Suicide and its effects on those left behind Published Sept. 24, 2015 By Kimberly Woodruff Staff Writer TINKER AIR FORCE BASE, Okla. -- Why? That's a question that family, friends, co-workers and acquaintances ask when someone close to them commits suicide. "Suicide affects a community," said Capt. Mayrin Munguia, a psychologist with the 72nd Medical Group. "People have a lot of questions and need to go through the grieving process." When there is a suicide on base, the Disaster Mental Health Response team is called on to come assist with those who are left behind. The DMHR team consists of Mental Health, Employee Assistance Program, Airman and Family Readiness Center and the Chaplain Corps. "People have strong reactions when told of a loved one's suicide," said the captain. "They ask 'What did I miss?' or 'What could I have done differently to help?'" Captain Munguia said that those who are impacted by the death can receive up to four undocumented psychological first aid appointments with a DMHR team member to help them process the trauma. "When a death happens, it is surprising how many people it affects," she said. Because everyone grieves in different ways, mental health professionals often educate survivors on what reactions they may expect in the days, weeks and months following the death. "We focus on the survivors' strengths and coping resources to help them," said Captain Munguia. "I tell my patients to avoid alcohol and drugs, and to get plenty of sleep. It is important to take care of yourself by exercising, eating, sleeping and talking it through with someone you trust. Additionally, it is important for commanders and first sergeants to also take care of themselves as they work through their processes." The captain added that when she tells groups to take care of each other, people tend to take ownership of that. Captain Munguia stated that people may feel a lot of anger and blame after a suicide while they try and make sense of what happened. She stated that it is difficult to understand why someone would take their life, but just know the decision was likely made while the person was in extreme pain and not in a good place emotionally. There are a number of risk factors involved with someone contemplating suicide. A marital or relationship problem is the No. 1 common risk for a person to take their own life. Other factors such as prolonged or unmanageable stress, legal problems, financial or work problems and worrying about the family follow closely behind. Maj. Ryan Buhite, a clinical psychologist and Mental Health Flight commander for the 72nd Medical Group, said it is often not just one thing that brings a person to take their own life, it is usually a culmination of different things. "People who decide to commit suicide often are depressed, feeling worthless, helpless to do anything about it, and hopeless that their situation will ever improve," he said. "They also often feel like a burden on others and that they don't fit in anywhere." Captain Munguia agrees. "Suicide is a complex issue, but when we see someone whose mood is much more sad or happy than usual, if they withdraw from others, behave recklessly, talk about feeling guilty or shamed, joke or talk about death or dying, or if they are giving away possessions, these are serious warning signs that something is bothering them," she said. "Ask them if they are doing OK, but don't accuse them. Just say something like, 'I notice you seem to be struggling or you seem tired, are you OK?'" The captain said each case is different with suicide, and each person responds differently. "That's both the beauty and complexity of human behavior," she said. "We all respond differently to trauma and it is impacted by the way we were raised, life experiences, our culture, religious or spiritual beliefs and core values." Major Buhite said if someone has safety concerns about a wingman, they should use the ACE model. They should Ask how they are doing and if they are having thoughts of suicide. They should demonstrate they Care about the person by listening and trying to assist. Finally, if there are safety concerns, they should never leave that individual alone and Escort them to professional emergency services such as the mental health clinic or the local emergency room while also informing the chain of command. "If you are not sure what you should do, there are many people working in the Mental Health Clinic who can answer questions," Major Buhite said. There are a lot of resources for a person to get help. Some service members have been reaching out for help at www.vets4warriors.com. Helping agencies include: -- National Suicide Prevention hotline: 1-800-273-TALK (8255) -- Chaplain: 734-2111 -- Mental Health Clinic: 582-6603 -- ADAPT: 582-6605 -- 72nd Security Forces: 734-3737