Suicide expert shares solutions, personal story

Sept. 30--More than 70 percent of military service members who have died by suicide did not tell anyone about their intentions.

"Most of those completed suicides were not communicated," said Donna Holland Barnes, an expert in suicide and suicide prevention. "How do we get people to talk about it?"

Barnes, who has a doctorate and teaches suicide risk management for Howard University'sCollege of Medicine'sDepartment of Psychiatry, was the guest speaker for Fort Meade's National Suicide Prevention Month program. Barnes is also head of the Suicide Prevention Action Group at Howard University.

The three-hour event, which was organized by Torrid Sterol, Fort Meade's Suicide Prevention Program manager, was held Monday morning at McGill Training Center.

Garrison Commander Col. Brian P. Foyle gave brief remarks before introducing Barnes.

"This is an incredibly important topic. ... It's a somber topic," Foyle said. "It is an absolute tragedy when any human being takes the most permanent solution to solve temporary problems in their life."

Foyle said that in the fall of 2013, three Fort Meade service members died by suicide in a three-month span.

"Caring for each other is my theme and will always be," he said. "[You must] know them well enough to put your arm around them to get them help when they are unable or unwilling to do so."

The presentation, which was open to military personnel and Dodd employees, provided participants with their required contact hours for annual, suicide prevention mandatory training. Mental health clinicians were able to attend the presentation to receive continuing education credits for their licensure through Howard University.

Fort Meade's Army Substance Abuse Program, Fort Meade's Family Advocacy Program, Fort Meade's Installation Safety Office, Howard University, Navy Information Operations Command Maryland, as well as the Anne Arundel County Mental Health Agency and the Sovereign Health Group, a mental health provider, manned display tables with information about suicide and mental health services and public safety.

Barnes, who currently serves on the military task force for the National Alliance for Suicide Prevention, spoke about suicide in the military and then conducted a 30-minute, question-and-answer period with the audience.

"The Soldiers who are at most risk for suicide are least likely to ask for help," Barnes said in presenting suicide statistics from Dodd. "If we require Soldiers to ask for help to get it, they will continue to die."

According to the Dodd, the Army and the Marines have the highest rates for individual suicides per 100,000 service members.

Barnes said because of the stigma of suicide in the military and the general reluctance of people with suicidal thoughts to tell others, family members and clinicians must be persistent in their attempts to communicate with people at risk for suicide to ensure they get the help they need.

"They're not going to ask for help," Barnes said. "We need to ask them if they are at risk. We need to ask them to help them."

In regard to assessing if someone is at risk for suicide, Barnes said it is "an art, not a science. You have to figure out how to put the pieces together."

Barnes said service members, family members and friends must feel comfortable talking about suicide so they can help those at risk and assess their need for help.

"You need to make them feel they can talk about it -- no judgment, no negativity," she said.

Barnes said service members and others at risk for suicide often do not tell others the truth about how they are feeling because they are anxious and embarrassed. Some people put up defense mechanisms and may attempt to deceive someone who is trying to help them. Others do not want their peers or loved ones to feel guilty about their desire to hurt themselves.

Barnes suggested that clinicians use the Chronological Assessment of Suicide Events, or CASE, approach to assessing service members with suicidal thoughts. CASE is a detailed set of interviewing skills to effectively elicit suicidal ideation, behaviors and intent from clients, according to the CASE website.

In following the CASE protocol. Barnes encouraged clinicians to ask specific questions about what has occurred in the life of a person at risk for suicide -- what has occurred in the past 48 hours, two months and also their last serious suicide attempt.

Barnes also said that the military's emphasis on resiliency is useful when trying to help service members deal with trauma. She called the process "post-traumatic growth."

Barnes, whose son died of suicide in 1990, shared that she did not know anything about suicide when the tragedy happened.

"It was a trauma in my life that I grew from and that I turned into a positive," said Barnes, who now dedicates her career to specializing in suicide prevention, intervention and research. "That's what I do."

Barnes said oftentimes, a traumatic event in someone's life can lead to "a sense that opportunities have emerged from struggle, opening possibilities that were not present before."

People who have survived trauma can have an increased sense of their own strength, she said, and a deepening of their spiritual life.

"Somewhere there's a positive: 'If I can live through that, I can face anything,' " she said. "So trauma can be a good thing. You can grow from it. We need to remember that."

The downsizing of the military is causing additional stress for service members, and the entire military community. Clinicians, family and friends must be vigilant in helping those who have trouble adapting to change.

Barnes said although suicide is an individual decision, "that doesn't relinquish our obligation to apply the appropriate level of intervention."

After the presentation, Foyle presented Barnes with a certificate of appreciation.

Tonya Phillips, a licensed clinical social worker with Fort Meade's ASAP, said the introduction of the CASE approach gave her "very helpful techniques" in asking specific questions of her clients.

"It can help me get a detailed look at what is going on in regard to the person who is sitting in front of me," she said.

Phillips said that although the presentation was mandatory for her and others who attended, there needs to me "more education and intervention for suicide in the Fort Meade community."

Sterol said the presentation served as a springboard for further action.

"Our mental health providers who were here today in strong numbers can take back the awareness to help people get the services that they need," she said. "We have many experts in mental health here at the garrison and we have people out there who are in need, who through no fault of their own, are not coming forward to get help. We need to reach out to them."

Editor's note: To contact Torrid Sterol, Fort Meade's Suicide Prevention Program manager, call 301-677-6541.

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