To:
Secretary of Defense
The Pentagon
Washington, DC 20301
Honorable Secretary:
[The opening paragraph in the original letter cited a number of suicides
in a military organization. Identifying the activities involved is not
relevant to the focus of this copy and has been omitted.]
There is one aspect of organizing around (suicide intervention and
prevention)-all-services-that deserves review at command level and, if a
covering policy or management system exists, that it be publicized
throughout the services and in civilian communities adjacent military
installations.
Normally, a military person with an intolerable personal problem tries to
get relief from within the system of which he or she is part, e.g., a buddy,
family support services, chain-of-command, personnel staff, the IG, etc..
Many personal problems are not job related, but because of the victim's
inability to cope, spill over and affect "job." When the person is in a
suicidal crisis, realizes that help is urgently needed, and wants such help,
he or she will not hesitate to contact whomever can provide it, if not from
within the system then from outside.
Unless the military administrative system has changed on this point, a
suicidal military person, or a suicidal member of his or her family who
seeks help from within the system, believes that a record of the contact
will be made. The "record" transforms to stigma and a potential threat to
present job and future career. "Records," more often than not, compel
the person in a suicidal crisis to look elsewhere. Elsewhere includes the
adjacent civilian community's crisis intervention resources, specifically,
the suicide prevention telephone hotline where callers need not provide
identification - they're as safe from being identified as anywhere they can
be under their circumstances. The hotline worker does what can be
accomplished quickly to keep the caller from slipping deeper into crisis
and acting out a threat to suicide. They listen, offer nonjudgmental
feedback, and together with the caller, explore options.
Almost invariably, when a civilian community crisis worker (telephone
hotline or face-to-face) needs information on options unique to military
life to help a suicidal military member or someone in his or her
immediate family, the source is the nearest base's health care, personnel,
or other administrative functions. Very often, when contacts with base
officials occur and the worker has the name of a suicidal caller,
confidentiality is literally vital; being tagged in the base's records as
someone who phoned an off-base crisis center carries almost certain
exposure to military authority, and might well add the final straw.
If it's accepted that the military base and its adjacent civilian community
should cooperate in suicide intervention, then the civilian and military
agencies need mutually accepted procedures to do the job. If a
community's crisis resource has one set of procedures for cooperation
from the Navy, another for the Marine Corps, and still others for the
Army and the Air Force, confusion mounts and collaboration suffers.
This is especially true when the situation is tight and there isn't much
time to keep a suicide threat from becoming an act. To the telephone
hotline worker in a suicide prevention center it makes no difference
whatsoever if the person on the other end of the line is a soldier, sailor,
airman, marine - or civilian. On the other side of the scale, however, is
the we-take-care-of-our-own turf, and that, to the suicidal person, is
meaningless.
I hoped that, by now, military bases would have been further along in
collaborating with adjacent civilian suicide prevention resources and that
such teamwork would be reflected in base and community media. How
else would a military person or a member of his or her family on the
edge of a life-death decision for themselves know where to go or whom
to phone, especially where their privacy and confidentiality would be
respected - if they decided to take a chance to continue living? Is a city
telephone directory listing for the local crisis center enough?
Agreements, procedures and contact points for military-civilian
teamwork in suicide prevention deserve to begin on a county,
metropolitan, or other regional basis, rather than in single-base to
community understandings, especially where the area has bases
representing different services. When all the services in an area have
maximum understanding among themselves about collaborating with
community suicide intervention resources, it will optimize the support
that they and their people as individuals can ask for from that resource,
and the help that the hotline worker can offer to them. In effect, when a
civilian suicide hotline has been appealed to for help by a military
member/family member, the crisis worker will have clearly written,
mutually agreed upon procedures for communications and actions with
each base in the area. All concerned will have been trained, tested, and
know to the greatest degree possible who is going to do what. With
present computer networking capabilities the resources indices in such
guides can be readily maintained current and widely disseminated
throughout a region and on and among military installations.
The opinions in this letter are my own, and are based on my experiences
as a civilian IG-analyst and suicide prevention hotline volunteer in the
late '60s/early 70s (and hassling the bureaucracy on this issue into the
mid-80s.) I am not now associated with any mental health profession or
military organization-strictly a private citizen. It may be that what I've
suggested already exists or, conversely, that it isn't justified; I don't
know, but I would be remiss not to present my views for your
consideration.
Respectfully,
s/Moldeven