Protective Factors

The following article was contributed by Duane France, Director of Veteran Services at Family Care Center Colorado Springs. His military background and professional experience as a clinical mental health counselor make him a very qualified spokesperson on suicide prevention. It should also be noted that in 2019, Duane was selected as El Paso County Veteran of the Year.

Home Front Military Network is honored to have him contribute to our blog during Suicide Prevention Awareness Month:

“Suicide in the military affiliated population is a significant challenge, both nationally and throughout the state of Colorado, but also within our local community. El Paso County and Colorado Springs are annually ranked as one of the most desirable locations in the country to be stationed for active military and to make a forever home for veterans and their families. The climate, the recreational opportunities, the educational and employment offerings; all of these together have resulted in hundreds of thousands of service members, veterans, and their families calling our community home.

Unfortunately, such a high concentration of a military population also comes with a correspondingly high number of deaths by suicide. Dr. Phillip Smith, a professor and researcher with the University of South Alabama, describes suicide as both common and rare. It is rare in the sense that many of us will go years without being personally impacted by it; it is common, because all of us have been impacted by suicide in a very personal way. Everyone who I have talked to who served, including myself, has a “number”…the number of those we served with who have died by suicide. Unfortunately, as time goes on, that number eclipses the number that we lost in combat.

The question has been, and continues to be, what can we do about it? How do we solve the problem of suicide in the military affiliated population? All of us want to stop it, but it seems to insolvable. One of the challenges is that we may be looking at suicide as a puzzle, but need to look it as a mystery. National security expert Geregory Treverton made the distinction in this way: a puzzle has a simple, factual answer and is solved by gathering more information. Applying this to the problem of suicide in the military population, we say, “if we can only find out why veterans choose to die by suicide, then we can address that problem and suicide will go away.” Instead, Terverton says, a mystery is different: it has many different factors and is solved more by analysis of the problem rather than gathering more information.

This analysis has been conducted at the national level, and people looking to impact the problem of SMVF suicide are increasingly focused on taking a public health approach to suicide prevention. As part of the public health approach, approaches are classified as either protective factors or risk factors. Protective factors are those that can be considered “prevention.” These are things that are necessary to have in place to keep someone from experiencing a suicidal crisis. Risk factors are those efforts that can reduce a person’s risk of dying by suicide, and are classified as either “intervention” or “postvention.”

Currently, in Colorado, there are two federal-state-local initiatives that are attempting to address this: the Governor’s Challenge to Prevent Veteran Suicide and the Colorado National Collaborative. The Governor’s Challenge is a partnership between the Department of Veterans Affairs, the Substance Abuse and Mental Health Services Administration, and various states around the country. The Colorado-National Collaborative is a partnership between the Centers for Disease Control, the American Foundation for Suicide Prevention, the Education Development Center, and the Colorado Office of Suicide Prevention. Both of these efforts have identified risk and protective factors to impact SMVF suicide.

Protective factors are those situations which will keep individuals, or groups of individuals, from experiencing stressful situations which could lead to suicidal ideations and behaviors. This is considered primary prevention, intervening in someone’s situation before negative effects occur, through providing stability and increasing wellness before a crisis. These include creating protective environments, strengthening economic supports, teaching coping and problem-solving skills, and providing education and awareness about suicide risk and prevention.

Primary prevention is not always possible, however. Another aspect of the public health approach is to identify and minimize risk for those individuals who may be experiencing a suicidal crisis. This moves from prevention to intervention; addressing the needs of those at greater immediate risk of suicide in order to minimize the risk and help them build wellness. Risk reduction measures include providing effective treatment for those in crisis, reducing access to lethal means of attempting suicide while an individual is in crisis, and providing postvention support.

The three protective factors which can prevent someone from experiencing a suicidal crisis are improving connectedness, increasing economic stability, and educating the community on suicide prevention measures. There are organizations in our community that are doing each of these things, and doing them well; but do those of them that are helping veterans remain connected realize that they’re helping to prevent veteran suicide? Do the homeless and unemployed veteran organizations consider themselves as part of the suicide prevention framework? This is the idea that we all need to understand…everything we do to enhance the wellness and wellbeing of our service members, veterans, or their families is suicide prevention.

Just as important, as previously mentioned, is the need to address risk reduction measures when an individual is in a suicidal crisis. This includes ensuring that we have access to the appropriate level of care, that we need to reduce access to lethal means when someone is in crisis, and we need to provide support for those who survive and attempt or those who have lost someone to suicide. The first two, access to care and reducing access to lethal means, can keep someone from engaging in suicidal self-injury; the third one, postvention, can prevent further harm.

As a collection of concerned citizens, we need to be able to come together and conduct an analysis that will solve the mystery of veteran suicide in our community. We need to establish protective factors that will ensure that our service members, veterans, and military family members live lives of wellness and strength; we also need to make sure that risk reduction measures are in place so that a crisis doesn’t result in the loss of another member of the military affiliated population.

It is through this…a coordinated, deliberate effort to organize a comprehensive suicide prevention approach…that we will be able to save the lives of those who sacrificed so much.”

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