Diana Moon, DCoE Public Affairs on September 27, 2013
Soldiers look at a suicide-prevention brochure that details suicide warning signs and suicide prevention resources. (U.S. Army photo by Gloria Montgomery)
Pastoral counseling has long been recognized by service members as a safe harbor for moral questioning. More commonly now, service members seek pastoral care for uncertainties related to psychological health. In this setting, chaplains may counsel individuals having thoughts of ending their lives. For those who want help but resist confiding in their superiors, chaplains provide a confidential and approachable first-step that opens the door to preventative measures in the event the service member is considering suicide.
The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) Chaplain Working Group, consisting of military and Department of Veterans Affairs’ chaplains, is a spiritually-focused forum on deployment-related challenges, psychological health and traumatic brain injury. Laying claim to their unique opportunity to help reduce the incidence of military suicides, the group met during September, Suicide Prevention Month, to emphasize broader awareness, collaboration and counseling among their ranks.
Words like, “resiliency,” “life affirmation” and “first responder” infused their discussion, which often returned to balancing the call to provide pastoral care with the need to collaborate with psychological health care providers. The group agreed that the pastoral–health care provider relationship is critical, the overall question being when to move from pastoral care to health care. They debated if the first mention of suicide was the key to coordinating with a psychological health care provider or if there were other subjective cues.
Dr. Jeffrey Rhodes, DCoE Chaplain Working Group co-leader, gave his perspective on the role of chaplains in suicide prevention.
“Chaplains are ‘first responders’ when a military unit or command suffers a suicide attempt or completion,” said Rhodes. “Chaplains are very good at knowing their care limits and are usually trusted by those who come to them for help … most will personally escort the individual to a mental health provider,” he said.
Dr. Rajeev Ramchand, a behavioral scientist and associate director for the Center for Military Health Policy at RAND Corporation, engaged the chaplains in a robust debate about the advantages and limitations of their role in helping at-risk service members. He drew from parts of his book, “The War Within: Preventing Suicide in the U.S. Military.”
“Chaplains are vital to suicide prevention efforts within the Defense Department as confidentiality is one of the main reasons service members go to chaplains,” explained Ramchand.
He also said that service members in need of intervention are more likely to view chaplains as a source of trust and comfort.
Ramchand shared six performance measures he believes are critical to an effective comprehensive suicide prevention strategy, and critical for chaplains to be aware of, use and promote:
Raises awareness and promotes self-care through media campaigns, training and educational courses
Identifies those at risk of suicide through mental health screenings and by recognizing the signs of peers in distress
Facilitates access to quality care by removing barriers that impede it, such as concerns that accessing care will harm military careers or not be kept confidential, and mistrust of psychological health professionals
Delivers quality care with programs aimed at improving the skills of behavioral health care providers managing suicidal patients
Restricts access to lethal means
Responds appropriately to suicides and suicide attempts, incorporating an appropriate response to the aftermath of a suicide as a fundamental component of suicide prevention
While revisiting the pastoral–health care provider relationship, the group agreed with Ramchand that improved communication and collaboration between professionals helps create a trustworthy hand-off to ensure that individuals don’t fall through the cracks when changing care providers. Promoting health-seeking behavior and making service members aware of the different types of behavioral health caregivers available to them are priorities when counseling individuals under emotional stress or at risk of hurting themselves.
For those in crisis, the Military Crisis Line provides 24/7 support at 800-273-8255 (military members press 1).
The next DCoE Chaplain Working Group is Nov. 6. For more information, contact the group.