Chapter 17 Management of Recruit Suicide
Management of Recruit Suicide Chapter 17 MANAGEMENT OF RECRUIT SUICIDE † ‡ § ANTHONY L. COX, MSW*; DONNA L. EDISON, DO ; ROBERT L. STEWART, PHD ; CARRIE DORSON, PHD ; AND ELSPETH CAMERON RITCHIE, MD, MPH¥ INTRODUCTION STRESS IN MILITARY TRAINING SUICIDE STATISTICS Military and Recruit Suicide Statistics Problems with Suicide Statistics RISK FACTORS AND VULNERABLE INDIVIDUALS Military-Specific Risk Recruit-Specific Risk Research on Risk Risk Prediction Models Protective Factors Suicide Contagion and Epidemics RISK ASSESSMENT PROCEDURES Echelons of Care Trust and Rapport Systematic Assessment Models of Assessment and Assignment of Risk Category Methodology: Elements of Suicide Risk Assessment MANAGEMENT OF SUICIDAL RECRUITS Management According to Level of Risk Management Plans and Strategies Staff Burnout and Mistakes PREVENTION OF RECRUIT SUICIDE HELPING SURVIVORS (POSTVENTION) SUMMARY ATTACHMENT: RISK-MANAGEMENT FLOWCHARTS * Lieutenant Colonel, Medical Corps, US Army, Walter Reed Army Institute of Research, Bldg 503, Rm 2W-85, 503 Robert Grant Avenue, Silver Spring, Maryland 20910 † Senior Child Psychiatrist, Walter Reed Army Medical Center; Assistant Professor of Psychiatry, Department of Psychiatry, Uniformed Services Uni- versity of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814 ‡ Colonel, Medical Service Corps, US Army; Chief, Behavioral Health, Dewitt Army Community Hospital, Fort Belvoir, Virginia 20060 § Formerly, Captain, US Air Force; Assistant Chief, Clinical Psychologist, Brooke Army Medical Center, 5239 Eisenhauer Road, #2424, San Antonio, Texas 78218 ¥ Colonel, Medical Corps, US Army; Associate Professor of Psychiatry, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814 311 Recruit Medicine INTRODUCTION One Army training base’s outpatient mental health clinic The risk factors, protective factors, pressures on sees an average of five recruits expressing suicidal intent practitioners, and other environmental aspects make each day.
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