Upstream Suicide Prevention

Upstream Suicide Prevention Video Series

Dr. Derek Griffith, along with sociologist Chris Smith and clinical psychologist Sarah Wilson, discuss "Demographic Considerations" in Video #3 of this series available at the U.S. Department of Veterans Affairs website.

Suicide has been recognized in recent years as a persistent and disturbingly prevalent problem among military service members and veterans. There have been numerous efforts to address this problem – particularly in the Departments of Defense (DoD) and Veterans Affairs (VA) – which, laudably, have often focused on improving intervention capacities in crisis situations. Examples include advertising suicide prevention hotlines, reducing access to lethal means, identifying persons in the highest risk categories, and training personnel in how to ask about and assess for suicide risk. From a public health standpoint, these suicide prevention efforts represent what might be understood as secondary or tertiary prevention efforts. The objective of this video series is to explore the possibility of preventing suicide further upstream, moving closer toward primary prevention.

Most of the experts featured in this series are not suicide prevention experts. That is by design. Despite significant efforts across DoD, VA, and other national systems, suicide rates continue to rise. This is true not just for military veterans but for the entire U.S. population. Innovative thinking is needed. We know enough about suicide to know that its causes are not simple. Military veterans who die by suicide are not all reacting to combat experiences – it is debatable even whether military service is a risk factor, protective factor, both, or neither. We know that veterans are affected by many of the same factors that are relevant for the rest of society: overall health, access to care, stigma, personal histories, belief systems, sociodemographic trends, and so on. And we know that distinguishing characteristics of the military – such as skewed demographic characteristics (e.g., age, gender, SES) and cultural norms (e.g., masculine ethos, familiarity with firearms) – have particular relevance for suicide risk in this population. These are some of the factors that receive attention in this video series.

Our hope with this video series is that in shifting our perspective on suicide – viewing it from the side so to speak – we will open new avenues for prevention efforts. An immediate audience for the video series is chaplains, especially those working in DoD and VA. A number of prior suicide prevention trainings have targeted chaplains, and surveys of military chaplains indicate that they feel relatively well equipped to participate in the basics of crisis intervention efforts. However, chaplains have simultaneously indicated not feeling adequately equipped to deal with many of the psychosocial upstream risk factors for suicidality. Further, military chaplains are often in a position to advise commanding officers on the topic of suicide. Knowledge of secondary/tertiary prevention resources is critical in such circumstances. We hope to supplement this knowledge with an appreciation for a broader range of considerations that may prove to be relevant in preventing suicide further upstream.