Tertiary Prevention Tertiary prevention strategies for suicide occurs in response to completed suicides and suicide attempts. 65 Tertiary prevention also provides interventions and care for individuals who had personal connections to someone who died from suicide. The goal of tertiary prevention is to help survivors grieve and to understand why the person killed him or herself. Service Members and Veterans Suicide is a national public health concern, and this claim is especially true among veterans and active military members. The U.S. Department of Veterans Affairs (VA) leads efforts to understand suicide risk factors for veterans, develop evidence- based prevention programs, and prevent veteran suicide by utilizing a public health approach. 67 The VA analyzes suicide data at the national and state levels to better guide these strategies. The U.S. Department of Defense (DoD) also publishes quarterly and annual suicide reports presenting suicide data on service members and their families. It describes intentional efforts to combat suicide, reduce the stigma associated with seeking help, and share program evaluation and policy review. 67 Service Member and Veteran Suicide Deaths in the U.S. Service Members According to the 2020 Department of Defense Suicide Event Report (DoDSER), 580 members died by suicide. Key findings included 67 : • Active component: The suicide rate increased from 2015 to 2020. • Reserve: There was no significant change in the suicide rate from 2015 to 2020. • National Guard: There was no significant change in the suicide rate from 2015 to 2020. • Service members who died were largely enlisted, male, and younger than 30 years old. Table 10 shows the suicide counts and rates per 100,000 Service members in the military. Veterans According to the most recent National Veteran Suicide Prevention Annual Report, the Veteran suicide count and the rate decreased in 2019 from 2018 and 2017. There were 399 fewer Veteran suicides in 2019 than in 2018, reflecting the lowest raw count of Veteran suicide deaths since 2007. In 2019, the number of suicide deaths among the U.S. population was 45,861, of which 6,261 (13.7%) were Veterans 67 . Despite a decrease in Veteran suicide deaths in 2019, the Veteran population remains at a significantly higher risk for suicide than non- Veterans in the U.S. 67 The Veteran suicide rate is 52.3% (i.e., 1.5x) higher than non-Veterans. 67,69
Figure 1. Stanley-Brown Safety Plan
Note. From Stanley, B., & Brown, G. K. (2021, August 6). Stanley-Brown safety plan [Graphic]. Stanley-Brown Safety Planning Intervention. https://bgg.11b.myftpupload.com/wp-content/uploads/2021/08/Stanley-Brown- Safety-Plan-8-6-21.pdf 63
Zero Suicide Zero Suicide is a framework that takes a systemic approach to identifying suicide risk across healthcare and behavioral healthcare systems. 40 The foundational belief of Zero Suicide is that the suicide deaths of individuals under care within healthcare and behavioral health systems are preventable. The Zero Suicide website provides a wide variety of resources available to community leaders, including the Zero Suicide Toolkit, to help implementors put the Zero Suicide framework into practice. Primary, Secondary, Tertiary Prevention If a suicide act has not occurred, it is important to determine the best prevention strategies. Strategies range from referral to prevention resources to immediate hospitalization and prescribed interventions to keep the individual from self-harm. The public health model of primary, secondary, and tertiary prevention is a valuable model for suicide.
Primary Prevention Primary prevention strategies for suicide are geared toward the general population and include activities and information that educate the community about strategies to decrease suicide. Primary prevention aims to reduce the number of new suicide cases in the general population. 65 These general suicide programs and information are appropriate for schools, homes, clinics, clubs, and social groups. Secondary Prevention Secondary prevention strategies for suicide aim to decrease the likelihood of a suicide attempt in high-risk patients. 66 This level of prevention includes the activities of crisis intervention programs and crisis hotlines. Secondary prevention comprises specific measures used to care for individuals in an active suicidal crisis. Crisis care is usually provided by hospitals, clinics, and hotlines.
57
Powered by FlippingBook