1. 1st SERGEANT’S BRIEFING Airmen in Distress
Neysa Etienne
Clinical Psychologist
Maxwell Air Force Base
Mental Health Clinic 42nd MDG

2. Learning objectives Describe Phenomenon of Suicide
Model
Mind
Manage your reactions to Airmen in distress
Take a collaborative, non-adversarial stance
Manage Suicide Risk in Airmen
Helpful Language and Approach
Reconcile conflicting goals
Plan for how to assist
Awareness of helping agencies
Identify and Manage Airman in Crisis
Manage your reactions
Reconcile Conflicting Goals: You desire to keep them safe, VS their desire to engage in self injurious behavior.

3. Why The 1st Sgt? Spends time w/ personnel almost every day
Is most likely familiar w/ typical behavior
One of the first to see problems develop
You are the first line of defense
Being proactive with wellness & safety benefits people as well as the AF’s mission
Rationale…
WHAT ARE YOU DEFENDING AGAINST? Lets take a look. This came out just last week…
Stats update…
HOW BIG OF A PROBLEM IS THIS? AND WHY IS IT RELEVANT TO YOU?
Every single one of those completed AD suicides had a 1st Sergeant, a dormmate, a Commander

4. COMPARISON BETWEEN:
Air Education & Training Command and AIR FORCE
AIR FORCE
LETS SEE WHAT WE BELIEVE ABOUT THESE NUMBERS…

5. SNAPSHOT: MILITARY FAMILIES
: > 1,100 members of the Armed Forces took their own lives
2010: ARMY suicide rate among active-duty soldiers decreased slightly
2009: 162
2010: 156
2010: Number of suicides in the Guard and Reserve increased by 55%
2009: 80
2010: 145
2010: More than half of the National Guard members who died by suicide had not deployed.
* Suicide among veterans accounts for as many as 1 in 5 suicides in U.S.
* No greater risk for service members compared to general population…
AVERAGE OF 1 SUICIDE EVERY 36 hours
& 3 These numbers may reflect differences in deployment tempos and percentages between AD vs Guard vs Reserves
4. Interesting Stat, and encouraging

6. “Mostly, I have been impressed by how little value our society puts on saving the lives of those who are in such despair as to want to end them. It is a societal illusion that suicide is rare. It is not.”
--Kay Redfield Jamison
HOW RARE IS IT?

7. SNAPSHOT: UNITED STATES
- 11th leading cause of death in the US
- 2nd leading cause of death among college students
- 3rd leading cause of death for young people aged 15-24
- 4th leading cause of death among people aged 25-44
- For every suicide event, 6 survivors are left behind
- More than 30,000 Americans Commit suicide every year
- 1 Suicide in the US approximately every 17 minutes
- 650,000 attempted suicides per year
- 2:3 Ratio (HOMICIDE TO SUICIDE) in the U.S.
Startling to think that over the course of these three + hours we will spend together, approximately 12 people would have taken their life somewhere in the US.

8. MYTH OR FACT 1. Suicide Usually Happens with no warning
2. More than 70% of people who kill themselves have previously considered it seriously?
3. There is most often a note left behind when someone commits suicide.
4. People who are suicidal are intent on dying and feel there is no turning back?
5. Someone who survives a suicide attempt is really not serious about it.
Discussing suicide openly with someone who seems really depressed does more harm than good.
People who attempt suicide once, are unlikely to try it again.
MYTH: Fact is 8/10 people who kill themselves give some sort of warning or clue to others, even if it is subtle.
FACT: Myth is Someone who talks about suicide a lot is just trying to gain attention
MYTH: Fact is, in most cases there is NO NOTE, or explanation.
MYTH: Fact is… most people who are suicidal are of two minds about it. Part wants to die, but part of them does not. The main thing is they want is to stop their pain.
MYTH: Fact is: Any suicide attempt should be treated as though the person intended to die, and not simply dismissed as an attention seeking device.
MYTH: Fact is discussing it openly can actually help not hurt.
MYTH: 80% of people who die from suicide have made at least one other attempt already.
MYTH OR FACT: SHOUT OUT WHAT YOU THINK!
Perhaps because suicide is rarely talked about openly,there are a lot of mis-
conceptions surrounding the issue,including who is at risk,why and under
what circumstances it occurs,and how to get help.Knowing the facts is critical
to taking action and essential in saving lives.
recommendation to “maintain continuity of care across
transitions” for service members and veterans. The
Defense Centers of Excellence for Psychological Health
and Traumatic Brain
Injury (DCoE) man-
ages the program
and its support
coaches. Family members are also encouraged to call
the program to find out how their service member can
get started with inTransition. Coaches are available
24/7 via toll-free call.
All inTransitioncoaches are skilled counselors who
understand today’s military culture and issues. They
understand and respect the importance of your privacy.
They are with you every step of the way. When you
contact inTransition, you will be assigned your own
coach who will:
Coachyou one-on-one as you go through your transition
Connectyou with your new provider
Empoweryou with tools to continue making healthy life choices
Simply call the toll-free numbers:
Inside the United States
(DSN) Outside the United States toll-free
(collect) Outside the United States
Join our listserv!

9. EXPERIENTIAL EXERCISE
FIND A PARTNER
FACE OFF
RELATE
DEBRIEF
WHY?
Let’s pause here for a moment for a fun little interactive exercise…
EVERYONE Get a Partner… Someone in close proximity. And I want you to face off, as best as you can. EYE to EYE. So be sure you are looking each other square in the face. Now one of you please volunteer to go first. Let me see? Who are my brave souls.
Okay, now for the next 4 minutes, I want you to look at your partner and share your most AMAZING sexual experience… Spare no detail! Just jump right in and tell them the who what when where how… and why it was SOOOOO FANTASTIC!
Hmmm… a bit quiet. Anyone feel a bit uncomfortable? Can someone tell me why?
Okay, so here is the thing, that I hope you can take away from that experience.
I was asking you to share a HIGHLIGHT EXPERIENCE, and it was not easy... For a number of reasons…
People do not come in for tx to share their life highlights. Usually PTSD equates to the worst experience in their life.
I hope you can remember that sense of discomfort you felt sharing a + experience, bc it is magnified 100 fold when your airman are coming to share something so – and painful, so we need to make it easier for them to share.

10. MIND & MODEL Theoretical Framework BIOPSYCHOSOCIAL MODEL
THE SUICIDE MODE (Rudd, 2009)
Predispositions to Suicide
Triggers
Interaction between:
Perceptions (thoughts)
Emotions (feelings)
Behaviors
Physiology

11. This diagram illustrates THE SUICIDE MODE (FRAME OF MIND) model of suicide. Attempts to provide a foundation to understand how an individual arrives at the point of wanting to end life by taking into account:
Any contributing biological and genetic factors such as: Genetic Predisposition towards impulsive behavior, family history of suicidal behavior, family history of psychiatric disorders.
Any contributing psychological factors: mood state, impaired problem solving, hopelessness, despair.
Any contributing social factors: lack of adequate support network, lack of adequate access to helping resources.
TAKEN ALL TOGETHER… the biological/psychological/ and social factors create a profile of PREDISPOSING FACTORS. OR A PERSON’S BASELINE RISK FOR SUICIDE…
This model is known as the suicidal mode (Rudd, 2006) According to theory, in the combination of predisposing factors and an acute stressor (SUCH AS) can trigger or activate a suicidal episode. The suicidal mode consists of cognitive, affective, behavioral, physiological, and motivational systems that interact with each other and sustain the suicidal state.

12. BASELINE RISK Predispositions Previous suicide attempts Impulsivity
Male
Same sex orientation
Recent discharge from inpatient unit
Family history of suicide
History of physical, emotional, or sexual abuse
Previous suicide attempts
Impulsivity
Subjective or Objective

13. ADDITIONAL RISK Additional Risk Factors Older Caucasian Isolated
Medical issues
Alcohol use
Depression
Panic attacks
The following basic risk factors have remained relatively consistent over the years…
The theoretical models identified cognitions, emotional processing, and associated behavioral responses as critical to understanding motivation to die, associated distress (and symptoms) and ultimately changing the suicidal process. Patients found the models easy to understand, distilling them down to thoughts, feelings and behaviors that are associated with suicide risk and hopelessness. In short, these treatments made it easy to sit down with a patient and explain in understandable language why they have tried or are thinking about killing themselves. This was an important consistency across effective treatments.

14. PROTECTIVE FACTORS Optimism about the future Strong social support
life has purpose and meaning
Feeling a sense of belonging
Willingness to seek help
Willingness to talk about problems
Effective coping and problem solving skills
Cultural norms that encourage
Optimistic… This will pass
Social support: from family, friends, and co-workers
Belief that your life… One individual told: Message of childhood…Mom and Dad never believed you would amount to much. You were not wanted, you were an accident…
The In Group and the Out Group (even in the AF)
Cultural Norms ENCOURAGE PEOPLE TO SEEK HELP… It is part of your job to create that cultural norm. Is that a norm you are familiar and comfortable with? If not… it will be hard for you to create… Need to work through your own reasons and examine your own beliefs…

15. KNOW YOURSELF Questions to ask self:
Self-Awareness of personal reactions
How to Manage Your Reactions
Unhelpful Attitudes
Recognize Difference in Goals
Conflict of interest in accomplishment
Reconcile differences
Collaborative approach

16. Questions to ask self Why do people die by suicide?
What are your beliefs about suicide?
What have you learned about suicide during your life?
What type of person kills themselves?
Who do you know that has died by suicide?
(Rudd, 2006)
What is your core belief?
How do you feel about the act? spiritual and/or moral
What is your personal experience, and how might past experiences you have had taint, inform and influence how you view this topic…

17. BE MINDFUL OF REACTIONS
Fear
Helplessness: “I can’t do anything to help”
Hopelessness: “Nothing I do matters”
Anxiety
Over-protectiveness: Reduce autonomy
Under-protectiveness: Casual avoidance
Anger
Lack of compassion: Inability to care
Criticism: Blaming

18. YOUR REACTION
Accept that we will have emotional reactions to the problems our Airmen bring to us
Take some time to explore our beliefs about the issues we will commonly face
Keep in mind that it is not our problem or perspective that matters, but the Airman’s
Recognize that you do not have to agree with an Airman’s beliefs, perspectives, or behavior in order to help them

19. ATTITUDES & BELIEFS Avoiding or denying that the Airman has a problem
Doing the bare minimum to help the Airman
Over-reliance on one’s own opinions and experiences
Defensiveness
Believing the Airman is being manipulative
Undervaluing or overvaluing helping agencies
Managing your reactions to Airmen in distress
What are your ATTITUDES and BELIEFS
Here are some A & B that are unhelpfu, or might get in the way?l

20. GOAL CONFLICT 1st Sergeant Goals: 1. Keep Airman safe
2. Keep others safe
3. Mission effectiveness
4. Protect unit morale
5. Stay out of trouble
Airman’s goals:
1. Reduce distress
2. Reduce pain
3. Alleviate suffering
4. Be understood
5. Stay out of trouble

21. APPROACH CONFLICT 1st Sergeant: Talk with others
Increase healthy behaviors
Access professional help
Distressed Airman:
Alleviate the pain
Drinking
Drugs
Reckless behaviors
Violence / aggression
Suicidal ideation
Approach to accomplishing the goal…
Important to recognize, so you are prepared for the struggle. Not caught off guard.

22. Reconciling Differences
Understand that the Airman engages in harmful behaviors because they “make sense” and they work
Recognize the functional purpose of the behaviors
View the Airman as individual with unique set of issues and circumstances
Listen to the Airman’s “story”
Part of the work of Reconciling these differences has to do with maintaining a COLLABORATIVE/NON-ADVERSARIAL STANCE
(reserch to support this). Based off of the work of David A Jobes (authored Managing Suicide Risk)
Emphasizes a CAMS approach which stands for: Collaborative Assessment and Management of Suicidality

23. "I got very angry when they kept asking me if I would do it again
"I got very angry when they kept asking me if I would do it again. They were not interested in my feelings. Life is not such a matter-of-fact thing and, if I was honest, I could not say if I would do it again or not. What was clear to me was that I could not trust any of these doctors enough to really talk openly about myself."

24. Collaborative approach
Managing risk vs “telling” the Airmen what is best for him/her.
Airmen is the “expert” on his or her behavior
Airmen feels safe discussing sensitive issues.
Increase the Airmen’s openness for discussion
Increase the patient’s help-seeking behaviors in the future
Improve the effectiveness of the risk assessment
1st Sgt is the “coach”
1st Sgt can reinforce any help-seeking behaviors and/or any already existing coping resources
Willing to do whatever it takes, however long, at whatever time
Decreases the 1st Sgt’s emotions (i.e. lessen the unrealistic sense of responsibility) Can’t work harder than they are willing
How you communicate matters…
(Jobes, 2006)
Create environment where Airman feels SAFE discussing…

25. HELPFUL APPROACHES LISTEN first before giving advice
Ask directly about thoughts of suicide
Take reports of suicidal ideation seriously
Don’t be judgmental
Don’t promise anything
Express genuine caring and hope
Don’t promise secrecy or what will or will not happen…
Regarding Military career, impact, hospitalization, secrecy… ETC…

26. HELPFUL LANGUAGE I've noticed you're feeling upset.
What's going on in your life?
Are you thinking about suicide?
What do you think might help?
Where would you like to go for help?
Why don't we make the call together?
I'm not going to feel comfortable without being sure you're going to get some help.
Accurate, Direct, & Precise:
Enhances Communication w/ Providers
Enhances Communication w/ Airmen
Characteristics:
Intent to die
Evidence of self-infliction
Outcome

27. Direct Communication HARD communication H Good Ex: “you look down”
Bad Ex: avoidance A
Good Ex: “Sometimes people are down”
Bad Ex: “Airmen don’t kill themselves” R
Good Ex: “Would it be ok if we talk”
Bad Ex: “get in my office” D
Good Ex: “Are you thinking about killing yourself”
Bad Ex: “ambiguity”

28. REDUCING ANXIETY Be direct Notice hesitancy and body language
“Are you thinking about suicide?”
“Do you know how you might do it?”
Notice hesitancy and body language
“It looks like this is difficult to talk about.”
Do not accept the first “no”
Ask in slightly different ways
Remain relaxed and unhurried
“I know this can be tough, so take your time.”

29. Raising the issue… Make behavioral observations Express concern
“I’ve noticed…” technique
Express concern
Avoid judgmental language
Stick to the facts

30. NORMALIZE DISTRESS
Normalize the Airman’s feelings through gradual sequencing of questions
“When people are extremely upset, they often feel like things will never get any better. Do you feel that way?”
“When people feel things will never get any better, they often think about death. Have you been thinking about death or not being around?”
“When people think about death, then sometimes think about killing themselves. Have you had any thoughts about suicide?”

31. ATTENUATE SHAME
Phrase questions so that positive response do not feel self-incriminating or accusatory
“With all this going on, have you been drinking more often?”
“You said you were opposed to suicide, but I’m wondering, with all this stress you’ve been experiencing, did you have some thoughts about suicide, even if only a little bit?”

32. WHAT ARE SOME SIGNS? Preoccupation with Death and Dying
Drastic changes in behavior or personality
Recent severe loss or threat of loss
Unexpected preparations for death
Giving away prized possessions
Previous attempts
Uncharacteristic impulsiveness
Loss of interest in personal appearance
Increased use or abuse of alcohol
Sense of hopelessness about the future
Morbid fascinations… (Music Choices, How room is decorated, clothing choices)
Person just seems off, “Not themselves”
Major Losses (reputation, loved one, relationship)
Making out a will, giving stuff away
History of self-injurious behavior, hx of attempts, statements
recklessness, risk taking (Drunk and playing with a tomahawk…) Reckless driving, flagrant violation of rules (uncharacteristic)
Poor hygiene, lack of military bearing
Comments about bleak future…

33. SEEK HELP WHEN… Persistent stress interfering w/ daily life
Difficulty coping
Difficulty functioning
Accumulating signs of distress
Multiple risk factors
Thoughts about suicide
Encourage people to seek help if you notice…

34. ACCESS TO LETHAL MEANS
Suicidal crises are short-term peaks in distress
Among survivors of life-threatening attempts:
24% decided within 5 minutes preceding attempt
70% decided within 60 minutes preceding attempt
Suicide rates by firearm:
57x higher in week following purchase
30x higher in month following purchase
7x higher in year following purchase
Routinely ask about methods and access to means multiple times
(Simon et al, 2001):
IN VIEW OF RESEARCH ON ATTEMPT SURVIVORS: The crisis response plan is very strategic in that it is designed to cover a 60 minute period of time, because if we can move a person through the first 60 minutes of a strong suicidal mindset, we are ACTUALLY addressing close to 94% of the people who would have actually made an ATTEMPT!
(Wintemute et al, 1999):

35. IMPORTANT TERMS Suicide Suicide Attempt with injury
Suicide Attempt without injury
Instrumental suicide-related behavior
Suicide threat
Suicidal ideation
Morbid ideation
Instrumental suicide-related behavior… RISKY BEHAVIORS
MORBID IDEATIONS- MORE PASSIVE

36. Consult Your suspicions are substantiated
Contact The Mental Health Clinic
When to Contact Them
DOCUMENT Your Interaction
You feel as if you have adequate evidence to support your concern.
Confirmed by Airman verbally, collateral information
Your observation
Warm hand off to Mental Health… AVAILABLE AT ANY POINT IN YOUR PROCESS OF MANAGING INITIAL CRISIS, but Clinical Risk Assessment of individual is officially conducted by a mental health provider…
Documentation of your interactions, observations, concerns, is very important… (NEXT SLIDE)

37. Document Improve Continued Risk Assessment
Improve Management Interventions
Help Develop Long Term Treatment Plans
Expedite the Transferring of Care
Very Important Function in the Case of Morbidity/mortality Reviews
Important in the case of CDE
Important in the case of Admin Separation

38. MH RISK ASSESSMENT Suicide Status Informed Consent
Commitment to Treatment
Crisis Response Plan
Suicide Tracking
Stabilization
Consent to treatment…
CDE and exceptions to consent
EMERGENT CDE G-Series Commander

39. Suicide Status Form: Filled out sitting next to the PT
Suicide Status Form: Filled out sitting next to the PT. Coming along side them…
Break Down of our risk assessment…

40. Item 1: Psychological Pain
“Psych-ache”: unbearable suffering unique to the individual
Suicide risk reduction occurs through 2 processes:
Increasing tolerance for psychological pain
Removing / ameliorating root of psychological pain

41. Item 2: Stress
Largely external (sometimes internal) pressures or demands that psychologically affect the individual
Relationship conflicts
Job loss
Command hallucinations
Ruminations
Intimately linked to overwhelming feelings

42. Item 3: Agitation
State of being emotionally upset, disturbed, and disquieted
Cognitive constriction
Predisposition for self-harm
Impulsive desire to do something to change or alter his or her unbearable state
Psychological energy / driving force behind suicidal behaviors

43. Item 4: Hopelessness
One’s expectation that a negative situation will not get better no matter what one does
Intimately linked to future thinking
Based largely on work of Aaron Beck

44. Item 5: Self-hate
Suicide as escape from unacceptable perceptions of self
Suicidal individuals are fundamentally preoccupied with their unhappiness
2 essential components of suicidal struggle (Baumeister, 1990):
Need for escape
Core importance of self

45. Item 6: Self-assessment
Behavioral self-report of risk
We have the tendency to overestimate suicide risk when compared to patient self-report
(Joiner, Rudd, & Rajab, 1999)

46. CONFIDENTIALITY Harm to Self Harm to Others Abuse Child Spousal Elder
UCMJ
LPSP (Limited Privilege Suicide Prevention)
1st Sgt & Commander
Profile
Line of Duty
Duty Impact/Restrictions
Mobility Restrictions
Informed Consent outlines expectations regarding the relatinship between the individual and the clinic, their protected health information, and what goes on in treatment.
EXCEPTIONS TO Confidentiality…
RELEASE OF INFORMATION: Normal procedure
Continued interaction
Treatment updates
Setbacks
Progress

47. Commitment to Treatment
I, ________________, agree to make a commitment to the treatment process. I understand that this means that I have agreed to be actively involved in all aspects of treatment including:
(1) attending sessions (or letting my therapist know when I can’t make it)
(2) setting treatment goals with my therapist
(3) voicing my opinions, thoughts, and feelings honestly and openly with my therapist (whether they are negative or positive, but most importantly my negative feelings)
(4) being actively involved during sessions
(5) completing homework assignments in between sessions
(6) taking my medications as prescribed
(7) trying new behaviors and new ways of doings things
(8) implementing my crisis response plan when needed
I also understand and acknowledge that, to a large degree, a successful treatment outcome depends on the amount of energy and effort I make. If I feel like treatment is not working, I agree to discuss it with my therapist and attempt to come to a shared understanding as to what the problems are, and to identify potential solutions together. In short, I agree to make a commitment to treatment, and to living. This agreement will apply for the next ____ months, at which time it will be reviewed with my therapist and modified as needed.

48. Crisis Response Plan
When thinking about suicide, I agree to do the following;
Use relaxation skills
Go for a walk or play a video game
Call a friend; (Earl; XXX-XXX-XXXX)
REPEAT ALL OF THE ABOVE
Call provider at Clinic X (Dr.; XXX-XXX-XXXX)
If unavailable, call Clinic (XXX-XXX-XXXX)
Call crisis hotline; TALK
Go to the emergency department
Call 911
PERCENTAGES: LIMIT ACCESS TO LETHAL WEAPONS…

49. TRACKING Levels: Stabilization Back to baseline Self-management
Mastered and uses skills
Utilization
1st Sgt’s Role
What we are working towards. Monitored at varying levels of intensity until we see the following…

50. ROLE OF LEADERSHIP · Good leadership promotes suicide prevention
· Build a supportive work environment
· Know Your Airman
· Know the warning signs
· Know the helping resources
· Ask the tough questions
· Encourage help seeking behaviors
· Stay involved until problem is resolved
· Recognize when help is needed and get it
· Apply Suicide Intervention Skills
THE TOUGH QUESTIONS…(i.e., about life problems, distress, suicidal ideation, alcohol use, etc.)

51. ASK CARE ESCORT A - Ask your wingman
Have the courage to ask the question, but stay calm
Ask the question directly: "Are you thinking of killing yourself?"
C - Care for your wingman
Calmly control the situation, do not use force, be safe
Actively listen to show understanding and produce relief
Remove any means that could be used for self-injury
E - Escort your wingman
Never leave alone
Escort to chain of command, behavioral health professional, Chaplain, or primary care provider
Call the National Suicide Prevention Lifeline: (TALK)
I am sure you are all familiar with this… I throw it in to reinforce what you already know, for the other AIRMAN, who are additional sets of eyes and ears… Empower them and lead by example.

52. URGENT HELP Escort the person to the ER or the Mental Health Clinic
Mental Health Clinic is on call 24/7
Notify your supervisor or call 911 for help
Don’t leave the person alone
Remove means of self harm
Suicide Prevention Hotlines:
TALK or SUICIDE
TALK can connect you to a counselor who understands military issues
By law, only commanders can order Airmen to receive a mental health evaluation, and only when following appropriate procedures
EMERGENT CDE
Commander who can give G-Series ORDERS

53. Research Direction Current Research in the Maxwell Clinic
 Guilt & Shame w/ Suicide Risk
Aim of this Research study
The proposed basic research attempt to advance our knowledge of the relationships between two specific cognitive/emotional processes, guilt and shame, with suicide risk.
guilt and shame often considered to be important psychological contributors to suicide risk, very little research…
AND Because guilt and shame are often associated with trauma, they could be particularly relevant among military populations, especially those with combat-related trauma.
Shame involves negative attributions about one’s worth and goodness, while guilt involves feelings of sadness, and remorse over specific actions.
In general, shame demonstrates a stronger relationship with depression than guilt (Kim et al., 2011), consistent with shame’s association with core identity. Because shame involves a sense of loss of one’s identity as a person of goodness, integrity, and virtue (Wilson, 2005), individuals experiencing shame may fear humiliation and reproach by others, and may feel unable to restore their value, integrity, and self-esteem. It has been suggested that this may lead to fantasizing about, or resorting to, suicide as a means of self-obliteration.

54. Tips for managing crises
Understand your own triggers or hot buttons
Be consistent in how you help Airmen
Avoid coercion
Encourage and model openness and honesty
Recognize positive change might be slow
Pay attention to positive changes
(not just negative changes)

55. Tips for after the crisis
Protect privacy
Normalize stress reactions
“Who wouldn’t feel this way?”
Foster a culture of help-seeking
“Who wouldn’t get help in this situation?”
Maintain Airman’s level of responsibility
Avoid stigmatization
Provide support on group level
Don’t single out Airmen in distress

56. Connecting Airmen to helping agencies

57. Be prepared Keep a list of helping agencies nearby
Familiarize yourself with AF policy
Discuss with leadership how problems and issues will be handled in the unit
Be Wingmen – don’t let your Airmen go alone

58. Question
If someone came to you with a problem, would you know the agencies and resources available to help them?
All of us, and especially those of us who are supervisors, have a sacred responsibility to know how to match people’s needs with community resources.
IDS and Community Sources of Support
Each installation has an Integrated Delivery System (IDS) consisting of all the helping agencies on a base. As individual agencies and as a collaborative agency the IDS exists to assess and respond to community needs.
Types of Help
List those services (classes, support groups, workshops) available at your base: Financial counseling, employment assistance, couples classes/support groups (PREP Fighting for your Marriage), parenting classes/support groups (Boys Town Commonsense Parenting), respite care, Infant and Toddler University play groups, conflict resolution workshops, dealing with difficult people workshops, life skills workshops, depression management classes/support groups, anxiety management classes/support groups, etc.
IDS Handout
Ask your IDS to put together a handout that lists each of the services above, the POC, and their telephone number.

59. Helping Agencies Airman & Family Readiness Center: 953-2353
Transition Assistance, Employment Assistance, Volunteer Resources, Information & Referral, Financial Readiness, Relocation Assistance, Air Force Aid, Personal & Work Life, Family Readiness, Family Ser-vices
Family Advocacy:
Family Maltreatment assessment & intervention, Outreach & Prevention Programs, New Parent Support Program, Family Resource Library
Sexual Assault Response Coordinator:
24 hr assault report hotline
Education, Awareness & Protection, Confidential Consultation, Victim Advocacy & Support

60. Helping Agencies Family Member Support Flight: 953-3524
Full time child care, School Age Program, Hourly Care, Part Time Enrichment, Give Parents A Break
Chaplain Service:
Counseling services for: Premarital/Marriage, Family/ Parenting, Religious Issues, Work Related Issues, and Grief
Catholic/Protestant Worship & Religious Education
Mental Health Clinic:
Group Therapy, Individual Therapy, Marriage Counseling, Personal Problem Assistance, Command Consultation, Evaluations, Psychological Testing, Relaxation Program, Healthy Thinking, Substance Abuse Evaluation & Treatment, Special Needs Coordination (SNIAC)
Health & Wellness Center (HAWC):
Nutrition Assessment & Counseling, Weight, Cholesterol, Hypertension & Diabetes Management, Exercise Assessment, Body Composition Assessment, Tobacco Cessation, Relaxation Room, Wellness Library

61. Helping Agencies
Educational & Developmental Intervention Services (EDIS):
Early intervention services for children under three years of age who have developmental delays of certain medical conditions
Behavioral Health Consultant:
Behavioral Health appointments in primary care setting
Military Family Life Consultant:
Free confidential counseling, up to 4 appointments
Military One Source:
Free confidential counseling, up to 12 appointments

62. Final thoughts
"Suicide, I have learned, is not a bizarre and incomprehensible act of self destruction. Rather, suicidal people use a particular logic, style of thinking that brings them to the conclusion that death is the only solution to their problems. This style can be readily seen, and there are steps we can take to stop suicide, if we know where to look".
-- Edwin Shneidman

63. Final Thoughts