In 2018, according to the Department of Defense’s 2019 Annual Suicide Report, 325 active duty soldiers, airmen, Marines, and sailors in the U.S. military died by suicide, an increase over the previous 5 years. The majority of those who died by suicide were men younger than 30, and they most often died by firearm. Besides demographics, risk factors for suicide among Service members include depression, anxiety, gun ownership, and substance use disorders.

Cailin Crockett headshotBloomberg Fellow Cailin Crockett notes an additional risk factor: feeling isolated. “Some of that certainly is related to being apart from friends and family as part of the job,” she says. “And the work that our military does is very stressful. This is a great public service that our Service members are providing our nation, and that’s a big weight to carry.”

Cailin leads prevention policy for intimate partner violence and child abuse/neglect for the Office of the Secretary of Defense Family Advocacy Program—the support division on U.S. and overseas military bases and installations that provides victim advocacy and clinical and non-clinical services. She also represents the Family Advocacy Program on the DoD Prevention Collaboration Forum, a Secretary of Defense initiative to promote primary prevention based on shared risk and protective factors for a range of violent, abusive, and harmful behaviors, including suicide.

For this National Suicide Prevention Month Q&A, we talked with Cailin about how her vital work interconnects with the other components of the Department of Defense’s violence prevention infrastructure, and how she feels this work has brought her full circle in her career. [Note: these remarks are attributable to Ms. Crockett in her personal capacity and do not reflect the views of the Department of Defense.]

Can you talk about the violence prevention measures being utilized by the Department of Defense?

When we talk about prevention, the Defense Department and the Family Advocacy Program look to the CDC’s violence prevention models that are based on the social-ecological framework for violence prevention. [These models look] at the different layers in which individuals and communities are interacting—including with their environments—in ways that can either increase their risk or lower their risk through protective factors, like social and community-based supports for seeking help before an issue becomes a crisis.

Our objective as the Family Advocacy Program and as the Department of Defense more broadly is to really increase awareness and understanding across the military community of what unhealthy behaviors look like—interpersonally, in relationships between parents and children, spouses and intimate partners; but also, importantly, within the domain of military units, [meaning] Service members and their interactions with one another—and what behaviors are indicative of risk. We’re encouraging people to seek help either for behaviors they’re observing in others or behaviors that are creating distress for themselves, so that we can intervene preventively before there’s a crisis.

As part of the Prevention Collaboration Forum, you work closely with the Defense Suicide Prevention Office, the Defense Sexual Assault Prevention and Response Office, and the Office for Diversity, Equity, and Inclusion, as well as other offices. Can you talk about the collaborative work you are doing within the forum, specifically relating to suicide prevention?

What the Department of Defense is doing with the Prevention Collaboration Forum is looking to build policies that are implementable across the services through our respective programs on base—that can intervene at those key points, before something rises to the level of a crisis. The work that I do with these offices [in the Prevention Collaboration Forum] is really focused on looking at how all of these forms of violence, abuse, and self-harm are interrelated. The hopeful piece of that is that in many ways they’re predictable, so they’re preventable.

When you look at risk factors for suicide, they include feeling a lack of social connectedness—feeling that you don’t have a community, that other people are not invested in your emotional welfare. Social disconnection is also a risk factor for domestic abuse. The fact that these forms of violence, in the case of domestic abuse, and self-harm, in the case of suicide, have shared risks creates a roadmap for violence prevention, because it indicates very clearly where community and social supports can play a role to reduce risks.

The timing of this piece is exciting because in mid-September the Defense Department, through the Prevention Collaboration Forum, published its first-ever policy on primary prevention for a range of violent and harmful behaviors. This policy guides prevention across the Total Force that addresses cross-cutting risk and protective factors for suicide, sexual assault, sexual harassment, domestic abuse, and child abuse and neglect.

I’d also like to put in a plug for the appropriateness of Domestic Violence Awareness Month being October, right after Suicide Prevention Month—because these are interconnected issues.

How did you get involved in this work?

I feel very tied to this work personally. My grandfather on my mom’s side served in WWII. After his service, he experienced post-traumatic stress disorder and died by suicide after decades of having been impacted by the challenges that come with serving in combat theater. That really had an impact on my grandmother and my mom and my aunt. They were all survivors—of domestic abuse and family violence.

For the past almost nine years, I’ve been working in federal policy on gender-based violence. I’ve had the opportunity to look at this work from a public health and social services perspective, working in the Department of Health and Human Services, and through a criminal justice lens in the Justice Department. I also worked for the White House Advisor on Violence Against Women in the previous administration, including work to promote what became the Special Victims’ Counsel that is now part of the military’s infrastructure in supporting victims of sexual assault and domestic violence.

I feel like I’ve come full circle in my career, now having the privilege to do this work in service of military members and their partners and families.

How has your experience as a Bloomberg Fellow been so far?

Having the privilege to learn from the foremost experts that are really leading the field, in terms of the science of prevention but also, what is so uniquely excellent about Hopkins is the tie to practice and policy—it’s a huge honor to be learning from this community and simultaneously bringing those lessons and expert insights into the work that I’m doing. It is a very cool thing to be working on these issues and looking to the literature and seeing who I’m citing when I’m making a case for a certain policy, and then having those folks be my MPH advisor, for instance. I’m really lucky to be able to learn from and connect with them directly.

If you or someone you know is thinking about or planning to take their own life, there is help 24/7: The National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 1-800-273-8255.

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