Suicide prevention is an all-hands effort, requiring a constant focus on taking care of all Sailors. That need is prompting subtle but important changes to a critical prevention program designed to help Sailors during the 90 days after a suicide-related behavior, the period of highest risk.
"As we start the New Year, I would like to acknowledge all the hard work being done to encourage Sailors to seek help and combat destructive behaviors," wrote Vice Adm. John B. Nowell, the Navy's personnel chief, in NAVADMIN 021/21, released Jan. 25.
"Although the overall suicide rate has started to move in the right direction, we must continue to keep the focus on Sailor support. We are still losing too many Sailors to suicide: 76 in 2020, 80 in 2019, and 79 in 2018."
Key to the Navy's proactive prevention approach to suicide is the Sailor Assistance and Intercept for Life (SAIL) Program.
To be successful, Nowell noted, this critical resource needs top-down, unit-level leadership engagement from start to finish. However, SAIL program case managers are having a hard time contacting many Sailors referred to the program, leading to the Sailor acceptance rate for care remaining around 50 percent, he wrote.
"To close this identified gap, we will implement changes to the SAIL program," Nowell wrote. "SAIL procedures will be modified to require Commanding Officers to instruct and verify that the Sailors who have experienced a suicide-related behavior contact the SAIL case manager at the nearest Fleet and Family Service Center."
Though Nowell called this a "minor change in policy," it is expected to significantly impact getting Sailors into the program by strengthening the communication link between Sailors and case managers.
Command referral remains mandatory when a Sailor exhibits suicidal behavior or attempts to take his or her own life.
Nowell calls on shipmates and leaders to reach out and ACT (Ask, Care, Treat) if they notice a change in a shipmate’s behavior or think a Sailor is having difficulties.
"Numerous life circumstances can produce added pressure to a force already stressed by operational demands," Nowell wrote. "If left unacknowledged and therefore unchecked, this pressure can strain Sailors’ psychological and emotional well-being."
Sailors and leaders at every level need to learn, understand, and identify factors that could increase suicide risk. Key to this, Nowell wrote, is knowing how your mission, work schedule, environment and other stressors might contribute to that risk.
"An important part of creating a command climate that encourages help-seeking behavior is intrusive leadership, especially at the deck plate level," Nowell wrote. "Know your Sailors—take actions to get to the left!"
He said that Engaged Deckplate Leaders need to call on their command's existing experts when necessary, including Command Resilience Teams and their Command Resilience Team Human Factors Councils, to identify struggles early, assist Sailors in utilizing resources, support Sailors as they recover from stressors and remain connected with Sailors throughout the entire process.
Extensive research has been conducted showing a caring contacts program to be effective in the vulnerable days following a suicide-related behavior—allowing time for the Sailor to choose safety. SAIL is the Navy’s "caring contacts" program. Since the inception of the program, SAIL has helped over 4,000 Sailors during the critical 90-day period after a suicide-related behavior.
Programs that encourage support, provide ongoing caring contacts and help Sailors navigate medical systems following a suicide-related behavior help ensure that no Sailor falls through the cracks and reduce deaths by suicide. To this end, Nowell encourages "warm handoffs," which he says, "are critical for at-risk Sailors."
Commands need to be especially attentive during a Sailor's temporary or permanent transition to another command, as well as any other times their normal social network is disrupted.
These handoffs are just as critical once a Sailor completes treatment.
"Reintegration must be done carefully, ensuring no support gaps between the medical provider and command leadership," Nowell said. "Sailors should receive the continual support needed to carry on in their careers and personal lives."
This constant support is "vital" to a successful recovery long-term, Nowell wrote, "regardless of whether that Sailor is transitioning back into the workplace, into another job field or into civilian life."
Finally, Nowell said that the current pandemic's difficulties should not be a reason a Sailor doesn't get needed help.
"Since COVID-19, we have seen our referral rate drop from near 100 percent to 83 percent," Nowell said. "After the Sailor is contacted, participation in the SAIL program remains voluntary, but you as leadership should take an active role in seeing that your Sailor gets the help they need."
Additional guidance for submitting SAIL referrals, including the Suicide Prevention Handbook and SAIL Commanders Toolkit, can be found on the Navy Suicide Prevention Program website:
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