Life at the Intersection— LGBT Airmen and Suicide Prevention DoD/VA Suicide Prevention Conference DAVID M. SCHONBERG, LMSW Strategic Integration Defense Suicide Prevention Office david.m.schonberg.civ@mail.mil (703) 614-8859

Disclosures Mr. David Schonberg has no financial or nonfinancial interest to disclose.

Learning Objectives At the conclusion of this activity, the participant will be able to: Describe a surveillance gap in the data that hinders suicide risk assessment for Lesbian, Gay, Bisexual, and Transgender (LGBT) Airmen Name two suicide prevention protective factors the Air Force is structured to uphold, benefiting LGBT Airmen

Overview ANG Documentary, I am an American Airman—David Schonberg Scope and Risk—Data Surveillance and Gaps The Power of Policy—Repeal of “Don’t Ask, Don’t Tell” Suicide Prevention Protective Factors in the Air Force Deborah Lee James, M. A. (2015, March 4). Air Force Diversity and Inclusion. USAF Medical Service. (2013). Appendices Air Force Guide For Suicide Risk Assessment, Management, and Treatment. Air Force Guide for Managing Suicidal Behaviors, 61-69. *Defense of Marriage Act is an additional policy change impacting our culture. “Fostering inclusion ensures an environment that capitalizes on the strengths of every individual and removes any artificial barriers to an Airman's opportunity to achieve his or her maximum potential.” SecAF James, CSAF Welsh, and CMSAF Cody, 2015

I am an American Airman—David Schonberg Released in Nov 2015, the ANG debuted an 18-min documentary about a gay Airman to promote inclusion and understanding of LGB Airmen The experience of Schonberg highlights just one story The ANG made a significant step in communicating the welcome, the contribution, and value for its LGB Airmen (2012). Retrieved March 9, 2015, from After Repeal: LGBT Service Members and Veterans The Facts; Service Women’s Action Network: http://servicewomen.org/wp-content/uploads/2012/10/Final-LGBT-Fact-Sheet-10.4.12.pdf Diversity. (2012). Air Force Instruction 36-7001. Equal Opportunity. (2012). Air Force Policy Directive 36-27. Human Resources Advisor Program. (2011). Air National Guard Instruction 36-2110. Equal Opportunity Program Military And Civilian. (2011). Air Force Instruction 36-2706. Air National Guard Military Equal Opportunity Program. (2003). Air National Guard Instruction 36-7.

Scope and Risk— Data Surveillance and Gaps There are an estimated 3,500 LGB Airmen serving in the ANG (Gates, 2010) Note: Transgender Airmen were not officially permitted to serve until June 30, 2016 LGBT persons experience increased risk for suicide—stigma, prejudice, discrimination (Meyer, 2003) Research supported by Air Force Guide for Managing Suicidal Behaviors, 2013 Gates, G. (2010). Lesbian, Gay, and Bisexual Men and Women in the US Military: Updated Estimates. The Williams Institute. Meyer, I. H. (2003). Prejudice, Social Stress, And Mental Health In Lesbian, Gay, And Bisexual Populations: Conceptual Issues And Research Evidence. Psychol Bull, 129, 647-697. USAF Medical Service. (2013). Appendices Air Force Guide For Suicide Risk Assessment, Management, and Treatment. Air Force Guide for Managing Suicidal Behaviors, 61-69. http://www.af.mil/News/Article-Display/Article/821968/carter-announces-policy-for-transgender-service-members/ Carter Announces Policy for Transgender Service Members, 30 June 2016

Scope and Risk— Data Surveillance and Gaps National Strategy for Suicide Prevention found staggering differences between straight and LGBT persons when looking at percentages of those who attempt suicide (NSSP, 2012) Each episode of LGBT victimization, such as physical or verbal harassment or abuse, increases the likelihood of self-harming behavior by 2.5 times on average (The Trevor Project, 2012) NSSP. (2012). National Strategy for Suicide Prevention. Retrieved March 9, 2014, from Action Alliance for Suicide Prevention: www.actionallianceforsuicideprevention.org/NSSP Project, T. T. (n.d.). The Leading National Organization Providing Crisis Intervention and Suicide Prevention Services to Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) Young People Ages 13-24. Retrieved March 9, 2014, from www.thetrevorproject.org

Scope and Risk— Data Surveillance and Gaps Gap in Surveillance Remains Despite the insights into the total number of LGBT Airmen, the ability to assess the prevalence of suicide-related events in this community is severely restricted Neither military- nor civilian-based data systems thoroughly capture individuals’ sexual orientation or gender identity Currently, sexual orientation or gender identity post-suicide is frequently unconfirmed Advances in LGBT suicide prevention will be enabled as universal methods are developed to disclose sexual orientation and gender identity NSSP. (2012). National Strategy for Suicide Prevention. Retrieved March 9, 2014, from Action Alliance for Suicide Prevention: www.actionallianceforsuicideprevention.org/NSSP Project, T. T. (n.d.). The Leading National Organization Providing Crisis Intervention and Suicide Prevention Services to Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) Young People Ages 13-24. Retrieved March 9, 2014, from www.thetrevorproject.org

The Power of Policy— Repeal of Don’t Ask, Don’t Tell Sept. 20, 2011—With a pen stroke, 17 years of isolating, discriminatory policy were reversed The experience of living post-Repeal is being worked out one day at a time, one Airman at a time, one new policy at a time June 9, 2015—DoD updates its Equal Opportunity program to protect against discrimination based on sexual orientation “Removing a barrier is not the same as receiving an invitation.” http://www.hrc.org/resources/the-repeal-of-dont-ask-dont-tell “For 17 years, the law prohibited qualified gay and lesbian Americans from serving in the armed forces and sent a message that discrimination was acceptable.” --HRC “Removing a barrier is not the same as receiving an invitation.” –Schonberg, 24 April 2017 Air Force Diversity. (2015). Retrieved March 9, 2015, from www.af.mil/diversity The Air Force broadly defines diversity as a composite of individual characteristics, experiences, and abilities consistent with the Air Force Core Values and the Air Force Mission. Air Force diversity includes but is not limited to: personal life experiences, geographic background, socioeconomic background, cultural knowledge, educational background, work background, language abilities, physical abilities, philosophical/spiritual perspectives, age, race, ethnicity, and gender. (www.af.mil/diversity)

Protective Factors in the Air Force Suicide Prevention Protective Factors in the Air Force The U.S. Air Force is built on core values Integrity First Service Before Self Excellence In All We Do Professional Military Education infuses personal and professional development to all Airmen Airman Comprehensive Assessment Annual Appraisals Affirms two key protective factors Sense of Meaning Sense of Belonging Sense of Belonging (vs. Thwarted Belongingness) Sense of Meaning (vs. Perceived Burdensomeness) NSSP (2012)

Summary ANG Documentary, I am an American Airman—David Schonberg Who is my Wingman—Data Surveillance and Gaps The Power of Policy—Repeal of “Don’t Ask, Don’t Tell” Suicide Prevention Protective Factors in the Air Force Deborah Lee James, M. A. (2015, March 4). Air Force Diversity and Inclusion. USAF Medical Service. (2013). Appendices Air Force Guide For Suicide Risk Assessment, Management, and Treatment. Air Force Guide for Managing Suicidal Behaviors, 61-69. *Defense of Marriage Act is an additional policy change impacting our culture. “Fostering inclusion ensures an environment that capitalizes on the strengths of every individual and removes any artificial barriers to an Airman's opportunity to achieve his or her maximum potential.” SecAF James, CSAF Welsh, and CMSAF Cody, 2015

References (2012). Retrieved March 9, 2015, from After Repeal: LGBT Service Members and Veterans The Facts; Service Women’s Action Network: http://servicewomen.org/wp-content/uploads/2012/10/Final-LGBT-Fact-Sheet-10.4.12.pdf Air Force Diversity. (2015). Retrieved March 9, 2015, from www.af.mil/diversity Air National Guard Military Equal Opportunity Program. (2003). Air National Guard Instruction 36-7. Deborah Lee James, M. A. (2015, March 4). Air Force Diversity and Inclusion. Diversity. (2012). Air Force Instruction 36-7001. Equal Opportunity. (2012). Air Force Policy Directive 36-27. Equal Opportunity Program Military And Civilian. (2011). Air Force Instruction 36-2706. Gates, G. (2010). Lesbian, Gay, and Bisexual Men and Women in the US Military: Updated Estimates. The Williams Institute Human Resources Advisor Program. (2011). Air National Guard Instruction 36-2110. Meyer, I. H. (2003). Prejudice, Social Stress, And Mental Health In Lesbian, Gay, And Bisexual Populations: Conceptual Issues And Research Evidence. Psychol Bull, 129, 647-697. NSSP. (2012). National Strategy for Suicide Prevention. Retrieved March 9, 2014, from Action Alliance for Suicide Prevention: www.actionallianceforsuicideprevention.org/NSSP Project, T. T. (n.d.). The Leading National Organization Providing Crisis Intervention and Suicide Prevention Services to Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) Young People Ages 13-24. Retrieved March 9, 2014, from www.thetrevorproject.org USAF Medical Service. (2013). Appendices Air Force Guide For Suicide Risk Assessment, Management, and Treatment. Air Force Guide for Managing Suicidal Behaviors, 61-69.

Questions?