STAFF: Good afternoon, everyone, and thanks again for joining us. Today we're going to talk about the DOD annual report on suicide.
Today the questions should be limited to this report. We have Ms. Elizabeth Foster, the Executive Director of the Office of Force Resiliency, for the Under Secretary of Defense for Personnel and Readiness, and Dr. Liz Clark, Director, Defense Suicide Prevention Office.
I'll turn it over to you ladies.
EXECUTIVE DIRECTOR ELIZABETH FOSTER: Great. Thanks so much, Jade.
And good afternoon, everyone. Thank you all so much for making time for this today.
So, as Jade said, today the Department of Defense is releasing the calendar year 2022 Annual Report on Suicide in the Military. During the engagement today I'm going to offer a few opening comments, and then we'll walk through the data in the report in detail, and then talk a bit about our current efforts and what the way forward looks like in this space.
So, if you go to Slide 2, before I dive into the data, I want to baseline around a few terms that you're going to hear us use throughout this briefing. The department uses three primary metrics to measure progress on suicide prevention.
First, we look at suicide counts. That is simply the number of people that died by suicide in a given time period. The second and primary metric that's really the focus of the report that we'll discuss today is suicide rates. And suicide rate is the number of Service members that die by suicide per 100,000 Service members.
And the reason the department uses suicide rate is because the size of the force is constantly fluctuating. Simply using the suicide count doesn't always give us an accurate picture of progress because the force could be smaller one year, bigger the next year. The suicide rate gives a more accurate picture of progress.
The third metric is we look at long-term trends. While year-to-year data is important in this space and can give us some early indicators of progress, the numbers in — in the suicide world can be quite volatile from year to year. And so if we want to know if we're truly making progress, we need to look at long-term trend lines. And we're going to talk a bit more about that in detail.
So now to dig into the top lines of the data. This year's data is largely consistent with the data outlined in the calendar year 2021 report. Fewer Service members died by suicide in 2022 than in 2021. However, because the size of the force is smaller in 2022, despite the reduction in suicide deaths, we did see a very slight increase in the suicide rate for the active component. We saw about a 3 percent increase in the suicide rate for the active component.
For Reserve and National Guard, we saw the suicide rate decrease by 12 percent and 18 percent, respectively. And for our military families, we saw the suicide rate decrease by 16 percent.
While we are cautiously encouraged by some of these numbers, we need to see sustained, long-term changes in the trend to know if we're truly making progress.
Now, as you all know, Secretary Austin did not wait for the results of this report to take significant action on suicide prevention. In September Secretary Austin announced a new suicide prevention campaign plan for the department focused around five lines of effort and supported by over 100 enabling tasks, modified and adopted from the recommendations of the Suicide Prevention and Response Independent Review Committee. And I'll talk a bit more about those recommendations and that plan later in our brief.
In closing, I'll just offer that every death by suicide is a tragedy. And each death has a profound effect on the teammates and family of those who died. And it has a detrimental impact on our military readiness. We owe it to our Service members and their families to redouble our efforts to prevent these tragedies.
So with that, I'm going to turn it over to Dr. Clark, who's going to walk through some of this data in a bit more detail.
DIRECTOR DSPO LIZ CLARK: Great. Thanks so much, Ms. Foster.
And this is Liz Clark.
So I'm going to go through Service member key data first and then I'm going to talk more about the rates in detail, then I'm going to provide a little bit more contextual information, then I'm going to switch over to family member suicide key data, and then I'm going to talk about our ongoing and current efforts in suicide prevention.
And so the overall — as Ms. Foster mentioned, we lost fewer Service members in — to suicide in '22 than we did in 2021. This translated into — into roughly similar suicide rates between the two years among the active component and slightly lower rates among the Reserve and National Guard compared to 2021.
And on the top left, you can see the specific suicide counts and rates per 100,000 Service members for 2022 for the active component, and separately, for the reserve and National Guard. Any Reserve and National Guard member who was on active duty at the time of death is still counted in the reserve component.
For the active component, there was a slight increase of three percent in the suicide rate, and this — this accounts for three deaths more in '22 than in '21. The rate difference is not statistically significant, so we have low confidence that this is a true change. It could be natural variability or chance.
Similarly, the slightly lower rates we saw among the Reserve and the Guard were not statistically different between calendar year '22 to '21, which again means we have low confidence that this is a true change and could be natural variability or chance.
And while it's helpful to review the short-term changes, these year-to-year comparisons are preliminary insights and have limited reliability in helping us understand the overall trends in military suicide rates. And again, we aim for a decrease in longer-term trends and we're not there yet.
Over on the top right, we also analyzed trends within the components for longer periods of time to see if the rates are increasing, decreasing, or staying the same, and they're more robust than the year-to-year comparisons.
And the suicide rates for the active components have gradually increased between 2011 and 2022. The Reserve and the National Guard suicide rates fluctuate but there is no increasing or decreasing trend across 2011 to 2022.
And then when compared to the U.S. population, military suicide rates were similar in most years after accounting for age and sex differences between 2011 and 2021. The CDC has not published final data for 2022, so this comparison is through 2021. I'm also going to go in more depth on the follow-on slides about rates.
Moving down to the bottom left with method and demographics, firearms continue to be the leading method of suicide deaths in the military. This is consistent from previous years, and this data continues to underscore the relevance and importance of lethal means safety within our department's prevention efforts.
And then moving over to demographics, the Service members who died by suicide in 2022 were mostly young enlisted males, which is consistent with previous years and the overall demographic profile of the total force. Other demographic factors, like marital status and race, were also similar to previous years, and they're detailed in the full report.
And then moving over, we've highlighted some data on health and life stressors from the DOD Suicide Event Report, or we call it the DODSER, and then a DODSER entry is completed for all confirmed and suspected suicides and suicide attempts.
Then, the data — the DODSER summary data report is included as an enclosure — this get — this year again within the annual suicide report, and this provides additional contextual information and helps us inform our comprehensive integrated approach to suicide prevention.
And the health and life stressors you see here are largely similar to previous years. And while there's a lot of misconceptions that suicide and suicide risk is only a mental health issue, we also have to consider several of these factor — risk factors if we want to reduce suicides.
This is why we take a comprehensive and integrated public health approach to suicide prevention and to foster a supportive environment, address stigma, improving the delivery of mental healthcare, promoting a culture of lethal means safety, and then revising suicide prevention training.
And moving to the next slide. Here, I'm going to discuss our assessment of rates in more detail. As I mentioned previously — mentioned previously by Ms. Foster, this assesses changes in suicide rates using three different measures, and that's annotated with grey numbered circles, as you see on the slides.
First, we analyze what is the trend between 2011 and 2022 to see if the rates are increasing, decreasing, or staying the same. Second assessment is we look at recent year-to-year changes as preliminary insights but not as trends. And then third, we compare it to the U.S. population after adjusting for age and sex differences which are associated with suicide risk.
And on the top left side, you can see all the suicide rates for the active component Service members gradually increase from 2011 to 2022, and this is indicated by the trend line that is inclining from left to right.
Underneath that, you can see the comparison between the suicide rates for you — the U.S. population, and that's the green line, and the active component rates that are standardized for age and sex differences, with respect to the U.S. population. And this is a necessary adjustment if we want to have a better comparison between the military and the overall U.S. population.
And when we compare the rates for each year between 2011 and 2021, the active component suicide rate was similar to the U.S. population for all years, with the exception of 2020 when it was higher.
On the right side, we provide information for each of the military services. All of the services' suicide rates within the active component gradually increased from 2011 to 2022. When we look at suicide rates for each service in 2022, they all had different year-to-year changes. Compared to last year, the Army suicide rate is slightly lower, and the suicide rates for the Marine Corps, Navy, and Air Force are slightly higher.
Moving to the next slide. From this slide, very similar format, it's information on rates for the Reserve and National Guard. The suicide rates for the Reserve and National Guard did not have an increasing or decreasing trend between 2011 and 2022, and while the rate fluctuated year-to-year, the trend line is essentially flat. When assessing the year-to-year changes, the 2022 suicide rate for the Reserves and National Guard appear slightly lower than the previous two years.
And on the right side is the comparison of suicide rates between the U.S. population and the Reserve and the National Guard that's adjusted for age and sex differences. Reserve suicide rate was similar to — to the U.S. population in all years. The National Guard suicide rate was similar to the U.S. population for most years, with the exception of 2012 and 2013, when they were higher.
Moving to the next slide. Here, we're highlighting some of the information that we have from the DODSER, the DOD Suicide Event Report data summary, and this allows the department to deliver more contextual information.
On the top half of the slide, we have additional information on Service members who died by suicide in 2022 and had completed a DODSER survey. On the bottom half, we've selected data on suicide attempts reported in the DODSER system, which is not like — which is likely not all attempts that occurred throughout the year.
These are specific to the active component, which have the most robust and the most complete data. And so I'll start with the information on the top.
Of those who died by suicide in 2022, 87 percent occurred in the continental United States, typically where there are larger concentrations of Service members — for example, in California, Texas, Virginia, and North Carolina.
Most suicide deaths, about 72 percent, occurred in either private residences, at 46 percent, or barracks and military housing, at 26 percent, and then some deaths occurred in other locations, like a vehicle, parking lot, or a public space, which makes up the third category you see here at 28 percent. And this tells us that we need to provide access to resources everywhere.
On the top right, the DODSER provided new information for us in calendar year 2022. For example, that four percent of active component Service members who died by — died by suicide identified as gay, lesbian, or bisexual. Another example of new information is that 14 percent experienced abuse before the age of 18. And over time, this new information will help shape our understanding of suicide risks and will help us tailor resources for all Service members.
Then turning your attention to the bottom half, about service — Service member suicide attempt data. In calendar year '22, there were over 1,200 suicide attempts that were reported in the DODSER among active component Service member, although this is likely an underestimate, given the many complexities surrounding reporting the intent of suicide.
31 percent of attempts were among female Service members, which is higher than the proportion of women in the military and the proportion of women in the military who died by suicide. This is consistent with what we see in the U.S. population, mainly because women typically choose less lethal means and they're more likely to survive suicide attempts.
For suicide attempt method, poisoning, including alcohol, drug, and non-drug poisoning, was the most common method at 59 percent among those who attempted suicide and survived.
On the bottom right, you'll see similar health and life stressors that we showed early for Service members who died by suicide. And while I won't go by — review this line by line, they're largely in line with what we saw in previous years and continue to inform our public health approach and drive collaboration with a number of partners who could support the military community in each of these areas to reduce risk and increase protective factors.
Next slide. Now, shifting gears and moving over to family member key data, we're now going to look at the data for military family members, specifically spouses and dependents. And by dependents, we mean dependent children up to age 23 and based on the Title 10 definition. This data is for calendar year 2021, as family member data lags one year behind Service member data due to the CDC sourcing.
The bottom line up front here is that fewer family members died by suicide in 2021 than in previous years, at 168, compared to the past two years, where the count was 202. And when looking at the 2021 suicide rates for military spouses and dependents, compared to 2020, there is a 16 percent decrease for all family members, 14 percent decrease for spouses, and 26 percent decrease for dependents.
And then on the left are the suicide rates per 100,000 military family members, then broken down separately for spouses and dependents. The suicide rates for military spouses and dependents in 2021 appears slightly lower than in 2020 and 2019, and this is true for all family members combined, for spouses and dependents separately. When we assess rates for family members by sex, we did see a decrease among military family members compared to previous reports.
And in 2021, suicide rates for spouses and dependents were similar to the U.S. population when accounting for age and sex differences. Then in last year's report, the suicide rate for male spouses was higher than the U.S. population. So remaining similar to the U.S. population is moving in the right direction.
Now, on the bottom left, you'll see that firearms are the most common method of suicide at 61 percent of spouses — of spouse suicide deaths, and 56 percent of dependent suicide deaths were by firearms. This is consistent with previous years. Hanging is the next leading method — 22 percent for spouses and 28 percent for dependents, which is not shown here, but again, it's consistent with previous years.
To the right of the method data, you could see the demographic and contextual information for spouses and dependents separately. What I'll point out here is military spouses that died by suicide in 2021 were almost equally male and female, but male — male spouses make up about 14 percent of the spouse population overall.
Also, about half of — half the spouses who died by suicide had military service history. When we separate by sex, we saw that 78 percent of male spouses had service history and 20 percent of female spouses had military history. And from the V.A. annual reports, we know that our veteran population has a higher suicide rate.
When comparing to the general U.S. population, what stands out is the higher proportion of female spouses that used firearms as a means for suicide compared to adult women in the U.S. population. This continues to underscore the relevance of secure storage and lethal means safety initiatives for our military families.
There are a few other summary points for you in the bottom right, some of which I've already covered. I won't read off the slide, but generally, the other demographic characteristics for those who died by suicide are in line with the overall demographic characteristics of each of these groups and are consistent with what we know about suicide risk, meaning suicide rates in the U.S. are higher among certain groups, like young males.
Moving to the next slide. Most people that read our annual suicide report are looking at the data, and the data gets the most attention. However, one of the unique parts about what we publish in the department is our effort to address and prevent suicide in — in our community.
Both are important parts of this conversation. So this is a high level summary to communicate what the department is doing to address suicide and advancing and strengthening our integrated public health approach. On the left, you could see our key focus areas across the department, and on the right in blue are examples of additional service-specific efforts.
Some key examples of the efforts to foster a supportive environment for Service members and families include taking care of our people, that deliver benefits to the military community, such as pay increases, BAH increases, childcare support and spouse employment, in order to improve the overall quality of life. These are important protective factors, even though at face value, they may not seem to directly be tied to suicide prevention.
The department is also continuing to hire and train a specialized prevention workforce, with over 400 members of this workforce already on board. We continue to learn from the on-site installation evaluations, to review best practices and improvement areas across the DOD installations to prevent harmful behaviors, including suicide. We've also expanded the year-long suicide prevention communication campaign, including new platforms, resources, and partnerships.
To strengthen how we're addressing stigma as a barrier to getting help, we've reviewed over 600 policy documents, an ongoing effort to remove language that stigmatizes stress reactions, mental health issues and treatments.
We've also revitalized the Real Warriors Campaign, which encourages the military community to seek help for psychological health concerns. The Real Warriors Campaign promotes culture of support and emphasizes that mental health is health, and that psychological fitness is in much — is much a priority as physical fitness. And the campaign is an ongoing effort to normalize help-seeking as a sign of strength.
We've also created and promoted resources to support parents and educators in the military community, which includes discussing feelings with elementary age children and then sharing healthy relationships and military care resources.
To improve the delivery of mental health care, the department has implemented the ability for Service members to request referrals for mental health evaluation for any reason. This is known as the Brandon Act. We've also implemented programs that address the unique challenges assessing mental health services among the Reserve and the National Guard, for example, the National Guard Star Behavioral Health Providers Program that provides continuing education programs to enhance behavioral health providers' knowledge and skills for treating Service members, veterans and their families.
And lastly, we continue to promote a culture of lethal means safety, which our data clearly showed how important it is. We've partnered with federal agencies to examine policy for safe storage, which is advancing the White House's strategy to reduce military and veteran suicides. We are working towards updating policies on secure storage of privately owned firearms, when residing on the installation in the barracks of dormitories and in military family housing when children reside in the home.
We've also initiated pilot programs to explore the appropriate settings and effective communication on safe storage and early military career training. And then we've published updated policy and program evaluation, and we've supported the military service-level program evaluation capabilities specific to lethal means safety.
And then on the right side, you can see service-specific efforts that I won't highlight here, but please do take a look at those.
MS. FOSTER: Great. So, this is Beth Foster. I'll just very quickly touch on what the way forward looks like in the suicide prevention space. And to talk about the way forward, I need to quickly take a step back and remind all of you that, in March of 2022, Secretary Austin launched the Suicide Prevention and Response Independent Review Committee, or the SPRIRC, as we call it.
And the SPRIRC brought in a number of different outside experts to do a deep review of the department's existing suicide prevention programs, to determine where gaps exist and where we may need to enhance those programs.
That report was released in February 2023. In March of 2023 Secretary Austin made an announcement that the department would take immediate action on 10 recommendations focused on behavioral health that could be done under our own existing resources and authority.
In addition, Secretary Austin launched a suicide prevention working group to do a thorough review of each of the SPRIRC's 127 recommendations. That effort culminated in the announcement that the secretary made in September, where he announced the department would be announcing a new suicide prevention campaign plan focused around five different lines of effort that you see laid out on slide 9 here.
Each of those lines of effort would be supported by over 100 enabling tasks that were adopted and modified from the SPRIRC's recommendations. I know that we had the opportunity to speak with some of you about this announcement in September, and so I'm not going to get into each of these lines of effort and the enabling tasks in significant detail. But I will just quickly say that what is significant and critical about this approach is the comprehensive nature.
So, we know that there is no one single cause of suicide. And we know that, for many Service members, they experience a range of different risk factors. And so, if we're going to address suicide in the military, we can't just look at mental health. We have to look at a range of different risk factors that may be contributing. And we need to get far upstream of the point of crisis.
We believe that this new suicide prevention campaign plan will allow the department to deepen our investment in our suicide prevention work and really accelerate our efforts to get after this difficult problem.
So, with that, I will turn it back to Jade, and we're looking forward to answering your questions.
STAFF: Thank you, ma'am.
Before we started with question-and-answers, we ask that you limit your questions to one question and one follow-up. We will call on those who are on our list.
Kelsey Baker, Military.com?
Q: Hi, yes. Thank you so much. My question pertains to — let me pull up my slide again — the new data from the survey that shows that 14 percent — I believe 14 percent of Service members who died by suicide had some sort of history of childhood abuse.
And I'm wondering, how is that data being collected? I assume it's not self-reported?
STAFF: Yeah, so I'm going to turn it over to Dr. Clark to answer that question.
DR. CLARK: Yeah, thanks so much for the question. So, it is through the DODSER, the DOD Suicide Event report, which is completed after any suicide death or suicide attempt. And it's then broken down by physical, sexual, and emotional abuse.
Q: Okay. Thank you.
STAFF: Do you have any follow-up?
Q: Not — not at this time, thanks.
STAFF: Okay. Thank you. Patty Kime, Military.com? Patricia Kime, are you there?
Q: There's a Patty from Task & Purpose but not from Mil.com.
STAFF: Oh, sorry about that. Do you have a question?
Q: I mean, I can answer as a Patty, Patty with Task & Purpose. I — I guess I'm curious about the — we're still seeing a lot of suicides happen with firearms, like you mentioned. And then you also — it was discussed about just different policies that are in place that are, kind of, ongoing. Are — is the data that we're seeing, you know, since firearms are still heavily being used, is it that some of the policies haven't been implemented yet, or is it — I guess, why are we still seeing firearms be, kind of, the use — or the use of firearms be the major part of this?
MS. FOSTER: Yeah, Patty, thank you so much for that question. And I think what I'd offer is, you know, certainly the department has been getting after this issue for a number of years, but we've got a lot more work to do. And that's precisely why you saw the secretary include in his announcement eight recommendations focused on lethal means safety. Because we do think we need to deepen our investment in this space to ensure that we are reaching Service members and their families and making sure that, you know, we're not only putting new policies into place but that we're effectively pushing down and communicating this message throughout our force.
I think you'll see a lot of that work continue as we work through SPRIRC implementation.
Q: Okay. And I know that, when you were going through some of the policies, it was mentioning dorms and just other on-base military housing, but I — I noticed that, in the report, it goes into how a lot of them are happening in private residences. Is there — are the policies going to, kind of, address that aspect of firearm safety?
MS. FOSTER: Yes. And I'll turn it over to Dr. Clark to answer that.
DR. CLARK: So, for the policies, it's only going to be on the military installation, to include the barracks and dormitories, and then military housing when a child resides in the housing.
MS. FOSTER: And Patty, let me just follow up on that. This is Beth Foster.
Part of our challenge in this space, as you know, is we've got a dearth of data when it comes to — to lethal means safety, and part of that is because of some restrictions in law that actually make it impossible for us to ask our Service members, even on an anonymous, confidential survey, about some of their lethal means safety practices.
And so that's part of why a lot of our efforts are focused on Service members that reside on the installation, although we — we do recognize there's a gap for those that — that live off-base, and that's precisely why the Secretary, in his announcement in September, wants the department to move forward with seeking a change in legislation that would allow us to gather some of that — more — more of that data so that we can ensure our lethal means safety programs are effective.
Q: Just one follow-up — is — the — the legal restrictions you were talking about, is that having to do with the — the data or is there something else that you're referring to?
MS. FOSTER: Yes, so it — it has to do with data and our ability to collect that data.
Q: Got it. Thank you.
STAFF: Heather, USNI News?
Q: Great, thank you so much. So my first question is that when looking at the data over the past couple years, there are some discrepancies in the — the rates and the counts, and I was wondering if you can explain why we're seeing those discrepancies year over year?
MS. FOSTER: Heather, to — could you provide a little — I'm not sure I understand the question, what discrepancies you're referring to?
Q: So if you look at what was published this — in this — the slides this year, for example, the Navy rates of 2021 in the — in the slides this year was 17.0, but when you look at the — this 2021 report, the Navy rate was 16.7. So, we noticed that over the couple years that there was — at least between this — the slides this year and the — last year, the numbers are slightly different in the rates, and we were hoping for an explanation on those discrepancies.
MS. FOSTER: Yeah, sure. Thanks, Heather. Let me pass it to Dr. Clark for that question.
DR. CLARK: Sure. Thanks so much for the question. And we are continuously updating the data in the quarterly suicide report, so that's probably where you're seeing some of that, but many times, it's those that were suspected and then confirmed. So those investigations might have still been open when we had our last report. And so now, we — this is a — the most up-to-date information that we have.
Q: Okay, thank you. And so, for my follow-up —
DR. CLARK: And if I could just —
Q: Go ahead.
DR. CLARK: — sorry. If I could just add to that, in — in our quarterly suicide report that's on our website, we do highlight those changes as well.
Q: All right, perfect. And then for my follow-up, I know that when the recommendations came out, there was a lot of — of ones that needed funding in order to be implemented.
Can you talk about whether or not you think these numbers and the fact that the rates continue to go up, especially within the Navy and Marine Corps, where we saw a — quite a big jump between 2021 and 2022, how that might help with getting the funding or whether or not you think that the — the recommendations that the Secretary of Defense has asked to be implemented will actually be able to be done and maybe lower the numbers in the coming years?
MS. FOSTER: Yeah, Heather, that's a great question. And I will — I'll be honest, my — my answer will be quite similar to — to what we talked about in September. Because of where the department is in our internal budget review process, I can't give you a — a — an exact number of the amount of funding that will be applied to the implementation of these recommendations.
What I can assure you is this is a SecDef priority, this is a priority for the Deputy Secretary of Defense and all of the services. And so we anticipate a — a robust investment will be made in this space. I just can't give you those exact numbers yet, but once the President's budget is released next year, we look forward to talking to you in a lot more detail about what those numbers look like.
Q: Thank you.
STAFF: Meghann Myers, Military Times?
Q: Thank you. So, you mentioned some of the legal barriers to implementing some of the IRC's recommendations. Two of the biggest ones were normalizing firearm purchasing rules on all military installations, and another one was, as you mentioned, being able to — commands being able to collect data on who has a personal firearm at home.
Are you working with Congress? Is anybody talking to people on the Hill about making those changes? And if not, why not?
MS. FOSTER: Yeah, Meghann, so I — I think the — the — the question about getting data for those Service members that live off-base and the legal restriction that exists in that space, yes, we are absolutely engaging with Congress on this.
And now that the Secretary has made the announcement and decision about what recommendations he'll be moving forward with, we anticipate that those conversations will only sort of pick up now that we've — now that we've got a decision in this space.
So — so short answer is yes, absolutely.
Q: And the same thing with normalizing purchasing rules, is that something that you need Congress to intervene with or is that something you can do on your own?
MS. FOSTER: I — I'm not sure I understand the question on normalizing purchase rules.
Q: — recommendation was, for instance, making — well, when you go to the PX, you can buy a gun, and apparently a lot of guns that are used in suicides are bought on — on base exchanges. The IRC recommended making all purchases over 25, having waiting periods, all of that stuff, in contrast to what they have now, which is that usually if you want to buy a gun on a military base, the — the PX follows whatever the local restrictions are on firearm purchasing.
The idea that you could make the rules the same at every military base, is that something that has been embraced? Is there some sort of congressional barrier to being able to do that on your own?
MS. FOSTER: Yeah, absolutely. So — so I'll take — those two recommendations are a bit different, the — the waiting period and then the purchasing under the age of 25.
So in terms of the waiting period recommendation, the department decided not to move forward with that recommendation at this time, and the reason for that is because of the lack of data that we have in this space. So, our Service members are in the unique situation where they can purchase — often purchase a firearm at an exchange but they can also then just go off base and purchase a firearm at a — at a private retailer.
So, our challenge is — what we need to better understand is — is if we put those restrictions in place at our military installations, is that going to have a demonstrable difference in — in affecting of the suicide — suicide prevention and the suicide rate? And we just need more data in order to fully assess that problem.
And actually, one of the SPRIRC recommendations looked at specifically is working on some data-sharing agreements with other interagency partners so that we can actually understand are — weapons that are purchased on installations, are those the weapons that are being used in these suicide deaths?
So I — I think we just have some more work to do to — to fully assess this problem.
Q: Great. And my — my follow-up is, you know, you guys mentioned that, across components, largely the suicide rates have held kind of steady since 2011, and in the meantime, there have been so many new initiatives, the entire infrastructure of how behavioral health is handled in the military has changed. Has — the fact that you haven't really seen those numbers budge very much, what is — what is your reaction to that? And is that a — is that indicative of how complicated suicide is, or indicative of, you know, the — the lack of — lack of resources that you're — that you're able to put toward this?
MS. FOSTER: Yeah, so Meghann, I'll — I'll take a a first stab at that question, and then pass it over to Dr. Clark. But I think there's a multitude of factors that are contributing here, and the challenge is it's difficult to isolate suicide to one specific cause or one specific risk factor. We're dealing with a range of different issues here. And so the challenge is that, you know, a lot of cultural change and a lot of the — the recommendations and the practices that we've been implementing, they are — they do just take some time to take root.
I think the other thing that I would offer here is that while we hold ourselves to a higher standard, and — than — than the civilian population, we are also still dealing with Service members that are coming from the civilian population. You know, we recruit from America. And so we've seen, you know, these challenges increase, especially in the last — in — in the most recent years in the civilian population. And so you know, we — we have to deal with those changes as well as we get new recruits into the force.
Q: Thank you.
STAFF: Okay. We're now moving to Ellie Watson, CBS News.
Q: Thank you. My question's on the — the Prevention Workforce. Who makes up that new 400? Is 400 the goal? What's the goal? And are you seeing Service members use those new resources?
MS. FOSTER: Yeah, so Ellie, thank you so much for the question and — and thanks for the opportunity to speak about this.
So the Prevention Workforce, just as a — a kind of a reminder here, this was one of the recommendations that came out of the Sexual Assault Independent Review Commission, and one of their recommendations was that they — the department stand up a dedicated and specialized integrated prevention workforce. And so, this Prevention Workforce is focused on targeting a range of harmful behaviors. So, they're looking at sexual assault, harassment, suicide, domestic violence and child abuse.
And what this workforce does is they're taking a public health approach to targeting prevention efforts and getting far to the left of the point of crisis. So, they're not replacing those folks that are doing crisis counseling, our nonmedical counselors who are engaging directly the Service members or our behavioral health specialists, but they're using data to look at how we can drive down the common risk factors that are contributing to some of these behaviors on our installations and build up the protective factors.
So overall, the department is planning to hire 2,000 personnel that will be located at installations all over the world. The 400 that have been hired thus far have been hired across the force. So, the services are connecting their own hiring for this workforce. And so, I'd — I'd have to get you a more specific breakdown around how many in each service, but that's — overall, that's what we're looking at here.
Q: And then I guess there's been some — a lack of — there've been some complaints among Service members about a lack of, like, mental health support. When they sign up for appointments, the mental health counselors — I'm thinking of the G.W. investigation — are overwhelmed. Are you having — are you seeing any problems retaining the workforce that is already in place?
MS. FOSTER: Yeah, absolutely. So, I — I — I think mental health access and access to care is — is a significant challenge at the department, and I think one that the SPRC recognized and the secretary addressed in the announcement that he made in September.
You know, we know that there is a shortage of behavioral health providers across the country, and so you know, we know that we are not going to hire ourselves out of this access-to-care problem. So, we need to look at some creative efforts to ensure that we can get more Service members in to seek care. So, one of the ways that we're looking at that is expanding the availability of our existing providers through creative solutions like staffing models, a case management workforce, additional administrative support. All of that is going into solving this problem.
I think the other thing I'd offer is that a lot of times, our Service members don't necessarily need to see a doctor. They may be experiencing a — a challenge, but that challenge could be resolved by more engaged leadership. It could be involved by seeing nonmedical counseling, or maybe they need to do something like go to the Family Advocacy Program to seek additional support for a relationship challenge they're experiencing, or — or go see a financial counselor. And so, a lot of our efforts are focused on doing some of that initial triage so that we can get our Service members to the right level of care, which will help us address some of those access-to-care barriers.
Q: Thank you
STAFF: Thanks, everyone. Thanks, everyone, for coming. The embargo lifted at 12:45. Have a great day.