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DCoE Director: Honing our Efforts to Reduce Suicide – a Public Health Scourge

Navy Capt. Mike Colston, director of Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (Photo courtesy of DCoE)

This article by Capt. Mike Colston, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, is reposted from the Military Health System in recognition of Suicide Prevention Awareness Month.

Suicide Prevention Awareness Month is a national observance during the month of September, but suicide prevention is a priority for the Department of Defense (DoD) every day of the year. Suicide is a pressing public health issue. Suicide rates have increased alarmingly in the U.S. over the past two decades. The Defense Health Agency (DHA) will lead in preventing suicide through three lines of action: fostering research, translating clinical knowledge to the field and informing policy.


The evidence base for suicide prevention remains thin. Research efforts such as the “Study to Assess Risk and Resilience in Service members Longitudinal Project” (STARRS-LP) and protocols under the cognizance of the Military Suicide Research Consortium are producing slow but hard-won gains in the science of suicidology.

Knowledge Translation

Interventions, such as brief suicide-focused cognitive behavioral therapy, have shown to reduce suicidal thinking and suicide attempts in treated groups. There is some evidence that these interventions, based on registry data in Northern Europe, have reduced suicides — a very high bar to prove as suicide is a low base-rate event. The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury will lead in promulgating practices such as this throughout the Military Health System.


We can inform policy changes. As recommended by the ”Department of Defense/Department of Veterans Affairs (VA) Clinical Practice Guidelines for Assessment and Management of Patients at Risk for Suicide,” we can consider ways to restrict access to lethal means that service members and veterans could use to take their own lives. This includes safer prescribing and dispensing of medications to prevent intentional overdoses and restriction of access to firearms and ammunition.  In addition, other efforts of means restriction – such as construction of suicide barriers on bridges, reducing access to pesticides, and the detoxification of natural gas supplies – showed immediate and lasting reductions in suicide in populations where these practices were implemented. 

We must act now to reduce suicides in our population by honing our efforts toward promising, implementable and measurable action.

Comments (2)

  • With great respect, so long as people who, like me, who have been or are suicidal, are treated as "other" or "patients" or "mentally ill," all the research and knowledge translation in the world won't address the core issues, which are as many and varied as there are human beings.

    I agree that policies which permit the automatic delivery of black-box drugs need to change, especially since I personally know many Veterans whose legal stash of such drugs is more than enough to be lethal.

    In my opinion, our efforts to reduce suicide to parameters that can be measured and treated is not the correct approach. This very article mentions touches briefly on what does work: human connection. That connection, whether with a trained professional or a layperson, saves lives. If society in general were to focus on building purposeful communities in the way the military does, suicidal people wouldn't feel so alone and isolated with their "ideation" and many more of us would choose to keep breathing. There's evidence for that approach hidden in all the clinical studies of "what works" for most "mental health" symptom olives; let's use it.

    • Bill, thank you for sharing your thoughts with us.

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This page was last updated on: September 14, 2017.