Suicide Postvention for the United States Military: Literature Review, Conceptual Model, and Recommendations.

Suicide continues to be a significant public health problem in the United States and the Department of Defense (DoD). Timely and systematic postvention efforts can play an instrumental role in helping family members, peers, and military command to best manage the aftermath of a suicide. To date, several postvention efforts have been implemented in the military. However, there continues to be an overall lack of understanding of the specific short- and long-term effects of exposure to military suicide. In addition, more emphasis needs to be placed on empirically driven approaches to postvention and program evaluation. The purpose of this article is threefold: (1) to provide a summary of the postvention literature with special emphasis placed on the military organization; (2) to propose a conceptual model as a framework for understanding Military-Unit Suicide Survivorship; and (3) to briefly highlight postvention strategies within the DoD in the context of a number of research, clinical, and policy recommendations.

Principal Component Analysis of the Suicide Opinion Questionnaire in a U.S. Military Sample of Marine Corps Non-Commissioned Officers.

Attitudes about suicide are important to examine among individuals within a specific setting, profession, and/or culture; if found to be condemnatory, such attitudes can be effectively modified with training. The Suicide Opinion Questionnaire (SOQ) is one of the most commonly used instruments for the measurement of attitudes toward suicide. The SOQ has not been tested in military populations and the measure has demonstrated multiple different factor structures across various studies performed on civilian samples. The purpose of this study was twofold: (1) to gain an understanding of the applicability and utility of the SOQ for the military; and (2) to examine the relationship among sex, education, prior exposure to suicide within one's military unit, and suicide opinions. A total of 1,758 Marine Non-Commissioned Officers (NCOs) completed the SOQ as part of a suicide program evaluation study. Results demonstrated a 4-component structure for the SOQ, accounting for approximately 30% of the total variance. Sex, education, and prior exposure to suicide within one's military unit were significantly related to suicide opinions. Recommendations are made for the development and empirical evaluation of a new and/or adapted, culturally sensitive suicide attitude measure for the military.

Perceived barriers to seeking mental health care among United States Marine Corps noncommissioned officers serving as gatekeepers for suicide prevention.

Reducing mental health stigma and perceived barriers to care is a necessary strategy for addressing the public health problem of suicide among the United States Armed Forces. The purpose of this study was threefold: (a) to empirically evaluate the principal component structure of the Perceived Barriers to Care (PBTC) measure; (b) to gain an understanding of the perceived barriers to seeking mental health services among Marine Corps noncommissioned officers (NCOs) selected to participate in a primary suicide prevention training program, Never Leave a Marine Behind (NLMB); and (c) to explore the relationship among sex, education, prior exposure to suicide within one's military unit, and perceived barriers to seeking mental health services. The data for the PBTC (N = 1,758) were drawn from a previously performed pretest/posttest program evaluation study of the Marine Corp's NLMB program, which took place over 6 months in 2009 (April-October). The three highest perceptions of barriers to care reported by NCOs for their Marines were related to being embarrassed, having members of one's unit have less confidence in the Marine, and concerns about being treated differently by military unit leadership. Three principal components for PBTC were identified, accounting for approximately 59% of the total variance. Higher education and prior exposure to suicide within one's military unit significantly correlated with greater perceived barriers to care; sex was not significantly correlated with greater perceived barriers to care. Implications of these findings, in relation to future research, are further discussed. (PsycINFO Database Record