The prevalence of common mental health problems in the military is higher than in the general population, but remains stable. While PTSD accounts for only a small number of cases, combat troops and reservists are at higher risk of developing it. Regulars who leave service early, and reservists, have a higher risk of developing mental health problems than their peers. Outcomes for early service leavers are likely to relate to pre-enlistment risk factors. Drinking at harmful levels is widespread in the Forces. The MOD has several strategies to protect the mental health of the Armed Forces. However, stigma associated with mental ill health is a major barrier to accessing help. A lack of research means that the impact of service on families is poorly understood.
Abstract: The U.S. Army’s Ask, Care, Escort (ACE) suicide gatekeeper training has been the annual requirement for all personnel since 2009; however, this training has never been formally evaluated. The present study evaluated three updated versions of ACE: a training for Army leaders (ACE-Suicide Intervention), a training for basic combat trainees (ACE for Basic Combat Training and One Station Unit Training), and a standard training for all personnel (ACE for the Force). Self-report surveys measured pre- to posttraining changes in objective and subjective knowledge and stigma, as well as preparedness, self-efficacy, and likelihood to engage in gatekeeper behaviors. Implementation outcomes, such as training acceptability, suitability, and usability were also assessed. Across these evaluations, participants reported that knowledge and gatekeeper behaviors significantly improved from pre- to posttraining. Implementation metrics revealed a high degree of acceptability and relevance for all three ACE trainings. Overall, the findings of these evaluations suggest important changes in key suicide prevention outcomes following the ACE suite of trainings. Further longitudinal assessment is needed to establish the full effectiveness of gatekeeper interventions in the Army.