Suicide and First Responders Bill Prasad Behavioral Health

Suicide and First Responders Bill Prasad Behavioral Health Coordinator Fairfax County Fire and Rescue

Suicide in America § Deaths per year: 30, 000 § 80 per day § One suicide every 15 minutes § Eleventh leading cause of death § Each suicide affects at least six people § 800, 000 attempts every year § 5 million have attempted suicide § Firearms used in 52% of suicides

Suicide by Race/Gender § White males: 72% of suicides § White males and females: 90% of suicides ---------------------§ Firefighters: 96% male/85% white § Paramedics: 69% male/93% white § Police officers: 85% male/85% white First responder population mirrors high risk group

Suicide by Occupation § OSHA tracks only on-the-job deaths § Many states do not track deaths by occupation § NYPD: Suicide rate of 29 per 100, 000 a year. General population is 12 per 100, 000 § NYPD: Most were white males who shot themselves while off duty § Nationally, twice as many police (300) complete suicide as are killed in the line of duty

Suicide by Occupation § Chicago FD: 2008 to 2009

Firefighter Suicide “A firefighter’s suicide strikes at the very core value of the profession– teamwork. ” “When a fire department experiences this tragedy, its impact can be emotionally and mentally debilitating for the personnel left behind to grieve. ” www. firechief. com

Suicides Per 100, 000

Completed Suicide

First Responder Risk Factors § Divorce § Trauma § Stress § Sudden fame

Divorce § National Rate: 50% § Police: 60 to 75% § Police: 80% of suicides linked to divorce or relationship break-up § Fire: 50 to 65% § Fire: Many relationship break-ups linked to 24 hour shifts, OT, stress

Trauma/Sudden Fame § New York: Three firefighters who helped rescue 9 -11 victims killed themselves within a year § Oklahoma City: A police sergeant who rescued four victims at the bombed Federal building completed suicide § Texas: A paramedic who helped rescue baby Jessica Mc. Clure from a well later took his life

Life Events as Triggers § Suicide/Death of loved one § Serious family illness § Loss of health § Loss of employment § Retirement § Financial problems § Legal problems

Life Events as Triggers § Victim of crime § Sexual assault/domestic violence § Witness to violence § Poor grades § Sexuality concerns § Substance abuse

Suicide Motivation § Loss or change in important relationship § To avoid or end perceived pain § Escape intolerable situation § Gain attention § Punish others/self § Become a martyr

Support System Warning Signs § Lack of support system § Rejected by peers § Separation from family or friends § Loner or newcomer § Feels like no one cares

Indirect Suicide Indicators § Buying a weapon § Giving away possessions § Making a will § Talking about a long trip § Taking unusual risks § Sudden religious interest/disinterest § Substance abuse relapse

Indirect Verbal Clues § I can’t go on any longer § I’m tired of life § Life has lost its meaning § I can’t take the pain § You’d be better of without me § You’re going to regret how you treated me

Direct Verbal Cues § I might as well be dead § I wish I were dead § If ------- doesn’t happen, I’m going to end it § I’m going to kill myself

Important Questions § Have you been thinking of hurting or killing § § § yourself? When did you last think of suicide? Have you ever attempted suicide? Has anyone in your family attempted/completed suicide? Do you have a plan? Do you have the means for carrying out plan?

Principles of Suicide Prevention Programs § Encourage help-seeking behavior § High risk target population= more intense effort § Age-specific § Developmentally appropriate § Culturally sensitive

Organizational Suicide Prevention Programs § Supported/endorsed by senior staff and union § Pamphlets, handouts, face-to-face briefings § Everyone has a responsibility § Focus on identifying red flags § Have accessible help

Risk Factors § § § § § Sex (male) Race (white) Age (15 to 34) and (65+) Depression Previous exposure (self or family) Loss of hope/rational thinking Means and plan No spouse or significant other Illness

Sources § Suicide: Prevention, Intervention, & Postvention, Clark, Thompson and Welzant § World Health Organization, Preventing Suicide § www. firechief. com

Suicide and First Responders Bill Prasad Behavioral Health Coordinator Fairfax County Fire and Rescue