Honing our efforts to reduce suicide – a public health scourge
Navy Capt. Mike Colston, director of Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury
SUicide Prevention Awareness Month is a national observance during the month of September, but suicide prevention is a priority for the Department of Defense (DoD) every day of the year. Suicide is a pressing public health issue. Suicide rates have increased alarmingly in the U.S. over the past two decades. The Defense Health Agency (DHA) will lead in preventing suicide through three lines of action: fostering research, translating clinical knowledge to the field and informing policy.
The evidence base for suicide prevention remains thin. Research efforts such as the “Study to Assess Risk and Resilience in service members Longitudinal Project” (STARRS-LP) and protocols under the cognizance of the Military Suicide Research Consortium are producing slow but hard-won gains in the science of suicidology.
Interventions such as brief suicide-focused cognitive behavioral therapy have been shown to reduce suicidal thinking and suicide attempts in treated groups. There is some evidence that these interventions, based on registry data in Northern Europe, may even have reduced suicides—a very high bar to prove as suicide is a low base-rate event. The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury will lead in promulgating practices such as this throughout the Military Health System.
We can inform policy changes. As recommended by the DoD-VA Clinical Practice Guidelines for Assessment and Management of Patients at Risk for Suicide, we can consider ways to restrict access to lethal means that service members and veterans could use to take their own lives. This includes safer prescribing and dispensing of medications to prevent intentional overdoses and restriction of access to firearms and ammunition. In addition, other efforts of means restriction – such as construction of suicide barriers on bridges, reducing access to pesticides, and the detoxification of natural gas supplies – showed immediate and lasting reductions in suicide in populations where these practices were implemented.
We must act now to reduce suicides in our population by honing our efforts toward promising, implementable and measurable action.