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4 results

  • An effective suicide prevention program in the Israeli Defense Forces: A cohort study

  • L. Shelef, L. Tatsa-Laur, E. Derazne, J.J. Mann, E. Fruchter
  • Journal:
    European Psychiatry / Volume 31 / January 2016
    Published online by Cambridge University Press:
    23 March 2020, pp. 37-43
  • Objective

    To evaluate the effectiveness of the IDF Suicide Prevention Program, implemented since 2006.

    Design

    Quasi-experimental (before and after) cohort study.

    Participants

    Two cohorts of IDF mandatory service soldiers: the first inducted prior to (1992–2005, n = 766,107) and the second subsequent to (2006–2012, n = 405,252) the launching of the intervention program.

    Exposure

    The IDF Suicide Prevention Program is a population-based program, incorporating: reducing weapon availability, de-stigmatizing help-seeking behavior, integrating mental health officers into service units, and training commanders and soldiers to recognize suicide risk factors and warning signs.

    Main outcome measure

    Suicide rate and time to suicide in cohorts before and after exposure to the Suicide Prevention Program.

    Results

    Trend analysis showed lower suicide rates in the cohort after intervention. The hazard ratio for the intervention effect on time to suicide was 0.44 (95% CI = 0.34–0.56, P < .001) among males. Lower risk was associated with: male gender; born in Israel; higher socio-economic status; higher intelligence score; and serving in a combat unit (HR = 0.43: 95% CI = 0.33–0.55).

    Conclusions

    There was a 57% decrease in the suicide rate following the administration of the IDF Suicide Prevention Program. The effect of the intervention appears to be related to use of a weapon, and being able to benefit from improved help-seeking and de-stigmatization. Future efforts should seek to extend the program's prevention reach to other demographic groups of soldiers. The success of the IDF program may inform suicide prevention in other military organizations and in the civilian sector.

  • The effect of the Suicide Prevention Program (SPP) on the characteristics of Israeli soldiers who died by suicide after its implementation

  • Leah Shelef, Ishai Nir, Lucian Tatsa-Laur, Ron Kedem, Niv Gold, Tarif Bader, Ariel Ben Yehuda
  • Journal:
    European Psychiatry / Volume 62 / October 2019
    Published online by Cambridge University Press:
    01 January 2020, pp. 74-81
    • Article
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  • Background:

    Suicide is major cause of death in the IDF. The Suicide Prevention Program (SPP) led to significant reduction in yearly rates of suicide. A study regarding demographic changes of those who died by suicide was done to further investigate its affect.

    Method:

    Nested case control retrospective study based on medical and HR data gathered between 1992 and 2016. Participants were divided into four groups: soldiers who died by suicide and non-suicidal soldiers, before and after SPP implementation.

    Results:

    Multivariate analysis with suicide as the binary logistic dependent variable before and after implementation of the SPP among four groups revealed that before SPP the OR was higher for males (OR, 7.885; 95% CI, 5.071–12.259;p < 0.001) compared to after (OR, 3.281; 95% CI, 1.600–6.726; p = 0.001). For support unit soldiers the values before SPP were OR, 14.962 and 95% CI, 8.427–26.563 (p < 0.001) while after SPP they were OR, 6.304 and 95% CI, 3.334–11.919 (p < 0.001). After SPP, OR was higher for psychiatric diagnosis at recruitment (OR, 5.830; 95% CI, 2.046–16.612; p = 0.001) than before SPP (OR, 2.422; 95% CI, 1.526–3.842; p < 0.001).For soldiers from Ethiopian ethnicity, after SPP values were higher (OR, 8.130 and 95% CI, 2.868–23.047 (p < 0.001) compared to before (OR, 3.522; 95% CI, 1.2891–6.650; p < 0.001). For those of Druse religion before values (OR, 4.027; 95% CI, 2.211–7.331; p < 0.001) were significant but not after.

    Conclusions:

    While the SPP succeeded in reducing risk of suicide in situational factors, dispositional risk factors were not affected by the SPP. The OR decreased in critical masses and rose in unique and smaller groups.

  • 11 - An Army Like No Other

  • from Part II - Land Forces
  • Edited by Peter R. Mansoor, Ohio State University, Williamson Murray, Ohio State University
  • Book:
    The Culture of Military Organizations
    Published online:
    05 October 2019
    Print publication:
    17 October 2019, pp 247-271

  • Summary

    The emergence of organizational culture in the Israeli Defence Forces can inform scholars and practitioners how military cultures are formed and evolve, and how they shape organizational habits and patterns of actions in newly established military organizations. This chapter examines the vision, plans, and means the IDF’s early leadership deployed in a conscious attempt to create a shared pool of values and practices in the armed forces of the young State of Israel. It offers three different examples illuminating the dynamics of the IDF’s self-fashioned culture, defiantly independent and idiosyncratic from its very inception: the early emergence of an offensive approach in conventional and sub-conventional conflicts; the desire to learn from other armies but emulate none; and the IDF’s relations with the Israeli government characterized by agency and self-promotion. Together, these shed light on the IDF’s early organizational culture, imprinted into the organization’s cultural DNA and persisting many decades to follow.

  • Part II - Land Forces

  • Edited by Peter R. Mansoor, Ohio State University, Williamson Murray, Ohio State University
  • Book:
    The Culture of Military Organizations
    Published online:
    05 October 2019
    Print publication:
    17 October 2019, pp 53-318

  • Summary

    The American Civil War presented an exceptional state of affairs in modern warfare, because strong personalities could embed their own command philosophies into field armies, due to the miniscule size of the prior US military establishment. The effectiveness of the Union Army of the Tennessee stemmed in large part from the strong influence of Ulysses S. Grant, who as early as the fall of 1861 imbued in the organization an aggressive mind-set. However, Grant’s command culture went beyond simple aggressiveness – it included an emphasis on suppressing internal rivalries among sometimes prideful officers for the sake of winning victories. In the winter of 1861 and the spring of 1862, the Army of the Tennessee was organized and consolidated into a single force, and, despite deficits in trained personnel as compared to other Union field armies, Grant established important precedents for both his soldiers and officers that would resonate even after his departure to the east. The capture of Vicksburg the following summer represented the culminating triumph of that army, cementing the self-confident force that would later capture Atlanta and win the war in the western theater.