Commentary: Connect to protect Published Sept. 22, 2020 By Stuart Bapties Robins Suicide Prevention Program Manager ROBINS AIR FORCE BASE, Georgia -- Suicide is the 10th leading cause of death in the U.S. for people over the age of 10, and suicide deaths have been on the rise over the past decade. Approximately 40,000 people in the U.S. die by suicide every year. That number is 24 percent higher than in it was in 1999 and accounts for 9,000 more lives lost per year than those killed in car accidents annually. With the COVID-19 pandemic, suicide has become of even greater concern. There is also growing evidence, documented in the June 2020 issue of QJM: An International Journal of Medicine, which shows the ongoing COVID-19 pandemic has had a profound psychological and social effect on people and communities and that COVID-19 is “associated with distress, anxiety, fear, depression and insomnia.” The expectation from leading researchers is that the mental health consequences of COVID-19, including suicidal behavior, are likely to be present for a long time and won’t actually peak until after the pandemic has run its course. So what can we do to help with this ongoing mental health crisis? How do we help stop people from dying of suicide? Let’s start by familiarizing ourselves with the warning signs and risk factors so that we know what to look for to prevent suicide. The National Suicide Prevention Lifeline alerts us to the following warning signs: Sleeping too much or too little Acting anxious or upset Showing rage Withdrawing or isolating Extreme mood swings Behaving recklessly Increasing use of drugs and/or alcohol Talking about seeking revenge Talking about feeling hopeless, trapped, or a burden to others Looking for a way to kill themselves Talking about suicide or wanting to die Now, what are the risk factors that make us worry about a person dying by suicide? According to the World Health Organization, many personal traits and risk factors make it more likely that an individual will try to commit suicide. These include: Severe depression Other mood disorders (such as bipolar disorder, also called manic depression) Anxiety disorders Impulsivity Sense of hopelessness Family history of suicide Knowing people who committed suicide or hearing about suicides Serious medical illness Personal loss Conflicts with other people Broken relationships Legal or work-related problems History of physical or sexual abuse Schizophrenia So, how can we help? Who can we turn to? There are many ways to get help for yourself or someone that you are worried about at any installation across the Department of Defense. Resources include the base chaplain, mental health clinic, Employee Assistance Program, Occupational Medicine Services psychologists, Military Family Life Consultants, and Military One Source, 1-800-342-9647. If you are uncertain how to proceed or are uncomfortable proceeding on your own, you can reach out to your supervisor, first sergeant, community resilience coordinators, or one of the integrated resilience training assistants that are attached to your unit – they are poised to help. Often, though, we are not at work when these things occur and that throws us for a loop because we don’t have access to our normal resources and don’t have time to spare looking for them. For immediate help, you can call 911 and let them know what is going on and they will send help. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255 or text the Crisis Text Line at 741741 to be connected with a trained crisis counselor immediately. These services are free of charge and are available to everyone. I advise everyone to put those numbers on their phone for quick access and share those numbers with loved ones. Now, let’s talk about prevention. How can we help before the person attempts suicide? When we talk about risk factors, we would do better to refer to risk factors as the trigger that caused a person to take the action of attempting suicide. I say this because it is rarely the sole reason that a person has decided to commit suicide; it’s more likely to be the last straw in a series of events that have brought the suicidal person to that place. With this in mind, if we stay connected and observant, we may be able to catch the warning signs that a person is throwing out that they are in distress – a cry for help that the suicidal person wants and needs someone to notice and intervene. We can use those warning signs as opportunities to get involved early and prevent a death. I know that we are all familiar with the Air Force Model of A.C.E. – Ask, Care, and Escort –however, we should really think through how we apply that model in a way that shows our concern and gets results. The first time that we ask or intervene in a possible suicide should not be the first time that we have thought through how we would intervene. The National Institute for Mental Health recommends the following to help someone dealing with emotional pain and suicidal thoughts or intentions. Ask – Confront the person in a caring and non-judgmental way by saying, “I care about you, and I am worried. Are you thinking about hurting or killing yourself?” Research shows questioning does not increase suicides or the thought of suicide. As this can be a difficult thing to do, you might seek support from someone else who cares about the person. Make no mistake though, the question has to be asked. They want you to ask. They need you to ask. Keep them safe – Ask the person if they have any weapons or other lethal items that are easily accessible. If they do, help this person figure out a plan for removing the weapons so that they cannot be accessed, or at least make it more difficult to act impulsively with a firearm. Unit first sergeants, CRCs, IRTAs and base counselors have been provided gun locks for distribution. If you can’t find a gun lock, contact the violence prevention integrator at your installation. Be there – Be open to listening and learning what the person is experiencing, thinking, and feeling. Simply being with the person and listening is a great way to show that you care, and it might help them open up to you. Remember, sometimes people just need to be heard. Help them connect – Help them find a mental health professional. Whether that is face-to-face with one of our base resources like Military Family Life Consultants, the chapel, mental health, or by calling Military One Source at 1-800-342-9647 or EAP. An excellent resource for immediate access to crisis counselors is the National Suicide Prevention Lifeline where trained crisis workers are available to talk 24 hours a day, 7 days a week. Put the number in this person’s phone or call with them so that they have extra support. To help them find a therapist, you can utilize the Substance Abuse and Mental Health Services Administration Behavioral Health Treatment Services Locator, or call SAMHSA’s National Helpline at 1-800-622-4357. Remember – If the situation is potentially life-threatening, call 911 or go to a hospital emergency room immediately. Stay connected – Keep in touch with the person after they are connected with a mental health professional. Following up with people who are thinking about suicide decreases their risk of committing suicide by showing that we care about them.