A review of the scientific evidence on suicide postvention (organizational responses to prevent additional suicides and help loss survivors cope), guidance for other types of organizations, and the perspectives of the family and friends of service members who have died by suicide provide insights that may help the U.S. Department of Defense formulate its own policies and programs in a practical and efficient way.
Suicide Postvention in the Department of Defense
Evidence, Policies and Procedures, and Perspectives of Loss Survivors
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Research Questions
- How do U.S. Department of Defense (DoD) policies and procedures map to the research evidence, resource guidelines, and recommendations regarding interventions in the aftermath of a suicide?
- What are the perspectives of military suicide loss survivors in terms of the support, resources, and respect they received from DoD and the U.S. Department of Veterans Affairs?
The U.S. Department of Defense (DoD) has been struggling with increasing rates of suicide among military personnel for the past decade. As DoD continues to implement new programs and examine its policies in an effort to prevent military personnel from taking their own lives, it is important to assess its current responses to suicide and to identify opportunities to enhance these programs and policies. Unfortunately, there is little scientific evidence on how best to respond to suicides, how to ensure that surveillance activities are managed appropriately and that loss survivors are given sufficient support to grieve, how additional suicides can be prevented, and how to honor and respect the decedent and his or her loved ones. At the same time, there are many resource guides intended to provide recommendations for organizations (mostly schools) in responding to suicides. A review of the existing scientific evidence on postvention (responses to prevent additional suicides in the aftermath of a suicide) and guidance for other types of organizations provides potential insights for DoD, however. Complemented by the perspectives of those most intimately touched by military suicide — the family and friends of those who have died — these sources may help DoD formulate its guidance in a practical and sensitive way.
Key Findings
The U.S. Department of Defense Has an Excellent System to Report and Track Suicides, but It Could Benefit from Additional Guidance and Improvements
- The U.S. Department of Defense Suicide Event Report (DoDSER) system helps monitor suicides in the military and generally surpasses similar systems used in civilian settings, but it would benefit from certain improvements.
- DoDSER lacks a field to indicate data sources, making it difficult to compare data, analyze trends, or determine the reliability of information, particularly for reservists and National Guard members who are not on active duty.
- DoD currently has no policies or procedures addressing what to do after a suicide death to prevent subsequent suicides, though resources are available to help those bereaved, and processes are in place to honor the service member and his or her family. The limited research literature points to potential opportunities to improve the current system, including screening service members in high-risk groups and helping support personnel recognize and treat those experiencing debilitating grief.
Military Suicide Loss Survivors Report a Range of Experiences in Navigating DoD Support Programs
- In interviews, military suicide loss survivors reported different experiences with DoD-provided casualty assistance officers (CAOs). Some found these officers extremely knowledgeable and supportive, while others felt that their CAO provided confusing or conflicting information.
- Loss survivors felt that the next of kin of service members who had died by suicide were treated differently by the military and that parents of service members were treated differently from spouses.
- Loss survivors found the investigative process emotionally difficult and found it challenging to navigate the administrative requirements in applying for benefits -- something that must occur soon after a death.
Recommendations
- DoD should further strengthen its existing suicide surveillance system by adding elements to the DoDSER, enumerating suicide rates among members of the reserve component, and conducting in-depth investigations on suicide incidents.
- DoD, the services, installations, and other military organizations should prepare an organizational response to suicide by developing a plan that specifies actions and responsible actors and by allocating sufficient resources.
- Military organizations should work with the media to encourage factual reporting and minimize sensationalism of suicides.
- Military leadership should work to identify individuals at high risk of suicide after a death.
- DoD should establish greater uniformity across CAOs in the ways they handle suicide deaths, consistent with standards.
- DoD should educate leaders, CAOs, and other support personnel about complicated grief and should train health care providers on evidence-based treatments for complicated grief.
- Policymakers should reconsider whether eligibility for DoD and U.S. Department of Veterans Affairs (VA) benefits should be affected by line-of-duty determinations (whether a death occurred as a result of military service), and DoD and VA procedures should ensure support for loss survivors in making informed decisions when benefits are dispensed.
Table of Contents
Chapter One
Introduction
Chapter Two
Surveillance
Chapter Three
Suicide Prevention After a Suicide
Chapter Four
Helping Loss Survivors Grieve
Chapter Five
Honor and Respect
Chapter Six
Loss Survivors' Perspectives
Chapter Seven
Recommendations
Appendix A
Postvention Guides Reviewed
Appendix B
Content Analysis of Resource Guides
Research conducted by
This research was sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.
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