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三种由国防部资助的公共卫生方法来减少军人自杀。

Three department of defense-funded public health approaches to reduce military suicide.

机构信息

Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Defense Suicide Prevention Office, Alexandria, VA, USA.

出版信息

Suicide Life Threat Behav. 2021 Apr;51(2):334-343. doi: 10.1111/sltb.12709.

Abstract

BACKGROUND

Suicide is a serious and growing public health concern, both for the United States (U.S.) and for the Department of Defense (DoD).

METHODS

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.

KEY RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

主要结果

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。

结论

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。

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