By Nancy Wesselink, PhD LMSW CEAP
First responders are killing themselves at approximately twice the rate of the general population. (Heyman, Dill, Douglas, 2018). While not a new statistic, it is leaving a towering question: Why? Why, when there are so many resources available to those who are experiencing suicidality? Why, when access to these resources is usually available 24/7/365 and is manned by real people on the other side of the call, just waiting for someone to reach out?
Suicide: We’ve talked about, we’ve trained on it, and there are entire organizations devoted to awareness and prevention. What have we done? We’ve put the walker on the highest wire without a safety net. We’ve made the topic of first responder suicide visible with no definitive solution in sight. Nothing has worked because we haven’t figured it out yet due to the complexities involved.
No matter what job the first responder has, the demands and tolls have a lot in common. They have the ability to break down the body, soul, and spirit of everyone over time. This can throw them into what I call “persistent bereavement,” a way of looking at life with virtually no hope; no happiness; no help; and, most importantly, no END.
The state of persistent bereavement does not happen quickly. It takes time for individuals in their first responder jobs to begin the slow slide into this melancholy. It’s slow, it’s pervasive, it’s all encompassing. It saps energy spiritually, physically, and mentally and creates a slow normalizing of sadness. Because it becomes normal, or you become accustomed to feeling melancholy, and because it lasts all day every day, no matter what activities you are doing, on the surface it looks like you are functioning well. To friends, family and co- workers, you seem fine. Feeling lousy has become “normal,” yet, over time, it can take a devastating toll on the mind and the body, resulting in total exhaustion.
Research has shown that persons contemplating suicide may repeatedly “practice” exposing themselves to painful aspects of self-harm in their heads so much so that the idea of dying by suicide becomes more and more palatable over time. (Van Orden, Witte, Cukrowicz, Braithwite, Selby, Joiner, 2010). Suicide becomes a comforting thought, one that affords a way out of the entrapment of persistent melancholy.
Simply bringing up the issue of suicide and giving it visibility does not mean that it becomes something solvable. In the clinical world, assisting clients with insight into their issues can cause increased anxiety and depression as they begin to understand the impact of these things on their lives and the lives of their loved ones. It is no different with suicide except for one key thing: Clinicians have tools to help clients navigate their difficulties with resources. The resources out there for help with suicidality are often fragmented, unstandardized, and harmful in their own rite. A disembodied voice on a phone does not have the same impact as sitting face-o-face. In one-on-one sessions, the atbility to connect is easier, confidentiality is assured, and everything can slow down so that these conversations can happen on a deeper level.
I have some thoughts about why the self-annihilation of police, firefighters, EMS, communications, detention/correctional officers, and others has not been significantly impacted by the availability of effective helplines. Here are just a few:
- By the time someone could reach out, it is generally too late. The decision to self-destruct has already been made.
- Reaching out implies cognitive awareness that someone on the verge of dying by suicide rarely possesses.
- Admitting to feeling suicidal still brings with it too much stigma and fear.
- Mistrust in resources.
There are no easy answers; however, there should be more emphasis on taking a proactive approach to this devastating problem. But how? What will it take to implement such approaches? How to get in front of something so deep and hidden?
There are many challenges in first responder organizations that hinder help-seeking. Leadership, while well-meaning, does not have the capacity to face the suicide issue head-on, mainly due to not having the resources it needs to be successful in imbedding suicide awareness into the culture. And yet, one suicide results in the perception of leadership’s inability to “save” the employee and leaves the organization in a state of shock and disbelief with deep grief and guilt–a devastating price to pay.
Training at the recruit level rarely if ever teaches potential personnel how to take care of themselves, especially in the area of psychological well-being. Learning the external elements of the job takes the focus away from giving students the tools they need to know how to identify emotional responses and how to enlist help when needed.
Stigma and fear are still the overriding obstacles that must be addressed and dismantled. Getting in front of the suicide issue will require putting together a complete and consistent plan of action, from beginning in the job all the way to retirement. Normalizing the psychological toll that doing the “job” takes requires all levels of rank to be thoroughly knowledgeable about how to start the conversation and ensure that it becomes a vital component of organizational design.
These are just a few of the reasons personnel are not asking for help. The question is, where do we start? For decades, peer support teams have trained their members in many ways to interact with individuals and work groups before, during, and after critical events. This training has been instrumental in positively impacting these individuals by supporting them through the expected emotional responses brought on by exposure to traumatic situations. Why not give trained peers the ability to detect when personal issues, not necessarily related to a traumatic event, are more present in someone? In other words, if an individual brings up a pending divorce, problem with a child, or other personal concern, the trained peer can shift focus from the event that brought them together to the more urgent problem articulated by the affected peer. And what if, when that occurs, the trained peer can then point the person in the direction of immediate help with that issue, not discounting the effect of the traumatic incident but rather giving equal time to current personal issues someone is unable to solve?
Teaching peer teams the trauma-informed skills needed to elicit critical information will assist them in helping an affected peer get the help needed before it’s too late. This proactive approach is an organic one, since the skills peer supporters learn are already part of their lexicon and they are comfortable communicating with struggling peers.
A robust and active trauma-informed peer team has the opportunity to make those crucial connections, thus impacting helplessness, hopelessness, and isolation. They have the opportunity to identify specific areas of concern, with the goal of providing an immediate step affected peers can take to begin solving them. Peer training in brief, solution-focused conversation hones in on the problem(s) with effective and appropriate goal-oriented solutions. (Kondrat, Teater, 2010).
This also increases the feeling of control that is so often missing when one feels entrapped in hopelessly unsolvable problems. Peer supporters have the means to connect with affected personnel and have proven to ease the effects of psychological “injury.” These individuals already have the capacity to interact on an empathic level. Why not give them extra tools to be able to extract information that may lead them to believe someone is at risk of self-harm? Oftentimes, it is the perception of the unsolvable problem that leads to suicidality. We already know that the so-called “one-on-ones” are where those deeper conversations take place. When one peer connects with an affected peer, communication is more meaningful and empathic and engenders those critical buffering influences that can positively impact the potential for self-harm. Using this opportunity to increase hope can create an environment where positive and immediate change can occur.
And it’s possible that this simple and practical idea may be the ultimate missing connection that can save countless lives.
References
Heyman, M., Dill, J., Douglas, R. (2018). Ruderman White Paper on Mental Health and Suicide of
First Responders [White Paper]. July 18, 2022, from Source:
https://rudermanfoundation.org/white_papers/police-officers-and-firefighters-are-more-likely-to-die-by-suicide-than-in-line-of-duty/
Kondrat, D.C., Teater, B. (2012). Solution-Focused Therapy in an Emergency Room Setting:
Increasing Hope in Persons Presenting with Suicidal Ideation. Journal of Social Work, 12:3.
Originally published online 22 Sept. 2010
DOI: 10.1177/1468017310379756
Published by Sage
Van Orden, K.A., Witte, T.K., Cukorwocz, K.C., Braithwaite, S., Shelby, E.A., and Joiner Jr,
T.E. (2010). The Interpersonal Theory of Suicide. Psychological Review, 117 (2), 575-600.
BIO:
Dr. Nancy Wesselink is the founder and chief consultant of One Source Counseling and Employee Assistance Services LLC in the metro Atlanta area. She founded the company in 2002 and currently provides services to more than 4000 employees in manufacturing, utility, government, and corporate settings. She has also provided consultation and behavioral health services to first responders for more than 25 years. She received her masters in social work from the University of Georgia and has a doctorate in human services from Capella University. She is a Certified Employee Assistance Professional and has more than 25 years in counseling and training, specializing in the unique issues of public safety employees and families.
Photo by Mohamed Hassan form PxHere
