Suicide and First Suicide and First RespondersResponders

Bill PrasadBill Prasad

Behavioral Health CoordinatorBehavioral Health Coordinator

Fairfax County Fire and RescueFairfax County Fire and Rescue

Suicide in AmericaSuicide in America

Deaths per year: 30,000Deaths per year: 30,000 80 per day80 per day One suicide every 15 minutesOne suicide every 15 minutes Eleventh leading cause of death Eleventh leading cause of death Each suicide affects at least six peopleEach suicide affects at least six people 800,000 attempts every year800,000 attempts every year 5 million have attempted suicide 5 million have attempted suicide Firearms used in 52% of suicidesFirearms used in 52% of suicides

Suicide by Race/GenderSuicide by Race/Gender

White males: 72% of suicidesWhite males: 72% of suicides White males and females: 90% of suicidesWhite males and females: 90% of suicides------------------------------------------------------------------------------------ Firefighters: 96% male/85% whiteFirefighters: 96% male/85% white Paramedics: 69% male/93% whiteParamedics: 69% male/93% white Police officers: 85% male/85% whitePolice officers: 85% male/85% white

First responder population mirrors high First responder population mirrors high risk grouprisk group

Suicide by OccupationSuicide by Occupation

OSHA tracks only on-the-job deathsOSHA tracks only on-the-job deaths Many states do not track deaths by occupationMany states do not track deaths by occupation NYPD: Suicide rate of NYPD: Suicide rate of 29 per 100,00029 per 100,000 a year. a year.

General population is General population is 12 per 100,00012 per 100,000 NYPD: Most were white males who shot NYPD: Most were white males who shot

themselves while off dutythemselves while off duty Nationally, twice as many police Nationally, twice as many police (300)(300) complete complete

suicide as are killed in the line of duty suicide as are killed in the line of duty

Suicide by OccupationSuicide by Occupation

Chicago FD: 2008 to 2009Chicago FD: 2008 to 2009

Firefighter SuicideFirefighter Suicide

““A firefighter’s suicide strikes at the very core A firefighter’s suicide strikes at the very core value of the profession– teamwork.”value of the profession– teamwork.”

““When a fire department experiences this When a fire department experiences this tragedy, its impact can be emotionally and tragedy, its impact can be emotionally and mentally debilitating for the personnel left mentally debilitating for the personnel left behind to grieve.” behind to grieve.”

www.firechief.comwww.firechief.com

Suicides Per 100,000Suicides Per 100,000

0

2

4

6

8

10

12

14

16

18

20

Gen Pop

Military

White Males 21to 55

LawEnforcement

Completed SuicideCompleted Suicide

0

10

20

30

40

50

60

70

80

AOD/MoodDisorder

Intoxicatedat TOD

PreviousMood

Disorder

Fire Arm

First Responder Risk FactorsFirst Responder Risk Factors

DivorceDivorce TraumaTrauma StressStress Sudden fameSudden fame

DivorceDivorce

National Rate: 50%National Rate: 50% Police: 60 to 75%Police: 60 to 75% Police: 80% of suicides linked to divorce or Police: 80% of suicides linked to divorce or

relationship break-uprelationship break-up Fire: 50 to 65%Fire: 50 to 65% Fire: Many relationship break-ups linked to Fire: Many relationship break-ups linked to

24 hour shifts, OT, stress24 hour shifts, OT, stress

Trauma/Sudden FameTrauma/Sudden Fame

New York: Three firefighters who helped New York: Three firefighters who helped rescue 9-11 victims killed themselves rescue 9-11 victims killed themselves within a yearwithin a year

Oklahoma City: A police sergeant who Oklahoma City: A police sergeant who rescued four victims at the bombed rescued four victims at the bombed Federal building completed suicideFederal building completed suicide

Texas: A paramedic who helped rescue Texas: A paramedic who helped rescue baby Jessica McClure from a well later baby Jessica McClure from a well later took his lifetook his life

Life Events as TriggersLife Events as Triggers

Suicide/Death of loved oneSuicide/Death of loved one Serious family illnessSerious family illness Loss of healthLoss of health Loss of employmentLoss of employment RetirementRetirement Financial problemsFinancial problems Legal problemsLegal problems

Life Events as TriggersLife Events as Triggers

Victim of crimeVictim of crime Sexual assault/domestic violenceSexual assault/domestic violence Witness to violenceWitness to violence Poor gradesPoor grades Sexuality concernsSexuality concerns Substance abuseSubstance abuse

Suicide MotivationSuicide Motivation

Loss or change in important relationshipLoss or change in important relationship To avoid or end perceived painTo avoid or end perceived pain Escape intolerable situationEscape intolerable situation Gain attentionGain attention Punish others/selfPunish others/self Become a martyrBecome a martyr

Support System Warning SignsSupport System Warning Signs

Lack of support systemLack of support system Rejected by peersRejected by peers Separation from family or friendsSeparation from family or friends Loner or newcomerLoner or newcomer Feels like no one caresFeels like no one cares

Indirect Suicide IndicatorsIndirect Suicide Indicators

Buying a weaponBuying a weapon Giving away possessionsGiving away possessions Making a willMaking a will Talking about a long tripTalking about a long trip Taking unusual risksTaking unusual risks Sudden religious interest/disinterestSudden religious interest/disinterest Substance abuse relapseSubstance abuse relapse

Indirect Verbal CluesIndirect Verbal Clues

I can’t go on any longerI can’t go on any longer I’m tired of lifeI’m tired of life Life has lost its meaningLife has lost its meaning I can’t take the painI can’t take the pain You’d be better of without meYou’d be better of without me You’re going to regret how you treated meYou’re going to regret how you treated me

Direct Verbal CuesDirect Verbal Cues

I might as well be deadI might as well be dead I wish I were deadI wish I were dead If ------- doesn’t happen, I’m going to end itIf ------- doesn’t happen, I’m going to end it I’m going to kill myselfI’m going to kill myself

Important QuestionsImportant Questions

Have you been thinking of hurting or killing Have you been thinking of hurting or killing yourself?yourself?

When did you last think of suicide?When did you last think of suicide? Have you ever attempted suicide?Have you ever attempted suicide? Has anyone in your family attempted/completed Has anyone in your family attempted/completed

suicide?suicide? Do you have a Do you have a planplan?? Do you have the Do you have the meansmeans for carrying out plan? for carrying out plan?

Principles of Suicide Prevention Principles of Suicide Prevention ProgramsPrograms

Encourage help-seeking behaviorEncourage help-seeking behavior High risk target population= more intense High risk target population= more intense

efforteffort Age-specificAge-specific Developmentally appropriateDevelopmentally appropriate Culturally sensitiveCulturally sensitive

Organizational Suicide Prevention Organizational Suicide Prevention ProgramsPrograms

Supported/endorsed by senior staff and Supported/endorsed by senior staff and unionunion

Pamphlets, handouts, face-to-face Pamphlets, handouts, face-to-face briefingsbriefings

Everyone has a responsibilityEveryone has a responsibility Focus on identifying red flagsFocus on identifying red flags Have accessible helpHave accessible help

Risk FactorsRisk Factors

Sex (male)Sex (male) Race (white)Race (white) Age (15 to 34) and (65+)Age (15 to 34) and (65+) DepressionDepression Previous exposure (self or family)Previous exposure (self or family) Loss of hope/rational thinkingLoss of hope/rational thinking Means and planMeans and plan No spouse or significant otherNo spouse or significant other Illness Illness

SourcesSources

Suicide: Prevention, Intervention, & Suicide: Prevention, Intervention, & Postvention, Clark, Thompson and Postvention, Clark, Thompson and WelzantWelzant

World Health Organization, Preventing World Health Organization, Preventing SuicideSuicide

www.firechief.comwww.firechief.com

Suicide and First Suicide and First RespondersResponders

Bill PrasadBill Prasad

Behavioral Health CoordinatorBehavioral Health Coordinator

Fairfax County Fire and RescueFairfax County Fire and Rescue