SAN ANTONIO (AFNS) - More than a decade in the making, the culture of the "wingman" approach to suicide prevention is still evolving as risk factors and causes of suicide are becoming more widely understood.

The wingman concept should be very familiar to most airmen. Suicide prevention training has been incorporated into airman culture from basic training though every level of professional military education and yearly refresher training.

For Lt. Col. Michael Kindt, the Air Force Suicide Prevention Program manager, when it comes to suicide prevention, the numbers are the key to understanding what approach to take.

"In the late 90s the numbers indicated that suicide was becoming a problem in the Air Force," he said. "There were about 20 suicides per 100,000 airmen. The suicide rate across the civilian sector was about 11 per 100,000."

This high suicide rate prompted senior Air Force leaders to take a look at suicide and develop a program to combat the trend, said Kindt. More than a decade later, the AFSPP has successfully cut the suicide rate in half by implementing 11 initiatives that address suicide prevention from the individual level up to the command level.

"The Community Action Information Board was developed and the wing or vice commander appointed to chair it on every base," Kindt said. "The Integrated Delivery System was also created. It made sure the chaplain, Airman and Family Readiness Centers and other agencies were on the same page and working together."

In addition to the agency and senior leader involvement, the AFSPP also brought supervisors and coworkers into the equation.

"When the program was developed they realized that a session with a psychiatrist wasn't enough to identify a suicide risk," Kindt said. "It was the people close to the individual who would notice behavioral changes and be able to address it in the most effective way."

Kindt said recognizing the behavioral change is only the first step. The most difficult step is to ask the question.

"It's a hard thing to do - ask a coworker or friend if they are thinking of hurting themselves," he said. "But imagine how much more difficult it would be for a person to approach you and tell you they are contemplating suicide. It's important to meet them halfway. If you ask the question 20 times in your career you may have just one where the person is contemplating suicide and you asking the question could be the key to that person opening up and result in saving a life."

The colonel also advocates taking the ACE approach to suicide intervention; asking directly if someone is thinking of hurting themselves, caring for the individual by removing them from a dangerous environment, and escorting them to a professional who can give them further help.

ACE is a simple concept but has powerful implications. Data collected on every Air Force suicide during the past 12 years has shown intervention by peers is extremely effective. That same data has also identified which airmen are at the highest risk and points out misconceptions regarding who is most likely to hurt themselves.

Many of the identified risks for suicide are the same as those in the civilian sector; relationship trouble, financial instability, legal action. However, there are some risk factors within the Air Force that the collected data has highlighted, such as higher-risk career fields.

"The data has shown that security forces, intelligence and manned maintenance career fields have about twice the suicide rate of other career fields," Kindt said.

According to some of the studies, security forces airmen have a comfort with weapons and access to weapons that puts them at a higher risk than an airman unfamiliar or uncomfortable with weapons.