A Prospective Study of Suicide Prevention in the USAF

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DESCRIPTION (provided by applicant): The overall goal of this proposal is to allow me to develop the skills necessary to become an independent investigator and a leading scholar in the design and evaluation of the effectiveness of community-based preventive mental health intervention research. My primary focus will be on prevention of suicide. I have a unique opportunity to assess, both retrospectively and prospectively, the effects of a program developed in the United States Air Force that may have implemented effective strategies for reducing the suicide rate among its members. The program in the USAF is an unusual example of a community level prevention to address suicide prevention specifically, and mental health illness in general, integrating universal and targeted approaches to prevention. In the United States, research and programs on prevention of suicide and related morbidities has languished while other public health challenges have not. In part this has been due to the lack of political and social will to address mental health problems, especially suicide. Recently, our nation's top leading public health official, the U.S. Surgeon General recognized prevention of suicide and suicidal behaviors as a national priority. Taken together, my current capacity to access a "naturalistic laboratory", in a climate of political imperative to advance the status of the field of suicide prevention, renders a prospect of tremendous potential for participating in advancing the field of mental preventive mental health. As the field of preventive trials for mental health moves forward, the availability of investigators who are broadly trained not only to conduct program evaluations but also can direct and carry out field trials for the evaluation of the effectiveness of interventions will become vital. I propose to transition to this level of competency, through engaging in a rigorous training program with a interdisciplinary team of mentors, expert consultants and collaborators. This career development award will build upon my already strong skills in epidemiology and public health, social sciences, and basic science research. It is designed to enhance my knowledge and skills in preventive mental health, focusing on suicide, and to develop new skills in investigative methodologies applicable to field trials. The major research question of this proposal is to investigate whether the USAF Suicide Prevention Program results in a reduction in events of suicide, attempted suicide, and related morbidities, such as domestic violence, alcoholism and depression and maintains the reduction over time.