APHDR Data Sets

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Overview

ASER 2004
ASER 2005 -2006
ASER 2007
DODSER 2008
DODSER 2009

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Sheet 1: ASER 2004

ASER CY 2004
Question	Answer Choices	Data Values	Variable Labels
Section I - Event Information
Event Date	[Type in date entry]	1 = Selected	EVENT_DATE
Type of Event	Completed suicide		EVENT_TYPE_COMPLETED
	Hospitalized		EVENT_TYPE_HOSPITALIZED
	Evacuated		EVENT_TYPE_EVACUATED
	Other		EVENT_TYPE_OTHER
Severity of Event	"Medical" intervention not required	1 = Selected	EVENT_SEVERITY_1
	Required "medical" intervention but was not life-threatening		EVENT_SEVERITY_2
	Required "medical" intervention and likely fatal without treatment		EVENT_SEVERITY_3
	Was fatal		EVENT_SEVERITY_4
Did event result in hospitalization?	Yes	1	EVENT_HOSP_Y
	No	2	EVENT_HOSP_N
	Don't Know	101	EVENT_HOSP_X
-- If yes, what type of facility?	MTF	1	EVENT_HOSP_MTF
	Civilian facility	2	EVENT_HOSP_CIV
	VA Hospital	3	EVENT_HOSP_VA
-- What was the name of the facility?	[Type in text entry]		EVENT_HOSP_NAMES
-- Admission date?	[Type in date entry]		EVENT_ADMIT_DATE
-- Discharge date?	[Type in date entry]		EVENT_DISCHARGE_DATE
Was the event related to a deployment?	Yes, anticipated deployment	1 = Selected	EVENT_DEPLOY_YA
	Yes, current deployment		EVENT_DEPLOY_YC
	Yes, post-deployment		EVENT_DEPLOY_YP
	No		EVENT_DEPLOY_N
-- If yes,
Start date of deployment?	[Type in date entry]		EVENT_DEPLOY_START
End date of deployment?	[Type in date entry]		EVENT_DEPLOY_END
Deployment location?	Afghanistan	1	EVENT_DEPLOY_ANT_LOC_AFG
	Iraq	2	EVENT_DEPLOY_ANT_LOC_IRQ
	Korea	3	EVENT_DEPLOY_ANT_LOC_KOR
	Kosovo	4	EVENT_DEPLOY_ANT_LOC_KOS
	Kuwait	5	EVENT_DEPLOY_ANT_LOC_KWT
	Other	100	EVENT_DEPLOY_ANT_LOC_OTH
Did patient/decedent communicate intent to others?	Yes	1	EVENT_COMMUN_Y
	No	2	EVENT_COMMUN_N
-- If yes, to whom? (check all that apply)	Supervisor	1 = Selected	EVENT_COMMUN_SUPER
	Chaplain		EVENT_COMMUN_CHAPLAIN
	Friend		EVENT_COMMUN_FRIEND
	Mental Health staff		EVENT_COMMUN_MHSTAFF
	Spouse or significant other		EVENT_COMMUN_SPOUSE
	Other		EVENT_COMMUN_OTHER
Primary method used	Overdose	1	EVENT_METHOD_OD
-- If overdose, select method	-- Prescription medication	2	EVENT_METHOD_OD_PRE
	-- Over-the-counter medication	3	EVENT_METHOD_OD_OTC
	-- Illicit drugs	4	EVENT_METHOD_OD_DRG
	Poisoning by solid or liquid substance (not medication)	5	EVENT_METHOD_PSN
	Firearm/gun	6	EVENT_METHOD_GUN
	Jumping from high place	7	EVENT_METHOD_JMP
	Motor vehicle crash	8	EVENT_METHOD_CAR
	Hanging, strangulation, or suffocation	9	EVENT_METHOD_HNG
	Cutting or piercing instrument	10	EVENT_METHOD_CUT
	Poisoning by vehicle exhaust	11	EVENT_METHOD_EXH
	Poisoning by utility gas	12	EVENT_METHOD_GAS
	Submersion (drowning)	13	EVENT_METHOD_SUB
	Other	100	EVENT_METHOD_OTH
	Don't Know	101	EVENT_METHOD_X
During the event, were drugs used?	Yes	1	EVENT_DRUGS_Y
	No	2	EVENT_DRUGS_N
During the event, was alcohol used?	Yes	1	EVENT_ALCOHOL_Y
	No	2	EVENT_ALCOHOL_N
	Don't Know	101	EVENT_ALCOHOL_X
Was the event committed in a public place where it would	Yes	1	EVENT_OBSERVABLE_Y
likely be observed and intervened in by others?	No	2	EVENT_OBSERVABLE_N
	Don't Know	101	EVENT_OBSERVABLE_X
The event was…	Planned, deliberate, and/or premeditated	1	EVENT_PLAN_PLN
	Impulsive and/or unplanned	2	EVENT_PLAN_IMP
	Don't Know	101	EVENT_PLAN_X
Section II - Patient/Decedent Personal Information
Last Name	[Type in text entry]		PATIENT_LAST_NAME
First Name & Middle Initial	[Type in text entry]		PATIENT_FIRST_NAME
			PATIENT_MIDDLE_INITIAL
Social Security Number	[Type in text entry]		PATIENT_SSN
Date of Birth	[Type in date entry]		PATIENT_DOB
Sex	Male	1	PATIENT_GENDER_M
	Female	2	PATIENT_GENDER_F
Residence	Barracks	1	PATIENT_RESIDE_BRK
	BEQ/BOQ	2	PATIENT_RESIDE_BXQ
	On-post family housing	3	PATIENT_RESIDE_ONP
	Off-post family housing	4	PATIENT_RESIDE_OFP
Resides Alone	Yes	1	PATIENT_RESIDE_ALONE_Y
	No	2	PATIENT_RESIDE_ALONE_N
	Don't Know	101	PATIENT_RESIDE_ALONE_X
Education	Did not complete high school	1	PATIENT_EDUCATION_NOT
	GED	2	PATIENT_EDUCATION_GED
	High school graduate	3	PATIENT_EDUCATION_HS
	Two-year college degree	4	PATIENT_EDUCATION_TWO
	Four-year college degree	5	PATIENT_EDUCATION_FOUR
Race (check all that apply)	American Indian	1	PATIENT_RACE_IND
	Asian	2	PATIENT_RACE_ASN
	White	3	PATIENT_RACE_WHT
	Black	4	PATIENT_RACE_BLK
	Other	100	PATIENT_RACE_OTH
	Don't Know	101	PATIENT_RACE_X
Race/ethnicity (check all that apply)	Hispanic
	-- Mexican	11	PATIENT_ETHNIC_MEX
	-- Puerto Rican	12	PATIENT_ETHNIC_PR
	-- Cuban	13	PATIENT_ETHNIC_CUB
	-- Latin American	14	PATIENT_ETHNIC_LAT
	-- Other Spanish	15	PATIENT_ETHNIC_SPN
	Native American
	-- Aleut	21	PATIENT_ETHNIC_ALT
	-- Eskima	22	PATIENT_ETHNIC_ESK
	-- U.S./Canadian Indian Tribes	23	PATIENT_ETHNIC_AIN
	Asian
	-- Chinese	31	PATIENT_ETHNIC_CHN
	-- Japanese	32	PATIENT_ETHNIC_JAP
	-- Korean	33	PATIENT_ETHNIC_KOR
	-- Indian	34	PATIENT_ETHNIC_IND
	-- Filipino	35	PATIENT_ETHNIC_FIL
	-- Vietnamese	36	PATIENT_ETHNIC_VTN
	-- Other Asian	37	PATIENT_ETHNIC_ASN
	Pacific Islander
	-- Melanesian	41	PATIENT_ETHNIC_MEL
	-- Polynesian	42	PATIENT_ETHNIC_POL
	-- Other Pacific Islands	43	PATIENT_ETHNIC_PAC
	Other	100	PATIENT_ETHNIC_OTH
	Don't Know	101	PATIENT_ETHNIC_X
	Don't Know
Marital status (check only one)	Married, resides with spouse	1	PATIENT_MARITAL_STATUS_MAR
	Married, geographically separated	2	PATIENT_MARITAL_STATUS_MGS
	Widowed	3	PATIENT_MARITAL_STATUS_WID
	Divorced	4	PATIENT_MARITAL_STATUS_DIV
	Separated, legally or due to relationship problems	5	PATIENT_MARITAL_STATUS_SEP
	Don't Know	101	PATIENT_MARITAL_STATUS_X
Minor children?	Yes	1	PATIENT_KIDS_Y
	No	2	PATIENT_KIDS_N
	Don't Know	101	PATIENT_KIDS_X
-- If yes, were the children residing with him/her?	Yes	1	PATIENT_KIDS_WITH_Y
	No	2	PATIENT_KIDS_WITH_N
	Don't Know	101	PATIENT_KIDS_WITH_X
Section III - Sponsor's Military Information
Service	Army	1	SPONSOR_SERVICE_ARM
	Navy	2	SPONSOR_SERVICE_NAV
	Air Force	3	SPONSOR_SERVICE_AF
	Marines	4	SPONSOR_SERVICE_MAR
	Coast Guard	5	SPONSOR_SERVICE_CG
	Other	100	SPONSOR_SERVICE_OTH
Component	Regular (e.g. Army, Air Force)	1	SPONSOR_COMPONENT_REG
	Reserve	2	SPONSOR_COMPONENT_RES
Duty status (check all that apply)	Active Duty	1 = Selected	SPONSOR_STATUS_ACTIVE
	AGR		SPONSOR_STATUS_AGR
	IET (Basic and Advanced Individualized Training)		SPONSOR_STATUS_IET
	Mobilized RC (Reserve and National Guard)		SPONSOR_STATUS_MOBILIZED
	ADT (Active Duty for Training)		SPONSOR_STATUS_ADT
	IDT (Weekend Reserve Drill)		SPONSOR_STATUS_IDT
	Retired		SPONSOR_STATUS_RETIRED
	Other		SPONSOR_STATUS_OTHER
Rank	Enlisted [1-9]	1 = Selected	SPONSOR_RANK_ENL
	Officer [1-10]		SPONSOR_RANK_OFF
	Cadet/Midshipman		SPONSOR_RANK_CAD
	Warrant Officer [1-5]		SPONSOR_RANK_WAR
		1 = Selected	SPONSOR_RANK_1
			SPONSOR_RANK_2
			SPONSOR_RANK_3
			SPONSOR_RANK_4
			SPONSOR_RANK_5
			SPONSOR_RANK_6
			SPONSOR_RANK_7
			SPONSOR_RANK_8
			SPONSOR_RANK_9
			SPONSOR_RANK_10
Relationship to sponsor	Sponsor	1	PATIENT_SPONSOR_REL_SPN
	Spouse	2	PATIENT_SPONSOR_REL_SPS
	Child	3	PATIENT_SPONSOR_REL_CHI
	Other	101	PATIENT_SPONSOR_REL_OTH
MOS (Miltiary Occupation Specialty Code)	[Type in text entry]		SPONSOR_MOS
Division	[Type in text entry]		SPONSOR_DIVISION
Brigade	[Type in text entry]		SPONSOR_BRIGADE
Battalion	[Type in text entry]		SPONSOR_BATTALLION
Company	[Type in text entry]		SPONSOR_COMPANY
UIC (Unit Identification Code)	[Type in text entry]		SPONSOR_UIC
Permanent Duty Station/Installation	[Type in text entry]		SPONSOR_LOC_STATION
City	[Type in text entry]		SPONSOR_LOC_CITY
State	[Type in text entry]		SPONSOR_LOC_STATE
Country	[Type in text entry]		SPONSOR_LOC_COUNTRY
Length of time in unit	[Type in years]		SPONSOR_TIME_UNIT_YEARS
	[Type in months]		SPONSOR_TIME_UNIT_MONTHS
	Check if unknown		SPONSOR_TIME_UNIT_UNKNOWN
Duty environment/status at time of event (check all that apply)	Garrison	1 = Selected	EVENT_ENV_GARRISON
	Leave		EVENT_ENV_LEAVE
	TDY		EVENT_ENV_TDY
	AWOL		EVENT_ENV_AWOL
	Deployed		EVENT_ENV_DEPLOYED
	Training		EVENT_ENV_TRAINING
	Psychiatric hospitalization		EVENT_ENV_PSYCH
	Medical hold		EVENT_ENV_MEDICAL_HOLD
	In evacuation chain		EVENT_ENV_EVACUATION
	Under command observation (e.g. CIP)		EVENT_ENV_COMMAND_OBS
	Other		EVENT_ENV_OTH
Section IV - Combat				1
Did the patient/decedent recently…
…experience direct combat operations?	Yes	1	HIST_COMBAT_Y	1
	No	2	HIST_COMBAT_N	2
	Don't Know	101	HIST_COMBAT_X	3
…have a close friend or unit member killed or seriously	Yes	1	HIST_COMBAT_FRIEND_Y	4
wounded in combat operations?	No	2	HIST_COMBAT_FRIEND_N	2
	Don't Know	101	HIST_COMBAT_FRIEND_X	101
…witness others (civilians, enemy combatants, unknown	Yes	1	HIST_COMBAT_WITNESS_Y
soldiers) killed or seriously wounded while participating	No	2	HIST_COMBAT_WITNESS_N
in combat operations?	Don't Know	101	HIST_COMBAT_WITNESS_X
Section V - Use of Medical and Helping Services Prior to the Event
In the past year was the patient/decedent seen by…
…Medical Treatment Facility	Yes, within 30 days before event	1	HIST_MTF_YM
	Yes, 31-365 days before event	2	HIST_MTF_YY
	No	2	HIST_MTF_N
	Don't Know	101	HIST_MTF_X
…Substance Abuse Services	Yes, within 30 days before event	1	HIST_SAS_YM
	Yes, 31-365 days before event	2	HIST_SAS_YY
	No	2	HIST_SAS_N
	Don't Know	101	HIST_SAS_X
…Family Advocacy Program	Yes, within 30 days before event	1	HIST_FAP_YM
	Yes, 31-365 days before event	2	HIST_FAP_YY
	No	2	HIST_FAP_N
	Don't Know	101	HIST_FAP_X
…Out-Patient Mental Health (including deployment	Yes, within 30 days before event	1	HIST_OUTMH_YM
mental health services)	Yes, 31-365 days before event	2	HIST_OUTMH_YY
	No	2	HIST_OUTMH_N
	Don't Know	101	HIST_OUTMH_X
…In-Patient Mental Health	Yes, within 30 days before event	1	HIST_INMH_YM
	Yes, 31-365 days before event	2	HIST_INMH_YY
	No	2	HIST_INMH_N
	Don't Know	101	HIST_INMH_X
Section VI - Risk Factors
Had the patient/decedent…
…been diagnosed with any Mood Disorder?	Yes	1	RISK_MOOD_Y
	No	2	RISK_MOOD_N
	Don't Know	101	RISK_MOOD_X
…-- If yes, is there a pending, related …	MEB		RISK_MOOD_MEB
	Admin separation		RISK_MOOD_ADMIN
…been diagnosed with Bipolar Disorder?	Yes	1	RISK_BIPOLAR_Y
	No	2	RISK_BIPOLAR_N
	Don't Know	101	RISK_BIPOLAR_X
…-- If yes, is there a pending, related …	MEB		RISK_BIPOLAR_MEB
	Admin separation		RISK_BIPOLAR_ADMIN
…been diagnosed with Major Depression?	Yes	1	RISK_MAJDEP_Y
	No	2	RISK_MAJDEP_N
	Don't Know	101	RISK_MAJDEP_X
…-- If yes, is there a pending, related …	MEB		RISK_MAJDEP_MEB
	Admin separation		RISK_MAJDEP_ADMIN
… been diagnosed with Psychotic Disorder?	Yes	1	RISK_PSYCHOTIC_Y
	No	2	RISK_PSYCHOTIC_N
	Don't Know	101	RISK_PSYCHOTIC_X
…-- If yes, is there a pending, related …	MEB		RISK_PSYCHOTIC_MEB
	Admin separation		RISK_PSYCHOTIC_ADMIN
… been diagnosed with PTSD?	Yes	1	RISK_PTSD_Y
	No	2	RISK_PTSD_N
	Don't Know	101	RISK_PTSD_X
…-- If yes, is there a pending, related …	MEB		RISK_PTSD_MEB
	Admin separation		RISK_PTSD_ADMIN
… been diagnosed with Anxiety Disorder?	Yes	1	RISK_ANXIETY_Y
	No	2	RISK_ANXIETY_N
	Don't Know	101	RISK_ANXIETY_X
…-- If yes, is there a pending, related …	MEB		RISK_ANXIETY_MEB
	Admin separation		RISK_ANXIETY_ADMIN
… been diagnosed with Personality Disorder?	Yes	1	RISK_PERSONALITY_Y
	No	2	RISK_PERSONALITY_N
	Don't Know	101	RISK_PERSONALITY_X
…-- If yes, is there a pending, related …	MEB		RISK_PERSONALITY_MEB
	Admin separation		RISK_PERSONALITY_ADMIN
… had a history with Substance Abuse?	Yes	1	RISK_SUBST_Y
	No	2	RISK_SUBST_N
	Don't Know	101	RISK_SUBST_X
…-- If yes, select all that apply		1 = Selected
Alcohol	Dependence		RISK_SUBST_ALC_DEP
	Abuse		RISK_SUBST_ALC_AB
Drugs	Dependence		RISK_SUBST_DRG_DEP
	Abuse		RISK_SUBST_DRG_AB
Medications, prescribed	Dependence		RISK_SUBST_PRE_DEP
	Abuse		RISK_SUBST_PRE_AB
Medications, not prescribed (e.g. OTC medication)	Dependence		RISK_SUBST_OTC_DEP
	Abuse		RISK_SUBST_OTC_AB
… been taking psychotropic medications?	Yes	1	RISK_PSYCHOTROPIC_Y
	No	2	RISK_PSYCHOTROPIC_N
	Don't Know	101	RISK_PSYCHOTROPIC_X
… had a family history of mental illness or suicide?	Yes	1	RISK_FAMILY_Y
	No	2	RISK_FAMILY_N
	Don't Know	101	RISK_FAMILY_X
… had prior self-injurious events?	Yes	1	RISK_SELFINJ_Y
	No	2	RISK_SELFINJ_N
	Don't Know	101	RISK_SELFINJ_X
...-- If yes,	One prior event		RISK_SELFINJ_NUM_ONE
	More than one prior event		RISK_SELFINJ_NUM_MORE
…-- Was this event similar to prior event(s)?	Yes	1	RISK_SELFINJ_SIMILAR_Y
	No	2	RISK_SELFINJ_SIMILAR_N
	Don't Know	101	RISK_SELFINJ_SIMILAR_X
Was there a gun in the home or immediate environment?	Yes	1	RISK_GUN_Y
	No	2	RISK_GUN_N
	Don't Know	101	RISK_GUN_X
Section VII - Relationships
Was the patient/decedent involved in a failed/failing	Yes	1	HIST_RELATION_Y
intimate relationship?	No	2	HIST_RELATION_N
	Don't Know	101	HIST_RELATION_X
Was there a recent spousal or family death?	Yes	1	HIST_FAMDEATH_Y
	No	2	HIST_FAMDEATH_N
	Don't Know	101	HIST_FAMDEATH_X
Is there an ongoing spousal or family severe illness?	Yes	1	HIST_FAMILLNESS_Y
	No	2	HIST_FAMILLNESS_N
	Don't Know	101	HIST_FAMILLNESS_X
Section VIII - Motivation
What was the patient/decedent's primary motivation for	A wish to escape from mental or physical pain	1	EVENT_MOTIVATION_ESC
committing suicide? (as judged by the clinician)	A fantasy of eternal rest or life with a loved one	2	EVENT_MOTIVATION_RST
	Anger, rage, revenge	3	EVENT_MOTIVATION_ANG
	Guilt, shame, atonement	4	EVENT_MOTIVATION_SHM
	A wish to be rescued, reborn, start over	5	EVENT_MOTIVATION_RES
	A wish to make an important statement or communication	6	EVENT_MOTIVATION_COM
	Other	100	EVENT_MOTIVATION_OTH
	Don't Know	101	EVENT_MOTIVATION_X
Section IX - Abuse and Trauma History
Was the patient/decedent a recent victim of…
… physical, sexual, or emotional abuse/assault (e.g. FAP)?	Yes	1	HIST_PHYSABUSE_Y
	No	2	HIST_PHYSABUSE_N
	Don't Know	101	HIST_PHYSABUSE_X
… sexual harassment?	Yes	1	HIST_SEXABUSE_Y
	No	2	HIST_SEXABUSE_N
	Don't Know	101	HIST_SEXABUSE_X
Section X - Military, Legal, and Administrative History
Was the patient/decedent an alleged or confirmed
perpetrator of recent…
… physical, sexual, emotional, or verbal abuse (e.g. FAP)?	Yes	1	HIST_EMOTABUSE_Y
	No	2	HIST_EMOTABUSE_N
	Don't Know	101	HIST_EMOTABUSE_X
… sexual harassment?	Yes	1	HIST_SEXHARASS_Y
	No	2	HIST_SEXHARASS_N
	Don't Know	101	HIST_SEXHARASS_X
Was the patient/decedent recently involved in…
… Courts Martial proceedings?	Yes	1	HIST_COURTSMARTIAL_Y
	No	2	HIST_COURTSMARTIAL_N
	Don't Know	101	HIST_COURTSMARTIAL_X
… Article 15 proceedings?	Yes	1	HIST_ARTICLE15_Y
	No	2	HIST_ARTICLE15_N
	Don't Know	101	HIST_ARTICLE15_X
… Administrative Separation proceedings?	Yes	1	HIST_ADMINSEP_Y
	No	2	HIST_ADMINSEP_N
	Don't Know	101	HIST_ADMINSEP_X
… AWOL or dessertion proceedings?	Yes	1	HIST_AWOL_Y
	No	2	HIST_AWOL_N
	Don't Know	101	HIST_AWOL_X
… Non-selection for advanced schooling/promotion/command?	Yes	1	HIST_NONSELECT_Y
	No	2	HIST_NONSELECT_N
	Don't Know	101	HIST_NONSELECT_X
Section XI - Work Problems
Did the patient/decedent…
… experience work dissatisfaction	Yes	1	HIST_WORK_Y
	No	2	HIST_WORK_N
	Don't Know	101	HIST_WORK_X
… have supervisor/coworker issues/problems?	Yes	1	HIST_SUPER_Y
	No	2	HIST_SUPER_N
	Don't Know	101	HIST_SUPER_X
… have a poor work performance review or evaluation?	Yes	1	HIST_PERFORM_Y
(e.g. bar for reenlistment, flagged record, extra duty	No	2	HIST_PERFORM_N
imposed)	Don't Know	101	HIST_PERFORM_X
… experience recent unit or workplace hazing?	Yes	1	HIST_HAZING_Y
	No	2	HIST_HAZING_N
	Don't Know	101	HIST_HAZING_X
… have any other experiences at work which may have	Yes		HIST_WORK_OTH_Y
led to the event?	No		HIST_WORK_OTH_N
	Don't Know
-- If yes, what other experiences?	[Type in text entry]		HIST_WORK_OTH_X
Section XII - Financial Problems
Did the patient/decedent…
… have excessive debt?	Yes	1	HIST_DEBT_Y
	No	2	HIST_DEBT_N
	Don't Know	101	HIST_DEBT_X
… experience bankruptcy?	Yes	1	HIST_BANKRUPT_Y
	No	2	HIST_BANKRUPT_N
	Don't Know	101	HIST_BANKRUPT_X
Section XIII - Completing Behavioral Health Provider's Information
Name	[Type in text entry]		ASER_PROVIDER_NAME
Phone number	[Type in text entry]		ASER_PROVIDER_PHONE
Phone number (DSN)	[Type in text entry]		ASER_PROVIDER_DSN
Email	[Type in text entry]		ASER_PROVIDER_EMAIL
Comments	[Type in text entry]
Section XIV - Narrative Summary
Sequence of events culminating in the suicide behavior	[Type in text entry]		SUM_CIRC
(Describe the details of the antecedent circumstances that
led to the suicide attempt/completion)
Why did this patient/decedent choose to injure or kill	[Type in text entry]		SUM_BPS
him/herself? (Provide a brief "bio-psycho-social" formulation
as to WHY this patient committed the suicide attempt/completion)
Risk management analysis (Any BH clinical involvement -	[Type in text entry]		SUM_RISK
elaborate on any issue of concern. Also elaborate on unit
actions that may have contributed)
									Changed by Debi on 2 Sep 10. Previously this file listed Afghanistan as 1 and Iraq as 2, but the data is going into the database as shown here.

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Sheet 2: ASER 2005 -2006

ASER CY 2005 and 2006
Yellow highlight indicates items that were added or modified from previous version.
Event reports initiated during previous CY and submited during current CY will include current CY questions and variables
Question	Answer Choices	Data Values	Variable Labels
Section I - Event Information
Event Date	[Type in date entry]		EVENT_DATE
Event Time	[Type in time entry]		EVENT_TIME
Geographic location of event
-- Country	[Type in text entry]		EVENT_LOCATION_COUNTRY
-- State (or equivalent)	[Type in text entry]		EVENT_LOCATION_STATE
-- City, post or camp	[Type in text entry]		EVENT_LOCATION_CITY
Event Setting	Residence (own)	1	EVENT_SETTING
	Residence of friend or family	2
	Work/jobsite	3
	Automobile (away from residence)	4
	Inpatient medical facility	5
	Other	100
Type of Event	Completed suicide	1 = Selected	EVENT_TYPE_COMPLETED
	Hospitalization (inpatient)		EVENT_TYPE_HOSPITALIZED
	Evacuation		EVENT_TYPE_EVACUATED
	Other		EVENT_TYPE_OTHER
-- If hospitalized, what types of	Military Treatment Facility	1	EVENT_HOSP_MTF
facilities were involved? (check	Civilian facility	2	EVENT_HOSP_CIV
all that apply)	VA hospital	3	EVENT_HOSP_VA
	Don't Know	101	EVENT_HOSP_X
-- List the facility name(s)	[Type in text entry]		EVENT_HOSP_NAMES
-- Start date of hospitalization?	[Type in date entry]		EVENT_HOSP_START_DATE
	Check if unknown	1 = Selected	EVENT_HOSP_START_UNKNOWN
-- End date of hospitalization?	[Type in date entry]		EVENT_HOSP_END_DATE
	Check if unknown	1 = Selected	EVENT_HOSP_END_UNKNOWN
	Check if patient is still in the inpatient facility	1 = Selected	EVENT_HOSP_END_STILL
Primary method used	Overdose (medication, drugs, or alcohol)	1	EVENT_METHOD
	Poisoning by solid or liquid substance (not medication)	2
	Poisoning by vehicle exhaust	3
	Poisoning by utility gas	4
	Firearm/gun, military issue or duty weapon	5
	Firearm/gun, other than military issue	6
	Jumping from high place	7
	Motor vehicle crash	8
	Hanging, strangulation, or suffocation	9
	Cutting or piercing instrument	10
	Submersion/drowning	11
	Other	100
	Don't Know	101
During the event, was alcohol used?	Yes	1	EVENT_ALCOHOL
	No	2
	Don't Know	101
During the event, were drugs used?	Yes	1	EVENT_DRUGS
	No	2
	Don't Know	101
-- If yes, what types of drugs were used?
-- Drugs (illicit/illegal)	Overdose	1	EVENT_DRUGS_ILLEGAL
	Used, no overdose	2
	Were not used	3
-- Prescripton medications	Overdose	1	EVENT_DRUGS_PRESCRIPTION
	Used, no overdose	2
	Were not used	3
-- Non-prescriptioln medications	Overdose	1	EVENT_DRUGS_OTC
(e.g. over-the-counter medication)	Used, no overdose	2
	Were not used	3
Is there evidence that the patient/decedent intended to die?	Yes	1	EVENT_INTENT_DIE
	No	2
	Don't Know	101
Was the method used (and quantity, if appropriate) one	Yes	1	EVENT_METHOD_LETHAL
that is typically lethal?	No	2
	Don't Know	101
Is there evidence the event involved death-risk gambling?	Yes	1	EVENT_DEATH_RISK_GAMBLING
(e.g. Russian roulette, walking railroad tracks, playing	No	2
"chicken")	Don't Know	101
Is there evidence that the event was planned and/or	Yes	1	EVENT_PLANNED
premeditated?	No	2
	Don't Know	101
Was the event performed under circumstances where it	Yes	1	EVENT_OBSERVABLE
would likely be observed and intervened in by others?	No	2
	Don't Know	101
Was a suicide note left?	Yes	1	EVENT_SUICIDE_NOTE
	No	2
	Don't Know	101
Prior to the event, did the patient/decedent communicate	Yes	1	EVENT_COMMUNICATE
potential for self-harm?	No	2
	Don't Know	101
-- If yes, how? (check all that apply)	Written	1 = Selected	EVENT_COMMUNICATE_HOW_WRITTEN
	Verbal		EVENT_COMMUNICATE_HOW_VERBAL
	Other		EVENT_COMMUNICATE_HOW_OTHER
-- To whom?	Supervisor		EVENT_COMMUNICATE_WHO_SUPER
	Chaplain		EVENT_COMMUNICATE_WHO_CHAP
	Mental health staff		EVENT_COMMUNICATE_WHO_MHSTAFF
	Friend		EVENT_COMMUNICATE_WHO_FRIEND
	Spouse or significant other		EVENT_COMMUNICATE_WHO_SPOUSE
	Other		EVENT_COMMUNICATE_WHO_OTHER
What was the patient/decedent's primary motivation	Emotion relief (e.g. to stop bad feelings, self hatred, anxiety relief)	1	EVENT_MOTIVATION
for performing this event? (select only one)	Interpersonal influence (e.g. to get help, get attention, shock others)	2
	Feeling generation (e.g. to stop feeling numb)	3
	Avoidance/escape (e.g. to avoid or escape deployment, prevent being hurt in others ways)	4
	Individual reasons (e.g. self-punishment, to express anger, be with deceased loved one)	5
	Hopelessness (e.g. pessimistic regarding future)	6
	Depression (e.g. chronic or severe clinically depressed mood)	7
	Other psychiatric symptoms (e.g. PTSD, psychotic)	8
	Impulsivity (e.g. due to substance abuse, personality characteristics)	9
	Other	100
	Don't Know	101
Duty environment/status at time of event (check all that apply)	Garrison	1 = Selected	EVENT_DUTY_ENV_GARRISON
	Leave		EVENT_DUTY_ENV_LEAVE
	TDY/TAD		EVENT_DUTY_ENV_TDY
	AWOL		EVENT_DUTY_ENV_AWOL
	Deployed		EVENT_DUTY_ENV_DEPLOYED
	Training		EVENT_DUTY_ENV_TRAINING
	Psychiatric hospitalization		EVENT_DUTY_ENV_PSYCH
	Medical hold		EVENT_DUTY_ENV_MEDICAL_HOLD
	In evacuation chain		EVENT_DUTY_ENV_EVACUATION
	Under command observation (e.g. CIP)		EVENT_DUTY_ENV_COMMAND_OBS
	Other		EVENT_DUTY_ENV_OTHER
Was the event related to a deployment?	Yes	1	EVENT_RELATED_DEPLOYMENT
	No	2
	Don't Know	101
-- If yes, what type of deployment(s)? (check all that apply)	Anticipated deployment	1 = Selected	EVENT_RELATED_DEPLOYMENT_ANT
	Current deployment		EVENT_RELATED_DEPLOYMENT_CUR
	Prior deployment		EVENT_RELATED_DEPLOYMENT_PRI
Section II - Patient/Decedent Personal Information
Social Security Number	[Type in text entry]		PAT_SSN
Date of Birth	[Type in date entry]		PAT_DOB
Sex	Male	1	PAT_SEX
	Female	2
	Don't Know	101
Relationship to sponsor	Sponsor	1	PAT_SPONSOR_RELATION
	Spouse	2
	Child	3
	Other	101
Racial category (check only one)	Asian/Pacific Islander	2	PAT_RACE
	Black/African American	3
	American Indian/Alaskan Native	1
	White/Caucasian	4
	Other	100
	Don't Know	101
Specific ethnic group (check only one)	Hispanic		PAT_ETHNIC
	-- Mexican	11
	-- Puerto Rican	12
	-- Cuban	13
	-- Latin American	14
	-- Other Spanish	15
	Native American
	-- Aleut	21
	-- Eskima	22
	-- U.S./Canadian Indian Tribes	23
	Asian
	-- Chinese	31
	-- Japanese	32
	-- Korean	33
	-- Indian	34
	-- Filipino	35
	-- Vietnamese	36
	-- Other Asian	37
	Pacific Islander
	-- Melanesian	41
	-- Polynesian	42
	-- Other Pacific Islands	43
	Other	100
	Don't Know	101
Marital status (check only one)	Never married	1	PAT_MARITAL
	Married	2
	Legally separated	3
	Divorced	4
	Widowed	5
	Don't Know	101
-- If married,	Resides with spouse	1	PAT_MARITAL_RESIDE
	Separated due to relationship issues	2
	Separated for reasons other than relationship (e.g. deployed)	3
	Don't Know	101
Education	Some high school, did not graduate	1	PAT_EDUCATION
	GED	2
	High school graduate	3
	Some college or technical school, no degree or certificate	4
	College degree of less than four years or technical school certificate	5
	Four-year college degree	6
	Master's degree or greater	7
	Don't Know	101
Residence at the time of event	Barracks, tents, or other shared military living environment	1	PAT_RESIDENCE
	Non-military shared living environment	2
	BEQ or BOQ	3
	On-post family housing	4
	Off-post family housing	5
	Other	100
	Don't Know	101
Did the patient/decedent reside alone at the time of the event?	Yes	1	PAT_RESIDE_ALONE
	No	2
	Don't Know	101
Did the patient/decedent have minor children?	Yes	1	PAT_CHILDREN
	No	2
	Don't Know	101
-- If yes, were the children residing with him/her?	Yes	1	PAT_CHILDREN_RESIDE_WITH
	No	2
	Don't Know	101
Section III - Sponsor's Military Information
Service	Army	1	SPONSOR_SERVICE
	Navy	2
	Air Force	3
	Marines	4
	Coast Guard	5
	Foreign military	6
	Other uniformed service	7
	Other	100
Component/Military status	Regular (e.g. Army, Air Force)	1	SPONSOR_COMPONENT
	Reserve (e.g. USAR, USMCR)	2
	National Guard	3
	Other	100
Job code (MOS, SSI, AFSC, DAFSC, or other military job code)	[Type in text entry]		SPONSOR_JOB_CODE
Duty status	Active Duty	1 = Selected	SPONSOR_DUTY_STATUS_ACTIVE
	AGR (Active Guard/Reserve)		SPONSOR_DUTY_STATUS_AGR
	IET (Basic and Advanced Individual Training)		SPONSOR_DUTY_STATUS_IET
	Mobilized RC (Reserve and National Guard)		SPONSOR_DUTY_STATUS_MOBILIZED
	ADT (Active Duty for Training)		SPONSOR_DUTY_STATUS_ADT
	IDT (Weekend Reserve Drill)		SPONSOR_DUTY_STATUS_IDT
	Retired		SPONSOR_DUTY_STATUS_RETIRED
	Released from active duty within 120 days		SPONSOR_DUTY_STATUS_RELEASED
	Other		SPONSOR_DUTY_STATUS_OTHER
	Does not apply		SPONSOR_DUTY_STATUS_NA
Pay grade	[E1-E9; W1-W5; O1-O10; Cadet/Midshipman]	[Codes delineated below]	SPONSOR_GRADE
	Does not apply	102
Permanent duty station/command location	Same as geographic event location	1	SPONSOR_DUTY_STATION_SAME
	Other location	2
-- If other location,
Country	[Type in text entry]		SPONSOR_DUTY_STATION_COUNTRY
State (or equivalent)	[Type in text entry]		SPONSOR_DUTY_STATION_STATE
City, post, or camp	[Type in text entry]		SPONSOR_DUTY_STATION_CITY
Permanent duty assignment
-- Division	[Type in text entry]		SPONSOR_DUTY_ASSIGN_DIVISION
-- Brigade	[Type in text entry]		SPONSOR_DUTY_ASSIGN_BRIGADE
-- Battalion	[Type in text entry]		SPONSOR_DUTY_ASSIGN_BATTALION
-- Company	[Type in text entry]		SPONSOR_DUTY_ASSIGN_COMPANY
UIC or other unit identification	[Type in text entry]		SPONSOR_UIC
Length of time in unit	[Type in years]		SPONSOR_TIME_UNIT_YEARS
	[Type in months]		SPONSOR_TIME_UNIT_MONTHS
	Check in unknown		SPONSOR_TIME_UNIT_UNKNOWN
		1 = Selected
Section IV - History
Was the patient/decedent seen by…
… a Medical Treatment Facility?	Yes	1	HIST_MTF
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_MTF_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Substance Abuse Services?	Yes	1	HIST_SAS
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_SAS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a Family Advocacy Program?	Yes	1
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_FAP
	---- Within 30 days	1	HIST_FAP_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Chaplain services?	Yes	1	HIST_CHAPLAIN
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_CHAPLAIN_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Outpatient Mental Health? (including deployment mental	Yes	1	HIST_OUTPATIENT_MH
health services)	-- If yes, how long prior to event? (select most recent occurrence)		HIST_OUTPATIENT_MH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Inpatient Mental Health?	Yes	1	HIST_INPATIENT_MH
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_INPATIENT_MH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Had the patient/decedent…
… been diagnosed with any Mood Disorder?	Yes	1	HIST_MOOD
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_MOOD_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with a Bipolar Disorder?	Yes	1	HIST_BIPOLAR
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_BIPOLAR_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with Major Depression?	Yes	1	HIST_MAJOR_DEPRESSION
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_MAJOR_DEPRESSION_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with a Psychotic Disorder?	Yes	1	HIST_PSYCHOTIC
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PSYCHOTIC_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with PTSD?	Yes	1	HIST_PTSD
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PTSD_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with an Anxiety Disorder?	Yes	1	HIST_ANXIETY
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_ANXIETY_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with a Personality Disorder?	Yes	1	HIST_PERSONALITY
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PERSONALITY_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… had a history of Substance Abuse?	Yes	1	HIST_SUBSTANCE_ABUSE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_SUBSTANCE_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…-- If yes, select all that apply
…---- Alcohol	Dependence	1 = Selected	HIST_SUBSTANCE_ALCOHOL_DEP
	Abuse		HIST_SUBSTANCE_ALCOHOL_ABUSE
…---- Drugs (illicit/illegal)	Dependence		HIST_SUBSTANCE_DRUGS_DEP
	Abuse		HIST_SUBSTANCE_DRUGS_ABUSE
…---- Prescription medications	Dependence		HIST_SUBSTANCE_PRESCRIP_DEP
	Abuse		HIST_SUBSTANCE_PRESCRIP_ABUSE
…---- Non-prescription medications (e.g. over-the-counter	Dependence		HIST_SUBSTANCE_OTC_DEP
medication)	Abuse		HIST_SUBSTANCE_OTC_ABUSE
… taken psychotropic medications?	Yes	1	HIST_PSYCHOTROPIC_MEDS
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PSYCHOTROPIC_MEDS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… had prior self-injurious events?	Yes	1	HIST_PRIOR_SELF_INJURY
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PRIOR_SELF_INJURY_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…-- If yes, how many prior event?	One prior event	1	HIST_PRIOR_SELF_INJURY_ONE
	More than one prior event	2
…-- Was this event similar to prior event(s)?	Yes	1	HIST_PRIOR_SELF_INJURY_SIM
	No	2
	Don't Know	101
…-- Age at first self-injurious event	[Type in text entry]		HIST_PRIOR_SELF_INJURY_AGE
Was the patient/decedent the subject of…
… Courts Martial proceedings?	-- If yes, how long prior to event? (select most recent occurrence)		HIST_COURTSMARTIAL
	---- Within 30 days	1	HIST_COURTSMARTIAL_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Article 15 proceedings or civilian criminal problems?	Yes	1	HIST_ARTICLE15
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_ARTICLE15_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Administrative Separation proceedings?	Yes	1	HIST_ADMIN_SEPARATION
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_ADMIN_SEPARATION_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… AWOL or desertion proceedings?	Yes	1	HIST_AWOL
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_AWOL_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a Medical Evaluation Board?	Yes	1	HIST_MEDICAL_BOARD
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_MEDICAL_BOARD_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… civil legal problems (e.g. child custody dispute, litigation)	Yes	1	HIST_CIVIL_LEGAL
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_CIVIL_LEGAL_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… non-selection for advanced schooling, promotion or command?	Yes	1	HIST_NON_SELECTION
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_NON_SELECTION_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Was the patient/decedent an alleged or confirmed
VICTOM of…
… physical abuse or assault?	Yes	1	HIST_VICT_PHYS_ABUSE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_VICT_PHYS_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual abuse or assault?	Yes	1	HIST_VICT_SEXUAL_ABUSE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_VICT_SEXUAL_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… emotional abuse or assault?	Yes	1	HIST_VICT_EMOT_ABUSE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_VICT_EMOT_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual harassment?	Yes	1	HIST_VICT_SEX_HARASS
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_VICT_SEX_HARASS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Was the patient/decedent an alleged or confirmed
PERPETRATOR of…
… physical abuse or assault?	Yes	1	HIST_PERP_PHYS_ABUSE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PERP_PHYS_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual abuse or assault?	Yes	1	HIST_PERP_SEXUAL_ABUSE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PERP_SEXUAL_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… emotional abuse or assault?	Yes	1	HIST_PERP_EMOT_ABUSE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PERP_EMOT_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual harassment?	Yes	1	HIST_PERP_SEX_HARASS
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PERP_SEX_HARASS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
List the three most recent deployments, if any, including
current deployments
Deployment location 1	Afghanistan	1	HIST_DEPLOY1_LOC
	Iraq	2
	Kuwait	3
	Korea	4
	Kosovo	5
	Other Europe	6
	North America	7
	Central or South America	8
	Other	100
Deployment start date	[Type in date entry]		HIST_DEPLOY1_START_DATE
Deployment end date (or expected end date)	[Type in date entry]		HIST_DEPLOY1_END_DATE
Deployment location 2	Afghanistan	1	HIST_DEPLOY2_LOC
	Iraq	2
	Kuwait	3
	Korea	4
	Kosovo	5
	Other Europe	6
	North America	7
	Central or South America	8
	Other	100
Deployment start date	[Type in date entry]		HIST_DEPLOY2_START_DATE
Deployment end date (or expected end date)	[Type in date entry]		HIST_DEPLOY2_END_DATE
Deployment location 3	Afghanistan	1	HIST_DEPLOY3_LOC
	Iraq	2
	Kuwait	3
	Korea	4
	Kosovo	5
	Other Europe	6
	North America	7
	Central or South America	8
	Other	100
Deployment start date	[Type in date entry]		HIST_DEPLOY3_START_DATE
Deployment end date (or expected end date)	[Type in date entry]		HIST_DEPLOY3_END_DATE
Did the patient/decedent experience direct combat operations?	Yes	1	HIST_DIRECT_COMBAT
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_DIRECT_COMBAT_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
-- If yes, did the patient/decedent…
… and his/her unit engage in battle resulting in casualties/wounded?	Yes	1	HIST_COMBAT_CASUALTIES
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_COMBAT_CASUALTIES_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… become wounded or injured in combat?	Yes	1	HIST_COMBAT_INJURED
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_COMBAT_INJURED_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… personally witness a unit member, ally, enemy, or civilian	Yes	1	HIST_COMBAT_WITNESS
being seriously wounded or killed?	-- If yes, how long prior to event? (select most recent occurrence)		HIST_COMBAT_WITNESS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… see the bodies of dead soldiers or civilians following battle?	Yes	1	HIST_COMBAT_SAW_BODIES
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_COMBAT_SAW_BODIES_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… kill others in combat (or have reason to believe others were	Yes	1	HIST_COMBAT_KILL
killed as a result of actions)?	-- If yes, how long prior to event? (select most recent occurrence)		HIST_COMBAT_KILL_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Was there evidence of…
… a failed or failing spousal or intimate partner relationship?	Yes	1	HIST_FAILED_REL_SPOUSE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_FAILED_REL_SPOUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a failed or failing other relationship?	Yes	1	HIST_FAILED_REL_OTHER
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_FAILED_REL_OTHER_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a completed spousal suicide?	Yes	1	HIST_SPOUSE_SUICIDE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_SPOUSE_SUICIDE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a completed family member suicide?	Yes	1	HIST_FAMILY_SUICIDE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_FAMILY_SUICIDE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a completed suicide by a friend?	Yes	1	HIST_FRIEND_SUICIDE
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_FRIEND_SUICIDE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a death of spouse or family member? (other than suicide)	Yes	1	HIST_FAMILY_DEATH
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_FAMILY_DEATH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a death of a friend? (other than suicide)	Yes	1	HIST_FRIEND_DEATH
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_FRIEND_DEATH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a physical health problem?	Yes	1	HIST_PHYSICAL_HEALTH
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_PHYSICAL_HEALTH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a chronic spousal or family severe illness?	Yes	1	HIST_FAMILY_ILLNESS
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_FAMILY_ILLNESS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… excessive debt or bankruptcy?	Yes	1	HIST_DEBT_BANKRUPTCY
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_DEBT_BANKRUPTCY_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… job problems? (e.g. laid off, fired, excessive pressure)	Yes	1	HIST_JOB_PROBLEMS
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_JOB_PROBLEMS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… supervisor or coworker issues or problems?	Yes	1	HIST_COWORKER_ISSUES
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_COWORKER_ISSUES_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a poor work performance review or evaluation? (e.g. bar for	Yes	1	HIST_POOR_PERFORMANCE
reenlistment, flagged record, extra duty imposed)	-- If yes, how long prior to event? (select most recent occurrence)		HIST_POOR_PERFORMANCE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… unit or workplace hazing?	Yes	1	HIST_WORKPLACE_HAZING
	-- If yes, how long prior to event? (select most recent occurrence)		HIST_WORKPLACE_HAZING_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Did the patient/decedent have a family history of mental illness	Yes	1	HIST_FAMILY_MENTAL
or suicide?	no	2
	Don't Know	101
Was there a gun in the home or immediate environment?	Yes	1	HIST_GUN_IN_HOME
	no	2
	Don't Know	101
Section V - Narrative Summary
Describe any details of the circumstances that led to the	[Type in text entry]		SUM_CIRCUMSTANCES
suicide attempt/completion that have not already been captured
by this form.
Provide a brief "bio-psycho-social" formulation as to WHY	[Type in text entry]		SUM_BIO_PSYCHO_SOCIAL
this patient/decedent engaged in suicidal behavior. (Optional)
Identify any additional risk management issues	[Type in text entry]		SUM_RISK_MANAGEMENT
associated with this case.
Section VI - ASER Completion Information
Today's date	[Auto-filled]		ASER_TODAYS_DATE
Location where this ASER was completed	Same as geographic event location	1	ASER_LOCATION_SAME
	Other location	2	ASER_LOCATION_OTHER
-- If other location,
Country	[Type in text entry]		ASER_LOCATION_COUNTRY
State (or equivalent)	[Type in text entry]		ASER_LOCATION_STATE
City, post, or camp	[Type in text entry]		ASER_LOCATION_CITY
Medical facility where this ASER was completed or	[Type in text entry]		ASER_FACILITY
support MTF (use standard acronym, e.g. WRAMC)
Behavioral Health provider
-- Name	[Type in text entry]		ASER_PROVIDER_NAME
-- Rank/grade	[Type in text entry]		ASER_PROVIDER_RANK
-- SSN	[Type in text entry]		ASER_PROVIDER_SSN
-- Phone number	[Type in text entry]		ASER_PROVIDER_PHONE
-- DSN prefix	[Type in text entry]		ASER_PROVIDER_DSN
-- Email	[Type in text entry]		ASER_PROVIDER_EMAIL
-- Specialty	Psychologist	1	ASER_PROVIDER_SPECIALTY
	Psychiatrist	2
	Social Worker	3
	Psychiatric Nurse	4
	Licensed Mental Health Counselor or equivalent	5
	Other	100
Form completer, if not Behavioral Health provider
-- Name	[Type in text entry]		ASER_COMPLETER_NAME
-- Rank/grade	[Type in text entry]		ASER_COMPLETER_RANK
-- SSN	[Type in text entry]		ASER_COMPLETER_SSN
-- Phone number	[Type in text entry]		ASER_COMPLETER_PHONE
-- DSN prefix	[Type in text entry]		ASER_COMPLETER_DSN
-- Email	[Type in text entry]		ASER_COMPLETER_EMAIL
Comments	[Type in text entry]		ASER_COMMENTS
		[Pay Grade Codes]
		11 = E1
		12 = E2
		13 = E3
		14 = E4
		15 = E5
		16 = E6
		17 = E7
		18 = E8
		19 = E9
		21 = W1
		22 = W2
		23 = W3
		24 = W4
		25 = W5
		31 = O1
		32 = O2
		33 = O3
		34 = O4
		35 = O5
		36 = O6
		37 = O7
		38 = O8
		39 = O9
		40 = O10
		50 = Cadet/Midshipman

---

Sheet 3: ASER 2007

ASER CY 2007
Yellow highlight indicates items that were added or modified from previous version.
Event reports initiated during previous CY and submited during current CY will include current CY questions and variables
Question	Answer Choices	Data Values	Variable Labels
Section I - Patient
Last Name	[type in text entry]		PAT_LAST_NAME
First Name	[type in text entry]		PAT_FIRST_NAME
Middle Initial	[type in text entry]		PAT_MIDDLE_INITIAL
Social Security Number	[type in text entry]		PAT_SSN
Date of Birth	[Calendar pop-up]		PAT_DOB
Sex	Male	1	PAT_SEX
	Female	2
	Don't Know	101
Relationship to sponsor	Sponsor	1	PAT_SPONSOR_RELATION
	Spouse	2
	Dependent	3
	Other	100
Racial category	American Indian/Alaskan Native	1	PAT_RACE
	Asian/Pacific Islander	2
	Black/African American	3
	White/Caucasian	4
	Other	100
	Don't Know	101
Specific ethnic group	Hispanic		PAT_ETHNIC
	-- Mexican	11
	-- Puerto Rican	12
	-- Cuban	13
	-- Latin American	14
	-- Other Spanish	15
	Native American
	-- Aleut	21
	-- Eskimo	22
	-- U.S./Canadian Indian Tribes	23
	Asian/Pacific Islander
	--Chinese	31
	-- Japanese	32
	-- Korean	33
	-- Indian	34
	-- Filipino	35
	-- Vietnamese	36
	-- Other Asian	37
	Pacific Islander
	-- Melanesian	41
	-- Polynesian	42
	-- Other Pacific Islands	43
	Other	100
	Don't Know	101
Current marital status	Never Married	1	PAT_MARITAL
	Married	2
	Legally separated	3
	Divorced	4
	Widowed	5
	Don't Know	101
-- If married,	Resides with spouse	1	PAT_MARITAL_RESIDE
	Separated due to relationship issues	2
	Separated for reasons other than relationship (e.g. deployed)	3
	Don't Know	101
Education	Some high school, did not graduate	1	PAT_EDUCATION
	GED	2
	High school graduate	3
	Some college or technical school, no degree or certificate	4
	College degree of less than four years or technical school certificate	5
	Four-year college degree	6
	Master's degree or greater	7
	Don't Know	101
Residence at time of event	Barracks, tents, or other shared military environment	1	PAT_RESIDENCE
	Non-military shared living environment	2
	Bachelor Enlisted Quarters (BEQ) or Bachelor Officer Quarters (BOQ)	3
	On-post family housing	4
	Off-post family housing	5
	Other	100
	Don't Know	101
Did the patient/decedent reside alone at the time of the event?	Yes	1	PAT_RESIDE_ALONE
	No	2
	Don't Know	101
Did the patient/decedent have minor children?	Yes	1	PAT_CHILDREN
	No	2
	Don't Know	101
-- If yes, were the children residing with him/her?	Yes	1	PAT_CHILDREN_RESIDE_WITH
	No	2
	Don't Know	101
Section II - Sponsor's Military Information
Service	Army	1	SPONSOR_SERVICE
	Air Force	2
	Navy	3
	Marines	4
	Coast Guard	5
	Foreign military	6
	Other uniformed service	7
	Other	100
Component/Military status	Regular (e.g. Army, Air Force)	1	SPONSOR_COMPONENT
	Reserve (e.g. USAR, USMCR)	2
	National Guard	3
	Other	100
Job code: (MOS, SSI, AFSC, DAFSC, or other military job code)	[Pull-down menu of Army MOS codes]	[Codes delineated below]	SPONSOR_JOB_CODE
Duty status (check all that apply)	Active Duty	1 = Selected	SPONSOR_DUTY_STATUS_ACTIVE
	AGR (Active Guard/Reserve)		SPONSOR_DUTY_STATUS_AGR
	IET (Basic and Advanced Individualized Training)		SPONSOR_DUTY_STATUS_IET
	Mobilized RC (Reserve and National Guard)		SPONSOR_DUTY_STATUS_MOBILIZED
	ADT (Active Duty for Training)		SPONSOR_DUTY_STATUS_ADT
	IDT (Weekend Reserve Drill)		SPONSOR_DUTY_STATUS_IDT
	Retired		SPONSOR_DUTY_STATUS_RETIRED
	Released from active duty within 120 days		SPONSOR_DUTY_STATUS_RELEASED
	Other		SPONSOR_DUTY_STATUS_OTHER
	Does not apply		SPONSOR_DUTY_STATUS_NA
Pay grade	[E1-E9; W1-W5; O1-O10; Cadet/Midshipman]	[Codes delineated below]	SPONSOR_GRADE
	Does not apply	102
Permanent duty station/command location	Same as geographic location	1	SPONSOR_DUTY_STATION_SAME
	Other location	2	SPONSOR_DUTY_STATION_COUNTRY
-- If other location
---- Country	[Pull-down menu]	[Codes delineated below]	SPONSOR_DUTY_STAT_CTRY_OTHER
---- If United States, State	[Pull-down menu]	[Codes delineated below]	SPONSOR_DUTY_STATION_STATE
---- City, post, or camp	[type in text entry]		SPONSOR_DUTY_STATION_CITY
Permanent duty assignment
-- Division	[Pull-down menu]	[Codes delineated below]	SPONSOR_DUTY_ASSIGN_DIVISION
-- Brigade	[type in text entry]		SPONSOR_DUTY_ASSIGN_BRIGADE
-- Battalion	[type in text entry]		SPONSOR_DUTY_ASSIGN_BATTALION
-- Company	[type in text entry]		SPONSOR_DUTY_ASSIGN_COMPANY
UIC or other unit identification	[type in text entry]		SPONSOR_UIC
	Check if unknown	1 = Selected
Section III - Event
Event date	[Calendar pop-up]		EVENT_DATE
Event time	[type in numeric military time]		EVENT_TIME
Geographic location of event
-- Country	[Pull-down menu]	[Codes delineated below]	EVENT_LOCATION_COUNTRY
-- If United States, State	[Pull-down menu]	[Codes delineated below]	EVENT_LOCATION_STATE
-- City, post, or camp	[Type in text entry]		EVENT_LOCATION_CITY
Event type			EVENT_TYPE
	Suicide attempt/gesture	2
	Suicidal ideation only (w/o an attempt or gesture)	3
	Completed suicide	1
	Test, calibration, or special study	4
Event setting	Resident (own) or barracks	1	EVENT_SETTING
	Residence of friend or family	2
	Work/jobsite	3
	Automobile (away from residence)	4
	Inpatient medical facility	5
	Other	100
Actions taken as a consequence of the current event	Hospitalization (inpatient)	1 = Selected	EVENT_ACTION_HOSPITALIZED
	Outpatient mental health evaluation/treatment		EVENT_ACTION_OUTPATIENT
	Evacuation		EVENT_ACTION_EVACUATED
	Other		EVENT_ACTION_OTHER
Primary method used			EVENT_METHOD
	Drugs	1
	Alcohol	2
	Gas, vapor poisoning by vehicle exhaust	3
	Gas, vapor poisoning by utility (or other) gas	4
	Solvents, pesticides and other agricultural chemicals	5
	Hanging	6
	Drowning	7
	Firearm/gun, military issue or duty weapon	8
	Firearm/gun, other than military issue	9
	Fire, steam, etc.	10
	Sharp or blunt object	11
	Jumping from high place	12
	Lying in front of a moving object	13
	Crashing a motor vehicle	14
	Other	100
	Don't Know	101
During the event, was alcohol used?	Yes	1	EVENT_ALCOHOL
	No	2
	Don't Know	101
During the event, were drugs used?	Yes	1	EVENT_DRUGS
	No	2
	Don't Know	101
-- If yes, what types of drugs were used?	Drugs (illicit/illegal)		EVENT_DRUGS_ILLEGAL
	-- Overdose	1
	-- Used, no overdose	2
	-- Were not used	3
	Prescription medications		EVENT_DRUGS_PRESCRIPTION
	-- Overdose	1
	-- Used, no overdose	2
	-- Were not used	3
	Non-prescription medications (e.g. over-the-counter medications)		EVENT_DRUGS_OTC
	-- Overdose	1
	-- Used, no overdose	2
	-- Were not used	3
Is there evidence that the patient/decedent intended to die?	Yes	1	EVENT_INTENT_DIE
	No	2
	Don't Know	101
For gestures and attempts only, did the patient experience	Yes	1	EVENT_EXPERIENCE_PHYSICAL_HARM
physical harm (including poisoning) as a result of the event?	No	2
	Don't Know	101
Was the method used (and quantity, if appropriate) one that is	Yes	1	EVENT_METHOD_LETHAL
typically lethal?	No	2
	Don't Know	101
Is there evidence that the event involved death-risk gambling?	Yes	1	EVENT_DEATH_RISK_GAMBLING
(e.g. Russian roulette, walking railroad tracks, playing "chicken")	No	2
	Don't Know	101
Is there evidence that the event was planned and/or	Yes	1	EVENT_PLANNED
premeditated?	No	2
	Don't Know	101
Was the event performed under circumstances where it	Yes	1	EVENT_OBSERVABLE
would likely be observed and intervened in by others?	No	2
	Don't Know	101
Was a suicide note left?	Yes	1	EVENT_SUICIDE_NOTE
	No	2
	Don't Know	101
Prior to the event, did the patient/decedent communicate	Yes	1	EVENT_COMMUNICATE
potential for self-harm? (other than a suicide note)	No	2
	Don't Know	101
-- If yes, how? (check all that apply)	Written	1 = Selected	EVENT_COMMUNICATE_HOW_WRITTEN
	Verbal		EVENT_COMMUNICATE_HOW_VERBAL
	Other		EVENT_COMMUNICATE_HOW_OTHER
-- To whom? (check all that apply)	Supervisor		EVENT_COMMUNICATE_WHO_SUPER
	Chaplain		EVENT_COMMUNICATE_WHO_CHAP
	Mental health staff		EVENT_COMMUNICATE_WHO_MHSTAFF
	Friend		EVENT_COMMUNICATE_WHO_FRIEND
	Spouse or significant other		EVENT_COMMUNICATE_WHO_SPOUSE
	Other		EVENT_COMMUNICATE_WHO_OTHER
What was the patient/decedent's primary motivation for	Emotion relief (e.g. to stop bad feelings, self-hatred, anxiety relief)	1	EVENT_MOTIVATION
performing this event?	Interpersonal influence (e.g. to get help, get attention, shock others)	2
	Feeling generation (e.g. to stop feeling numb)	3
	Avoidance/escape (e.g. to avoid or escape deployment, prevent being hurt in other ways)	4
	Individual reasons (e.g. self-punishment, to express anger, be with deceased loved one)	5
	Hopelessness (e.g. pessimistic regarding future)	6
	Depression (e.g. chronic or severe clinically depressed mood)	7
	Other psychiatric symptoms (e.g. PTSD, psychotic)	8
	Impulsivity (e.g. due to substance abuse, personality characteristics)	9
	Other	100
	Don't Know	101
Duty environment/status at time of event (check all that apply)	Garrison	1 = Selected	EVENT_DUTY_ENV_GARRISON
	Leave		EVENT_DUTY_ENV_LEAVE
	TDY/TAD		EVENT_DUTY_ENV_TDY
	AWOL		EVENT_DUTY_ENV_AWOL
	Deployed		EVENT_DUTY_ENV_DEPLOYED
	Training		EVENT_DUTY_ENV_TRAINING
	Psychiatric hospitalization		EVENT_DUTY_ENV_PSYCH
	Medical hold		EVENT_DUTY_ENV_MEDICAL_HOLD
	In evacuation chain		EVENT_DUTY_ENV_EVACUATION
	Under command observation (e.g. CIP)		EVENT_DUTY_ENV_COMMAND_OBS
	Other		EVENT_DUTY_ENV_OTHER
Was the event related to a deployment?	Yes	1	EVENT_RELATED_DEPLOYMENT
	No	2
	Don't Know	101
-- If yes, what type of deployment(s)? (check all that apply)	Anticipated deployment	1 = Selected	EVENT_RELATED_DEPLOYMENT_ANT
	Current deployment		EVENT_RELATED_DEPLOYMENT_CUR
	Prior deployment		EVENT_RELATED_DEPLOYMENT_PRI
Please describe the general sequence of events leading up to	[type in text entry up to 4000 characters]
the ideation/attempt/completion and discovery/intervention
Section IV - History
PRIOR TO THE EVENT, was the patient/decedent seen by:
...a Medical Treatment Facility?	Yes	1	HIST_MTF
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_MTF_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…Substance Abuse Services?	Yes	1	HIST_SAS
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_SAS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a Family Advocacy Program?	Yes	1	HIST_FAP
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_FAP_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…Chaplain services?	Yes	1	HIST_CHAPLAIN
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_CHAPLAIN_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…Outpatient Mental Health? (including deployment mental	Yes	1	HIST_OUTPATIENT_MH
health services)	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_OUTPATIENT_MH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…Inpatient Mental Health?	Yes	1	HIST_INPATIENT_MH
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_INPATIENT_MH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
PRIOR TO THE EVENT, had the patient/decedent…
…been diagnosed with any Mood Disorder (e.g. major depression, etc.)?	Yes	1	HIST_MOOD
	No	2
	Don't Know	101
…….If yes, been diagnosed with a Bipolar Disorder?	Yes	1	HIST_BIPOLAR
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_BIPOLAR_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…….been diagnosed with Major Depression?	Yes	1	HIST_MAJOR_DEPRESSION
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_MAJOR_DEPRESSION_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…….been diagnosed with Dysthymic Disorder?	Yes	1	HIST_DYSTHYMIC
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_DYSTHYMIC_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…….been diagnosed with any other Mood Disorder?	Yes	1	HIST_OTHERMOOD
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_OTHERMOOD_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…been diagnosed with an Anxiety Disorder (e.g. PTSD, etc.)?	Yes	1	HIST_ANXIETY
Removed HIST_ANXIETY_TIME	No	2
	Don't Know	101
…….if yes, been diagnosed with PTSD?	Yes	1	HIST_PTSD
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_PTSD_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…….been diagnosed with Panic Disorder?	Yes	1	HIST_PANIC
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_PANIC_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…….been diagnosed with Generalized Anxiety Disorder?	Yes	1	HIST_GENANXIETY
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_GENANXIETY_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…….been diagnosed with Acute Stress Disorder?	Yes	1	HIST_STRESS
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_STRESS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…….been diagnosed with any other Anxiety Disorder?	Yes	1	HIST_OTHERANXIETY
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_OTHERANXIETY_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…been diagnosed with a Personality Disorder?	Yes	1	HIST_PERSONALITY
			HIST_PERSONALITY_TIME
	-- If yes, how long prior to the event? (select the most recent occurrence)
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…been diagnosed with a Psychotic Disorder?	Yes	1	HIST_PSYCHOTIC
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_PSYCHOTIC_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	No	2
	Don't Know	101
…had a history of Substance Abuse?	Yes	1	HIST_SUBSTANCE_ABUSE
	No	2	HIST_SUBSTANCE_ABUSE_TIME
	Don't Know	101
…….If the patient/decedent had a history with substance abuse,	Alcohol
select all that apply:	-- Dependence	1 = Selected	HIST_SUBSTANCE_ALCOHOL_DEP
	-- Abuse		HIST_SUBSTANCE_ALCOHOL_ABUSE
	Drugs (illicit/illegal)
	-- Dependence		HIST_SUBSTANCE_DRUGS_DEP
	-- Abuse		HIST_SUBSTANCE_DRUGS_ABUSE
	Prescription medications
	-- Dependence		HIST_SUBSTANCE_PRESCRIP_DEP
	-- Abuse		HIST_SUBSTANCE_PRESCRIP_ABUSE
	Non-prescription medications (e.g. OTC medication)
	-- Dependence		HIST_SUBSTANCE_OTC_DEP
	-- Abuse		HIST_SUBSTANCE_OTC_ABUSE
…taken Psychotropic Medications?	Yes	1	HIST_PSYCHOTROPIC_MEDS
	No	2
	Don't Know	101
…….if yes, taken Antidepressants?	Yes	1	HIST_ANTIDEPRESSANTS
	No	2
	Don't Know	101
…….taken Anti-anxiety medications?	Yes	1	HIST_ANTIANXIETY
	No	2
	Don't Know	101
…….taken Antimanics?	Yes	1	HIST_ANTIMANICS
	No	2
	Don't Know	101
…….taken Anticonvulsants?	Yes	1	HIST_ANTICONVULSANTS
	No	2
	Don't Know	101
…….taken Antipsychotics?	Yes	1	HIST_ANTIPSYCHOTICS
	No	2
	Don't Know	101
…had prior self-injurious events?	Yes	1	HIST_PRIOR_SELF_INJURY
Removed HIST_PRIOR_SELF_INJURY_TIME	No	2
	Don't Know	101
…….If yes, how many prior events?	One prior event	1	HIST_PRIOR_SELF_INJURY_ONE
	More than one prior event	2
…….Was this event similar to prior event(s)	Yes	1	HIST_PRIOR_SELF_INJURY_SIM
	No	2
	Don't Know	101
…….Age at first self-injurious event	[type in numeric entry]		HIST_PRIOR_SELF_INJURY_AGE
Please elaborate on any other relevant details related to the	[type in text entry up to 4000 characters]		HIST_OTHER_MH_TREATMENT
patient/decedent's mental health treatment history
PRIOR TO THE EVENT, was the patient/decedent the subject of:
…Courts Martial proceedings?	Yes	1	HIST_COURTS_MARTIAL
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_COURTS_MARTIAL_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…Article 15 proceedings or civilian criminal problems?	Yes	1	HIST_ARTICLE15
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_ARTICLE15_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…Administrative Separation proceedings?	Yes	1	HIST_ADMIN_SEPARATION
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_ADMIN_SEPARATION_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…AWOL or desertion proceedings?	Yes	1	HIST_AWOL
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_AWOL_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a Medical Evaluation Board?	Yes	1	HIST_MEDICAL_BOARD
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_MEDICAL_BOARD_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…civil legal problems? (e.g. child custody dispute, litigation)	Yes	1	HIST_CIVIL_LEGAL
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_CIVIL_LEGAL_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…non-selection for advanced schooling, promotion, or command?	Yes	1	HIST_NON_SELECTION
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_NON_SELECTION_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Please describe or elaborate on life stressors or other circumstances	[type in text entry up to 4000 characters]
affecting the patient/decedent prior to the event:
PRIOR TO THE EVENT, was the patient/decedent an alleged or
confirmed VICTIM of:
…physical abuse or assault?	Yes	1	HIST_VICT_PHYS_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_VICT_PHYS_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…sexual abuse or assault?	Yes	1	HIST_VICT_SEXUAL_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_VICT_SEXUAL_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…emotional abuse or assault?	Yes	1	HIST_VICT_EMOT_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_VICT_EMOT_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…sexual harassment?	Yes	1	HIST_VICT_SEX_HARASS
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_VICT_SEX_HARASS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
PRIOR TO THE EVENT, was the patient/decedent an alleged or
confirmed PERPETRATOR of:
…physical abuse or assault?	Yes	1	HIST_PERP_PHYS_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_PERP_PHYS_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…sexual abuse or assault?	Yes	1	HIST_PERP_SEXUAL_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_PERP_SEXUAL_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…emotional abuse or assault?	Yes	1	HIST_PERP_EMOT_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_PERP_EMOT_ABUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…sexual harassment?	Yes	1	HIST_PERP_SEX_HARASS
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_PERP_SEX_HARASS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Please describe any known childhood or developmental history that	[type in text entry up to 4000 characters]
may have contributed to the event:
How many deployments?	0	1	HIST_DEPLOY_COUNT
	1	2
	2	3
	3 or more	4
…If anything other than zero is selected, the following questions are asked
for the three most recent deployments
Please specify the MOST RECENT deployment first.
Deployment location 1:	United States	1	HIST_DEPLOY1_LOC
	Iraq	2
	Afghanistan	3
	Kuwait	4
	Korea	5
	Kosovo	6
	Other Europe	7
	North America	8
	Central or South America	9
	Other	100
Deployment 1 start date:	[Calendar pop-up]		HIST_DEPLOY1_START_DATE
Deployment 1 end date:	[Calendar pop-up]		HIST_DEPLOY1_END_DATE
Deployment 1 R&R start date:	[Calendar pop-up]		HIST_DEPLOY1_RR_START_DATE
Deployment 1 R&R end date:	[Calendar pop-up]		HIST_DEPLOY1_RR_END_DATE
Deployment location 2:	United States	1	HIST_DEPLOY2_LOC
	Iraq	2
	Afghanistan	3
	Kuwait	4
	Korea	5
	Kosovo	6
	Other Europe	7
	North America	8
	Central or South America	9
	Other	100
Deployment 2 start date:	[Calendar pop-up]		HIST_DEPLOY2_START_DATE
Deployment 2 end date:	[Calendar pop-up]		HIST_DEPLOY2_END_DATE
Deployment location 3:	United States	1	HIST_DEPLOY3_LOC
	Iraq	2
	Afghanistan	3
	Kuwait	4
	Korea	5
	Kosovo	6
	Other Europe	7
	North America	8
	Central or South America	9
	Other	100
Deployment 3 start date:	[Calendar pop-up]		HIST_DEPLOY3_START_DATE
Deployment 3 end date:	[Calendar pop-up]		HIST_DEPLOY3_END_DATE
Did the patient/decedent experience direct combat operations?	Yes	1	HIST_DIRECT_COMBAT
	No	2
	Don't Know	101
…If yes, how long prior to event? (select the most recent occurrence)
…..Deployment 1 (most recent)	Within 30 days	1	HIST_DIRECT_COMBAT_DEP1
	Within 3 months	2	HIST_DIRECT_COMBAT_DEP1_TIME
	Within 1 year	3
	Over 1 year ago	4
…..Deployment 2	[Simple check box]	1 = Selected	HIST_DIRECT_COMBAT_DEP2
…..Deployment 3	[Simple check box]	1 = Selected	HIST_DIRECT_COMBAT_DEP3
…If yes, did the patient/decedent…
…..and his/her unit engage in battle resulting in casualties/wounded?	Deployment 1 (most recent)	1 = Selected	HIST_COMBAT_CASUALTIES_DEP1
	Deployment 2		HIST_COMBAT_CASUALTIES_DEP2
	Deployment 3		HIST_COMBAT_CASUALTIES_DEP3
…..become wounded or injured in combat?	Deployment 1 (most recent)		HIST_COMBAT_INJURED_DEP1
	Deployment 2		HIST_COMBAT_INJURED_DEP2
	Deployment 3		HIST_COMBAT_INJURED_DEP3
…..personally witness a unit member, ally, enemy, or civilian being	Deployment 1 (most recent)		HIST_COMBAT_WITNESS_DEP1
seriously wounded or killed?	Deployment 2		HIST_COMBAT_WITNESS_DEP2
	Deployment 3		HIST_COMBAT_WITNESS_DEP3
…..see the bodies of dead soldiers or civilians following battle?	Deployment 1 (most recent)		HIST_COMBAT_SAW_BODIES_DEP1
	Deployment 2		HIST_COMBAT_SAW_BODIES_DEP2
	Deployment 3		HIST_COMBAT_SAW_BODIES_DEP3
…..kill others in combat (or have reason to believe others were	Deployment 1 (most recent)		HIST_COMBAT_KILL_DEP1
killed as a result of actions)?	Deployment 2		HIST_COMBAT_KILL_DEP2
	Deployment 3		HIST_COMBAT_KILL_DEP3
Please describe any additional relevant military history including	[type in text entry up to 4000 characters]
additional relevant deployment history:
PRIOR TO THE EVENT, was there evidence of…
…a failed or failing spousal or intimate partner relationship?	Yes	1	HIST_FAILED_REL_SPOUSE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_FAILED_REL_SPOUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a failed or failing other relationship?	Yes	1	HIST_FAILED_REL_OTHER
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_FAILED_REL_OTHER_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a completed spousal suicide?	Yes	1	HIST_SPOUSE_SUICIDE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_SPOUSE_SUICIDE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a completed family suicide?	Yes	1	HIST_FAMILY_SUICIDE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_FAMILY_SUICIDE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a completed suicide by a friend?	Yes	1	HIST_FRIEND_SUICIDE
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_FRIEND_SUICIDE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a death of spouse or family? (other than suicide)	Yes	1	HIST_FAMILY_DEATH
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_FAMILY_DEATH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…the death of a friend? (other than suicide)	Yes	1	HIST_FRIEND_DEATH
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_FRIEND_DEATH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a physical health problem?	Yes	1	HIST_PHYSICAL_HEALTH
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_PHYSICAL_HEALTH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a chronic spousal or family severe illness?	Yes	1	HIST_FAMILY_ILLNESS
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_FAMILY_ILLNESS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…excessive debt or bankruptcy?	Yes	1	HIST_DEBT_BANKRUPTCY
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_DEBT_BANKRUPTCY_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…job problems? (e.g. laid off, fired, excessive pressure)	Yes	1	HIST_JOB_PROBLEMS
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_JOB_PROBLEMS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…supervisor or coworker issues or problems?	Yes	1	HIST_COWORKER_ISSUES
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_COWORKER_ISSUES_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…a poor work performance review or evaluation? (e.g. bar for	Yes	1	HIST_POOR_PERFORMANCE
reenlistment, flagged record, extra duty imposed)	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_POOR_PERFORMANCE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…unit or workplace hazing?	Yes	1	HIST_WORKPLACE_HAZING
	-- If yes, how long prior to the event? (select the most recent occurrence)		HIST_WORKPLACE_HAZING_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Did the patient/decedent have a family history of mental illness?	Yes	1	HIST_FAMILY_MENTAL
	No	2
	Don't Know	101
Was there a gun in the home or immediate environment?	Yes	1	HIST_GUN_IN_HOME
	No	2
	Don't Know	101
Please describe or elaborate on any additional details related to	[type in text entry up to 4000 characters]
these factors (Items 75-90):
Provide a brief "bio-psycho-social" formulation as to WHY this	[type in text entry up to 4000 characters]
patient/decedent engaged in suicidal behavior:
Today's date	[Auto-filled]		ASER_TODAYS_DATE
Location where this ASER was completed:	Same as geographical event location	1	ASER_LOCATION_SAME
	Other location	2	ASER_LOCATION_OTHER
-- If other location,
---- Country	[Pull-down menu]	[Codes delineated below]	ASER_LOCATION_COUNTRY
---- If United States, State	[Pull-down menu]	[Codes delineated below]	ASER_LOCATION_STATE
---- City, post, or camp	[Type in text entry]		ASER_LOCATION_CITY
Medical facility where this ASER was completed or supporting MTF:	[Presently a pull-down menu of Army MTFs]	[Codes delineated below]
Behavioral Health provider:
…Name	[type in text entry]		ASER_PROVIDER_NAME
…Rank/grade	[type in text entry]		ASER_PROVIDER_RANK
…Phone number	[type in text entry]		ASER_PROVIDER_PHONE
…DSN prefix	[type in text entry]		ASER_PROVIDER_DSN
…Email	[type in text entry]		ASER_PROVIDER_EMAIL
…Specialty	Licensed Mental health Counselor or equivalent	1	ASER_PROVIDER_SPECIALTY
	Psychiatric Nurse	2
	Psychiatrist	3
	Psychologist	4
	Social Worker	5
	Other	100
Information based on certain types of records requires special privacy	Interviews with:
protection. Please indicate what sources or information were used	…The patient (non-fatalities)	1 = Selected	SOURCE_INTERVIEW_PATIENT
to compile this report: (check all that apply)	…Co-workers/supervisors		SOURCE_INTERVIEW_COWORKERS
	…Responsible investigative agency officer		SOURCE_INTERVIEW_OFFICER
	…Involved professionals, such as physicians, behavioral health clinicians, drug and alcohol		SOURCE_INTERVIEW_PROFESSIONALS
	counselors, chaplains, military police, family service personnel (e.g. ACS) etc.
	…Family members		SOURCE_INTERVIEW_FAMILY
	Review of records including:
	…Medical and behavioral health records		SOURCE_REVIEW_MEDICAL
	…Family Advocacy Records		SOURCE_REVIEW_ADVOCACY
	…Army Substance Abuse Program records (ASAP)		SOURCE_REVIEW_SUBSTANCE
	…Personnel and counseling records		SOURCE_REVIEW_PERSONNEL
	…Responsible investigative agency records (e.g. CID)		SOURCE_REVIEW_AGENCY
	…Court-martial records		SOURCE_REVIEW_COURTMARTIAL
	…Records related to manner of death, such as casualty reports, toxicology/lab reports,		SOURCE_REVIEW_MANNER
	pathology/autopsy reports, suicide notes, etc.)
Form completer, if not Behavioral Health provider:
…Name	[type in text entry]		ASER_COMPLETER_NAME
…Rank/grade	[type in text entry]		ASER_COMPLETER_RANK
…Phone number	[type in text entry]		ASER_COMPLETER_PHONE
…DSN prefix	[type in text entry]		ASER_COMPLETER_DSN
…Email	[type in text entry]		ASER_COMPLETER_EMAIL
Comments:	[type in text entry up to 4000 characters]		ASER_COMMENTS
[Pay Grade Codes]		[MOS/Job Codes]
11 = E1		9 = Officer Candidates
12 = E2		11 = Infantry
13 = E3		13 = Field Artillery
14 = E4		14 = Air Defense Artillery
15 = E5		15 = Aviation
16 = E6		18 = Special Forces
17 = E7		19 = Armor
18 = E8		21 = (63B) Corps of Engineers
19 = E9		25 = Signal Corps
		27 = Paralegal
21 = W1		31 = Military Police Corps
22 = W2		33 = Electronic Warfare
23 = W3		35 = Military Intelligence
24 = W4		37 = Psychological Operations Corps
25 = W5		38 = Civil Affairs
		42 = Adjutant General
31 = O1		44 = Finance
32 = O2		45 = Armament Maintenance
33 = O3		46 = Public Affairs
34 = O4		52 = Special Equipment
35 = O5		56 = Religious Support
36 = O6		63 = Vehicle Maintenance
37 = O7		68 = (60-71, 91) Medical Department
38 = O8		74 = Chemical
39 = O9		79 = Recruitment and Re-enlistment
40 = O10		88 = Transportation
		89 = Explosives and Ammunition
50 = Cadet/Midshipman		92 = (43, 57) Quartermaster Corps
		94 = (27, 62, 91) Electronic Maintenance
		96 = Intelligence
		97 = Counter/Human Intelligence
		98 = Communications Intelligence
		999 = Other
[Country Codes]		[State Codes]
0 = United States		0 = Alabama
1 = Iraq		1 = Alaska
2 = Afghanistan		2 = Arizona
3 = Kuwait		3 = Arkansas
4 = Korea		4 = California
5 = Kosovo		5 = Colorado
6 = Other Europe		6 = Connecticut
7 = North America		7 = Delaware
8 = Central or South America		8 = District of Columbia
999 = Other		9 = Florida
		10 = Georgia
		11 = Hawaii
		12 = Idaho
		13 = Illinois
		14 = Indiana
		15 = Iowa
		16 = Kansas
		17 = Kentucky
		18 = Louisiana
		19 = Maine
		20 = Maryland
		21 = Massachusetts
		22 = Michigan
		23 = Minnesota
		24 = Mississippi
		25 = Missouri
		26 = Montana
		27 = Nebraska
		28 = Nevada
		29 = New Hampshire
		30 = New Jersey
		31 = New Mexico
		32 = New York
		33 = North Carolina
		34 = North Dakota
		35 = Ohio
		36 = Oklahoma
		37 = Oregon
		38 = Pennsylvania
		39 = Rhode Island
		40 = South Carolina
		41 = South Dakota
		42 = Tennessee
		43 = Texas
		44 = Utah
		45 = Vermont
		46 = Virginia
		47 = Washington
		48 = West Virginia
		49 = Wisconsin
		50 = Wyoming
[Division Codes]		[Medical Facility Codes]
1 = 1st Armored Division		1 = Fox Army Health Center
2 = 1st Cavalry Division		3 = Lyster Army Community Hospital
3 = 1st Infantry Division		5 = Bassett Army Community Hospital
4 = 2nd Infantry Division		8 = RW Bliss Army Health Center
5 = 3rd Infantry Division		32 = Evans Army Community Hospital
6 = 4th Infantry Division		37 = Walter Reed Army Medical Center
7 = 10th Mountain Division		47 = Eisenhower Army Medical Center
8 = 25th Infantry Division		48 = Martin Army Community Hospital
9 = 82nd Airborne Division		49 = Winn Army Community Hospital
10 = 101st Airborne Division		52 = Tripler Army Medical Center
11 = 7th Infantry Division		57 = Irwin Army Community Hospital
12 = 24th Infantry Division		58 = Munson Army Health Center
13 = 28th Infantry Division		60 = Blanchfield Army Community Hospital
14 = 29th Infantry Division		61 = Ireland Army Community Hospital
15 = 34th Infantry Division		64 = Bayne-Jones Army Community Hospital
16 = 35th Infantry Division		69 = Kimbrough Ambulatory Care Center
17 = 38th Infantry Division		75 = General Leonard Wood Army Community Hospital
18 = 40th Infantry Division		81 = Patterson Army Health Center
19 = 42nd Infantry Division		86 = Keller Army Community Hospital
20 = 49th Armored Divisioln		89 = Womack Army Medical Center
21 = 75th Division (Training Support)		98 = Reynolds Army Community Hospital
22 = 78th Division (Training Support)		105 = Moncrief Army Community Hospital
23 = 80th Division (Institutional Training)		108 = William Beaumont Army Medical Center
24 = 84th Division (Training Support)		109 = Brooke Army Medical Center
25 = 85th Division (Training Support)		110 = Darnall Army Medical Center
26 = 87th Division (Training Support)		121 = McDonald Army Health Center
27 = 91st Division (Training Support)		122 = Kenner Army Health Center
28 = 95th Division (Institutional Training)		123 = DeWitt Army Community Hospital
29 = 98th Division (Institutional Training)		125 = Madigan Army Medical Center
30 = 100th Division (Institutional Training)		131 = Weed Army Community Hospital
31 = 104th Division (Institutional Training)		247 = Monterey Army Health Center
32 = 108th Division (Institutional Training)		256 = DiLorenzo Tricare Health Clinic
		273 = Lawrence Joel Army Health Center
		308 = Kirk Army Health Center
		309 = Barquist Army Health Center
		330 = Guthrie Army Health Center
		352 = Dunham Army Health Center
		390 = Andrew Rader Army Health Center
		606 = US Army MEDDAC Heidelberg
		607 = Landstuhl Regional Medical Center
		609 = US Army MEDDAC Bavaria
		610 = US Army MEDDAC Camp Zama, Japan
		612 = 121st General Hospital, Korea
		953 = Rodriguez Army Health Center, Puerto Rico
		222 = Iraq
		33 = Kuwait
		444 = Afghanistan
		999 = Other

---

Sheet 4: DODSER 2008

DoDSER CY 2008
Yellow highlight indicates items that were added or modified from previous version.
Red highlight indicates items that were deleted from previous version.
Event reports initiated during previous CY and submited during current CY will include current CY questions and variables
Question	Answer Choices	Data Values	Variable Labels
Patient Military Branch selected before creating report
Section 1 - Patient/Decedent Personal Information
Event Type	Suicide	1	EVENT_TYPE
	Suicide attempt (evidence of intent to die)	2	Army only
	Self harm (without intent to die)	3	Army only
	Suicidal ideation only (without an attempt/self harm)	4	Army only
For Administrative Use Only	Test, calibration, or special study	1 = Selected
Last Name	[Type in text entry]		PAT_LAST_NAME
First Name	[Type in text entry]		PAT_FIRST_NAME
Middile Initial	[Type in text entry]		PAT_MIDDLE_INITIAL
Social Security Number	[Type in text entry]		PAT_SSN
Date of Birth	[Calendar pop-up]		PAT_DOB
Sex	Male	1	PAT_SEX
(DK OPTION REMOVED)	Female	2
Relationship to sponsor	Sponsor	1	PAT_SPONSOR_RELATION
	Spouse	2
	Dependent	3
	Other	100
Service	Army	1	PAT_SERVICE
	Air Force	2
	Navy	3
	Marine Corps	4
	Coast Guard	5
	Foreign Military	6
	Other uniformed service	7
	Other	100
Racial category	American Indian/Alaskan Native	1	PAT_RACE
	Asian/Pacific Islander	2
	Black/African American	3
	White/Caucasian	4
	Other	100
	Don't Know	101
Specific ethnic group	Hispanic		PAT_ETHNIC
	-- Mexican	11
	-- Puerto Rican	12
	-- Cuban	13
	-- Latin American	14
	-- Other Spanish	15
	Native American
	-- Aleut	21
	-- Eskimo	22
	-- U.S./Canadian Indian Tribes	23
	Asian
	-- Chinese	31
	-- Japanese	32
	-- Korean	33
	-- Indian	34
	-- Filipino	35
	-- Vietnamese	36
	-- Other Asian	37
	Pacific Islander
	-- Melanesian	41
	-- Polynesian	42
	-- Other Pacific Islands	43
	Other	100
	Don't Know	101
Current marital status	Never married	1	PAT_MARITAL
	Married	2
	Legally separated	3
	Divorced	4
	Widowed	5
	Don't Know	101
-- If married,	Resides with spouse	1	PAT_MARITAL_RESIDE
	Separated due to relationship issues	2
	Separated for reasons other than relationship (e.g. deployed)	3
	Don't Know	101
Education	Some high school, did not graduate	1	PAT_EDUCATION
	GED	2
	High school graduate	3
	Some college or technical school, no degree or certificate	4
	College degree of less than four years or technical school certificate	5
	Four-year college degree	6
	Master's degree or greater	7
	Don't Know	101
Residence at time of event	Barracks, tents, or other shared military living environment	1	PAT_RESIDENCE_
	Bachelor Enlisted Quarters (BEQ) or Bachelor Officer Quarters (BOQ)	2	Removed:Non-military shared living environment
	On-base family housing	3
	Owned or leased apartment or house	4
	Ship	5
	Other	100
	Don't Know	101
Did the patient/decedent reside alone at the time	Yes	1	PAT_RESIDE_ALONE
of the event?	No	2
	Don't Know	101
Did the patient/decedent have minor children?	Yes	1	PAT_CHILDREN
	No	2
	Don't Know	101
-- If yes, were the children residing with him/her?	Yes	1	PAT_CHILDREN_RESIDE_WITH
	No	2
	Don't Know	101
Section II - Sponsor's Military Information
Component/Military status	Regular (e.g. Army, Air Force)	1	SPONSOR_COMPONENT
	Reserve (e.g. USAR, USMCR)	2
	National Guard	3
	Other	100
Job code (MOS, SSI, AFSC, DAFSC, or other military job code)	[Pull-down menu of Army MOS codes]	[Codes delineated below]	SPONSOR_JOB_CODE
Duty status at time of event (check all that apply)	Active Duty	1 = Selected	SPONSOR_DUTY_STATUS_ACTIVE
	AGR (Active Guard/Reserve)		SPONSOR_DUTY_STATUS_AGR
	IET (Basic and Advanced Individualized Training)		SPONSOR_DUTY_STATUS_IET
	Mobilized RC (Reserve and National Guard)		SPONSOR_DUTY_STATUS_MOBILIZED
	ADT (Active Duty for Training)		SPONSOR_DUTY_STATUS_ADT
	IDT (Weekend Reserve Drill)		SPONSOR_DUTY_STATUS_IDT
	Retired		SPONSOR_DUTY_STATUS_RETIRED
	Released from active duty within 120 days		SPONSOR_DUTY_STATUS_RELEASED
	Other		SPONSOR_DUTY_STATUS_OTHER
	Does not apply		SPONSOR_DUTY_STATUS_NA
Pay grade	[E1-E9; W1-W5; O1-O10; Cadet/Midshipman	[Codes delineated below]	SPONSOR_GRADE
	Does not apply	102
Permanent duty station/command location	Same as geographic event location	1	SPONSOR_DUTY_STATION_SAME
	Other location	2
-- If other location
---- Country	[Pull-down menu]	[Codes delineated below]	SPONSOR_DUTY_STATION_COUNTRY
---- If United States, State	[Pull-down menu]	[Codes delineated below]	SPONSOR_DUTY_STATION_STATE
---- City, post or camp	[Type in text entry]		SPONSOR_DUTY_STATION_CITY
Permanent duty assignment
-- Division	[Pull-down menu]	[Codes delineated below]	SPONSOR_DUTY_ASSIGN_DIVISION
-- Company	[Type in text entry]		SPONSOR_DUTY_ASSIGN_COMPANY
Command	(Air Force)		SPONSOR_DUTY_ASSIGN_COMMAND
Name of unit	(Navy/Marines)		SPONSOR_DUTY_ASSIGN_NAVY_UNIT
MSC (Marines)/Echelon 2 (Navy)	(Navy/Marines)		SPONSOR_DUTY_ASSIGN_MAR_MSC
MAJCOM (Marines)	(Navy/Marines)		SPONSOR_DUTY_ASSIGN_MAR_MAJ
Force (Marines)	(Navy/Marines)		SPOSOR_ASSIGN_MAR_FORCE
Length of time in unit	[Type in years]		SPONSOR_TIME_UNIT_YEARS
	[Type in months]		SPONSOR_TIME_UNIT_MONTHS
Section III - Event Information
Event Date	[Calendar pop-up]		EVENT_DATE
Event Time	[Type in numeric military time]		EVENT_TIME
Geographic location of event
-- If United States, State	[Pull-down menu]	[Codes delineated below]	EVENT_LOCATION_STATE
-- City/post/camp	[Type in text entry]		EVENT_LOCATION_CITY
-- Country	[Pull-down menu]	[Codes delineated below]	EVENT_LOCATION_COUNTRY
Event setting	Residence (own) or barracks	1	EVENT_SETTING
	Residence of friend or family	2
	Work/jobsite	3
	Automobile (away from residence)	4
	Inpatient medical facility	5
	Other	100
Actions taken as a consequence of the current event	Hospitalization (inpatient)	1 = Selected	EVENT_ACTION_HOSPITALIZED
(this item will not appear if event is a completed suicide)	Outpatient mental health evaluation/treatment		EVENT_ACTION_OUTPATIENT
(Army/AF only)	Evacuation		EVENT_ACTION_EVACUATED
	Other		EVENT_ACTION_OTHER
-- If hospitalization,
---- Start date of hospitalization	[Calendar pop-up]		EVENT_HOSP_START_DATE
	Check if unknown	1 = Selected	EVENT_HOSP_START_UNKNOWN
---- End date of hospitalization	[Calendar pop-up]		EVENT_HOSP_END_DATE
	Check if unknown	1 = Selected	EVENT_HOSP_END_UNKNOWN
	Check if patient is still in the inpatient facility		EVENT_HOSP_END_STILL
Primary method used	Drugs	1	EVENT_METHOD
	Alcohol	2
	Gas, vapor poisoning by vehicle exhaust	3
	Gas, vapor poisoning by utility (or other) gas	4
	Solvents, pesticides and other agricultural chemicals	5
	Hanging	6
	Drowning	7
	Firearm/gun, military issue or duty weapon	8
	Firearm/gun, other than military issue	9
	Fire, steam, etc.	10
	Sharp or blunt object	11
	Jumping from high place	12
	Lying in front of a moving object	13
	Crashing a motor vehicle	14
	Other	100
	Don't Know	101
During the event, was alcohol used?	Yes	1	EVENT_ALCOHOL
	No	2
	Don't Know	101
During the event, were drugs used?	Yes	1	EVENT_DRUGS
	No	2
	Don't Know	101
-- If yes, what types of drugs were used?
---- Drugs (illicit/illegal)	Overdose	1	EVENT_DRUGS_ILLEGAL
	Used, no overdose	2
	Were not used	3
---- Prescription medications	Overdose	1	EVENT_DRUGS_PRESCRIPTION
	Used, no overdose	2
	Were not used	3
---- Non-prescription medications (e.g. over-the-counter medications)	Overdose	1	EVENT_DRUGS_OTC
	Used, no overdose	2
	Were not used	3
Is there evidence that the patient/decedent intended to die?	Yes	1	EVENT_INTENT_DIE
	No	2
	Cannot determine	3	(DK option removed)
Were there self-inflicted injuries (including poisoning)?	Yes	1	EVENT_SELF_INFLICTED_INJURIES
	No	2
Is there evidence the event involved death-risk gambling?	Yes	1	EVENT_DEATH_RISK_GAMBLING
(e.g. Russian roulette, walking railroad tracks, playing "chicken")	No	2
	Don't Know	101
Is there evidence the event was planned and/or premeditated?	Yes	1	EVENT_PLANNED
	No	2
	Don't Know	101
Was the event performed under circumstances where it would	Yes	1	EVENT_OBSERVABLE
be observed and intervened in by others?	No	2
	Don't Know	101
Was a suicide note left?	Yes	1	EVENT_SUICIDE_NOTE
	No	2
	Don't Know	101
Prior to the event, did the patient/decedent communicate	Yes	1	EVENT_COMMUNICATE
potential for self-harm? (other than a suicide note)	No	2
	Don't Know	101
-- If yes, how? (check all that apply)	Written	1 = Selected	EVENT_COMMUNICATE_HOW_WRITTEN
	Verbal		EVENT_COMMUNICATE_HOW_VERBAL
	Other		EVENT_COMMUNICATE_HOW_OTHER
-- To whom? (check all that apply)	Supervisor		EVENT_COMMUNICATE_WHO_SUPER
	Chaplain		EVENT_COMMUNICATE_WHO_CHAP
	Mental health staff		EVENT_COMMUNICATE_WHO_MHSTAFF
	Friend		EVENT_COMMUNICATE_WHO_FRIEND
	Spouse or significant other		EVENT_COMMUNICATE_WHO_SPOUSE
	Other		EVENT_COMMUNICATE_WHO_OTHER
What was the patient/decedent's primary motivation for performing this event? (ARMY/AF ONLY)	Emotion relief (e.g. to stop bad feelings, self-hatred, anxiety relief)	1	EVENT_MOTIVATION
	Interpersonal influence (e.g. to get help, get attention, shock others)	2
		Individual reasons (e.g. self-punishment, to express anger, be with deceased loved one)	5
		Hopelessness (e.g. pessimistic regarding future)	6
	Depression (e.g. chronic or severe clinically depressed modd)	7
	Other psychiatric symptoms (e.g. PTSD, psychotic)	8
	Impulsivity (e.g. due to substance abuse, personality characteristics)	9
	Other	100
	Don't Know	101
Duty environment/status at time of event (check all that apply)	Garrison (Army/AF only)	1 = Selected	EVENT_DUTY_ENV_GARRISON
	Leave		EVENT_DUTY_ENV_LEAVE
	TDY/TAD		EVENT_DUTY_ENV_TDY
	AWOL		EVENT_DUTY_ENV_AWOL
	Deployed		EVENT_DUTY_ENV_DEPLOYED
	Training		EVENT_DUTY_ENV_TRAINING
	Psychiatric hospitalization		EVENT_DUTY_ENV_PSYCH
	Medical hold		EVENT_DUTY_ENV_MEDICAL_HOLD
	In evacuation chain		EVENT_DUTY_ENV_EVACUATION
	Under command observation (e.g. CIP)	(Army/AF only)	EVENT_DUTY_ENV_COMMAND_OBS
	Correctional facility	(Narvy/Marines only)	EVENT_DUTY_ENV_CORR_FACILITY
	With Permanent Command	(Navy/Marines only)	EVENT_DUTY_ENV_PERMCOMM
	Other		EVENT_DUTY_ENV_OTHER
Please describe the general sequence of events leading up to	[Type in text entry up to 4000 characters]		EVENT_SEQUENCE_EVENTS
the ideation/attempt/completion and discovery/intervention.
Section IV - History
PRIOR TO THE EVENT, was the patient/decedent seen by…
… a Medical Treatment Facility?	Yes	1	HIST_MTF
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_MTF_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Substance Abuse Services?	Yes	1	HIST_SAS
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_SAS_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a Family Advocacy Program?	Yes	1	HIST_FAP
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_FAP_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Chaplain services?	Yes	1	HIST_CHAPLAIN
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_CHAPLAIN_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Outpatient Mental Health? (including deployment mental	Yes	1	HIST_OUTPATIENT_MH
health services)	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_OUTPATIENT_MH_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Inpatient Mental Health?	Yes	1	HIST_INPATIENT_MH
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_INPATIENT_MH_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
PRIOR TO THE EVENT, had the patient/decedent…
… been diagnosed with any Mood Disorder (e.g. major depression, etc.)?	Yes	1	HIST_MOOD
	No	2
	Don't Know	101
…….If yes, been diagnosed with a Bipolar Disorder?	Yes	1	HIST_BIPOLAR
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_BIPOLAR_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Major Depression?	Yes	1	HIST_MAJOR_DEPRESSION
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_MAJOR_DEPRESSION_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Dysthymic Disorder?	Yes	1	HIST_DYSTHYMIC
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_DYSTHYMIC_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with any other Mood Disorder?	Yes	1	HIST_OTHERMOOD
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_OTHERMOOD_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with an Anxiety Disorder (e.g. PTSD, etc.)?	Yes	1	HIST_ANXIETY
	No	2
	Don't Know	101
……. If yes, been diagnosed with PTSD?	Yes	1	HIST_PTSD
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_PTSD_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Panic Disorder?	Yes	1	HIST_PANIC
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_PANIC_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Generalized Anxiety Disorder?	Yes	1	HIST_GENANXIETY
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_GENANXIETY_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Acute Stress Disorder?	Yes	1	HIST_STRESS
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_STRESS_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with any other Anxiety Disorder?	Yes	1	HIST_OTHERANXIETY
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_OTHERANXIETY_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with a Personality Disorder?	Yes	1	HIST_PERSONALITY
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_PERSONALITY_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with a Psychotic Disorder?	Yes	1	HIST_PSYCHOTIC
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_PSYCHOTIC_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… had a history of Substance Abuse?	Yes	1	HIST_SUBSTANCE_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_SUBSTANCE_ABUSE_TIME
	---- Within 3 months	2
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. If the patient/decedent had a history with substance abuse,	Alcohol
select all that apply	-- Dependence	1 = Selected	HIST_SUBSTANCE_ALCOHOL_DEP
	-- Abuse		HIST_SUBSTANCE_ALCOHOL_ABUSE
	Drugs (illicit/illegal)
	-- Dependence		HIST_SUBSTANCE_DRUGS_DEP
	-- Abuse		HIST_SUBSTANCE_DRUGS_ABUSE
	Prescription medications
	-- Dependence		HIST_SUBSTANCE_PRESCRIP_DEP
	-- Abuse		HIST_SUBSTANCE_PRESCRIP_ABUSE
	Non-prescription medications (e.g. OTC medication)
	-- Dependence		HIST_SUBSTANCE_OTC_DEP
	-- Abuse		HIST_SUBSTANCE_OTC_ABUSE
… taken Psychotropic Medications?	Yes	1	HIST_PSYCHOTROPIC_MEDS
	No	2
	Don't Know	101
……. If yes, taken Antidepressants?	Yes	1	HIST_ANTIDEPRESSANTS
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_ANTIDEPRESSANTS_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…….. taken Anti-anxiety medications?	Yes	1	HIST_ANTIANXIETY
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_ANTIANXIETY_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. taken Antimanics?	Yes	1	HIST_ANTIMANICS
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_ANTIMANICS_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. taken Anticonvulsants?	Yes	1	HIST_ANTICONVULSANTS
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_ANTICONVULSANTS_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. taken Antipsychotics?	Yes	1	HIST_ANTIPSYCHOTICS
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_ANTIPSYCHOTICS_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… had prior self-injurious events?	Yes	1	HIST_PRIOR_SELF_INJURY
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_PRIOR_SELF_INJURY_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. If yes, how many prior events?	One prior event	1	HIST_PRIOR_SELF_INJURY_ONE
	More than one prior event	2
……. Was this event similar to prior event(s)?	Yes	1	HIST_PRIOR_SELF_INJURY_SIM
	No	2
	Don't Know	101
……. Age at first self-injurious event	[Type in text entry]		HIST_PRIOR_SELF_INJURY_AGE
Did the patient/decedent receive his/her required suicide prevention	Yes	1	HIST_RECEIVE_TRAINING
trainings?
-- If yes, how long prior to the event? (select the most recent occurance)	---- Within 30 days	1	HIST_RECEIVE_TRAINING_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Please elaborate on any other relevant details related to the	[Type in text entry up to 4000 characters]		HIST_OTHER_MH_TREATMENT
patient/decedent's menthal health treatment history
PRIOR TO THE EVENT, was the patient/decedent the subject of…
… Courts Martial proceedings?	Yes	1	HIST_COURTS_MARTIAL
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Article 15 proceedings or civilian criminal problems? (Army/AF only)	Yes	1	HIST_ARTICLE15
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_ARTICLE15_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… NJP or Civilian Criminal Proceedings? (Navy/MC)	Yes		HIST_NJP
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_NJP_TIME
	---- Within 30 days
	---- Within 3 months
	---- Within 1 year
	---- Over 1 year ago
	No
	Don't Know
… Administrative Separation proceedings?	Yes	1	HIST_ADMIN_SEPARATION
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_ADMIN_SEPARATION_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… AWOL/UA?	Yes	1	HIST_AWOL
Changed from AWOL/desertion proceedings?	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_AWOL_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a Medical Evaluation Board?	Yes	1	HIST_MEDICAL_BOARD
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_MEDICAL_BOARD_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… civil legal problems? (e.g. child custody dispute, litigation)	Yes	1	HIST_CIVIL_LEGAL
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_CIVIL_LEGAL_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… non-selection for advanced schooling, promotion, or command?	Yes	1	HIST_NON_SELECTION
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_NON_SELECTION_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Please describe or elaborate on life stressors or other circumstances	[Type in text entry up to 4000 characters]		HIST_OTHER_LIFE_STRESSORS
affecting the patient/decedent prior to the event
PRIOR TO THE EVENT, was the patient/decedent an alleged or
confirmed VICTIM of…
… physical abuse or assault?	Yes	1	HIST_VICT_PHYS_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_VICT_PHYS_ABUSE_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual abuse or assault?	Yes	1	HIST_VICT_SEXUAL_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_VICT_SEXUAL_ABUSE_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… emotional abuse or assault?	Yes	1	HIST_VICT_EMOT_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_VICT_EMOT_ABUSE_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual harassment?	Yes	1	HIST_VICT_SEX_HARASS
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_VICT_SEX_HARASS_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
PRIOR TO THE EVENT, was the patient/decedent an alleged or
confirmed PERPETRATOR of…
… physical abuse or assault?	Yes	1	HIST_PERP_PHYS_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_PERP_PHYS_ABUSE_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual abuse or assault?	Yes	1	HIST_PERP_SEXUAL_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_PERP_SEXUAL_ABUSE_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… emotional abuse or assault?	Yes	1	HIST_PERP_EMOT_ABUSE
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_PERP_EMOT_ABUSE_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual harassment?	Yes	1	HIST_PERP_SEX_HARASS
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	HIST_PERP_SEX_HARASS_TIME
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Please describe any known childhood or developmental history	[Type in text entry up to 4000 characters]		HIST_CONTRIB_CHILD_DEV
that may have contributed to the event
How many deployments?	0	1	HIST_DEPLOY_COUNT
	1	2
	2	3
	3 or more	4
… If number is greater than zero,
Please specify the MOST RECENT deployment first…
Deployment location 1	United States	1	HIST_DEPLOY1_LOC
	Iraq	2
	Afghanistan	3
	Kuwait	4
	Korea	5
	Kosovo	6
	Other Europe	7
	North America	8
	Central or South America	9
	Other	100
… Deployment 1 start date	[Calendar pop-up]		HIST_DEPLOY1_START_DATE
… Deployment 1 end date	[Calendar pop-up]		HIST_DEPLOY1_END_DATE
… Deployment 1 R&R start date	[Calendar pop-up]		HIST_DEPLOY1_RR_START_DATE
… Deployment 1 R&R end date	[Calendar pop-up]		HIST_DEPLOY1_RR_END_DATE
Deployment location 2	United States	1	HIST_DEPLOY2_LOC
	Iraq	2
	Afghanistan	3
	Kuwait	4
	Korea	5
	Kosovo	6
	Other Europe	7
	North America	8
	Central or South America	9
	Other	100
… Deployment 2 start date	[Calendar pop-up]		HIST_DEPLOY2_START_DATE
… Deployment 2 end date	[Calendar pop-up]		HIST_DEPLOY2_END_DATE
Deployment location 3	United States	1	HIST_DEPLOY3_LOC
	Iraq	2
	Afghanistan	3
	Kuwait	4
	Korea	5
	Kosovo	6
	Other Europe	7
	North America	8
	Central or South America	9
	Other	100
… Deployment 3 start date	[Calendar pop-up]		HIST_DEPLOY3_START_DATE
… Deployment 3 end date	[Calendar pop-up]		HIST_DEPLOY3_END_DATE
Did the patient/decedent experience direct combat operations?	Yes	1	HIST_DIRECT_COMBAT
	No	2
	Don't Know	101
… If yes, how long prior to event?
……. Deployment 1 (most recent)	Within 30 days	1	HIST_DIRECT_COMBAT_DEP1
	Within 3 months	2	HIST_DIRECT_COMBAT_DEP1_TIME
	Within 1 year	3
	Over 1 year ago	4
……. Deployment 2	[Simple check box]	1 = Selected	HIST_DIRECT_COMBAT_DEP2
……. Deployment 3	[Simple check box]	1 = Selected	HIST_DIRECT_COMBAT_DEP3
… If yes, did the patient/decedent…
……. and his/her unit engage in battle resulting in casualties/wounded?	Deployment 1 (most recent)	1 = Selected	HIST_COMBAT_CASUALTIES_DEP1
	Deployment 2		HIST_COMBAT_CASUALTIES_DEP2
	Deployment 3		HIST_COMBAT_CASUALTIES_DEP3
……. become wounded or injured in combat?	Deployment 1 (most recent)		HIST_COMBAT_INJURED_DEP1
	Deployment 2		HIST_COMBAT_INJURED_DEP2
	Deployment 3		HIST_COMBAT_INJURED_DEP3
……. personally witness a unit member, ally, enemy, or civilian	Deployment 1 (most recent)		HIST_COMBAT_WITNESS_DEP1
being seriously wounded or killed?	Deployment 2		HIST_COMBAT_WITNESS_DEP2
	Deployment 3		HIST_COMBAT_WITNESS_DEP3
……. see the bodies of dead soldiers or civilians following battle?	Deployment 1 (most recent)		HIST_COMBAT_SAW_BODIES_DEP1
	Deployment 2		HIST_COMBAT_SAW_BODIES_DEP2
	Deployment 3		HIST_COMBAT_SAW_BODIES_DEP3
……. kill others in combat (or have reason to believe others were	Deployment 1 (most recent)		HIST_COMBAT_KILL_DEP1
killed as a result of actions?	Deployment 2		HIST_COMBAT_KILL_DEP2
	Deployment 3		HIST_COMBAT_KILL_DEP3
Did the patient/decedent have orders to deploy?	Yes	1	EVENT_ORDERS_DEPLOY
	No	2
	Not applicable	3
	Don't Know	101
Was the event related to a deployment?	Yes	1	EVENT_RELATED_DEPLOYMENT
	No	2
	Don't Know	101
… If yes, what type of deployment(s)? (check all that apply)	Anticipated deployment	1 = Selected	EVENT_RELATED_DEPLOYMENT_ANT
	Current deployment		EVENT_RELATED_DEPLOYMENT_CUR
	Prior deployment		EVENT_RELATED_DEPLOYMENT_PRI
Please describe any additional relevant military history including	[Type in text entry up to 4000 characters]		HIST_ADDITIONAL_MILITARY
additional relevant deployment history
PRIOR TO THE EVENT, was there evidence of…
… a failed or failing spousal or intimate partner relationship?	Yes	1	HIST_FAILED_REL_SPOUSE
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_FAILED_REL_SPOUSE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a failed or failing other relationship?	Yes	1	HIST_FAILED_REL_OTHER
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_FAILED_REL_OTHER_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a completed spousal suicide?	Yes	1	HIST_SPOUSE_SUICIDE
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_SPOUSE_SUICIDE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a completed family suicide?	Yes	1	HIST_FAMILY_SUICIDE
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_FAMILY_SUICIDE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a completed suicide by a friend?	Yes	1	HIST_FRIEND_SUICIDE
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_FRIEND_SUICIDE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a death of spouse or family? (other than suicide)	Yes	1	HIST_FAMILY_DEATH
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_FAMILY_DEATH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… the death of a friend? (other than suicide)	Yes	1	HIST_FRIEND_DEATH
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_FRIEND_DEATH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a physical health problem?	Yes	1	HIST_PHYSICAL_HEALTH
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_PHYSICAL_HEALTH_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a chronic spousal or family severe illness?	Yes	1	HIST_FAMILY_ILLNESS
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_FAMILY_ILLNESS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… excessive debt or bankruptcy?	Yes	1	HIST_DEBT_BANKRUPTCY
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_DEBT_BANKRUPTCY_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… job problems? (e.g. laid off, fired, excessive pressure)	Yes	1	HIST_JOB_PROBLEMS
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_JOB_PROBLEMS_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… supervisor or coworker issues or problems?	Yes	1	HIST_COWORKER_ISSUES
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_COWORKER_ISSUES_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a poor work performance review or evaluation? (e.g. bar for	Yes	1	HIST_POOR_PERFORMANCE
reenlistment, flagged record, extra duty imposed)	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_POOR_PERFORMANCE_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… unit or workplace hazing?	Yes	1	HIST_WORKPLACE_HAZING
	-- If yes, how long prior to the event? (select the most recent occurance)		HIST_WORKPLACE_HAZING_TIME
	---- Within 30 days	1
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Did the patient/decedent have a family history of mental illness?	Yes	1	HIST_FAMILY_MENTAL
	No	2
	Don't Know	101
Was there a gun in the home or immediate environment?	Yes	1	HIST_GUN_IN_HOME
	no	2
	Don't Know	101
Please describe or elaborate on any additional details related to	[Type in text entry up to 4000 characters]		HIST_ADDITIONAL_HOME_WORK
these factors (Items 77-92)
Section V - Narrative Summary
(For Providers Only) Provide a brief "bio-psycho-social" formulation	[Type in text entry up to 4000 characters]	(Army/AF only)	SUM_BIO_PSYCHO_SOCIAL
as to WHY this patient/decedent engaged in suicidal behavior.
Today's date	[Auto-filled]		ASER_TODAYS_DATE
Location where this DoDSER was completed	Same as geographic event location	1	ASER_LOC_SAME
	Other location	2	ASER_LOC_OTHER
-- If other location,
---- Country	[Pull-down menu]	[Codes delineated below]	ASER_LOC_COUNTRY_OTHER
---- If United States, State	[Pull-down menu]	[Codes delineated below]	ASER_LOC_STATE
---- City, post, or camp	[Type in text entry]		ASER_LOC_CITY
Medical facility where this DoDSER was completed or supporting MTF	[Pull-down menu] (Army/AF only)	[Codes delineated below]	ASER_LOC_MEDICAL_FACILITY
Behavioral Health provider
-- Name	[Type in text entry] (Army/AF only)		ASER_PROVIDER_NAME
-- Rank/grade	[Type in text entry] (Army/AF only)		ASER_PROVIDER_RANK
-- Phone number	[Type in text entry] (Army/AF only)		ASER_PROVIDER_PHONE
-- DSN prefix	[Type in text entry] (Army/AF only)		ASER_PROVIDER_DSN
-- Email	[Type in text entry] (Army/AF only)		ASER_PROVIDER_EMAIL
-- Specialty (Army/AF only)	Licensed Mental Health Counselor or equivalent	1	ASER_PROVIDER_SPECIALTY
	Psychiatric Nurse	2
	Psychiatrist	3
	Psychologist	4
	Social Worker	5
	Other	100
Form Completer (Non-Behavioral Health Provider)
-- Name	[Type in text entry]		ASER_COMPLETER_NAME
-- Rank/grade	[Type in text entry]		ASER_COMPLETER_RANK
-- Command (Navy/Marines only)	[Type in text entry]		ASER_COMPLETER_COMMAND
-- Phone number	[Type in text entry]		ASER_COMPLETER_PHONE
-- DSN prefix	[Type in text entry]		ASER_COMPLETER_DSN
-- Email	[Type in text entry]		ASER_COMPLETER_EMAIL
Information based on certain types of records requires special	Interviews with:	1 = Selected
privacy protection by some Service's suicide surveillance programs.	-- The patient (non-fatalities)	(Army/AF only)	SOURCE_INTERVIEW_PATIENT
Please indicate what sources of information were used to compile	-- Co-workers/supervisors		SOURCE_INTERVIEW_COWORKERS
this report (check all that apply)	-- Responsible investigative agency officer		SOURCE_INTERVIEW_OFFICER
	-- Involved professionals, such as physicians, behavioral health clinicians, drug and		SOURCE_INTERVIEW_PROFESSIONALS
	alcohol counselors, chaplains, military police, family service personnel (e.g. ACS), etc.
	-- Family members		SOURCE_INTERVIEW_FAMILY
	Review of records including:
	-- Medical and behavioral health records		SOURCE_REVIEW_MEDICAL
	-- Family Advocacy Records		SOURCE_REVIEW_ADVOCACY
	-- Army Substance Abuse Program records (ASAP)		SOURCE_REVIEW_SUBSTANCE_ABUSE
	-- Substance Abuse Program records		SOURCE_REVIEW_SUBAbNotArmy
	-- Personnel Records		SOURCE_REVIEW_PERSONNEL
	-- Responsible investigative agency records (e.g. CID)		SOURCE_REVIEW_AGENCY
	-- Court-martial records		SOURCE_REVIEW_COURTMARTIAL
	-- Records related to manner of death, such as casualty reports, toxicology/lab		SOURCE_REVIEW_MANNER
	reports, pathology/autopsy reports, suicide notes, etc.
Comments	[Type in text entry up to 4000 characters]		ASER_COMMENTS
[Pay Grade Codes]		[MOS/Job Codes]
11 = E1		9 = Officer Candidates
12 = E2		11 = Infantry
13 = E3		13 = Field Artillery
14 = E4		14 = Air Defense Artillery
15 = E5		15 = Aviation
16 = E6		18 = Special Forces
17 = E7		19 = Armor
18 = E8		21 = (63B) Corps of Engineers
19 = E9		25 = Signal Corps
		27 = Paralegal
21 = W1		31 = Military Police Corps
22 = W2		33 = Electronic Warfare
23 = W3		35 = Military Intelligence
24 = W4		37 = Psychological Operations Corps
25 = W5		38 = Civil Affairs
		42 = Adjutant General
31 = O1		44 = Finance
32 = O2		45 = Armament Maintenance
33 = O3		46 = Public Affairs
34 = O4		52 = Special Equipment
35 = O5		56 = Religious Support
36 = O6		63 = Vehicle Maintenance
37 = O7		68 = (60-71, 91) Medical Department
38 = O8		74 = Chemical
39 = O9		79 = Recruitment and Re-enlistment
40 = O10		88 = Transportation
50 = Cadet/Midshipman		89 = Explosives and Ammunition
		92 = (43, 57) Quartermaster Corps
		94 = (27, 62, 91) Electronic Maintenance
		96 = Intelligence
		97 = Counter/Human Intelligence
		98 = Communications Intelligence
		999 = Other
[Country Codes]		[State Codes]
0 = United States		0 = Alabama
1 = Iraq		1 = Alaska
2 = Afghanistan		2 = Arizona
3 = Kuwait		3 = Arkansas
4 = Korea		4 = California
5 = Kosovo		5 = Colorado
6 = Other Europe		6 = Connecticut
7 = North America		7 = Delaware
8 = Central or South America		8 = District of Columbia
999 = Other		9 = Florida
		10 = Georgia
		11 = Hawaii
		12 = Idaho
		13 = Illinois
		14 = Indiana
		15 = Iowa
		16 = Kansas
		17 = Kentucky
		18 = Louisiana
		19 = Maine
		20 = Maryland
		21 = Massachusetts
		22 = Michigan
		23 = Minnesota
		24 = Mississippi
		25 = Missouri
		26 = Montana
		27 = Nebraska
		28 = Nevada
		29 = New Hampshire
		30 = New Jersey
		31 = New Mexico
		32 = New York
		33 = North Carolina
		34 = North Dakota
		35 = Ohio
		36 = Oklahoma
		37 = Oregon
		38 = Pennsylvania
		39 = Rhode Island
		40 = South Carolina
		41 = South Dakota
		42 = Tennessee
		43 = Texas
		44 = Utah
		45 = Vermont
		46 = Virginia
		47 = Washington
		48 = West Virginia
		49 = Wisconsin
		50 = Wyoming
[Division Codes]		[Medical Facility Codes]
1 = 1st Armored Division		1 = Fox Army Health Center
2 = 1st Cavalry Division		3 = Lyster Army Community Hospital
3 = 1st Infantry Division		5 = Bassett Army Community Hospital
4 = 2nd Infantry Division		8 = RW Bliss Army Health Center
5 = 3rd Infantry Division		32 = Evans Army Community Hospital
6 = 4th Infantry Division		37 = Walter Reed Army Medical Center
7 = 10th Mountain Division		47 = Eisenhower Army Medical Center
8 = 25th Infantry Division		48 = Martin Army Community Hospital
9 = 82nd Airborne Division		49 = Winn Army Community Hospital
10 = 101st Airborne Division		52 = Tripler Army Medical Center
11 = 7th Infantry Division		57 = Irwin Army Community Hospital
12 = 24th Infantry Division		58 = Munson Army Health Center
13 = 28th Infantry Division		60 = Blanchfield Army Community Hospital
14 = 29th Infantry Division		61 = Ireland Army Community Hospital
15 = 34th Infantry Division		64 = Bayne-Jones Army Community Hospital
16 = 35th Infantry Division		69 = Kimbrough Ambulatory Care Center
17 = 38th Infantry Division		75 = General Leonard Wood Army Community Hospital
18 = 40th Infantry Division		81 = Patterson Army Health Center
19 = 42nd Infantry Division		86 = Keller Army Community Hospital
20 = 49th Armored Divisioln		89 = Womack Army Medical Center
21 = 75th Division (Training Support)		98 = Reynolds Army Community Hospital
22 = 78th Division (Training Support)		105 = Moncrief Army Community Hospital
23 = 80th Division (Institutional Training)		108 = William Beaumont Army Medical Center
24 = 84th Division (Training Support)		109 = Brooke Army Medical Center
25 = 85th Division (Training Support)		110 = Darnall Army Medical Center
26 = 87th Division (Training Support)		121 = McDonald Army Health Center
27 = 91st Division (Training Support)		122 = Kenner Army Health Center
28 = 95th Division (Institutional Training)		123 = DeWitt Army Community Hospital
29 = 98th Division (Institutional Training)		125 = Madigan Army Medical Center
30 = 100th Division (Institutional Training)		131 = Weed Army Community Hospital
31 = 104th Division (Institutional Training)		247 = Monterey Army Health Center
32 = 108th Division (Institutional Training)		256 = DiLorenzo Tricare Health Clinic
		273 = Lawrence Joel Army Health Center
		308 = Kirk Army Health Center
		309 = Barquist Army Health Center
		330 = Guthrie Army Health Center
		352 = Dunham Army Health Center
		390 = Andrew Rader Army Health Center
		606 = US Army MEDDAC Heidelberg
		607 = Landstuhl Regional Medical Center
		609 = US Army MEDDAC Bavaria
		610 = US Army MEDDAC Camp Zama, Japan
		612 = 121st General Hospital, Korea
		953 = Rodriguez Army Health Center, Puerto Rico
		222 = Iraq
		33 = Kuwait
		444 = Afghanistan
		999 = Other

---

Sheet 5: DODSER 2009

DoDSER 2009 CY(1 Jul-31 Dec 2009)
DoDSER 2009 changes went in to effect 1 July 2009, no changes were made from CY 2008 to 30 June 2009!!!
Yellow highlight indicates items that were added or modified from previous version.
Red highlight indicates items that were deleted from previous version.
Event reports initiated during previous CY and submited during current CY will include current CY questions and variables
Question	Answer Choices	Data Values	Variable Labels
Section 1 - Patient/Decedent Personal Information
Event Type	Suicide	1	eventType
	Suicide attempt (evidence of intent to die)	2
	Self harm (without intent to die)	3 (Army only)
	Suicidal ideation only (without an attempt/self harm)	4 (Army only)
Event Date	[Calendar pop-up]		eventDate
Event Time	[Type in numeric military time]		eventTime
Last Name	[Type in text entry]		patLastName
First Name	[Type in text entry]		patFirstName
Middile Initial	[Type in text entry]		patMiddleInitial
Social Security Number	[Type in text entry]		patSsn
Date of Birth	[Calendar pop-up]		patDob
Sex	Male	1	patSex
	Female	2
Relationship to sponsor	Sponsor	1	patSponsorRelation
	Spouse	2
	Dependent	3
	Other	100
Service	Army	1	patService
	Air Force	2
	Navy	3
	Marines	4
	Coast Guard	5
	Foreign Military	6
	Other uniformed service	7
	Other	100
Racial category	American Indian/Alaskan Native	1	patRace
	Asian/Pacific Islander	2
	Black/African American	3
	White/Caucasian	4
	Other	100
	Don't Know	101
Specific ethnic group	Hispanic		PatEthnic
	-- Mexican	11
	-- Puerto Rican	12
	-- Cuban	13
	-- Latin American	14
	-- Other Spanish	15
	Native American
	-- Aleut	21
	-- Eskimo	22
	-- U.S./Canadian Indian Tribes	23
	Asian
	-- Chinese	31
	-- Japanese	32
	-- Korean	33
	-- Indian	34
	-- Filipino	35
	-- Vietnamese	36
	-- Other Asian	37
	Pacific Islander
	-- Melanesian	41
	-- Polynesian	42
	-- Other Pacific Islands	43
	Other	100
	Don't Know	101
Current marital status	Never married	1	patMarital
	Married	2
	Legally separated	3
	Divorced	4
	Widowed	5
	Don't Know	101
-- If married,	Resides with spouse	1	patMaritalReside
	Separated due to relationship issues	2
	Separated for reasons other than relationship (e.g. deployed)	3
	Don't Know	101
Education	Some high school, did not graduate	1	patEducation
	GED	2
	High school graduate	3
	Some college or technical school, no degree or certificate	4
	College degree of less than four years or technical school certificate	5
	Four-year college degree	6
	Master's degree or greater	7
	Don't Know	101
Residence at time of event	Barracks, tents, or other shared military living environment	1	patResidence
	Bachelor Enlisted Quarters (BEQ) or Bachelor Officer Quarters (BOQ)	2
	On-base family housing	3
	Owned or leased apartment or house	4
	Ship	5
	Other	100
	Don't Know	101
Did the patient/decedent reside alone at the time	Yes	1	patResideAlone
of the event?	No	2
	Don't Know	101
Did the patient/decedent have minor children?	Yes	1	patChildren
	No	2
	Don't Know	101
-- If yes, were the children residing with him/her?	Yes	1	patChildrenResideWith
	No	2
	Don't Know	101
Section II - Sponsor's Military Information
Component/Military status	Regular (e.g. Army, Air Force)	1	sponsorComponent
	Reserve (e.g. USAR, USMCR)	2
	National Guard	3
	Other	100
Job code (MOS, SSI, AFSC, DAFSC, or other military job code)	[Pull-down menu of Army MOS codes]	[Codes delineated below]	sponsorJobCode
	Air Force/Marine Corp/Navy	[Type in text entry]	sponsorJobCodeNonArmy
Duty status at time of event (check all that apply)	Active Duty 8	1 = Selected	sponsorDutyStatusActive
	ADSW (Active Duty order for Special Work) (Marines)		sponsorDutyStatusAdsw
	AGR (Active Guard/Reserve) 8		sponsorDutyStatusAgr
	AR/AGR (Marines only)		sponsorDutyStatusAgr
	Basic Training (Army/Air Force only)		sponsorDutyStatusIet
	Advanced Individualized Training (AIT) (Army/Air Force only)		sponsorDutyStatusAit
	Mobilized RC (Reserve and National Guard)		sponsorDutyStatusMobilized
	ADT (Active Duty for Training) (Army/Air Force only)		sponsorDutyStatusAdt
	AT/ADT (Active Duty for Training) (Navy/Marines)		sponsorDutyStatusAdt
	INADT (Initial Active Duty for Training orders) (Navy/Marines)		sponsorDutyStatusInadt
	IDT (Weekend Reserve Drill)		sponsorDutyStatusIdt
	Retired		sponsorDutyStatusRetired
	Released from active duty within 120 days		sponsorDutyStatusReleased
	Not on Active Duty or in a Drill Status		sponsorDutyStatusNotActive
	SELRES (Not on Active Duty or in a Drill Status) Army only		sponsorDutyStatusNotActive
	Does not apply		sponsorDutyStatusNa
	Other		sponsorDutyStatusOther
Pay grade	[E1-E9; W1-W5; O1-O10; Cadet/Midshipman	[Codes delineated below]	sponsorGrade
	Does not apply	102
Permanent duty station/command location	Same as geographic event location	1	SponsorDutyStationSame
	Other location	2
If other location
---- Country	[Pull-down menu]	[Codes delineated below]	sponsorDutyStationCountry
---- If United States, State		[Codes delineated below]	sponsorDutyStationState
---- City, post or camp		[Type in text entry]	sponsorDutyStationCity
Permanent duty assignment
-- Division	[Pull-down menu]	[Codes delineated below]	sponsorDutyAssignDivision
-- Brigade	[Type in text entry]		sponsorDutyAssignBrigade
-- Battalion	[Type in text entry]		sponsorDutyAssignBattalion
-- Company	[Type in text entry]		sponsorDutyStationState
Command	(Air Force)		sponsorAssignCommand
Name of unit	(Navy/Marines)		sponsorAssignNavyUnit
MSC (Marines)/Echelon 2 (Navy)	(Navy/Marines)		sponsorAssignMarMsc
MAJCOM (Marines)	(Navy/Marines)		sponsorAssignMarMaj
Force (Marines)	(Navy/Marines)		sponsorAssignMarForce
UIC or other unit identification	[Type in text entry]		sponsorUic
In a Warrior Transition Unit (Army Only)	Check box		sponsorWtu
Length of time in unit	[Type in years]		sponsorTimeUnitYears
	[Type in months]		sponsorTimeUnitMonths
Section III - Event Information
Geographic location of event
-- Country	[Pull-down menu]	[Codes delineated below]	eventLocationCountry
-- If United States, State	[Pull-down menu]	[Codes delineated below]	eventLocationState
-- City/post/camp	[Type in text entry]		eventLocationCity
Event setting	Residence (own) or barracks	1	eventSetting
	Residence of friend or family	2
	Work/jobsite	3
	Automobile (away from residence)	4
	Inpatient medical facility	5
	Other	100
Actions taken as a consequence of the current event	Hospitalization (inpatient)	1 = Selected	eventActionHospitalized
(this item will not appear if event is a completed suicide)	Outpatient mental health evaluation/treatment		eventActionOutpatient
	Evacuation		eventActionEvacuated
	Other		eventActionOther
-- If hospitalization,
---- Start date of hospitalization	[Calendar pop-up]		eventHospStartDate
	Check if unknown	1 = Selected	eventHospStartUnknown
---- End date of hospitalization	[Calendar pop-up]		eventHospEndDate
	Check if unknown	1 = Selected	eventHospEndUnknown
	Check if patient is still in the inpatient facility		eventHospEndStill
Primary method used
	Drugs	1	eventMethod
	Alcohol	2
	Gas, vapor poisoning by vehicle exhaust	3
	Gas, vapor poisoning by utility (or other) gas	4
	Solvents, pesticides and other agricultural chemicals	5
	Hanging	6
	Drowning	7
	Firearm/gun, military issue or duty weapon	8
	Firearm/gun, other than military issue	9
	Fire, steam, etc.	10
	Sharp or blunt object	11
	Jumping from high place	12
	Lying in front of a moving object	13
	Crashing a motor vehicle	14
	Other	100
	Don't Know	101
During the event, was alcohol used?	Yes	1	eventAlcohol
	No	2
	Don't Know	101
During the event, were drugs used?	Yes	1	eventDrugs
	No	2
	Don't Know	101
-- If yes, what types of drugs were used?
---- Drugs (illicit/illegal)	Overdose	1	eventDrugsIllegal
	Used, no overdose	2
	Were not used	3
---- Prescription medications	Overdose	1	eventDrugsPrescription
	Used, no overdose	2
	Were not used	3
---- Non-prescription medications (e.g. over-the-counter medications)	Overdose	1	eventDrugsOtc
	Used, no overdose	2
	Were not used	3
Is there evidence that the patient/decedent intended to die?	Yes	1	eventIntentDieEvidence
	No	2
	Cannot determine	3
Were there self-inflicted injuries (including poisoning)?	Yes	1	eventSelfInflictedInjuries
	No	2
	Cannot determine	3
Is there evidence the event involved death-risk gambling?	Yes	1	eventDeathRiskGambling
(e.g. Russian roulette, walking railroad tracks, playing "chicken")	No	2
	Cannot determine	3
Is there evidence the event was planned and/or premeditated?	Yes	1	eventPlanned
	No	2
	Cannot determine	3
Was the event performed under circumstances where it would	Yes	1	eventObservable
be observed and intervened in by others?	No	2
	Don't Know	101
Was a suicide note left?	Yes	1	eventSuicideNote
	No	2
	Don't Know	101
Prior to the event, did the patient/decedent communicate	Yes	1	eventCommunicate
potential for self-harm? (other than a suicide note)	No	2
	Don't Know	101
-- If yes, how? (check all that apply)	Written	1 = Selected	eventCommunicateHowWritten
	Verbal		eventCommunicateHowVerbal
	Other		eventCommunicateHowOther
-- To whom? (check all that apply)	Supervisor		eventCommunicateWhoSuper
	Chaplain		eventCommunicateWhoChap
	Mental health staff		eventCommunicateWhoMhstaff
	Friend		eventCommunicateWhoFriend
	Spouse or significant other		eventCommunicateWhoSpouse
	Other		eventCommunicateWhoOther
What was the patient/decedent's primary motivation for performing this event?	Emotion relief (e.g. to stop bad feelings, self-hatred, anxiety relief)	1	eventMotivationEmotionRelief
	Interpersonal influence (e.g. to get help, get attention, shock others)	2	eventMotivationInfluence
(ARMY/AF ONLY)	Feeling generation (e.g. to stop feeling numb)	3	eventMotivationFeelingGeneration
Responses may be populated for Navy/Marines on 2009 questionnaires if record completed in 2010	Avoidance/escape (e.g. to avoid or escape deployment, prevent being hurt in other ways)	4	eventMotivationAvoidance
	Individual reasons (e.g. self-punishment, to express anger, be with deceased loved one)	5	eventMotivationIndividualReasons
	Hopelessness (e.g. pessimistic regarding future)	6	eventMotivationHopelessness
	Depression (e.g. chronic or severe clinically depressed modd)	7	eventMotivationDepression
	Other psychiatric symptoms (e.g. PTSD, psychotic)	8	eventMotivationOtherPsychiatric
	Impulsivity (e.g. due to substance abuse, personality characteristics)	9	eventMotivationImpulsivity
	Other	100	eventMotivationOther
	Don't Know	101	eventMotivationDontKnow
Duty environment/status at time of event (check all that apply)	Garrison	1 = Selected	eventDutyEnvGarrison
	Leave		eventDutyEnvLeave
	TDY/TAD		eventDutyEnvTdy
	AWOL/ UA		eventDutyEnvAwol
	Deployed		eventDutyEnvDeployed
	Training		eventDutyEnvTraining
	Psychiatric hospitalization		eventDutyEnvPsych
	Medical hold		eventDutyEnvMedicalHold
	In evacuation chain		eventDutyEnvEvacuation
	Under command observation (e.g. CIP)		eventDutyEnvCommandObs
	With Permanent Command (Navy/Marines only)		eventdutyEnvPercomm
	Correctional Facility		eventDutyEnvCorrFacility
	Other		eventDutyEnvOther
Please describe the general sequence of events leading up to	[Type in text entry up to 4000 characters]		eventSequenceEvents
the ideation/attempt/completion and discovery/intervention.
Section IV - History
PRIOR TO THE EVENT, was the patient/decedent seen by…
… a Medical Treatment Facility?	Yes	1	histMtf
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histMtfTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Substance Abuse Services?	Yes	1	histSas
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histSasTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a Family Advocacy Program?	Yes	1	histFap
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histFapTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Chaplain services?	Yes	1	histChaplain
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histChaplainTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Outpatient Mental Health? (including deployment mental	Yes	1	histOutpatientMh
health services)	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histOutpatientMhTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101	histInpatientMhMedLocation
… Inpatient Mental Health? (including deployment mental	Yes	1	histInpatientMh
health services)	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histInpatientMhTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
PRIOR TO THE EVENT, had the patient/decedent…
… been diagnosed with any Mood Disorder (e.g. major depression, etc.)?	Yes	1	histMood
	No	2
	Don't Know	101
…….If yes, been diagnosed with a Bipolar Disorder?	Yes	1	histBipolar
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histBipolarTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Major Depression?	Yes	1	histMajorDepression
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histMajorDepressionTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Dysthymic Disorder?	Yes	1	histDysthymic
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histDysthymicTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with any other Mood Disorder?	Yes	1	histOtherMood
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histOtherMoodTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with an Anxiety Disorder (e.g. PTSD, etc.)?	Yes	1	histAnxiety
	No	2
	Don't Know	101
……. If yes, been diagnosed with PTSD?	Yes	1	histPtsd
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPtsdTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Panic Disorder?	Yes	1	histPanic
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPanicTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Generalized Anxiety Disorder?	Yes	1	histGenAnxiety
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histGenAnxietyTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with Acute Stress Disorder?	Yes	1	histStress
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histStressTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. been diagnosed with any other Anxiety Disorder?	Yes	1	histOtherAnxiety
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histOtherAnxietyTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with a Personality Disorder?	Yes	1	histPersonality
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPersonalityTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with a Psychotic Disorder?	Yes	1	histPsychotic
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPsychotictime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… been diagnosed with a traumatic brain injury (TBI)?	Yes	1	histTbi
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histTbiTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… had a history of Substance Abuse?	Yes	1	histSubstanceAbuse
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histSubstanceAbuseTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. If the patient/decedent had a history with substance abuse,
select all that apply	Alcohol Dependence	1 = Selected	histSubstanceAlcoholDep
	Alcohol Abuse		histSubstanceAlcoholAbuse
	Drugs (illicit/illegal) Dependence		histSubstanceDrugsDep
	Drugs (illicit/illegal) Abuse		histSubstanceDrugsAbuse
	Prescription medications Dependence		histSubstancePrescripDep
	Prescription medications Abuse		histSubstancePrescripAbuse
	Non-prescription medications (e.g. OTC medication) Dependence		histSubstanceOtcDep
	Non-prescription medications (e.g. OTC medication) Abuse		histSubstanceOtcAbuse
… taken Psychotropic Medications?	Yes	1	histPsychotropicMeds
	No	2
	Don't Know	101
……. If yes, taken Antidepressants?	Yes	1	histAntidepressants
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histAntidepressantsTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
…….. taken Anti-anxiety?	Yes	1	histAntianxiety
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histAntianxietyTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. taken Antimanics?	Yes	1	histAntimanics
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histAntimanicsTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. taken Anticonvulsants?	Yes	1	histAnticonvulsants
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histAnticonvulsantsTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. taken Antipsychotics?	Yes	1	histAntipsychotics
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histAntipsychoticsTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… had prior self-injurious events?	Yes	1	histPriorSelfInjury
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPriorSelfInjuryTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
……. If yes, how many prior events?	One prior event	1	histPriorSelfInjuryOne
	More than one prior event	2
……. Was this event similar to prior event(s)?	Yes	1	histPriorSelfInjurySim
	No	2
	Don't Know	101
……. Age at first self-injurious event	[Type in text entry]		histPriorSelfInjuryAge
Did the patient/decedent receive his/her required suicide prevention	Yes	1	histReceiveTraining
trainings?	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histReceiveTrainingTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
What training was received and how was it delivered	[Type in text entry up to 4000 characters]		histReceivedTrainingList
Please elaborate on any other relevant details related to the	[Type in text entry up to 4000 characters]		histOtherMhTreatment
patient/decedent's menthal health treatment history
PRIOR TO THE EVENT, was the patient/decedent the subject of…
… Courts Martial proceedings?	Yes	1	histCourtsMartial
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histCourtsMartialTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Article 15 proceedings or civilian criminal problems?	Yes (Army/Air Force only)	1	histArticle15
… NJP or Civilian Criminal Proceedings?	Yes (Navy/Marines)	1	histNjp
	-- If yes, how long prior to the event? (select the most recent occurance)		histArticle15Time
	---- Within 30 days	1	histNjpTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… Administrative Separation proceedings?	Yes	1	histAdminSeparation
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histAdminSeparationTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… AWOL/UA?	Yes	1	histAwol
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histAwolTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a Medical Evaluation Board?	Yes	1	histMedicalBoard
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histMedicalBoardTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… civil legal problems? (e.g. child custody dispute, litigation)	Yes	1	histCivilLegal
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histCivilLegalTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… non-selection for advanced schooling, promotion, or command?	Yes	1	histNonSelection
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histNonSelectionTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Please describe or elaborate on life stressors or other circumstances	[Type in text entry up to 4000 characters]		histOtherLifeStressors
affecting the patient/decedent prior to the event
PRIOR TO THE EVENT, was the patient/decedent an alleged or
confirmed VICTIM of…
… physical abuse or assault?	Yes	1	histVictPhysAbuse
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histVictPhysAbuseTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual abuse or assault?	Yes	1	histVictSexualAbuse
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histVictSexualAbuseTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… emotional abuse or assault?	Yes	1	histVictEmotAbuse
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histVictEmotAbuseTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual harassment?	Yes	1	histVictSexHarass
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histVictSexHarassTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
PRIOR TO THE EVENT, was the patient/decedent an alleged or
confirmed PERPETRATOR of…
… physical abuse or assault?	Yes	1	histPerpPhysAbuse
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPerpPhysAbuseTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual abuse or assault?	Yes	1	histPerpSexualAbuse
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPerpSexualAbuseTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… emotional abuse or assault?	Yes	1	histPerpEmotAbuse
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPerpEmotAbuseTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… sexual harassment?	Yes	1	histPerpSexHarass
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPerpSexHarassTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Please describe any known childhood or developmental history	[Type in text entry up to 4000 characters]		histContribChildDev
that may have contributed to the event
How many deployments?	0	1	histDeployCount
	1	2
	2	3
	3 or more	4
… If number is greater than zero,
Please specify the MOST RECENT deployment first…
Deployment location 1	United States	1	histDeploy1LocUs
	Iraq	2	histDeploy1LocIraq
	Afghanistan	3	histDeploy1LocAfghanistan
	Kuwait	4	histDeploy1LocKuwait
	Korea	5	histDeploy1LocKorea
	Kosovo	6	histDeploy1LocKosovo
	Other Europe	7	histDeploy1LocOtherEurope
	North America	8	histDeploy1LocNorthAmerica
	Central or South America	9	histDeploy1LocCentralOrSouthAmerica
	Shipboard	10	histDeploy1LocShipboard
	Other	100	histDeploy1LocOther
… Deployment 1 start date	[Calendar pop-up]		histDeploy1StartDate
… Deployment 1 end date	[Calendar pop-up]		histDeploy1EndDate
… Deployment 1 R&R start date	[Calendar pop-up]		histDeploy1RrStartDate
… Deployment 1 R&R end date	[Calendar pop-up]		histDeploy1RrEndDate
Deployment location 2	United States	1	histDeploy2LocUs
	Iraq	2	histDeploy2LocIraq
	Afghanistan	3	histDeploy2LocAfghanistan
	Kuwait	4	histDeploy2LocKuwait
	Korea	5	histDeploy2LocKorea
	Kosovo	6	histDeploy2LocKosovo
	Other Europe	7	histDeploy2LocOtherEurope
	North America	8	histDeploy2LocNorthAmerica
	Central or South America	9	histDeploy2LocCentralOrSouthAmerica
	Shipboard	10	histDeploy2LocShipboard
	Other	100	histDeploy2LocOther
… Deployment 2 start date	[Calendar pop-up]		histDeploy2StartDate
… Deployment 2 end date	[Calendar pop-up]		histDeploy2EndDate
Deployment location 3	United States	1	histDeploy3LocUs
	Iraq	2	histDeploy3LocIraq
	Afghanistan	3	histDeploy3LocAfghanistan
	Kuwait	4	histDeploy3LocKuwait
	Korea	5	histDeploy3LocKorea
	Kosovo	6	histDeploy3LocKosovo
	Other Europe	7	histDeploy3LocOtherEurope
	North America	8	histDeploy3LocNorthAmerica
	Central or South America	9	histDeploy3LocCentralOrSouthAmerica
	Shipboard	10	histDeploy3LocShipboard
	Other	100	histDeploy3LocOther
… Deployment 3 start date	[Calendar pop-up]		histDeploy3StartDate
… Deployment 3 end date	[Calendar pop-up]		histDeploy3EndDate
Was a waiver to deploy required and/or obtained for OIF/OEF?	Yes	1	histDeployWaiver
	No	2
	Don't Know	101
Did the patient/decedent experience direct combat operations?	Yes	1	histDirectCombat
	No	2
	Don't Know	101
… If yes, how long prior to event?			histDirectCombatDep1
……. Deployment 1 (most recent)	Within 30 days	1	histDirectCombatDep1Time
	Within 3 months	2
	Within 1 year	3
	Over 1 year ago	4
……. Deployment 2	[Simple check box]	1 = Selected	histDirectCombatDep2
……. Deployment 3	[Simple check box]	1 = Selected	histDirectCombatDep3
… If yes, did the patient/decedent…
……. and his/her unit engage in battle resulting in casualties/wounded?	Deployment 1 (most recent)	1 = Selected	histCombatCasualtiesDep1
	Deployment 2		histCombatCasualtiesDep2
	Deployment 3		histCombatCasualtiesDep3
……. become wounded or injured in combat?	Deployment 1 (most recent)		histCombatInjuredDep1
	Deployment 2		histCombatInjuredDep2
	Deployment 3		histCombatInjuredDep3
……. personally witness a unit member, ally, enemy, or civilian	Deployment 1 (most recent)		histCombatWitnessDep1
being seriously wounded or killed?	Deployment 2		histCombatWitnessDep2
	Deployment 3		histCombatWitnessDep3
……. see the bodies of dead soldiers or civilians following battle?	Deployment 1 (most recent)		histCombatSawBodiesDep1
	Deployment 2		histCombatSawBodiesDep2
	Deployment 3		histCombatSawBodiesDep3
……. kill others in combat (or have reason to believe others were	Deployment 1 (most recent)		histCombatKillDep1
killed as a result of actions?	Deployment 2		histCombatKillDep2
	Deployment 3		histCombatKillDep3
Did the patient/decedent have orders to deploy?	Yes	1	eventOrdersDeploy
	No	2
	Not applicable	3
	Don't Know	101
Was the event related to a deployment?	Yes	1	eventRelatedDeployment
	No	2
	Don't Know	101
… If yes, what type of deployment(s)? (check all that apply)	Anticipated deployment	1 = Selected	eventRelatedDeploymentAnt
	Current deployment		eventRelatedDeploymentCur
	Prior deployment		eventRelatedDeploymentPri
Please describe any additional relevant military history including	[Type in text entry up to 4000 characters]		histAdditionalMilitary
additional relevant deployment history
PRIOR TO THE EVENT, was there evidence of…
… a failed or failing spousal or intimate partner relationship?	Yes	1	histFailedRelSpouse
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histFailedRelSpouseTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a failed or failing other relationship?	Yes	1	histFailedRelOther
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histFailedRelOtherTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a completed spousal suicide?	Yes	1	histSpouseSuicide
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histSpouseSuicideTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a completed family suicide?	Yes	1	histFamilySuicide
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histFamilySuicideTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a completed suicide by a friend?	Yes	1	histFriendSuicide
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histFriendSuicideTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a death of spouse or family? (other than suicide)	Yes	1	histFamilyDeath
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histFamilyDeathTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… the death of a friend? (other than suicide)	Yes	1	histFriendDeath
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histFriendDeathTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a physical health problem?	Yes	1	histPhysicalHealth
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPhysicalHealthTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a chronic spousal or family severe illness?	Yes	1	histFamilyIllness
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histFamilyIllnessTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… excessive debt or bankruptcy?	Yes	1	histDebtBankruptcy
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histDebtBankruptcyTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… job problems? (e.g. laid off, fired, excessive pressure)	Yes	1	histJobProblems
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histJobProblemsTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… supervisor or coworker issues or problems?	Yes	1	histCoworkerIssues
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histCoworkerIssuesTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… a poor work performance review or evaluation? (e.g. bar for	Yes	1	histPoorPerformance
reenlistment, flagged record, extra duty imposed)	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histPoorPerformanceTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
… unit or workplace hazing?	Yes	1	histWorkplaceHazing
	-- If yes, how long prior to the event? (select the most recent occurance)
	---- Within 30 days	1	histWorkplaceHazingTime
	---- Within 3 months	2
	---- Within 1 year	3
	---- Over 1 year ago	4
	No	2
	Don't Know	101
Did the patient/decedent have a family history of mental illness?	Yes	1	histFamilyMental
	No	2
	Don't Know	101
Was there a gun in the home or immediate environment?	Yes	1	histGunInHome
	no	2
	Don't Know	101
Please describe or elaborate on any additional details related to	[Type in text entry up to 4000 characters]		histAdditionalHomeWork
these factors (Items 77-92)
Section V - Narrative Summary
Question Asked of all Services
(For Medical Providers Only) Provide a brief "bio-psycho-social" formulation	[Type in text entry up to 4000 characters]		sumBioPsychoSocialMar
as to WHY this patient/decedent engaged in suicidal behavior.
Location where this DoDSER was completed	Same as geographic event location	1	aserLocSame
	Other location	2
-- If other location,
---- Country	[Pull-down menu]	[Codes delineated below]	aserLocCountry
---- If United States, State	[Pull-down menu]	[Codes delineated below]	aserLocState
---- City, post, or camp	[Type in text entry]		aserLocCity
Medical facility where this DoDSER was completed or supporting MTF
Army MTF	[Pull-down menu]	[Codes delineated below]	aserLocMedicalFacility
Air Force Command	[Type in text entry]		aserLocMedicalFacilityAf
Navy/Marine Corps Location	[Type in text entry]		aserLocMedicalFacilityOther
Behavioral Health provider	Question Asked of all Services
-- Name	[Type in text entry]		aserProviderName
-- Rank/grade	[Type in text entry]		aserProviderRank
-- Phone number	[Type in text entry]		aserProviderPhone
-- DSN prefix	[Type in text entry]		aserProviderDsn
-- Email	[Type in text entry]		aserProviderEmail
-- Specialty	Licensed Mental Health Counselor or equivalent	1	aserProviderSpecialty
	Psychiatric Nurse	2
	Psychiatrist	3
	Psychologist	4
	Social Worker	5
	Other	100
Form Completer (Non-Behavioral Health Provider)
-- Name	[Type in text entry]		aserCompleterName
-- Rank/grade	[Type in text entry]		aserCompleterRank
-- Command (Navy/Marines only)	[Type in text entry]		aserCompleterCommand
-- Phone number	[Type in text entry]		aserCompleterPhone
-- DSN prefix	[Type in text entry]		aserCompleterDsn
-- Email	[Type in text entry]		aserCompleterEmail
Information based on certain types of records requires special	Interviews with:	1 = Selected
privacy protection by some Service's suicide surveillance programs.	-- The patient (non-fatalities)	Question Asked of all Services	sourceInterviewPatient
Please indicate what sources of information were used to compile	-- Co-workers/supervisors		sourceInterviewCoworkers
this report (check all that apply)	-- Responsible investigative agency officer		sourceInterviewOfficer
	-- Involved professionals, such as physicians, behavioral health clinicians, drug and		sourceInterviewProfessionals
	alcohol counselors, chaplains, military police, family service personnel (e.g. ACS), etc.
	-- Family members		sourceInterviewFamily
	Review of records including:
	-- Medical and behavioral health records		sourceReviewMedical
	-- Family Advocacy Records		sourceReviewAdvocacy
	-- Army Substance Abuse Program records (ASAP)	Army Only	sourceReviewSubstanceAbuse
	Substance Abuse Program		sourceReviewSubAbNotArmy
	-- Personnel Records		sourceReviewPersonnel
	-- Responsible investigative agency records (e.g. CID)		sourceReviewAgency
	-- Court-martial records		sourceReviewCourtmartial
	-- Records related to manner of death, such as casualty reports, toxicology/lab		sourceReviewManner
	reports, pathology/autopsy reports, suicide notes, etc.
Comments	[Type in text entry up to 4000 characters]		aserComments
[Pay Grade Codes]		[MOS/Job Codes]
11 = E1		9 = Officer Candidates
12 = E2		11 = Infantry
13 = E3		13 = Field Artillery
14 = E4		14 = Air Defense Artillery
15 = E5		15 = Aviation
16 = E6		18 = Special Forces
17 = E7		19 = Armor
18 = E8		21 = (63B) Corps of Engineers
19 = E9		25 = Signal Corps
		27 = Paralegal
21 = W1		31 = Military Police Corps
22 = W2		33 = Electronic Warfare
23 = W3		35 = Military Intelligence
24 = W4		37 = Psychological Operations Corps
25 = W5		38 = Civil Affairs
		42 = Adjutant General
31 = O1		44 = Finance
32 = O2		45 = Armament Maintenance
33 = O3		46 = Public Affairs
34 = O4		52 = Special Equipment
35 = O5		56 = Religious Support
36 = O6		63 = Vehicle Maintenance
37 = O7		68 = (60-71, 91) Medical Department
38 = O8		74 = Chemical
39 = O9		79 = Recruitment and Re-enlistment
40 = O10		88 = Transportation
		89 = Explosives and Ammunition
50 = Cadet/Midshipman		92 = (43, 57) Quartermaster Corps
		94 = (27, 62, 91) Electronic Maintenance
		96 = Intelligence
		97 = Counter/Human Intelligence
		98 = Communications Intelligence
		999 = Other
[Country Codes]		[State Codes]
0 = United States		0 = Alabama
1 = Iraq		1 = Alaska
2 = Afghanistan		2 = Arizona
3 = Kuwait		3 = Arkansas
4 = Korea		4 = California
5 = Kosovo		5 = Colorado
6 = Other Europe		6 = Connecticut
7 = North America		7 = Delaware
8 = Central or South America		8 = District of Columbia
999 = Other		9 = Florida
		10 = Georgia
		11 = Hawaii
		12 = Idaho
		13 = Illinois
		14 = Indiana
		15 = Iowa
		16 = Kansas
		17 = Kentucky
		18 = Louisiana
		19 = Maine
		20 = Maryland
		21 = Massachusetts
		22 = Michigan
		23 = Minnesota
		24 = Mississippi
		25 = Missouri
		26 = Montana
		27 = Nebraska
		28 = Nevada
		29 = New Hampshire
		30 = New Jersey
		31 = New Mexico
		32 = New York
		33 = North Carolina
		34 = North Dakota
		35 = Ohio
		36 = Oklahoma
		37 = Oregon
		38 = Pennsylvania
		39 = Rhode Island
		40 = South Carolina
		41 = South Dakota
		42 = Tennessee
		43 = Texas
		44 = Utah
		45 = Vermont
		46 = Virginia
		47 = Washington
		48 = West Virginia
		49 = Wisconsin
		50 = Wyoming
[Division Codes]		[Medical Facility Codes]
1 = 1st Armored Division		1 = Fox Army Health Center
2 = 1st Cavalry Division		3 = Lyster Army Community Hospital
3 = 1st Infantry Division		5 = Bassett Army Community Hospital
4 = 2nd Infantry Division		8 = RW Bliss Army Health Center
5 = 3rd Infantry Division		32 = Evans Army Community Hospital
6 = 4th Infantry Division		37 = Walter Reed Army Medical Center
7 = 10th Mountain Division		47 = Eisenhower Army Medical Center
8 = 25th Infantry Division		48 = Martin Army Community Hospital
9 = 82nd Airborne Division		49 = Winn Army Community Hospital
10 = 101st Airborne Division		52 = Tripler Army Medical Center
11 = 7th Infantry Division		57 = Irwin Army Community Hospital
12 = 24th Infantry Division		58 = Munson Army Health Center
13 = 28th Infantry Division		60 = Blanchfield Army Community Hospital
14 = 29th Infantry Division		61 = Ireland Army Community Hospital
15 = 34th Infantry Division		64 = Bayne-Jones Army Community Hospital
16 = 35th Infantry Division		69 = Kimbrough Ambulatory Care Center
17 = 38th Infantry Division		75 = General Leonard Wood Army Community Hospital
18 = 40th Infantry Division		81 = Patterson Army Health Center
19 = 42nd Infantry Division		86 = Keller Army Community Hospital
20 = 49th Armored Divisioln		89 = Womack Army Medical Center
21 = 75th Division (Training Support)		98 = Reynolds Army Community Hospital
22 = 78th Division (Training Support)		105 = Moncrief Army Community Hospital
23 = 80th Division (Institutional Training)		108 = William Beaumont Army Medical Center
24 = 84th Division (Training Support)		109 = Brooke Army Medical Center
25 = 85th Division (Training Support)		110 = Darnall Army Medical Center
26 = 87th Division (Training Support)		121 = McDonald Army Health Center
27 = 91st Division (Training Support)		122 = Kenner Army Health Center
28 = 95th Division (Institutional Training)		123 = DeWitt Army Community Hospital
29 = 98th Division (Institutional Training)		125 = Madigan Army Medical Center
30 = 100th Division (Institutional Training)		131 = Weed Army Community Hospital
31 = 104th Division (Institutional Training)		247 = Monterey Army Health Center
32 = 108th Division (Institutional Training)		256 = DiLorenzo Tricare Health Clinic
		273 = Lawrence Joel Army Health Center
		308 = Kirk Army Health Center
		309 = Barquist Army Health Center
		330 = Guthrie Army Health Center
		352 = Dunham Army Health Center
		390 = Andrew Rader Army Health Center
		606 = US Army MEDDAC Heidelberg
		607 = Landstuhl Regional Medical Center
		609 = US Army MEDDAC Bavaria
		610 = US Army MEDDAC Camp Zama, Japan
		612 = 121st General Hospital, Korea
		953 = Rodriguez Army Health Center, Puerto Rico
		222 = Iraq
		33 = Kuwait
		444 = Afghanistan
		999 = Other