Lieutenant Colonel Michael Pooler, USA, Deputy Chief of Staff, Personnel, Maine Army National Guard
Thank you, Congressman Michaud for allowing the Maine Army National Guard to submit written testimony on suicide. Suicide prevention is taken very seriously in the Maine Army National Guard from the top down. Unfortunately, since 2009, the Maine Army National Guard has had two suicides. Though we do not have specific numbers, we know that numerous interventions have occurred that have saved lives. As training continues, interventions will increase. Leaders across the state are keenly aware of the problem and are working together to reduce the stigma and create a help-seeking environment. We view the increase in interventions as confirmation that our attempt to create an environment where Soldiers, families and commanders recognize the signs of suicide and ask for help without fear of retribution as very positive progress.
Support Staff and Organizational Training
Our support staff consists of a variety of federal and contracted personnel. Our primary federal employees consist of two Army National Guard chaplains, a Suicide Prevention Program Manager, one Army National Guard behavioral health officer, and two substance abuse personnel. Our primary contracted personnel are: a Director of Psychological Health, two Military Family Life and Children Consultants, a Military One Source representative, a Personal Financial Counselor and several Family Program contractors who run a 24/7 assistance hotline. Each has a part in finding help for our Soldiers and Families.
The Army National Guard has a Resiliency, Risk Reduction and Suicide Prevention (R3SP) Campaign Plan designed to coordinate various programs to ensure our Soldiers bounce back from adversity. A critical part of this is the Comprehensive Soldier Fitness program with Master Resiliency Trainers and Resiliency Training Assistants. These Soldiers support unit commanders in training Soldiers to be resilient through various means. Another component of the R3SP program is the Suicide Prevention Program Manager, who is the conduit between the National Guard Bureau and the State of Maine to coordinate and facilitate intervention training. Applied Suicide Intervention Skills Training (ASIST) is conducted semi-annually for selected service members. ASIST has strategically placed trained Soldiers in units across the state to be the eyes and ears of commanders to observe the signs of suicide and provide interventions for those with suicidal ideation. ASIST is enhanced by Ask, Care, Escort (ACE), an Army-wide intervention program. ACE teaches every Soldier the warning signs of suicide, how to ask the suicide question, the nature of care needed by a suicidal Soldier, and when and how to escort such Soldiers to health care professionals to save lives. ACE is unit led, supported by unit commanders, and promotes a “buddy-care” mentality that encourages help-seeking by those going through crises or struggling with addictions. ACE is a mandatory one-hour training block taught annually at the company level.
Suicide prevention takes many forms. Since relationship issues and substance abuse are frequently associated with suicidal thinking and behavior, we have stepped up efforts to strengthen relationships and reduce alcohol and drug abuse. Our chaplains conduct four to five Strong Bonds events annually aimed at married couples and single Soldiers to build healthy and enduring relationships. Our Counter Drug Program works tirelessly to educate and influence Soldiers, recruits, and families in the dangers and warning signs of addiction.
We also have the Maine Military and Community Network which works with clergy, law enforcement, and volunteer groups to support our Soldiers and families. A key component of this is the Maine Military Clinical Outreach Network where we train clinicians on the military culture and attempt to find civilian providers to see our Soldiers at a free or reduced rate. The Governor’s Military and Community Leadership Council also works at the policy level to coordinate comprehensive support for all our service members in Maine.
Access to assistance
The Army National Guard is organized to train and deploy Soldiers; therefore, we do not have any staff dedicated to treat our Soldiers. Our staff is trained help Soldiers find treatment; however, as a rural state, treatment options are limited and our only access to a military medical treatment facility is in another state.
Nationally in the Army National Guard, in 2009 and 2010, roughly one half of Soldiers that committed suicide did not deploy, which determines VA eligibility.[i]
VA eligible Soldiers. We have a close working relationship with the great Suicide Prevention staff at Togus VA Hospital and the regional Vet Centers. The staff is easy to reach, ready to help, and eminently qualified. They have become a reliable and competent resource and benefit for us; however, from our perspective, they seem to be extremely understaffed.
Non VA eligible Soldiers that buy TRICARE. We are finding that many Soldiers with suicidal ideations have not deployed, so they are not eligible for VA support. Even though Soldiers are eligible to buy TRICARE at a very reasonable price, most do not. However, even those that buy TRICARE, have a very difficult time finding clinicians who will see them. Many clinicians that want to help Soldiers find the process to become a TRICARE provider extremely cumbersome and the $27.50/hour reimbursement does not cover basic overhead, so we lack the number of counseling providers needed for our Soldiers. There needs to be a concerted effort to recruit and retain not only behavioral health providers, but also the gatekeepers to support the primary care providers. Also, someone other than the providers needs to maintain the TRICARE websites to ease the frustrations Soldiers find when looking for help. Much of the information on the website is outdated.
Soldiers without health insurance. Obviously, this is a population that creates the biggest challenge. Our staff works tirelessly contacting providers to find someone to help at a reduced rate or free.
The most effective approach is to create an environment where Soldiers feel they can ask for help without fear of repercussion or stigma and we work to continuously improve this environment. We provide the training to recognize the signs, where to get help and how to get Soldiers the support needed.
Community coordination and support allow the Guard to find the resources available for our Soldiers. This has saved lives.
Contractors provide continuity of support because our full time force of Soldiers will eventually deploy.
[i] R3SP Update, 29 JAN 11, Army National Guard Bureau, COL Greg Bliss