Every Sailor, Every Day: Changing the Conversation about Stress and Suicide in the U.S. Navy

Background:

Psychological toughness in the military has traditionally equated to a “suck it up” mentality. Findings from Navy’s suicide case reviews reveal gaps in identification and intervention when Sailors experience stressors associated with suicide risk. Needing a fresh approach to opening the dialogue about psychological health, Navy Suicide Prevention (SP) Branch launched the “Every Sailor, Every Day” (ESED) campaign. ESED complements policy efforts to reduce barriers to seeking help, enable early recognition of risk factors, promote intervention and champion self-care. ESED targets 18-24 year-old Sailors and their influencers (peers, leaders, providers and families).

Program background:

The Health Belief Model is at the campaign’s theoretical foundation, demonstrating susceptibility to psychological health challenges while promoting self-efficacy through accessible behavior changes. Messaging complies with the U.S. Surgeon General’s National Strategy for Suicide Prevention to ensure advancement of a safe narrative.

Materials (including posters, infographics, newsletter articles, blog posts, videos, implementation toolkits and social media messaging) are co-created with Sailors in focus groups to ensure audience orientation. ESED’s “1 Small ACT” message is applied to tips promoting preventive actions and intervention-focused behaviors. Content is deployed across digital and traditional media and grassroots engagement to activate audiences whether deployed or ashore. Partnerships include Navy and Military Health System organizations and campaigns, and Non-Government Organizations including the National Suicide Prevention Lifeline’s #BeThe1To campaign. Evaluation occurs through engagement analysis, focus groups and analysis of Navy data.

Evaluation Methods and Results:

Beginning in 2017, ESED launched focus groups to inform content promoting lethal means safety and utilizing support services. Findings indicated that existing approaches didn’t resonate with Sailors and beliefs about the career impacts of seeking help perpetuated barriers. New lethal means safety materials encouraging use of gun locks during high-risk periods were created reflecting Sailors’ values and behaviors regarding firearms. Distribution coincided with availability of 20,000 free gun locks throughout the Navy. All available gun locks were depleted within three months.

In 2018, testimonial products were created sharing a Sailor’s experience seeking help for psychological health and alcohol misuse while maintaining her top-secret security clearance, ultimately reaching more than 1K Sailors within one month and generating positive discussion. Additionally, targeted social media outreach during 2018 SP Month and winter 2019 lead to 100+ clicks for help from the Military Crisis Line.

ESED has met each of its campaign objectives, which are regularly assessed qualitatively and quantitatively. Content has reached over 22 million Facebook and Twitter users, and inspired more than 150 grassroots events.

Conclusions:

By applying a social marketing approach to promoting evidence-based prevention and intervention practices, ESED has contributed to reshaping Navy culture toward one that is increasingly supportive of psychological health. Navy partly attributes a higher acceptance rate for its newest intervention program, increased demand for free gun locks and willingness to intervene to ESED.

Implications for research and/or practice:

ESED is considered a thought-leader when it comes to promoting a positive and safe suicide prevention narrative in the military. Focus group feedback indicates that messaging is effectively tailored to its audiences, motivating an increase in open dialogue, and is positioned to affect perceptions and behavioral adoption.