There were 47,500 suicide fatalities in the U.S. in 2019 and an estimated 1.4 million suicide attempts according to the CDC. That’s an average of 130 suicides per day.
This means it’s likely that you’ve worked in a situation involving suicide as a paramedic, firefighter, dispatcher or rescuer. But it also means it’s possible that you’ve experienced suicide, suicide attempts or suicidal thoughts on a personal-level as a friend, family member, fellow responder or even yourself.
While the risks of suicide are complex and there is no single cause—the American Foundation for Suicide Prevention (AFSP) states that suicide occurs most often when stressors and health issues create an experience of hopelessness and despair.
The AFSP also notes that the rate of suicide is highest in middle-aged white men and in 2019 men died by suicide 3.63x as often as women and white males accounted for 69.38% of suicide deaths.
If some of those risk factors and circumstances hit home—you’re not alone. You’re constantly called to scenes full of trauma, put in inherently dangerous situations and faced with stressful scenarios—and it comes at a cost.
According to the CDC, firefighters are more likely to die by suicide than in the line of duty, EMS providers are 1.39x more likely to die by suicide than the public and studies have found that about a fourth of public safety telecommunicators have symptoms of post-traumatic stress disorder and depression. And while that should be concerning enough to inspire action—it’s important to note that these incidents are likely severely underreported.
Most people who are considering suicide show signs through what they say or what they do. Here are the changes in behavior or new behaviors that the AFSP says to look for:
There are protective measures and strategies that can help prevent suicide says the AFSP, including:
If you haven’t already, it’s time to make mental health a priority in your organization. One way to do this is through developing a comprehensive behavioral health program. This can include a peer support program, which, according to the International Association of Fire Fighters (IAFF), have been demonstrated to be an effective method of providing support to groups. After all, no one knows what you’re truly up against as a responder more than your brothers and sisters.
For more information on how you can develop an impactful behavioral health program, please download our free Behavioral Health Concerns booklet available at vfis.com which covers top behavioral health concerns for emergency responders, how to develop a peer support program and more.
Beyond creating an active peer support group that remains a constant priority, you can help create connection among your team by simply spending time together, hosting team building activities, getting involved in your community to build a strong sense of purpose and finding ways to cultivate deeper,
trusting relationships.
You can create a behavioral health program, develop a peer support group and host events to help your team connect. But, if mental health concerns are still seen as a “part of the job” or perceived as “weak” or making someone “unfit for the job”—your efforts will fall flat and the consequences could be grim.
There needs to be a top-down, bottom-up understanding that suicide and mental health concerns are very real, very serious and very common. Create a culture that emphasizes open communication, prioritizes mental health and works each day to show every member of your team that they are valued and not alone.
The AFSP says that if you’re worried about someone, always assume that you’re the only person who will act and start a private conversation with them. Ask them directly if they’re thinking about suicide, let them know you’re open to talking about mental health, tell them you care about them, encourage them to talk seek treatment, listen to them and follow up.
Whether it’s for a patient, fellow responder or yourself—understanding coping strategies for suicide is one of those things you can keep in your toolbox but hope you never use. Mayo Clinic states that someone’s suicide can trigger very intense emotions including shock, anger, guilt, despair, confusion and feelings of rejection. Some of the difficulties of dealing with this type of grief include people not reaching out for help (or to just talk) because of the potential stigma or religious implications of suicide or simply because they don’t know how to cope with this type of loss.
Whether you’re experiencing suicidal thoughts, coping with suicide grief or suspect someone else is thinking about suicide—always know when it’s time to seek professional help and encourage others to do the same.
If you’re looking for a professional who understands your needs as an emergency responder, check out the Directory of Behavioral Health Professionals from the National Volunteer Fire Council (NVFC) as a part of the their Share the Load Program. This list, which was developed in combination with the Firefighter Behavioral Health Alliance and American Psychological Association, provides a state-based directory of behavioral health professionals that are equipped and ready to help firefighters, EMS providers, dispatchers and rescue workers and is available to download here: nvfc.org/phfd.
One of the best numbers to keep on hand that can help any American (regardless of location, time of day, occupation, etc.), is the National Suicide Prevention Lifeline at 1.800.273.8255. This is a national network of local crisis centers available 24/7 that provide free and confidential emotional support to people in suicidal crisis or emotional distress. And soon you’ll only need to remember three numbers, because “9-8-8” is expected to be available nationwide as of mid-2022. This will be the new, easy-to-remember 3-digit phone number for Americans in crisis that will connect you directly with suicide prevention and mental health crisis counselors.
Lastly, remember there’s always hope for the future (new coping mechanisms are being researched every day) and know that you are important, valuable and not alone. If you’re struggling, please hold on and reach out for help.