers. justment after deployment. When all three are present,
the risk of suicidal behavior could be quite serious:
I do not have any special insight into suicide or much o the feeling of being an unbearable burden on fam-
new information. I hope that I can assist with a roadmap ily, friends, or society

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