A retired Air Force colonel, David Litts has embarked on a second career mission: to promote suicide prevention, a cause he championed during his last 10 years of active duty. “Military personnel are patriotic volunteers who risk their lives to protect the freedoms we enjoy every day,” he says. “They work in very high-stress situations, and it is our duty to help ensure that they have access to the best mental health services possible.”
Litts brings 23 years of military experience to the Suicide Prevention Resource Center (SPRC) Training Institute. He directs the U.S. Air Force-funded Air Force Clinical Training Project, which is just winding down its one-year contract. Its goal: Help mental health professionals and clinicians in the Air Force better assess and manage suicide risk, one of the most important symptoms of post-traumatic stress disorder, anxiety, and depression.
Litts recruited six faculty members and armed them with the SPRC-developed curriculum, Assessing and Managing Suicide Risk. They traveled the world delivering training workshops to 1,400 mental health clinicians at 45 Air Force bases, providing services to 347,000 active-duty members.
How did you transition from the Air Force to EDC?
I spent 23 years in the Air Force, and the last 10 years of that I was focused principally on suicide prevention. I had just finished a tour at the Pentagon developing Department of Defense policy in quality improvement and risk management. This was in the mid-1990s, when the Air Force was experiencing an increase in suicides. The Air Force chief of staff became concerned about the increase, so he asked the Air Force surgeon general to put together a task force. I was appointed the executive director for the task force. We developed the first comprehensive suicide prevention program to be associated with a reduction in the suicide rate across a population. There had been nothing like it before in scope or size. We were really pioneers.
As a result of that success, I was invited to join the staff of the U.S. Surgeon General to help write and disseminate a national strategy for suicide prevention. I was in a transitional point in my Air Force career when EDC was able to get the SAMHSA [Substance Abuse Mental Health Services Administration] grant for SPRC. I was included in that proposal and when EDC won the award. I retired from the Air Force and transitioned to EDC in 2002.
Do mental health clinicians treating military personnel have special training needs around suicide prevention?
Military personnel tend to be young and separated from their extended families. So they don’t have access to an experienced family member to help them navigate life’s challenges. Mental health clinicians are one part of the military community that helps fill the roles that would normally be filled by parents and grandparents if they were closer.
The sad truth is there are very few training programs for mental health professionals anywhere in the country that give specific attention to assessing and managing suicide risk. It’s something that most providers pick up on their own, whether they learn it through their clinical experience or have a clinical supervisor who gives them some tips. There are very few programs that incorporate our kind of curriculum into their training.
So in that regard, the Air Force mental health professionals were no different from mental health professionals across the country. They had not been trained in this kind of high-risk work. What’s different is the Air Force made suicide prevention a priority and had the opportunity to disseminate this training to their mental health staff.
What are your hopes for this program’s success and possible expansion into other military divisions?
Ten years ago, when the Air Force launched its first suicide-prevention program, there was a lot of debate about whether or not it was even possible to reduce suicide through this type of an effort. A lot of people, including mental health practitioners, were skeptical. But over a six-year period, the suicide rate dropped by one-third. You can reduce suicide rates and save lives, one person at a time.
Suicide-prevention efforts really make a difference. The SPRC training program was developed by a group of the nation’s most respected clinician researchers and is the first curriculum that so neatly packages instruction and skill demonstration into a one-day, face-to-face workshop format. We are thrilled with how this program has been accepted and we have had nothing but expressions of high satisfaction from the Air Force. We have trained faculty on the curriculum from the Marine Corps and Army Reserves, and expect this to lead to dissemination across those services.
What is the most satisfying aspect of your work?
We’ve offered this curriculum to 5,000 mental health practitioners across the country. It’s been very well received and the demand for it is strong. We’re in the process of evaluating the curriculum and are optimistic that we can demonstrate improvements in the care provided by those who receive the training. We do believe lives will be saved—suicides will be prevented—because we’re doing this work.