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Connectedness: An Expanded Approach to Suicide Prevention

  • Published
  • By Maj Alexander F. MacDonald, BSC
  • AMC Mental Health Consultant, HQ AMC/SGPS
TMF Fall 2014 --  

The significance of suicide cannot be overstated. For example, according to DoD statistics, more active duty service members died by suicide in 2012 than in combat. Additionally, within the United States, more than twice as many people die by suicide than by homicide, and suicide is the leading cause of death among persons aged 15-24 and the second leading cause of death among persons aged 25-35.

With this increased significance has come an array of methods to address this important topic. Here at AMC, there have been increased efforts to identify not only symptoms that could lead to an increased risk for suicide, but also to identify root causes that would cause an individual to make such a drastic decision. One root cause being explored is the concept of connectedness.

At present, the topic of suicide is being discussed at all levels of the United States Air Force (USAF). This focus on suicide and its prevention is the result of a current uptick in the numbers of completed suicides within the USAF. The intent of this article is to provide an expanded perspective on suicide prevention within the USAF. Specifically the objectives of this article include:
  • The recommended integration of the current USAF risk factor model of suicide prevention with Thomas Joiner's Interpersonal Psychological Model as proposed in his 2005 text, Why People Die by Suicide.
  • The role of connectedness as a protective factor against suicide.
  • A challenge to increase connectedness both privately and professionally.

Currently, the USAF approach to suicide prevention focuses on a risk factor model. This model consists of identifying risk factors that may lead to an increased risk of harm to self and then developing means to minimize these factors. Identification of risk factors includes looking at both community and individual contributing factors. This community and individual risk factor model to suicide prevention is reflected in the current suicide prevention trainings, wingman days, and tracking of risk factors within medical treatment facilities and community-based agencies such as the community action information board and integrated delivery system team.

Joiner's (2005) interpersonal psychological model to suicide prevention has three components: thwarted belongingness, perceived burdensomeness, and acquired capability to overcome the fear and pain associated with death. The first two components, thwarted belongingness and perceived burdensomeness, can lead the individual to have suicidal ideation, but the third component, acquired capability, is needed for one to consider suicide seriously as a viable option.

I recommend that suicide prevention within the USAF needs to include an integration of both the risk factor model and Joiner's interpersonal psychological model of suicide prevention. The need for this integration recognizes that risk factors alone do not equal an increased risk for suicidal behavior. Rather, risk factors can lead to increased distress and--when combined with the components of the interpersonal psychological model (thwarted belongingness, perceived burdensomeness, and acquired capability)--an individual can be at an increased risk for suicide. While all components of this integrated model are significant, this article focuses on the role of connectedness as a starting point to an expanded approach to suicide prevention within the USAF.

The significance of connectivity and its role in suicide prevention can be seen in both U.S. suicide prevention efforts and suicide prevention efforts within the USAF. Nationally, the 2012 suicide prevention strategy identifies connectivity as a protective factor, and nearly every protective factor identified in USAF suicide prevention efforts addresses the need for connectedness. This involves connection with self, others, and the environment. No matter the setting or level of prevention efforts, the United States and the USAF both recognize the increased need for connectedness of individuals as a protective factor against suicidal intent.

The ways and means to increased connectedness can be considered both strategically and tactically. Strategically, overall assessments could be made for communities and individuals that identify strengths or protective factors that could aid in preventing suicide. Along with these strengths assessments, opportunities and limitations for implementing the findings could be further assessed. Tactically speaking, individuals can seek mentoring, emphasis can be given to balancing both internal and external needs, and--most importantly--individuals can recognize and implement a personal approach to connectedness.

In conclusion, a two-fold challenge is extended to those reading this article. First, we as individuals need to examine our own sense of connectedness and determine its personal meaning and implications. Second, we must use our individual strengths/skill sets to increase the sense of connectedness of the people with whom we interact. These challenges allow individuals and communities to connect with others to reduce the stress imposed by everyday risk factors and alleviate feelings of thwarted belongingness, perceived burdensomeness, and acquired capability. Connection is truly the key to meaningful and effective suicide prevention.

Practical Things You Can Do to Connect With Others
  • Work out. Join a class through a local gym or community center or start a lunchtime group walk at work.
  • Walk your dog. People who have a dog and walk it have an easy way to interact with others, especially other dog owners.
  • Go outside and walk the neighborhood, sit out front, or stop to greet people who go by as you do yard work.
  • Do lunch; invite someone out for lunch or coffee.
  • Volunteer. Volunteering gives you an instant connection with other people who share an interest in the same cause.
  • Take a class. If you've always wanted to start or finish a degree, one benefit is that you're almost sure to find friends at school. Or take a community college, extension, or parks and recreation course in a subject or hobby that interests you.
  • Join a faith community. Researchers believe that people who are religious are happier in part because they have a strong social connection in their faith community.

Source: http://www.pbs.org/thisemotionallife/topic/connecting/getting-connected