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
20
18
16
14
12
10
8
6
4
2
0
Gen Pop
Military
White Males 21
to 55
Law
Enforcement
Completed Suicide
80
70
60
50
40
30
20
10
0
AOD/Mood Intoxicated
Disorder
at TOD
Previous
Mood
Disorder
Fire Arm
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 McClure 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