NB Minutes "CAP has had more visable suicides lately"

[Ned]

SPP done wrong or implemented half a$$ed is dangerous and can create problems where there weren't any. 

Insightful. 

I supposed I'd have to agree.

Just like ES done wrong, or DDR done wrong, or O-flts done wrong, or CPFTs done wrong . . .  .

[ZigZag911]

What we apparently seem to be trying to create is a civilian version of "The Air Force."  We may have the identifier of "Auxiliary of the USAF" but that doesn't mean that we have to follow their models for everything or institute every program, job, organizational structure, requirements, etc that they have.

I have been sustaining a version of this point for 10 years.  CAP has some very different factors at work in its membership than does the USAF.  If we try to apply every aspect of the USAF on CAP, the results will be more of a problem than a solution.

Yes, some functions are helpful.  However, others do not apply. 

I've said much the same thing regarding our insistence on maintaining community level "squadrons" with a full staff where there simply are not sufficient members to do so.

Yeah, we have chartered flights, but I'm not sure what the point is, since they are expected to do everything a squadron does!

Returning to the main point, very little evidence has been offered that CAP is facing more risk of suicide by its members than civilian society at large. While the loss of any member in this way is certainly a tragedy, I've yet to be convinced there is a need for yet another new program.

[flyerthom]

And clearly, one of the things that we are looking at is SM expertise.  It should not surprise you that the National HSO, CISM chief, and I have discussed this very issue - whether the necessary expertise is most likely to be found, if at all,  in medical, CISM, or CP.  We get that.

Really, really.

Then a simple solution Ned. And I'll ask you to pass this up the chain and even volunteer to be a project officer on it:

The Emergency Nurses Association Injury Prevention Institute :

http://www.ena.org/ipinstitute/news/

Offers QPR Suicide Prevention Online training:

#

QPR Suicide Prevention Online TrainingQPR Saves Lives!
QPR - Question, Persuade, and Refer -- 3 simple steps that anyone can learn to help save a life from suicide. Just as people trained in CPR and the Heimlich Maneuver help save thousands of lives each year, people trained in QPR learn how to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone for help. QPR can be learned in our Gatekeeper course in as little as one hour. To learn more about the online training program, go to http://www.ewu.edu/qprgatekeeper/flashdetect.php?version=old
www.ewu.edu/qprgatekeeper - log in to training after completing payment process
www.ewu.edu/qpr - home page for general information
www.ewu.edu/x40903.xml - page for cost and registration information
Take advantage of the non-profit discount for ENA. The Gatekeeper online training is usually $29.95, but you can register for $24.95 by using the following code: QPRNP

The ENA Injury Prevention Institute STOP Program might also be something CAP should look at: http://www.ena.org/ipinstitute/STOP/default.asp


We really should do an epidemiological study though before we go off and add yet more things to do for a volunteer's limited time base.

[JohnKachenmeister]

CAP stress causing suicide?  Naw...

Homicide...? maybe.  Suicide...? never.

There IS a slight risk of increased suicidal ideation as a result of CAP service, that being the possibility of PTSD as a result of exposure to violently-stressful incidents like the deaths resulting from an aircraft crash.  We do have a fledgling program of CISM, that should, when fully implemented, prevent the development of PTSD and the associated depression that follows.

Since so few of our members actually find dead persons (Finding them from 1,000 feet above does not count, any more than bombing from 30,000 feet above causes PTSD) I suspect this problem is minimal and should not occupy 6 pages of discussion, nor ANY time at all of the NB.

However, I think it is indicative of a problem that NHQ has.  They are more eager to solve problems that do not exist than to solve problems that do exist and have been identified.

This alone is causing an increasing disconnect between the membership and the National HQ.

[jimmydeanno]

CAP stress causing suicide?  Naw...

Homicide...? maybe.  Suicide...? never.

There IS a slight risk of increased suicidal ideation as a result of CAP service, that being the possibility of PTSD as a result of exposure to violently-stressful incidents like the deaths resulting from an aircraft crash.  We do have a fledgling program of CISM, that should, when fully implemented, prevent the development of PTSD and the associated depression that follows.

Since so few of our members actually find dead persons (Finding them from 1,000 feet above does not count, any more than bombing from 30,000 feet above causes PTSD) I suspect this problem is minimal and should not occupy 6 pages of discussion, nor ANY time at all of the NB.

However, I think it is indicative of a problem that NHQ has.  They are more eager to solve problems that do not exist than to solve problems that do exist and have been identified.

This alone is causing an increasing disconnect between the membership and the National HQ.

So really what we need to be looking at is, "Does anything in CAP service have the ability to increase the risk of suicidal tendencies in our organization?"  Simpler, does CAP have a negative effect on people causing them to want to kill themselves?  If there is, that is what we should be looking at, not a nation-wide program to start diagnosing and evaluating suicidal tendencies of all members hoping to catch a latent risk.

We appear to have that already, CISM and the Chaplain program.  We have avenues for people to talk to people, we have Character Development lessons devoted to suicide, DDR has some suicide awareness stuff that they cover from time to time. 

The military takes a more active role in suicide awareness and prevention because their mission DOES impact suicide rates because of what the individuals involved do.  While there are a few things that might put stress on people in our organization, we have already identified those areas and have things in place to help address the initial signs. 

[RADIOMAN015]

CAP stress causing suicide?  Naw...

Homicide...? maybe.  Suicide...? never.

However, I think it is indicative of a problem that NHQ has.  They are more eager to solve problems that do not exist than to solve problems that do exist and have been identified.

This alone is causing an increasing disconnect between the membership and the National HQ.

Surely I think any of us who became aware of a member that was going to kill/harm him/herself we would take appropriate action.  HOWEVER, we are not extensively educated & trained mental health professionals, who I might add also miss their clients true intentions at times     What would be the expectation of this CAP training

When you add mandatory training that members must complete before they can do WHAT REALLY BROUGHT THEM INTO CAP TO DO & WHAT THEY GET ENJOYMENT FROM , the effectiveness of this required training can get diluted by many members overall attitude of "oh no here's another hoop we have to jump through!".  Perfect example is the new ORM requirement policy letter that recently came out.  Basically EVERYONE has to take that basic course.  Likely many more will have to take the advance course (so perhaps for the suicide course there would also be an advanced level)   Ooops, have an accident, surely it's your fault; and commanders you are also responsible, surely there should be no accidents if you have an effective program.  So now with another potential new program --  I have to wonder, IF someone in your squadron commits suicide (not at a CAP meeting or other CAP activity), what's the chain of command response going to be  
RM   

[JohnKachenmeister]

Guys... it's not like we got CAP members falling out of windows like snowflakes in Michigan...  This isn't Wall Street in 1929.

[Westernslope]

At the National Conference this year there are 3 Learning Labs pertaining to suicide.

DO10   Suicide:  Recognition & Intervention Opportunities for CAP


Presenters:   Lt Col Sam Bernard, CAP National CISM Team Leader; and members of his staff

In the United States an average of 1 person every 15.8 minutes dies by suicide.  Suicide is the 11th ranking cause of death in the USA, with homicides ranking 15th; suicide ranks 3rd for the young, ages 15 to 24.  This learning lab will explore the warning signs and tools available to prevent these tragedies in CAP.

HC01   Intermediate QPR Suicide Prevention – Part I

Presenter:   Chaplain Lt. Col. James Sickmeyer, North Central Region Chaplain

Dealing with the growing incidence of suicide. Chaplains and CAP members may find themselves in a position to recognize and mitigate suicidal behavior. This class will provide a proven model and encouragement tools designed to recognize early warning signs of suicide. Ask a question, save a life. Learn what questions to ask and how to deal with them.

Chaplain Sickmeyer has been a QPR Triage Trainer at the beginning, intermediate and advanced levels for the QPR Institute of Spokane, WA since 2004.


HC01   Intermediate QPR Suicide Prevention – Part II

Presenter:   Chaplain, Lt Col James Sickmeyer, North Central Region Chaplain

Dealing with the growing incidence of suicide. Chaplains and CAP members may find themselves in a position to recognize and mitigate suicidal behavior. This class will provide a proven model and encouragement tools designed to recognize early warning signs of suicide. Ask a question, save a life. Learn what questions to ask and how to deal with them.

Completion of the first session is a prerequisite.

Chaplain Sickmeyer has been a QPR triage trainer at the beginning, intermediate and advanced levels for the QPR Institute of Spokane, WA since 2004.

[Chappie]

At the National Conference this year there are 3 Learning Labs pertaining to suicide.


HC01   Intermediate QPR Suicide Prevention – Part I

Presenter:   Chaplain Lt. Col. James Sickmeyer, North Central Region Chaplain

Dealing with the growing incidence of suicide. Chaplains and CAP members may find themselves in a position to recognize and mitigate suicidal behavior. This class will provide a proven model and encouragement tools designed to recognize early warning signs of suicide. Ask a question, save a life. Learn what questions to ask and how to deal with them.

Chaplain Sickmeyer has been a QPR Triage Trainer at the beginning, intermediate and advanced levels for the QPR Institute of Spokane, WA since 2004.


HC01   Intermediate QPR Suicide Prevention – Part II

Presenter:   Chaplain, Lt Col James Sickmeyer, North Central Region Chaplain

Dealing with the growing incidence of suicide. Chaplains and CAP members may find themselves in a position to recognize and mitigate suicidal behavior. This class will provide a proven model and encouragement tools designed to recognize early warning signs of suicide. Ask a question, save a life. Learn what questions to ask and how to deal with them.

Completion of the first session is a prerequisite.

Chaplain Sickmeyer has been a QPR triage trainer at the beginning, intermediate and advanced levels for the QPR Institute of Spokane, WA since 2004.[/i]

My understanding is that these two sessions are training sessions which will result in those participating in both sessions receiving a certificate of completion, etc.

[John Bryan]

Also Tuesday/Wednesday Pre-Conference class is being offered:

8:00 AM  -  5:00 PM
ICISF/CISM Suicide Prevention, Intervention & Postvention

Why do people kill themselves?  How do I ask someone if they are feeling suicidal?  What do I do if they say they ARE suicidal?  How do I deal with the strong emotions suicide generates?  This course will provide answers for these and other questions many of crisis interventionists have about suicide.  It will provide participants with basic information about suicide as well as help participants develop practical skills for prevention, intervention and postvention.  Small group role plays will allow participants to apply the suggested techniques as they are learned.

NOTE:  Students must participate fully on both days to successfully complete the course. 

I took this class through ICISF and it is very helpful.....I would highly recommend it.

[RiverAux]

At the National Conference this year there are 3 Learning Labs pertaining to suicide.

DO10   Suicide:  Recognition & Intervention Opportunities for CAP


Presenters:   Lt Col Sam Bernard, CAP National CISM Team Leader; and members of his staff

In the United States an average of 1 person every 15.8 minutes dies by suicide.  Suicide is the 11th ranking cause of death in the USA, with homicides ranking 15th; suicide ranks 3rd for the young, ages 15 to 24.  This learning lab will explore the warning signs and tools available to prevent these tragedies in CAP.

HC01   Intermediate QPR Suicide Prevention – Part I

Presenter:   Chaplain Lt. Col. James Sickmeyer, North Central Region Chaplain

Dealing with the growing incidence of suicide. Chaplains and CAP members may find themselves in a position to recognize and mitigate suicidal behavior. This class will provide a proven model and encouragement tools designed to recognize early warning signs of suicide. Ask a question, save a life. Learn what questions to ask and how to deal with them.

Chaplain Sickmeyer has been a QPR Triage Trainer at the beginning, intermediate and advanced levels for the QPR Institute of Spokane, WA since 2004.


HC01   Intermediate QPR Suicide Prevention – Part II

Presenter:   Chaplain, Lt Col James Sickmeyer, North Central Region Chaplain

Dealing with the growing incidence of suicide. Chaplains and CAP members may find themselves in a position to recognize and mitigate suicidal behavior. This class will provide a proven model and encouragement tools designed to recognize early warning signs of suicide. Ask a question, save a life. Learn what questions to ask and how to deal with them.

Completion of the first session is a prerequisite.

Chaplain Sickmeyer has been a QPR triage trainer at the beginning, intermediate and advanced levels for the QPR Institute of Spokane, WA since 2004.

Another example of poor research that doesn't bode well -- despite what they're advertising in the program overall suicide rates have declined since the 1950s according to the CDC.  Suicide rates among 5-24 year olds increased through the mid 1990s but have dropped since then.  By the way, the suicide rate among 5-14 year olds is 10-20 times less than that of any other age group.  The highest suicide rates are in those over 45 and those have dropped by half since the 1950s. 

So, basically suicide is a DECLINING issue despite the ad.   

[RiverAux]

By the way, if we're really going to make it a priority to keep CAP members from dying off CAP-time, we forget about suicide and worry about health issues.

The death rate from heart disease is 19 times higher than the suicide rate.  The death rate from diabetes is twice as high as the suicide rate.

You know what would probably reduce the number of deaths of CAP members more than anything else?  Make all members meet the height/weight restrictions and require PT tests for ES participants. 

[Cecil DP]

Suicide is something that everyone should be aware of, and should be alert to the signs of. I believe most suicides are preventable. The question is how do we react to the situation? Will CAP mandate "suicide Prevention classes"? Who will teach them? Who will certify the instructors? Who does one contact, if they find someone at risk?

[Eclipse]

There is also the unintended consequence of being supposedly trained to know the signs.

We are not, by definition, mental health professionals (even those who are by trade).

Being trained in the signs of suicide infers a responsibility to act on the signs, which in turn opens the window for liability if we don't.

[Ned]

There are times when I have a hard time believing we are looking at the same post.

Another example of poor research that doesn't bode well -- despite what they're advertising in the program overall suicide rates have declined since the 1950s according to the CDC.

Maybe it's just me, but I can't find anywhere that the poster "advertised" anything about suicide rates over time.  I guess it is always easier to "disprove" an asertion that was never made.  This is a fair example of a Strawman Argument.

They did (correctly as near as I can tell) talk about some specific current suicide factoids.

Do you really dispute the notion that suicide is a current severe public health problem?

(I get the fact that you don't think CAP should have any role in the problem, but do you really believe it is not a huge problem?)

Suicide is a major, preventable public health problem. In 2004, it was the eleventh leading cause of death in the U.S., accounting for 32,439 deaths.

See the paper here.

Suicide rates among 5-24 year olds increased through the mid 1990s but have dropped since then.  By the way, the suicide rate among 5-14 year olds is 10-20 times less than that of any other age group.

That may account for why I have met so few clinically depressed kindergartners, but it doesn't seem very helpful to the discussion at hand.  You can cherry-pick the data all you'd like, but you need to deal with the inconvenient fact that suicide is the third leading cause of death for 15-24 year olds, an age group somewhat more comparable to CAP.  And that is right now, today.  Not 1950.CDC Suicide Fact Sheet

So, basically suicide is a DECLINING issue despite the ad.   

Good news.  Crime Rates in the US have declined, so there is no further need for police or the courts.  Feel free to leave your front door unlocked.

and Cancer rates are declining as well, so there is certainly no reason to learn how to prevent it.

By the way, if we're really going to make it a priority to keep CAP members from dying off CAP-time, we forget about suicide and worry about health issues.

The death rate from heart disease is 19 times higher than the suicide rate.  The death rate from diabetes is twice as high as the suicide rate.

You know what would probably reduce the number of deaths of CAP members more than anything else?  Make all members meet the height/weight restrictions and require PT tests for ES participants. 

More good news!  CAPP 52-18 already teaches about nutrition, obesity, and fitness training.  Seniors can read and  benefit from this excellent publication.

So since we already "worry" about these issues, tell me again why we shouldn't worry about suicide, too?

There is also the unintended consequence of being supposedly trained to know the signs.

We are not, by definition, mental health professionals (even those who are by trade).

Being trained in the signs of suicide infers a responsibility to act on the signs, which in turn opens the window for liability if we don't.

Non-concur.  We are certainly not medical professionals, either, but we encourage all of our members to receive first aid training to help in emergencies when their skills and abilities permit.

Every SPP I've seen is pretty similar to a mental health first aid program.

[jimmydeanno]

That may account for why I have met so few clinically depressed kindergartners, but it doesn't seem very helpful to the discussion at hand.  You can cherry-pick the data all you'd like, but you need to deal with the inconvenient fact that suicide is the third leading cause of death for 15-24 year olds, an age group somewhat more comparable to CAP.  And that is right now, today.  Not 1950.CDC Suicide Fact Sheet

Ned,

I respect what you've said here, but how is what you said any different from the cherry picking you noted above?

Because suicide is the "third leading cause of death" doesn't make it a pandemic.  Tragic, but still not that common. "Accident" is the #1 (33%) and "homicide" is the #2 (15%).  Shouldn't we be more concerned about creating a homicide prevention program?  Heart disease is #5 (3%), stroke is #7. 

So 11% of the deaths in that age bracket are caused by suicide.  That doesn't mean that 11% of people in that bracket will commit suicide. 

[RiverAux]

There are times when I have a hard time believing we are looking at the same post.

Another example of poor research that doesn't bode well -- despite what they're advertising in the program overall suicide rates have declined since the 1950s according to the CDC.

Maybe it's just me, but I can't find anywhere that the poster "advertised" anything about suicide rates over time.  I guess it is always easier to "disprove" an asertion that was never made.  This is a fair example of a Strawman Argument.

Well, what do you call this from the agenda for 2 of the 3 learning labs that I quoted?

Dealing with the growing incidence of suicide.

Dealing with the growing incidence of suicide.

[sparks]

Good Grief how many more "feel good" ventures will NHQ come up with! Juveniles are more apt to die or be injured in a vehicle accident than anything else. Does CAP offer them or seniors a safe driving program? Does it provide classes to recognize the signs of an unsafe driver? Of course not because it is beyond the fundamental ability of us as senior members impact their exposure. The only impact we have is risk reduction when they are in CAP vehicles.

Auto accidents, drug abuse and heat exhaustion are far bigger life threatening issues than suicide.

Some will say that we need mandatory training because it MIGHT save a life. The same argument can be made for countless other risks too.

Keep focusing on the mission instead of the latest in what seems to be a long list of distracting mandates from Maxwell.   

[Ned]

Well, what do you call this from the agenda for 2 of the 3 learning labs that I quoted?

Dealing with the growing incidence of suicide.

Dealing with the growing incidence of suicide.

I call that "Oops.  My Bad".  You were correct.

Look, I don't think we are really very far apart on this.

(Primarily because I don't (yet) have a position to debate.)

But I honestly don't think the threshold question should be "Does CAP aggravate or increase suicidal ideation in our members?" or even "Exactly how many suicides or attempts have occured on CAP time in the last x years?".

I think the threshold question is something more like "Is suicide a significant preventable problem that affects our cadets?"  and if so, "Is there anything CAP might reasonably do given our limited resources in time, dollars, and expertise?"

Because, based on what I've seen to this point, nothing suggests to me that CAP somehow causes or aggravates the problem.  Indeed, Maj Lord may well be correct that CAP members may well have a lower rate than the general public.

Although the picture isn't complete, it looks like suicide is a serious issue in the lives of a significant number or our cadets.

The much, much harder question is what, if anything, to do about it.

And before anyone can answer that question, we need to take the time and effort to review the evidence-based programs already in existence to see if any might be appropriate given our limitations.

It may be that there is nothing "off the shelf" that is remotely appropriate.

As it turns out, there is a government database, National Registry of Evidence-based Practices and Programs run by the US Department of Health and Human Service's Substance Abuse and Mental Health Services Administration that allows us to review potential programs.

(I note that the QPR Institute's programs are peer reviewed, but not yet accepted for inclusion in the NREPP database.)


But everything that we are discussing is - in essence - classic ORM.  You and others are certainly correct that accidents and homicide are greater risks for our cadets and certainly health challenges like heart disease and cancer are serious risks for our older members.

But until we study the issue fully and consider the alternatives we can't begin to answer questions that would allow us to make decisions about what actions, if any, could preserve the largest number of our human assets given our available resources.

And it is worth restating that all the talk about "NHQ mandates" in this area is simply premature "bad mouthing" of a number of hard-working staffers.

There is no mandate.  There are no specific proposals to debate.  There are no non-specific proposals to debate.

But I guess that has never stopped us on CT before.

[Major Lord]

I don't think the argument is with you Ned, though you seem to have had the role of  advocatus diaboli for the SPP imposed on you. ( A role for which you are well suited) The good doctor in the memo from National does make four very specific recommendations for program development that he states we must act on proactively. None of his recommendations include any studies or attempts at justification other than his pronouncements that it should be done.

His royal "whereas" proclamation implies the facts are fully accepted and understood, and its time to move to his solutions. He appears to be an unpublished expert in the field of suicide and CIS, but his document seems to me, high-handed.

I actually don't have any specifc debate about the four proposals per se, other than that there is no evidence to suggest a need for their imposition upon the members, a fact belabored here in terms ranging from the bellicose to the merely profane.

Major Lord