The second element of PPIP is the preventive health assessment (PHA), which in 1996 replaced the periodic physical examination program for all active-duty members. The PHA is a four-stage process that includes a prevention-oriented clinical screening, occupational examination, screening of military-unique medical requirements and counseling. The PHA will help ensure the highest rates of mission and mobility readiness by providing feedback to commanders on the health of their troops.
Air Force leadership is concerned about the ability of its members to cope with increasing levels of stress in the face of significant increases in operations tempo and force downsizing. As a result, the Air Force established an integrated product team (IPT) to evaluate suicides among active-duty members and to develop strategies for suicide prevention and intervention.
The IPT identified numerous factors as leading causes of suicide service wide. Chief among them were relationship difficulties, members facing adverse actions viewed as 'career ending,' financial difficulties, substance abuse and the perception that seeking help would have a negative impact on the individual's career. After evaluating this information, the team called in consultants from both the Air Force and public sector to develop a comprehensive approach to suicide prevention.
Since the inception of the suicide prevention IPT, the suicide rate for active-duty members has decreased by more than 35 percent. This has been strong senior leadership, awareness training for all Air Force members, training at all levels of professional military education, and the development of critical incident stress management teams at every installation. The bottom line in successful suicide prevention is self-aid and buddy care. Everyone must lead the culture shift in the way prevention services are delivered and remove the stigma of seeking help.
The Air Force established policies providing limited confidentiality protection to service members experiencing personal problems and greatly expanded the proactive role of mental health service providers. Various helping agencies in the Air Force - such as family services, chaplains, mental health services, substance abuse and health and wellness centers - now work together to provide comprehensive prevention services that enhance both individual and organizational resilience. In fact, a civilian consultant hired by DoD to evaluate the military services' suicide prevention programs praised the Air Force's program as one that is 'as advanced and enlightened as any I have heard of.'
Commanders, first sergeants, first-line supervisors and co-workers must be aware of danger signs and encourage members to seek help. Leaders should become familiar with Air Force Instruction (AFI) 44-154, 'Suicide Prevention Education and Community Training,' and AFI 44- 153, 'Critical Incident Stress Management.'
Base helping agencies are now working closely together under an integrated delivery system, or IDS. The IDS is designed to link base helping agencies to address risk factors, reduce stress and improve the coping skills and general well- being of individuals and families in the Air Force community. Wing commanders received guidance on implementing this system for their units earlier this year. Commanders at all levels can now work closely with the various agencies to offer a more comprehensive range of prevention services, increase the protective factors and decrease the behavioral risk factors in the community.
As base agencies join ranks, potential problems can be identified earlier and efforts taken more quickly to prevent tragic trends.
***