Life or death: suicide prevention Published May 16, 2008 By Airman 1st Class Daryl Knee 90th Space Wing Public Affairs F.E. Warren AFB, Wyo. -- I will never leave an Airman behind. I will never falter. And I will not fail. A coffin slowly lowers into the ground. The spouse's knuckles whiten as the scene continues, the grip upon an American flag never changing until the funeral's end. The departed no longer resides with the living. Death becomes one of war; however, in this case, there was no war. There was no violence. The victim was the killer. "It's never so bad that suicide is the best answer," said Lt. Col. (Dr.) John Stetson, 90th Medical Operations Squadron. "Every suicide is a real loss." The reason There is no cookie-cutter approach to determine why someone would kill themselves, said Jeff Randall, 90th MDOS. Every person is different. Each person has a unique personality and will react to issues in a different way. There are trying situations inherent in the military lifestyle, Mr. Randall said. Military members must deal with those complications and are expected to continue working with little to no change in status. "Part of our military job is to be ready for deployment at any time. War is very stressful," he said. "The military is asked to perform at a very high level in the most stressful circumstances." Also, with the Air Force's limited resources and force shaping, the Airmen are working harder and longer, Mr. Randall said. Coupled with the military stressors, any other overwhelming happening, whether it's marital or financial problems, depression or alcohol, may make a person feel like there is no solution, said Glen Garcia, 90th MDOS. The person may become isolated, drawn into themselves and even reclusive: situations where people are more at risk for suicide. "In a study, a person who had attempted suicide was asked what would have prevented him from trying," Mr. Garcia said. "He said, 'Had someone just noticed me or made me feel valuable ....' He thought no one would even care that he was gone. He was wrong." Most suicidal people don't really want to die, Mr. Randall said. They want their life to change but don't know how to do so except through death. "There is no problem that isn't common to man," he said. "People have persevered through some of the toughest things imaginable and have done very well." Relationship issues present a higher danger for possible suicides, Mr. Garcia said. Difficulties may arise when a breakup occurs. "They were the only one for me. I can't live without them ...." The person should take a step back and think of their options, he said. Suicide should not be among them. The impact Taking one's own life has a devastating impact on surviving family members, Mr. Garcia said. The people left behind tend to blame themselves or question if they had seen signs and could have done anything to prevent the death. Suicide damages unit morale too, Mr. Garcia continued. The squadrons suffer not only a loss of a coworker, but of a friend. It can take weeks if not months for unit morale to rise again. "The military can replace the job," Mr. Randall said. "But nothing can replace you. Nothing can replace a friend, son, daughter, father or mother." Also, many people deny that suicide is a real thing, he said. Coworkers or loved ones may never think that someone they know might consider killing themselves. Many people hope that by avoiding the reality of suicide, it will go away. However, the results of a suicide are far reaching. Family members of a suicide may become depressed and the children may age thinking suicide is an alternative method to solving problems, Colonel Stetson said. Instead, people are urged to care for one another. "As Airmen, we share a wingman culture where it is part of our mindsets and habits to link with and look out for one another," said Gen. C. Robert Kehler, Air Force Space Command commander. "In most cases, those who commit suicide display behavior or provide signs to indicate they are considering taking their lives." Those signs include recent changes in behavior: - Hopelessness - Depression - Anxiety - Agitation - Anger and irritability - Isolation and withdrawal - No appetite - Insomnia - Loss of interest in work and normal activities Understanding the red flags is the first step in suicide prevention, Mr. Randall said. The solution Look and listen for signs of a possible suicide, Mr. Garcia said. If something is odd or out of place, stay with the person until what's truly wrong surfaces. "When it seems possible that someone is considering suicide, ask them open ended questions," Mr. Randall said. "Stay away from the yes-or-no questions. 'Are you okay?' sounds like a checklist item and doesn't convey the empathy the person needs. "Remember, the key to preventing a suicide is stopping the problems when they are small," he said. "Suicide prevention doesn't occur in the emergency room." Most military members who attempt suicide will talk with someone they trust, Mr. Randall said. This puts an emphasis on supervisors and leadership. Be a leader who their troops can talk to about problems in their life. If the person can't trust the supervisor, a chance to save a life may be lost. Thoughts of suicide also derive from the missing feeling of value, Mr. Garcia said. If a person is in a leadership role, they should ensure their troops feel like the job they are doing is valuable and make them feel they are needed. Mr. Randall said there are many approaches one should not take when questioning someone who is on the verge of suicide: Do not - ignore or not take the problem seriously. - use reverse psychology, and say, "Do it." - keep it secret. - be judgmental. - try to convince them they are not suicidal. - take them drinking. Everyone looks to the professionals for help, Mr. Randall said. But it's not the experts that encounter most early calls for help: It's the friends. "Suicide prevention is a wingman responsibility and every member of our Air Force Space Command team has an important leadership role to play: Look for and be aware of risk factors; inquire by talking with your people; note the seriousness of their concerns; and know how to get help," General Kehler said. The spouse drives home from the funeral with more questions than answers. The lips tightly clenched and face blank, the spouse thinks, Why? How could I have helped? How could something have been so bad that ending one's life is the only solution? The empty passenger seat responds to the unasked questions in the only way it can. Silence.