Leaders Guide - Suicidal Behavior

When a Marine dies by suicide, the entire command will be put under stress. There are pressing administrative obligations and investigations, and many members of the unit may feel intense grief, anger, and/or guilt over the situation. In some cases, those left behind may experience distress associated with the belief that something could have been done to prevent the death. This can have serious impact on the readiness of the unit. Support to help Marines and unit members cope with feelings of loss is very important at this critical time.

What to Look For

Death has occurred that is a confirmed or suspected suicide.

What to Do

The immediate requirement is for notification of the chain of command through appropriate channels and initiation of other administrative obligations. At the same time, leaders will want to check for the effects of suicide on the unit and others, and begin damage control.
Generate PCR for the suicide IAW Marine Corps Casualty Manual.
- Mention pertinent facts suggesting that the death was suicide: (e.g. Method, witnesses, weapons, notes, verbalizations, medical findings, prior actions, possible stressors/causes, etc.)
Notify NCIS (see Legal Quick Reference).
Determine Line of Duty/Misconduct (see Legal Quick Reference).
Fulfill family notification requirements IAW Marine Corps Casualty Manual, and:
- Find out how the family is doing.
- Offer to help, as authorized and appropriate.
Fill out and forward completed Department of the Navy Suicide Incident Report (DONSIR) IAW Marine Corps Casualty Manual section 8305. To get a copy of the form email the Suicide Prevention Section Headquarters.
Have leaders, chaplains, or other trusted professionals walk around and find out how the surviving Marines in the unit are doing:
Was the death completely unexpected?
- Was anyone a close friend and now distraught or in grief?
- Does anyone need to be monitored for delayed reaction?
- Did some see signs and feel guilty that they did not do more?
- Does anyone need assistance?
Ensure that your Marines feel free to seek assistance to get back to full readiness.
Arrange Critical Incident Stress Management (CISM) sessions for the entire unit if needed. Circumstances that may warrant this include:
- A large proportion of the unit seems disturbed by the event.
- A large proportion of the unit witnessed the incident.
- A unit is isolated, small, and highly close-knit, such as a Special Forces unit.
Continue to monitor your unit members for delayed or persistent reactions over the next six months.

What to Avoid

The idea is for leaders to let their Marines know they are safe and in good hands if they ask for help. If you can communicate your genuine concern for your Marine they will tell their fellow Marines that seeing you was the right thing to do and that you had their best interests in mind. Here are some things that might destroy trust, close the lines of communication, or deter other Marines from asking for help in the future:

Minimizing the problem or not taking the problem seriously. Saying, “is that all?”
Telling them to “suck it up”, or “get over it”.
Keeping the problem a secret rather than getting appropriate chain of command involved.
Telling personnel who do not have a need to know, making the problem a source of unit gossip.
Ignoring the problem and hoping it will go away.
Delaying necessary referrals for Marines who have been greatly impacted by the suicide.

What to Expect after Taking Action

Most Marines will eventually recover from the incident without significant intervention.
But some may need more assistance to return to full readiness.
Issues may flare up occasionally, but will eventually fade with minimal intervention.

Troubleshooting

Depending on the situation, some Marines may have trouble getting over the event and may need more assistance to return to full readiness. Some Marines may or may not be reluctant to admit having trouble dealing with the death of a unit member. Here are a few tips for helping reluctant Marines:

Marine does not endorse a problem: In order to help a Marine who is reluctant to disclose a problem you may want to reassure the Marine, convincingly and genuinely, that you have the best of intentions and only want to help. You want to see the Marine get better not only because you are concerned about what you have seen and heard, but also because you want the Marine to take care of the problem before the problem gets out of hand and starts affecting performance as well as the readiness of the unit. Emphasize to the Marine that you are all in this together. When one Marine hurts the whole unit hurts. Therefore, it is important for you to make sure that the Marine is doing well and not just having to suck it up. You may also want to emphasize that getting help is a sign of strength and loyalty to the unit because they are making sure that they are ready to be there for fellow Marines and would want fellow Marines to do the same. If the Marine continues to be reluctant in disclosing the problem reinforce that you are always available to talk if they should change their mind.
Marine gets angry when asked about problem: If the Marine gets angry when asked about the problem it may be due to several factors. For example, the Marine may be ashamed of having the problem noticed, resentful due to feelings that the unit is the problem, may feel that nobody can understand or help with the problem. The Marine may also place blame on themselves for the problem or perhaps feel guilty for not getting a grip on life. Take this opportunity to turn the emotion toward getting help. The trick is to get the Marine to endorse frustration and sadness and realize that problem solving is not a solo operation. Keep the focus on what your Marine is feeling. Do not accuse the Marine of not giving 100% this will increase anger. Say, “you seem really angry about…”to show your understanding and promote discussion. If you can get the Marine to endorse the anger, you can probably get acknowledgement that help would be welcomed. In order to get the Marine to accept help from the command the Marine will need to trust that the command is truly interested in helping. Good listening will go a long way toward building this trust.
Marine does not want help: In this case the Marine has endorsed that there is a problem and does not want help. The Marine may or may not say why, but it is probably because of the belief that it is no one else's business or concern of negative career implications. Reassure the Marine, convincingly and genuinely, that you have the best of intentions and only want to help. You want to see the Marine get better not only because you are concerned about what you have seen and heard, but also because you want the Marine to take care of the problem before the problem gets out of hand and starts affecting performance as well as the readiness of the unit. Emphasize to the Marine that you are all in this together. When one Marine hurts the whole unit hurts. Therefore, it is important for you to make sure that the Marine is doing well and not just having to suck it up. You may also want to emphasize that getting help is a sign of strength and loyalty to the unit because they are making sure that they are ready to be there for fellow Marines and would want fellow Marines to do the same. If you are in the field, you can order the Marine to your forward rest and recuperation unit for “three hot and a cot” and further observation. They, in turn, will either observe that the Marine is recuperated and send them back to duty, or will refer them to a higher level of care.
Marine agrees to get help but does not follow through: Sometimes a Marine will agree to get help, but for any number of reasons may not follow through. The Marine may decide the problem is not bad enough and can fix it alone. The Marine may have agreed to get help just to get out of your office, or may have genuinely forgotten the time of the appointment. In any case the solution is to put the responsibility onto the Marine to get the needed help. Emphasize that you genuinely want to see your Marine get better, and listen to any concerns shared. Offer again to help. If there is resistance to your help, emphasize that the bottom line is performance, and that it is ultimately the Marine's responsibility to take advantage of all the help that is offered so that the problem does not start to affect performance. Be sure the Marine understands that letting the problem fester and get worse is what will negatively affect progression.
Marine does not get better after getting help: In some cases a Marine may get help but still not improve. This may be because the Marine's needs are different and a more intensive intervention is needed, either because the Marine is not motivated to improve, or because there is a more serious problem such as a personality disorder or mental illness. If you are not having any success at the small unit level, and you feel like you have given it a good effort, then you should be refer your Marine to a professional with more specialized expertise. In cases of adjustment problems, the chaplains or Marine and Family Services have counselors who can usually get to the root of the problem. If not, they will recognize that the problem is more serious, such as clinical depression or anxiety, and will refer the Marine for a mental health evaluation and treatment. If after mental health intervention the Marine is still not getting better, and the Marine is still a problem for the unit, mental health may contact the command with a recommendation for administrative action.
Marine seems mentally ill or suicidal but refuses evaluation: See Command Directed Evaluation