Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Defense Suicide Prevention Office, Alexandria, VA, USA.
Suicide Life Threat Behav. 2021 Apr;51(2):334-343. doi: 10.1111/sltb.12709.
Suicide is a serious and growing public health concern, both for the United States (U.S.) and for the Department of Defense (DoD).
Using the social-ecological framework, we provide examples of how three newly developed, DoD-funded pilots/programs have incorporated a public health approach to help prevent military suicide.
The first two programs demonstrate how non-clinical, community-based approaches can be tailored to specific military subgroups at the individual, relational, and community levels. These programs include a universal suicide prevention program developed for Special Operations service members, spouses, and mental health providers, and a selective suicide prevention program pilot developed for military chaplains to support them in their role as a "gateway" to care for distressed service members, improve mental health and chaplaincy collaboration, and prevent burnout. The third program illustrates how the creation of and policy of a methodology/infrastructure to conduct standardized, theory-driven suicide death reviews across the DoD may inform the DoD public health approach to surveillance, review, and synthesis of suicide data, informed by the social-ecological model. Potential program limitations and evaluation efforts are discussed.
Future prevention approaches should enhance coordination and communication between DoD, VA, and community organizations to enhance multi-level suicide prevention programming for military personnel, veterans, and civilians.
自杀是一个严重且日益严重的公共卫生问题，无论是对美国（U.S.）还是对国防部（DoD）而言。
我们使用社会生态框架，举例说明了三个新开发的、由国防部资助的试点/计划如何采用公共卫生方法来帮助预防军人自杀。
前两个计划展示了非临床、基于社区的方法如何能够针对特定的军事群体在个人、关系和社区层面进行定制。这些计划包括为特种作战部队成员、配偶和心理健康提供者开发的通用自杀预防计划，以及为军事牧师开发的选择性自杀预防计划试点，以支持他们作为“门户”为苦恼的服务成员提供关怀，改善心理健康和牧师合作，并预防倦怠。第三个计划说明了如何创建和制定一种方法/基础设施，以便在整个国防部内进行标准化、基于理论的自杀死亡审查，这可能会为国防部的自杀数据监测、审查和综合提供公共卫生方法，该方法由社会生态模型提供信息。讨论了潜在的计划限制和评估工作。
未来的预防方法应加强国防部、VA 和社区组织之间的协调和沟通，以增强针对军事人员、退伍军人和平民的多层次自杀预防计划。
