By Dr. Lisa Grossman
It’s a painfully difficult topic, yet, the reality of this line of work that we have to talk about. It’s the topic that seems to have touched everyone in some way, shape, or form. It’s suicide, and it’s on the rise among first responders.
The Numbers
Over the years, we have seen a steady increase in the number of suicides across this country among our first responders. BLUE H.E.L.P. is an organization that brings awareness to suicide and mental health issues, and has been recording law enforcement suicides, including corrections and federal officers, since January 2016. In 2019, 238 law enforcement officers were lost to suicide, 171 in 2020, and there have been 35 to date in 2021. In addition to their efforts with the law enforcement community, they have now expanded to include firefighters through RED H.E.L.P. with the same mission of education, support, and acknowledgment. Although they just began their efforts, they have reported two firefighters lost to suicide to date for 2021.
While numbers vary among sources, according to the Firefighter Behavioral Health Alliance, 82 firefighters and 21 EMTs/paramedics were lost to suicide in 2018, and 119 firefighters and 20 EMTs/paramedics in 2019. In addition to those disciplines, the veteran suicide rate continues to rise along with active-duty service members. Although there is a two-year lag in reporting data, the VA has reported the rate has gone from 17.5 veterans a day in 2017 to 17.6 in 2018, with concerns that the number may tick higher as we work our way through the impact of the coronavirus.
How Does Someone Get to That Point?
One of the most common questions I get asked is, “how does someone get to that point,” the place where they see no other option. Sadly, it’s often a combination of things. The brain is not wired to see and do the things that these men and women have to see and do on a daily basis. But, they do it and do it proudly. They respond to the horrific calls, the tragic scenes, and hug the family members left in despair, all while navigating their own struggles and challenges. Sadly, the burden of it all becomes too heavy to continue to carry and some can’t pull themselves from the darkest of places. The intention is not to hurt their loved ones, colleagues, or friends, but the pain becomes too great, and they are unable to see through it.
Many risk factors have been linked to first responder suicides, including Post Traumatic Stress (and other mental health challenges such as depression and anxiety), health concerns, marital problems, substance abuse, and financial challenges. The combination of these with the trauma they are exposed to on a regular basis can have a lasting and devastating impact on one’s psyche over time if they don’t get the help and resources they need.
What to Watch For
While most people who struggle with depression don’t die by suicide, depression can increase the risk of suicide. It is important to know the signs of depression and other mental health-related conditions that could potentially lead someone down that path. Some of the big indicators someone is dealing with depression are not being able to get out of bed and having difficulties sleeping, struggling with feelings of hopelessness or worthlessness, shutting down, loss of appetite, and drastic changes in mood. In addition, it is also helpful to know the signs and symptoms of Post Traumatic Stress Disorder as it can co-occur with depression and is quite common among first responders. Nightmares, flashbacks, and hypervigilance are all common characteristics of PTSD, but it is important to point out that just because someone has experienced these symptoms doesn’t mean they have Post Traumatic Stress Disorder. It is important to see a mental health professional for a proper diagnosis.
In addition to the signs and symptoms of related mental health conditions, there are also indicators that someone may be contemplating suicide. Talking about going away or making statements like “you’d be better off without me” or “I’m a burden to our family,” saying goodbye, increasing the use of alcohol or drugs, having a sudden change in behavior such as improved mood or happiness quickly after signs of depression or sadness, engaging in reckless behavior, becoming withdrawn, and having a history of previous attempts, can be experienced by those who are thinking about suicide.
What Can You Do?
Though some of the signs may be there, sometimes it’s difficult to catch these in those closest to us. It is for this reason that I stress to people to listen to their gut. If ‘something’ is telling you there may be a problem and you’re concerned, it is imperative to take action! If you see warning signs or get that feeling, ask the difficult questions and explore invitations. The statement I use when teaching suicide prevention and intervention is to be comfortable being uncomfortable. It may be hard to ask someone you work with, love, or care about if they are thinking about suicide, but those tough questions need to be asked.
If you think or feel someone may be contemplating suicide, directly ask them, “are you thinking about suicide.” If they say yes, ask them, “do you have a plan” and “when was the last time you thought about it.” If they are responding with a yes, be there to support and listen and connect them to the right resources; you can call the National Suicide Hotline (800-273-8255) with them or one of the other numbers provided below, reach out to their mental health professional if they are working with one, or take them to the nearest hospital. Some facilities now have policies and procedures in place to assist a first responder in crisis, including a separate area to wait while getting evaluated. The important thing is to get help, and don’t try to handle the situation alone! Encourage and support the appropriate help and give reassurance.
Sadly, the stigma around mental health and suicide is the top reason first responders don’t get the help they need. They are worried they will lose their job or position, be labeled, or may be be afraid others will view them as weak. It takes strength to ask for help, and getting help does not equal mental illness. It is imperative that we change the conversation around mental health and talk about topics like suicide more openly. At the end of the day, it’s ok not to be ok!
If you or someone you know is struggling with thoughts of suicide, PLEASE reach out!
National Suicide Hotline 800-273-8255
Copline: 800-267-5463
Fire/EMS Helpline: 888-731-3473
Crisis Text Line: Text “Blue” to 741741
Veterans Crisis Line: 800-273-8255; press 1 for Veterans Crisis Line or Text 838255