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