DoDSER 2016 proposed changes

DoDSER Items where “No known history” will be included as a response option.

For the items listed below, the current “data unavailable” response option will be replaced with “No Known History” as a response option. The question stems will not be changed, only the response options. This complies with DODIG-2015-016 recommendation 3.b.1.

Item:

12. Was the patient/decedent in a state of transition (either recent, current or upcoming within 90 days), including events such as deployment, geographic move, separation and retirement?

20a. For the job held at the time of the event, did the patient work more than 50 hours per week?

20b. For the job held at the time of the event, did the patient have stress associated with work environments due to limited resources (e.g. personnel)?

20c. For the job held at the time of the event, did the patient have job duties or work environments that were unpredictable?

20d. For the job held at the time of the event, did the patient have an increase in workload, production, or quotas (within 30 days of the event)?

20e. For the job held at the time of the event, did the patient have a job that caused him or her to have less than 8 hours of sleep in the 72 hours prior to the event?

41. Prior to the event, did the patient/decedent communicate potential for self-harm (other than a suicide note)?

45. Prior to the event, was the patient/decedent seen by a Medical Treatment Facility?

46. Prior to the event, was the patient/decedent seen by Substance Abuse Services?

47. Prior to the event, was the patient/decedent seen by a Family Advocacy Program?

48. Prior to the event, was the patient/decedent seen by Outpatient Behavioral Health? (including deployment mental health services)?

49. Prior to the event, was the patient/decedent seen by Inpatient Behavioral Health? (including deployment mental health services)

50a. Prior to the event had the patient/decedent been diagnosed with any mood disorder? (e.g., major depression, etc.).

50b. Prior to the event had the patient/decedent been diagnosed with bipolar disorder?

50d. Prior to the event had the patient/decedent been diagnosed with Major Depression?

50f. Prior to the event had the patient/decedent been diagnosed with Dysthymic Disorder?

50h. Prior to the event had the patient/decedent been diagnosed with any other Mood Disorder?

51a. Prior to the event had the patient/decedent been diagnosed with an Anxiety Disorder?

51b. Prior to the event had the patient/decedent been diagnosed with PTSD?

51d. Prior to the event had the patient/decedent been diagnosed with Panic Disorder?

51f. Prior to the event had the patient/decedent been diagnosed with Generalized Anxiety Disorder?

51h. Prior to the event had the patient/decedent been diagnosed with Acute Stress Disorder?

51j. Prior to the event had the patient/decedent been diagnosed with any other Anxiety Disorder?

52a. Prior to the event had the patient/decedent been diagnosed with a Sleep Disorder?

53a. Prior to the event had the patient/decedent been diagnosed with any Adjustment Disorder?

54a. Prior to the event had the patient/decedent been diagnosed with any Personality Disorder?

54b. Prior to the event had the patient/decedent been diagnosed with Paranoid Personality Disorder?

54d. Prior to the event had the patient/decedent been diagnosed with Schizoid Personality Disorder?

54f. Prior to the event had the patient/decedent been diagnosed with Schizotypal Personality Disorder?

54h. Prior to the event had the patient/decedent been diagnosed with Antisocial Personality Disorder?

54j. Prior to the event had the patient/decedent been diagnosed with Borderline Personality Disorder?

54l. Prior to the event had the patient/decedent been diagnosed with Histrionic Personality Disorder?

54n. Prior to the event had the patient/decedent been diagnosed with Narcissistic Personality Disorder?

54p. Prior to the event had the patient/decedent been diagnosed with Avoidant Personality Disorder?

54r. Prior to the event had the patient/decedent been diagnosed with Dependent Personality Disorder?

54t. Prior to the event had the patient/decedent been diagnosed with Obsessive Compulsive Personality Disorder?

54v. Prior to the event had the patient/decedent been diagnosed with Personality Disorder NOS?

55a. Prior to the event had the patient/decedent been diagnosed with any Psychotic Disorder?

55b. Prior to the event had the patient/decedent been diagnosed with Schizophrenia Catatonic Type?

55d. Prior to the event had the patient/decedent been diagnosed with Schizophrenia Disorganized Type?

55f. Prior to the event had the patient/decedent been diagnosed with Schizophrenia Paranoid Type?

55h. Prior to the event had the patient/decedent been diagnosed with Schizophrenia Residual Type?

55j. Prior to the event had the patient/decedent been diagnosed with Schizophrenia Undifferentiated Type?

55l. Prior to the event had the patient/decedent been diagnosed with Schizophreniform Disorder?

55n. Prior to the event had the patient/decedent been diagnosed with Schizoaffective Disorder?

55p. Prior to the event had the patient/decedent been diagnosed with Delusional Disorder?

55r. Prior to the event had the patient/decedent been diagnosed with Brief Psychotic Disorder?

55t. Prior to the event had the patient/decedent been diagnosed with Shared Psychotic Disorder?

55v. Prior to the event had the patient/decedent been diagnosed with Psychotic Disorder due to med. Condition?

55x. Prior to the event had the patient/decedent been diagnosed with Substance-Induced Psychotic Disorder?

55z. Prior to the event had the patient/decedent been diagnosed with Psychotic Disorder NOS?

56a. Prior to the event had the patient/decedent been diagnosed with a Traumatic Brain Injury (TBI)?

57. Prior to the event had the patient/decedent been diagnosed with any other psychiatric disorder?

58a. Prior to the event had the patient/decedent had a history of substance abuse?

59a. Prior to the event had the patient/decedent had a history of tobacco use?

60a. Prior to the event had the patient/decedent taken Psychotropic Medications?

60b. Prior to the event had the patient/decedent taken Antidepressants?

60d. Prior to the event had the patient/decedent taken Anti-anxiety medications?

60f. Prior to the event had the patient/decedent taken Antimanics?

60h. Prior to the event had the patient/decedent taken Anticonvulsants?

60j. Prior to the event had the patient/decedent taken Antipsychotics?

60l. Prior to the event had the patient/decedent taken Sleep medications?

61a. Was the patient/decedent known to use pain medication at the time of the event?

61b. Was the patient/decedent known to be using opioids at the time of the event?

63a. Did the patient/decedent have prior self-injurious events?

72a. Prior to the event, was the patient/decedent the subject of civil legal problems? (e.g., child custody dispute, litigation)

74a. Were there other known life stressors or other circumstances affecting the patient/decedent prior to the event?

77. Did the patient/decedent experience direct combat operations?

81a. Prior to the event, was the patient/decedent an alleged or confirmed VICTIM of physical abuse or assault?

82a. Prior to the event, was the patient/decedent an alleged or confirmed VICTIM of sexual abuse or assault?

83a. Prior to the event, was the patient/decedent an alleged or confirmed VICTIM of emotional abuse or assault?

84a. Prior to the event, was the patient/decedent an alleged or confirmed VICTIM of sexual harassment?

85a. Prior to the event, was the patient/decedent an alleged or confirmed PERPETRATOR of physical abuse or assault?

86a. Prior to the event, was the patient/decedent an alleged or confirmed PERPETRATOR of sexual abuse or assault?

87a. Prior to the event, was the patient/decedent an alleged or confirmed PERPETRATOR of emotional abuse or assault?

88a. Prior to the event, was the patient/decedent an alleged or confirmed PERPETRATOR of sexual harassment?

89a. Are there any known childhood developmental history issues that may have contributed to the event?

90a. Prior to the event, was there evidence of a failed or failing spousal or intimate partner relationship?

91a. Prior to the event, was there evidence of a failed or failing other relationship?

92a. Prior to the event, was there evidence of a completed spousal suicide?

93a. Prior to the event, was there evidence of a completed family suicide?

94a. Prior to the event, was there evidence of a completed suicide by a friend?

95a. Prior to the event, was there evidence of a death of a spouse or family member? (other than suicide)?

96a. Prior to the event, was there evidence of a death of a friend? (other than suicide)

97a. Prior to the event, was there evidence of a physical health problem?

98a. Prior to the event, was there evidence of a chronic spousal or family severe illness?

99a. Prior to the event, was there evidence of excessive debt or bankruptcy?

100a. Prior to the event, was there evidence of job problems? (e.g, laid off, fired, excessive pressure)

101a. Prior to the event, was there evidence of supervisor or coworker issues or problems?

102a. Prior to the event, was there evidence of a poor work performance review or evaluation?

103a. Prior to the event, was there evidence of unit or workplace hazing?

104. Did the patient/decedent have a family history of mental illness?

DoDSER items where an explanation/justification will be required when the “Don’t Know/Data Unavailable” response item is used.

For the items listed below, if the user selects “Don’t Know/Data Unavailable” as their response a free-text box will appear and ask the user to explain why the data was unavailable. The question stems will not be changed, only the free-text explanation following selection of “don’t know/data unavailable.” This complies with DODIG-2015-016 recommendation 3.b.2.

Items:

6. Racial category:

7. Specify ethnic group:

8. Current marital status: 8a. Data Unavailable (in relation to current marital status):

11. Residence at the time of the event:

12. Was the patient/decedent in a state of transition (either recent, current or upcoming within 90 days), including events such as deployment, geographic move, separation and retirement?

28. In a Warrior Transition Unit (WTU)?

33. During the event, was alcohol used? (Confirmed by Toxicology, witness statements or evidence at the scene, etc…)

34. During the event, were drugs used? (Confirmed by Toxicology, witness statements or evidence at the scene, etc…)

35. Is there evidence that the patient/decedent intended to die?

36. Were there self-inflicted injuries (including poisoning)?

37. Is there evidence the event involved death-risk gambling (e.g., Russian roulette, walking railroad tracks, playing chicken)?

38. Is there evidence the event was planned and/or premeditated?

39. Was the event performed under circumstances where it would likely be observed and intervened by others?

40. Was a suicide note left?

41. Prior to the event, did the patient/decedent communicate potential for self-harm (other than a suicide note)?

45. Prior to the event, was the patient/decedent seen by a Medical Treatment Facility?

48. Prior to the event, was the patient/decedent seen by Outpatient Behavioral Health?

49. Prior to the event, was the patient/decedent seen by Inpatient Behavioral Health?

62. Please indicate whether the patient/decedent met the criteria of polypharmacy at the time of the event:

63d. If the patient/decedent had prior events was this event similar to prior events?

64a. Did the patient/decedent receive his/her required suicide prevention training?

66a. Prior to the events, was the patient/decedent the subject of Courts Martial proceedings?

67a. Prior to the event, was the patient/decedent the subject of Article 15 proceedings or civilian criminal proceedings?

68a. Prior to the event, was the patient/decedent the subject of an ongoing inquiry or investigation for alleged misconduct?

69a. Prior to the event, was the patient/decedent the subject of Administrative Separation proceedings?

70a. Prior to the event, was the patient/decedent the subject of AWOL/UA?

71a. Prior to the event, was the patient/decedent the subject of a Medical Evaluation Board?

72a. Prior to the event, was the patient/decedent the subject of civil legal problems? (e.g., child custody dispute, litigation)

73a. Prior to the event, was the patient/decedent the subject of non-selection of advanced schooling, promotion, or command?

76. Was a waiver to deploy required and/or obtained for OIF/OEF?

78. Did the patient/decedent have orders to deploy?

79a. Was the event related to a deployment?

105. Was there a gun in the home or immediate environment?

The following changes were requested from the individual Service Suicide Prevention Program Managers for DoDSER:

• Change the wording of Item 1 – Event Type (Army only):

  • From: “Self-harm – without intent to die”

  • To: “Self-harm – Non-suicidal Self-Directed Violence”
    
    

• Change the wording of Item 1 – Event Type (Army only):

  • From: “Ideation only – without an attempt/self-harm”

  • To: “Ideation only - Other suicidal behavior: preparatory acts”
    
    

• Update dropdown list on Item 24: Permanent duty assignment
  
  

• Remove Item 28: “In a Warrior Transition Unit (WTU)?”
  
  

• Change the wording of Item 45: was patient seen by a Medical treatment Facility?

  • From: “a Medical Treatment Facility?”

  • To: “an Inpatient/Outpatient Medical Facility?”
    
    

• Remove individual items querying personality disorders.

  • Create a drop down list from which personality disorders can be selected instead
    
    

• Remove individual Items querying psychotic disorders.

  • Create a drop down list from which psychotic disorders can be selected instead
    
    

• Create an additional response option for Item 60 (psychotropic medication use) to indicate whether psychoactive medication(s) was taken at the time of the event.
  
  

• Create an additional response option for Item 61 (pain medication use) to indicate whether pain medication was taken at the time of the event.
  
  

• Remove Item 62 (Polypharmacy)
  
  

• Change the wording of Item 78:

  • From: “Did the patient/decedent have orders to deploy?”

  • To: “Was the patient/decedent on order to deploy?”
    
    

• Update dropdown list for item 109 (List of Military Treatment Facilities).
  
  

• Correct typos in Privacy Act Statement

  • Change from: “DoD Blanket Route Uses”

  • Change to: “DoD Blanket Routine Uses”
    
    

  • Change from: “I Agree / I Disagree”

  • Change to: “Service Member Agrees / Service Member Disagrees”
    
    

• Add third button to complete the Privacy Act Statement page that acknowledges that a Service member declines to be interviewed, but that the report will be completed using existing documentation from the individual’s medical record.
  
  

• Add fourth button to complete the Privacy Act Statement page to indicate that a Service member was not available for an interview.

• Items suggested for removal of “Data Unavailable” response option will be incorporated into the list of items for which explanations will be required when the “Don’t Know/Data Unavailable” response option is selected.

• This includes items 6,7,8,9,11,12,19,20,39,46, and 47
  
  

• For Item 21, edit the question stem to state that this item pertains to the Reserve Component, and add response options that allow differentiation of the various statuses of reserve members, to include specification of Title 10 verses Title 32 status.
  
  

• Edit item 36:

  • From: “Were there self-inflicted injuries (including poisoning)?”

  • To: “Were there intentional injuries other than those directly related to the method of suicide (including poisoning)?”
    
    

• Edit item 37:

  • From: “Is there evidence the event involved death risk gambling (e.g., Russian roulette, walking railroad tracks, playing ‘chicken’)?

  • To: “Is there evidence that the Service member engaged in risk-taking actions that clearly have a high chance of death (e.g., Russian roulette, walking railroad tracks, playing ‘chicken’)?
    
    

• Change item 42 to include a ‘drop-down’ menu that lists common motivations for suicide and add a follow-up item (Free text response) that asks “what was the primary reason for the person’s emotional pain?”
  
  

• Add a follow item to question 67 (Article 15) if ‘yes’ is selected. Follow up question will ask, “Was the patient/decedent reduced in rank?”
  
  

• For question110, for Navy and Marine Corps, edit the survey logic so that non-behavioral health form completers (i.e. Commanders) do not have to include ‘dummy’ information for this item to be able to complete the form.

  • T2 will investigate options for this.
    
    

• For question 112, remove or condense this item as it is burdensome for the form completers.

• T2 will investigate options for condensing this item.