America’s Suicide Problem and Finding a Solution in Ourselves

By JC Glick and Wael Khalifa

This first appeared in The Havok Journal on October 12, 2021.

There is no surprise and there is no “sugar-coating” it – we have a suicide problem. 

Who are “we”? 

It is not just veterans, first-responders, and healthcare workers. 

It is all of us – teachers, cab drivers, pilots, artists.  It is all of the people that feel there is no hope that they are the problem, that they don’t fit anymore in the world around them. 

We have a national problem with suicide, and while we are all willing to acknowledge it, talk about it, wring our hands when we hear about it, and do push-ups for it, we really don’t have any solutions to prevent it. 

Suicide is one of the top ten leading causes of death in any age group overall in the United States, the second leading cause of death among individuals between the ages of 10 and 35, and there were nearly two and a half times as many suicides in the U.S. as there were homicides in 2019.  We can only assume that the 2020 and 2021 numbers will be worse given the isolation, financial hardships, and community impact of the COVID pandemic among other stressors of the past year.  The military has already released their numbers, and the results are extremely disheartening, with a 15% increase in DoD suicides.

We look at an overburdened mental health system, a population that feels disconnected from each other, information that is manipulated to the point where people don’t know what to believe, and then piped into echo chambers where it is further manipulated to extremes – there is no wonder why we are where we are.  It seems like no amount of resources will ever get us to a solution – the whole problem seems hopelessly doomed, and getting worse every day.

There are numerous training opportunities and resources available to people to counter suicide; however, many are well-intentioned but don’t provide what people need; they are antiquated in-process and pedagogy; and scarce and scattered resources create additional challenges when attempting to apply resilience techniques.

The cost of these challenges is that oftentimes direct help is never sought out, and behavioral signs may be visible, but unrecognizable or challenging to address by the people closest to us, who honestly have some of the most and best opportunities to intervene. While there has been training available, like most training, it has not been uniquely tailored to the learner, and it is clear, the learner is the most important person in this type of training.  The curriculum and the instructor must take a subordinate role in preparing the learner to identify recurring signs and manifestations, and safely register each approach in their bespoke way.

The problem is that the necessary experience and wisdom gained in the aftermath of a tragic loss of life could have been attained through preemptive and preventive measures, such as immersive and response training to enhance awareness and application.

But the solution isn’t inaccessible.  The solution isn’t far.  The solution isn’t difficult.  The solution is in our control.

The solution is us.  Each person reading this is the solution.  Every person you talk about this article with is the solution.  We are the solution.

While this might sound trite – it truly is the answer we need, and though it will not prevent every suicide, we can drastically reduce the number.

So, what does it mean – we are the solution?

It doesn’t mean we take a pledge affirming not to take our own lives. 

What it means is that we attack suicide when and where it is most vulnerable.

We attack it when people are going through stressful challenges when people are depressed when people are at the precipice of losing hope. 

We attack it in our homes, our schools, our workplaces, everywhere we encounter people.

We attack it by talking to each other. 

Many people talk about “hard” or “difficult” conversations.  However, anything we don’t know how to do, haven’t practiced, and are unfamiliar with are hard or difficult things.  Before you could ride a bike, tell time, tie your shoes, all those tasks were hard or difficult.  Before we understood math, grammar, or history, school was hard or difficult.  Anything that requires you to apply a skill to a situation (knowledge) is hard or difficult until you have learned it, experienced it, maybe even failed at it.  We might say we are not prepared to have this conversation.  We might say we are not trained to have these conversations.  We might even say that, because of the first two statements, these conversations are uncomfortable to have with a person, but let us not call these conversations hard or difficult.  These conversations are glorious because if we are talking to a person who is in crisis, they are not taking their own lives, and that is glorious.

Now the question is – how do we prepare for these glorious conversations?

Practice.

We need to get past the days of legacy learning and antiquated training, where static solutions are provided for commonplace problems.  Suicide is a complex and unique problem, that requires nuanced and distinct solutions.  You cannot learn how to talk about suicide from a book or a blackboard, nor can you do it from a slide or a movie.  The only way you can learn the skill is to practice it over and over until you feel comfortable.

So, what do you do?  Go search for people in crises?  Get role players that are available any time you like?

Well, the Air Force came up with a solution, and it truly is culture changing.  The answer is virtual reality.

Imagine a movie where you can talk to the characters, and they care about what you say – in fact, they react to your words.  That immersive experience helps you have some of the most challenging conversations you may ever have in your life. Well, the Air Force teamed up with the Moth+Flame VR company and created a VR solution that melds state-of-the-art cinematography with cutting-edge VR environment creation.  They were also able to integrate the power of conversational Natural Language Processing (NLP) to improve the fluency of human-computer interactions and create visceral synthetic experiences that humanize the VR experience.  In short, they made a program that teaches you through experience.

Overall, VR training has provided the USAF a transitional pathway from traditional learning to Immersive Learning by providing human realistic conversational interactions in a simulated environment with unrivaled realism to intricately challenging but necessary conversations.

Immersive training increases speed to proficiency when learning a new skill set and is a more effective and efficient method to retain knowledge. Immersive learning is a form of experiential learning that significantly increases someone’s ability to address issues of suicide prevention much faster and with better chances of applying competencies to positively impact lives.

The immersive technology has addressed current inefficiencies and constraints while providing previously unseen rates of engagement and retention that are exponentially higher than traditional learning models. These high rates have been attributed to the intense nature and realism experienced through the scenarios.

In addition to the continuous engagement, another common component to this training is that it’s voice-activated, so a participant is required to say things out loud that might be completely new and very challenging.

As of June 2021, the USAF deployed Moth+Flame’s VR immersive experience to over 1,000 Airmen with the following measurable outcomes that were achieved through self-assessment tools: 97% recommend the VR training; 187% increase in Very Prepared responses; 156% increase in Very Confident responses; 41% increase in likelihood to intervene to a person in crises; and impacts across measures increased 7x with ages 18-25.

So, is this the “magic bullet”? No. But at a time when so many people are talking about what to do about suicide, the Air Force put their money where their mouth is and developed a tool that seems to have an impact. 

Will it prevent suicide – not alone, but it is the first meaningful step to actual impact.  It will help us have the conversations we need to have to intervene, and intervention will prevent suicide. 

Together, we truly can influence those considering suicide.  We are the solution.  With training and confidence, we can make a difference, and anything that makes us better at attacking this problem is certainly worth the look.