Annex F: CF Expert Panel on Suicide Prevention: Terms of Reference

Aim

To provide a platform to review international best practices in suicide prevention and to provide recommendations to the Canadian Forces (CF) Surgeon General for the enhancement of: suicide prevention policy, clinical practice guidelines and a surveillance system for the Canadian Forces.

Background

Suicide amongst Canadian Forces Members is a major concern for all levels of leadership in the Canadian Forces. Since the early 1990s with the increased operational tempo, suicide in the CF and its possible relationship to deployment has generated considerable concern.

Director General Health Services (DGHS) tracks the rate of suicide among CF Regular Force personnel overall and compares these numbers to the Canadian population as the Canadian mortality rates become available. The rate of suicide among personnel with a history of deployment is also tracked and compared to those without such a history.

To date suicide rates in the CF remain stable. The rate of suicide among male CF personnel during the period 2005-2008 was actually lower than the rate during the period 2000-2004. Additionally, there appears to be no consistent relationship between a history of deployment and increased risk of suicide.

The most recent statistical comparisons with the general population were in 2004. The results indicate that the rate of suicide among male CF personnel between 2000 and 2004 was about 75% of the rate among Canadian males, once the two have been age-standardized. The number of suicides by female CF personnel is so low that it is not possible to compare with matched civilian statistics.

Under the Strengthening the Forces campaign the CF delivers suicide intervention and educational training on a regular basis. This ranges from a two day skill based workshop known as “ASIST” (Applied Suicide Intervention Skills) to shorter awareness sessions. While educational approaches to suicide prevention have intuitive appeal, convincing evidence of efficacy of programs is limited.

Within the CF Health Services extensive efforts are also expended to identify people at risk for mental health problems and to provide them with the assistance they require. Examples of these include: pre-deployment and post-deployment screenings, as well as, specific Mental Health (MH) assessment during Periodic Health Assessments.

We have an effective suicide prevention program. We are working to enhance it further because the death of even one CF member by suicide is one too many. This expert panel will provide an opportunity to examine current civilian and international military practice with a view to sharing lessons learned and to determine best practices in surveillance and prevention.

Strategic Objectives

1. Review civilian and international military experience in suicide prevention programs and lessons learned.
2. Review the available scientific evidence, epidemiology and current best practices in the area of suicide prevention and surveillance; and
3. Develop a series of recommendations for the management of suicide prevention and intervention in Canadian Forces that is balanced, feasible and logical given the available evidence. Suicide prevention recommendations will not be limited to educational approaches.

Mission Statement

The mission is to conduct a two day international expert panel to undertake a review of current civilianand international military pactice regarding suicide prevention policy, clinical practice and surveillance systems.

Funding

1. Contracting International Subject Matter Experts to present details about their current programs and current scientific knowledge; and
2. TD for Workshop Participants

Assigned Tasks

OPI for this project is Directorate of Mental Health, Canadian Forces Health Services group HQ.

Conclusion

This expert panel will provide a timely and important means to review evidence based best practices for suicide prevention in both a civilian and military context. The panel will make specific recommendations that will be used to enhance our current CF programs.