Gatekeeper Training for Suicide Prevention: A Theoretical Model and Review of the Empirical Literature.

摘要

The rate of military suicides has been increasing in recent years. In 2010 the most recent year for which we have epidemiologic data there were 301 suicide deaths among service members on active duty, equating to a rate of 18.0 suicides per 100,000 service members (Luxton et al., 2012). The increase in suicide within the Department of Defense (DoD), and more specifically among the Army and Marine Corps, has generated concern among policymakers, military leaders, and the public at large. This concern is evidenced by the creation in 2010 of a congressionally directed task force (Department of Defense Task Force on the Prevention of Suicide by Members of the Armed Foces, 2010), a new DoD office (the Department of Defense Suicide Prevention Office) focused specifically on suicide prevention, the Army s allocation of $50 million to study suicide within its ranks ( NIMH, U.S. Army Sign MOA to Conduct Groundbreaking Suicide Research, 2008), and increased media scrutiny (Edwards-Stewart et al., 2011). Each service has implemented policies and programs focused on preventing suicide within the ranks. These suicide prevention programs rely heavily on trainings for service members and their leadership that aim to train service members on how to identify individuals who may be at risk of suicide, provide immediate support, and refer them to an appropriate individual who is able to offer help. In both the Army and Marine Corps, the service members responsible for identifying and referring at-risk individuals ( gatekeepers ) are typically noncommissioned officers (NCOs) and members of the chaplaincy (including chaplains and chaplain assistants in the Army and chaplains and religious program specialists in the Navy that serve marines) (Ramchand et al., 2011).