The Air Force is using virtual reality to fight its suicide epidemic
"It’s one thing to tell somebody how to do something, it’s another to go through the experience."
Airman Mike is having a real bad day. He’s in a tough spot at work, his wife left him and took the kids, and he’s posting a lot of worrisome stuff on Instagram. Unfortunately, there are a lot of Mikes in the Air Force, and now you’re at his house, trying to check in on him. What do you do?
That’s exactly the question the Air Force’s new suicide prevention virtual reality simulator is trying to help airmen answer. The 30-minute training session being demoed at Scott and Travis Air Force Bases puts trainees in the shoes of airmen checking in on their virtual buddies at a rough time in their lives.
In the simulator, participants enter Mike’s home, where they are presented with multiple dialogue options to choose from in an attempt to help him process his situation and encourage him to seek help. If airmen choose the wrong option and end up escalating the situation, a training coach chimes in to give you advice. The key is to get trainees used to asking tough questions, which could mean the difference between life or death for an airman in distress.
“The unique part of this VR training is that it’s voice-activated, so you’re required to say things out loud that maybe you’ve never had to say before,” said Master Sgt. Shawn Dougherty, a VR training facilitator at Travis, in a press release. “Actually saying phrases like ‘do you have a gun in the house’ or ‘are you thinking about harming yourself.’ We’ve seen over this week, even with squadron leadership, saying uncomfortable phrases like that, they actually say them quieter than other phrases that they’re more comfortable with. “
Dougherty said the training is helpful because it allows airmen to “get those reps” asking those questions so that they are more familiar if they have to ask them in a real-life situation.
The VR program takes shape as the Air Force continues to struggle with a suicide crisis in the ranks. The service saw a record 137 airmen and civilians die by suicide in 2019, and branch chief Gen. Charles “CQ” Brown Jr. said in September that the Air Force was on track to hit a similar number in 2020.
At the time, 98 airmen had died by suicide. In January, the popular Facebook page Air Force amn/nco/snco revealed that the branch had 131 cases of suspected suicide in 2020, 82 of which were active duty, although the Air Force was unable to confirm those numbers. Officials said the Defense Suicide Prevention Office produces annual data on DoD-wide statistics, but the 2020 report may be delayed due to COVID-19.
Of course, it would be helpful if the military actually had enough mental health counselors to go around: a Pentagon Inspector General report released in August found that seven of 13 military medical treatment facilities did not meet mental health access standards, and an average of 53 percent of all active-duty service members and their families referred to mental health care did not receive mental health care, though the reasons why remain unclear.
“All of these types of delays in mental health care increase the risk of jeopardizing patient safety and affecting the readiness of the force,” the Inspector General wrote. “For example, in June 2019, active duty service members and their families referred to the TRICARE network waited 57 days for behavioral health counseling and therapy intake, and 79 days for psychiatry, on average, at Naval Health Clinic Oak Harbor.”
So why not try VR to see if it sticks? The Air Force currently uses role-play training to help airmen prepare for those situations, but it’s not quite as convincing when you’re talking to an airman reading off a script in a fluorescent-lit office. Plus, trainees in that situation have a tendency not to enunciate the tough questions as much as they should.
“These are things you may not want to say, especially if you’re not an extrovert when you’re dealing with your airmen,” said Gen. Jacqueline Van Ovost, head of Air Mobility Command, who awarded the contract for the VR software to developer Moth + Flame.
This isn’t another dull Jeff-and-Tina style computer training, by the way. Early reports show that the VR suicide prevention training is actually worthwhile, and the graphics look impressive.
“While immersed, I felt as if I was in the room with the individual in the VR program,” wrote one airman who commented on the news on the popular Facebook page Air Force amn/nco/snco. “Afterwards, I had to collect myself. I believe the new approach is going to be a good way to deliver a heart-wrenching subject in a way to negate the PowerPoint and Charlie Brown-teacher style of trainings.”
Though Mike is an animated character in the simulator, he was voiced by an actor with very convincing lines, the commenter said. “It was a real person,” he wrote. “Cussing, angry, and a roller coaster of emotions.”
Nicholas Pilch, who wrote the press release about the VR program and participated in it himself, said he wound up empathizing with Mike’s plight.
“I answered incorrectly a couple times to see what his reaction would be, and the actor really pulled me into his story,” Pilch wrote. “His wife has left him and taken the kids. She won’t talk to him, and during a tussle, she fell and hit her neck on something that left a mark. Mike is at his wits’ end, and he doesn’t come out and say he is going to hurt himself, but it’s implied.”
The Air Force uses VR for a wide range of vocational skills training, such as cockpit simulators for pilots, loadmaster training for C-130 aircrews, and maintenance training for maintainers, Van Ovost said. This new suicide prevention training could open up the door for training on additional interpersonal skills, such as sexual assault prevention. AMC is already working with developers to try to build modules for those skills.
“I’m continuing to fund additional modules to have more content,” Van Ovost said at the Air Warfare Symposium on Wednesday. “Hopefully if the feedback comes back positive, this is something we would like to scale.”
At the moment, only base leadership, squadron commanders, superintendents and first sergeants at Travis and Scott Air Force Bases are trying out the VR program, but the plan is to roll out the training to all airmen at those bases this spring.
Initial feedback studies are also reporting phenomenal results: 98% of leaders at Scott and Travis said they would recommend the training in their respective units, and 93% said VR training would be more effective than traditional training programs, said 1st Lt. Emma Quirk, a spokeswoman for Air Mobility Command.
The scenario “was spot on. I’ve dealt with this exact thing before,” said one airman at Scott, according to Quirk.
“It’s one thing to tell somebody how to do something, it’s another to go through the experience,” said another.
AMC also hopes to get out a version of the VR training program for the spouses of airmen, according to Quirk. To make the program more real, at the end of it participants talk about the importance of tough conversations with Tony Dungy, the son of a Tuskegee airman. Dungy’s son took his own life in 2005.
“We need to have these tough conversations because they will help us get to that spiritual strength,” Dungy said. “This is something that happens as a community, and the more we can encourage the tough conversations, the stronger we’ll get, together.”