Suicide Prevention Training
Psychological Services
Section
Miami-Dade Police Department
Dr. Scott W. Allen
Police Psychologist
CLINICAL CORRELATES OF
SUICIDE
Disorders
Depression
Adult
Youth
++
+
Schizophrenia
+
++
Personality
Disorders
Alcohol Abuse
0
++
++
++
Drug Abuse
+
++
Object Loss
++
++
Legend: ++ Highly Correlated
+ Correlated
0 Not Correlated
THE 10 COMMONALITIES OF
SUICIDE
In previous publication (Shneidman 1985, 1990b)
1. The common purpose of suicide is to seek a solution
2. The common goal of suicide is cessation of consciousness
3. The common stimulus in suicide is intolerable psychological pain
4. The common stressor in suicide is frustrated psychological needs
5. The common emotion in suicide is hopelessness-helplessness
6. The common cognitive state in suicide is ambivalence
7. The common perpetual state in suicide is constriction
8. The common action in suicide is egression
9. The common interpersonal act in suicide is communication of intention
10.The common consistency in suicide is with lifelong coping patterns
SUICIDE RISK VARIABLES
Relationship Potential
 Absence or limited meaningful
supportive relationships
Suicide History
 High lethality potential of attempt(s)
 Presence of specific plan
SUICIDE RISK VARIABLES
(Continued)
Current Suicidal Ideation
 Presence of specific plan
 Accessibility of lethal means
 Behavior suggestive of decision to die (e.g.,
severing relationships, giving away valued
possessions; inappropriate sense of peace,
calm or happiness; verbalizations regarding
the utility of death)
 Family history of suicide, especially parental
suicide when patient between ages of 5-12
SUICIDE RISK VARIABLES
(Continued)
Psychiatric Medical Factors
 Chronic psychiatric disorders
 Recent discharge from psychiatric hospital
(within 3 months)
 Remission of psychiatric episode but
continuance of secondary depression
 Impulsivity (violence toward others and self,
reckless driving, spending money)
 Alcohol abuse
 Drug abuse
DIFFERENCE BETWEEN SUICIDE
ATTEMPTERS
AND SUICIDE COMPLETERS
ATTEMPTERS
1.GENDER
FEMALE
(3:1)
COMPLETERS
MALE
(3:1)
2. AGE
STEADY INCREASE
THEN DECREASES
STEADY RISE WITH AGE
3. DIAGNOSIS
UP TO 50% COULD HAVE
DX OF DEPRESSED
ONLY 10-15% ARE
DEPRESSED, 30% ARE
SCHIZO-AFFECTIVE MOOD
CONGRUENT/
INCONGRUENT AND
DELUSIONAL
4. RATES
10-12% OF THE GENERAL
POPULATION HAVE MADE
AT LEAST ONE ATTEMPT
12 PER 100,000
5. METHOD
DRUG OVERDOSE
GUNSHOT OR HANGING
CHARACTERISTICS OF SUICIDE
ATTEMPTERS
Cognitive Style
1. Dichotomous (either-or) Thinking.
2. Rigid, inflexible cognitive style (things just are the way
they are).
3. Inability to conceive if long term effects of actions.
4. Positive expectancies regarding the effectiveness of
suicide as a solution to life problems.
5. Lack of insight; actions speak louder than words.
6 .Poor problem solving abilities (generates less possible
solutions, prematurely rejects potentially viable
alternatives, less active in problem solving behaviors).
7. Generalized feelings of hopelessness.
CHARACTERISTIC OF SUICIDE
ATTEMPTERS
(Continued)
Affect Regulation
1. Tendency toward chronic feelings of anger,
guilt, depression, anxiety, and boredom;
2. Inability to regulate emotional arousal in
stressful situations (can’t turn off feelings);
4. Intense, unstable affect with rapid changes
in nature of feelings.
CHARACTERISTIC OF SUICIDE
ATTEMPTERS
(Continued)
Affect Tolerance
1. Belief that they “Can’t Stand” or tolerate
negative affect.
2. Restrictive and negative beliefs about the
place of negative feelings in the world. Bad
feelings wrong.
3. Tendency toward impulsive attempts to get rid
of affect (i.e., cutting, drinking, drug taking,
binge eating).


Suicide is a Problem-Solving Behavior
Specifically, a complex set of behaviors
aimed at:
1) improving an unpleasant situation (chronic
depression)
2) ** preserving a threatened self-image
(embarrassment and humiliation)
3) exercising omnipotence vs. helplessness
(terminal illness/intractable pain)
** Most frequently occurring suicidal dynamic
within law enforcement suicide
COGNITIVE DISTORTION:
My feelings are wrong
My thinking is correct
Rational however confused and illogical
thinking
Suicidal Paradox
Suicide is a problem solving behavior,
individuals become less anxious and
symptomatic AFTER they have decided to kill
themselves. Therefore, an actively suicidal
individual will appear to be “back to
themselves”. Thus, it is imperative to ask this
person, “Are you better or have you decided
to kill yourself?”.
Euphemism
Euphemisms are “watered down” verbalizations of what a
person is actually attempting to say. For example, a person
may say, “You aren’t going to do anything stupid are you?”,
or, “You aren’t going to hurt yourself, are you?”. A suicidal
person (even if this person is your best friend) will
manipulate this transaction by saying, “No”. The usage of
the euphemism allows the suicidal person to avoid truthfully
responding because the internal talk of the person is, “No,
I’m not doing anything stupid, I have given this a lot of
thought, and I’m killing myself.”, or, No, I’m not going to hurt
myself, I’m going to blow my head off”.
INTERVENTION
[Please Note: the following is actually the
general content of what is suggested to be
discussed in this section as each
department will have their own specific
policies and procedures within State laws
and regulations]
INTERVENTION
(Continued)
It is imperative that the initial segment of this training include
the Department’s operational perspective regarding the posthospitalization phase of the police officer’s treatment. It is
highly recommended that every department have either a
written order or an accepted philosophical understanding
that the hospitalization will be considered a medical crisis
hospitalization and the police officer will not be at risk for
losing his/her job solely predicated upon the hospitalization.
The biggest barrier in the hospitalization process is the
police officer’s fear (which is immediately validated by police
officer peers attempting to assist the at-risk officer) that any
hospitalization will eventually lead to termination from the
department.
INTERVENTION
(Continued)
The actual first step in the intervention process is to
understand that the number one risk factor for police
suicide is embarrassment/humiliation. Therefore, early
Identification of at-risk officers is crucial. Whenever an
officer is arrested and/or relieved of duty (especially if there
is media involvement), police officer peers, family
members, or police psychologist staff should initiate a
face-to-face assessment (always go to the potentially
suicidal officer as opposed to agreeing to meet him/her
somewhere) which would entail verbalizing the direct
question (remember: no euphemisms),
INTERVENTION
(Continued)
“Are you considering or have you decided to kill
yourself and what is your plan?”. If the response is,
“Yes.”, then immediate voluntary crisis
hospitalization is required. Further, if your
department utilizes a staff or consulting
psychologist, it is strongly suggested that they be
utilized for the hospitalization process. This serves
two purposes; first, the mental health professional
can more quickly facilitate the actual hospitalization
process, and the subsequent post-discharge
follow-up process.
INTERVENTION
(Continued)
Second, as the saying goes, No good deed goes unpunished,
it is recommended that police officer friends and peers of the
at-risk officer do not actively facilitate the hospitalization
process as this will eventually cause a significant shift in the
interpersonal balance of power among the officers.
Specifically, following discharge from the hospital, the
affected officer will be able to cognitively appreciate that his
friends and peers saved his life via the hospitalization.
However, on an emotional level, the officer will again,
experience a profound embarrassment and humiliation that
he was hospitalized by his friends.
INTERVENTION
(Continued)
A final dynamic in the department’s attempt to lower the
number of police suicides is the incorporation of a
notification process whenever a police officer is arrested
and/or relieved of duty. Typically, the Professional
Compliance Bureau (Internal Affairs), the Domestic Crimes
Bureau, or the Sexual Crimes Bureau are the entities which
initiate and prosecute the arrest process, while individual
districts facilitate the relief from duty process. Whenever
either action occurs, the initiating entity is tasked with
notifying the Psychological Services Section which then
immediately responds to that entity and completes a suicidal
assessment of the officer(s).
INTERVENTION
(Continued)
A further responsibility of the Psychological
Services Section staff is to contact friends
and/or family members to directly respond to
the specific bureau/district or to the jail. This
process ensures that family and friends will
initiate direct contact with the at-risk officer
which will significantly decrease the potential
for that officer to attempt any self-destructive
behaviors.