Implementation Issues

The recommendations above rely almost entirely on existing mechanisms, processes, and resources. A notable exception is the recommendation that all suicides trigger a standardized clinical quality assurance investigation. Setting up the infrastructure (personnel, protocols, data capture mechanisms, training, quality control, logistics, etc.) will require substantial effort over a year or more. Ongoing funding will be required largely for travel to bases to complete the investigations.

The recommendation to have a separate group develop best practices for management of high-risk individuals in outpatient settings will have limited resource implications, though it will require active participation of those in the operational chain of command. The same is true of the recommendation to consider implementing a version of the USAF “hands-off” policy for those under investigation.

The resources required for reinforcing the CF’s ability to systematically improve the quality of mental health care it delivers will be substantial, but the benefits to the CF will be substantial as well. Quality improvement needs to occur for reasons that go far beyond suicide prevention. Given that the cornerstone of quality improvement efforts is rich electronic data on the process and outcomesof mental health care, substantial resources and effort will need to be directed towards capturing, analyzing, and interpreting such data. These efforts are likely to be not only cost-effective, but actually cost-saving, with improvements in productivity, decreased absenteeism, and decreases in other medical expenses typically exceeding incremental program costs [126-128].

Educating key stakeholders about the CF’s approach to suicide prevention will be best accomplished by developing a formal communications plan that consistently emphasizes the same key messages. A central goal of the communication plan should be to enhance confidence in the CF’s suicide prevention strategy.

  • Recommendation 57: An implementation plan for all of the Panel’s recommendations should be developed. Because of the resource implications and the complexities involved,the plans for development of a clinical suicide quality assurance investigation system and the overall reinforcement of the CF’s quality improvement capacity for mental health care should be emphasized.
  • Recommendation 58: A comprehensive communications plan should be developed to educate all stakeholders about the CF’s suicide prevention program. The efforts to engage the media to encourage responsible reporting of suicides should be rolled into this comprehensive plan.
  • Recommendation 59: The CF’s suicide prevention program has progressed enough that CFAO 19-44 should be repealed and replaced with a suitable policy instrument that sketches out the essential features of the CF’s current approach.
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