1. Headquarters U.S. Air Force
Integrity - Service - Excellence
Suicide Prevention
Lt Gen C. Bruce Green
Surgeon General
13 Oct 11
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2. PSA: AF Family Suicide Risk
Video Begins on Click
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3. PSA: AF Family Suicide Risk
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4. The Suicidal Mind
Suicide is a behavior, not a disease
How we think and communicate about it affects its rate
Usually characterized by desperation, hopelessness
Rage: anger and frustration - Impulse
Avoidance: legal/financial concerns, guilt
Mental illness: Depression, Bipolar Illness
Substance use often fuels the fire
Top risk factors
Relationship problems
Mental health history
Legal/ administrative problems
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5. Where We Left Off Last Year
120 AD Suicides ARC in Duty Status 24
110 ARC not in duty status Civilian Suicides 22
100 CY AD Rate Total Force Rate 20
90 18
80 16
Number
70 14
Rate/100K
60 12
50 10
40 8
30 6
20 4
10 2
0 0
2004 2005 2006 2007 2008 2009 2010
Sense of Urgency: AF experienced more suicides in CY10
16.4/100K than any year since 1994 – 2011 Rate 14.4/100K
*As of 3 Oct 11 Integrity - Service - Excellence 5

6. Gap Analysis
Comprehensive gap analysis
Volpe, RAND, with 11 AFSPP Elements
Input from MAJCOM/ARC Mental Health
Consultants and CAIB/IDS leaders
Findings by Volpe & RAND
Encompass 11 AFSPP Elements
23 AFSPP Gaps Identified
Messaging (1)
Standardization (3)
Evaluation (2)
Guidance (15)
Application (2)
“The Air Force suicide-prevention program could provide a
model for the other Services.” – RAND, The War Within
TMT: 41111 Integrity - Service - Excellence 6

7. New Suicide Prevention
Initiatives
Point of Attack Process
Frontline Supervisor Training for at-risk AFSCs Strategic Communication Plan
Semiannual Wingman Days Shift to strengths-based messaging
Security Forces/JAG initiatives RAND social media study
VCSAF Memos Improved weekly dashboard slide
Face-to-face suicide prevention training Fort Hood Follow-on Review
Unit Consultation Tools Response to DHB DoD TF on the
Comprehensive Post-Suicide Guidelines Prevention of Suicide by Military
Members
Public Affairs Guidance for Suicide
2011 Community Assessment
Increase AD mental health providers by 25% Expanded use of multimedia tools
Add 70 more to Primary Care CSAF/CMSAF PSAs
“The Air Force’s pioneering suicide prevention program was producing the first
empirical evidence that a comprehensive, public health approach could, in fact,
reduce suicide across a population.” – Volpe Report
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8. Air Force Suicide
Prevention Overview
Suicide Rates (per 100,000/yr) AD Risk Factors/Stressors (%)
10 year Pre-Program 13.5 Relationship Problems 54.2
10 year Post-Program 9.9
History of Any Mental Health 45.8
CY10 Active Duty 16.4 Diagnosis
CY11 Active Duty (Rolling Rate) 14.4 Legal/Admin Problems 33.9
CY11 Q2-Q3 Active Duty 11.5
Seen by Mental Health in Past 18.6
CY11 Total Force (Rolling Rate) 13.4 Month
CY11 Q2-Q3 Total Force 12.9
By AD Career Group (CY 10-11) Alcohol in System at Death 17
(per 100,000/yr)
Security Forces (3P) 33.8 Deployed in the Past Year 12
Aircraft Maintenance (2A) 21.8
Financial Problems 10.2
Intelligence (1N) 0.0
Security Forces rate down 30% from Feb ‘11 peak
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9. Prevent the Final Impulsive
Action
Identify those at risk
Know your Airmen
Create a culture of resilient Airmen
ACE: Ask, Care, Escort
Stress is Ubiquitous – Simple Adaptive Behaviors (Humor) are Effective
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10. Musical Stairs
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11. Musical Stairs
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12. “TRUSTED CARE ANYWHERE”
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13. BACK UP SLIDES
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14. Where Leaders Can Help
Core Elements of Suicide Prevention Leadership Involvement
#1 Leadership Involvement Conduct face-to-face training
#2 Address Prevention through PME Encourage PME
#3 Guidelines for Commanders: Use Leader’s Guide for Managing Personnel in Distress
Use of Mental Health Services
#4 Unit-Based Preventive Services Employ Resilience Elements (AFI 44-172, Mental Health)
#5 Wingman Culture Plan semi-annual Wingman Days
#6 Investigative Interview Policy Heighten vigilance for Airmen under investigation
#7 Post Suicide Response Make use of Leaders’ Post-Suicide Checklist
#8 IDS & CAIB Support your local CAIB/IDS
#9 Limited Privilege SPP Know when to recommend privileged counseling
#10 Commander Consultation Tools Collaborate with your IDS on unit assessments
#11 Suicide Event Tracking and Analysis Support the completion of DoDSER database
Help Improve Resilience & Destigmatize Mental Health
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15. UNCLASSIFIED // FOUO
Metric AF Active Duty and AF Total Force Suicides Status: Yellow
Objective Track suicides over time to identify trends
Metric Owner: AFMSA/SG3OQ Metric POC: Major Michael McCarthy Last Updated On: 30 Sep 11
Metric Definition: Suicide Rate= (Raw Number of Suicides Over the Last 12 Months/End Strength) x100,000
120 24
AD Suicides ARC in Duty Status ARC not in duty status
110 22
100 Civilian Suicides CY AD Rate Total Force Rate 20
CY10 DoD Rate
90 18
Rate/100K
Red Boundary
Number
80 16
70
60
*
*
Green Boundary
14
12
50 10
40 8
30 6
20 4
10 2
0 0
2004 2005 2006 2007 2008 2009 2010 2011
* 52 Week Rolling Rate
Results Analysis
CY10/CY11 #s * Rolling 12 Month Rate
AD AF Suicides through 30 Sep: 38/32 14.4
Total Force Suicides through 30 Sep: 72/63 13.4
Improvement Actions/Next Steps
- Update AFI 44-154, Suicide and Violence Prevention Education and Training
- Suicide Prevention Program Evaluation Grant Proposal
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