Emergency Personnel
Each year more than 30,000 Americans take their own lives. Another 50,000 visit emergency rooms for self-inflicted injuries. Emergency personnel are often called to respond to these injuries and deaths. Suicide and suicide attempts can take an emotional toll beyond the unintentional injuries. Any sudden death is a shock to the family and friends of the deceased, as well as to bystanders and first responders. How first responders act in these situations can make a difference for the patient, as well as the family and friends of a person who has died by suicide or made a suicide attempt.
Helping People who Attempt Suicide
Having to use time and resources to help someone who intentionally injured themselves may raise mixed emotions. It is important to realize your emotions regarding suicide and suicide attempts to be able to professionally help the patient, their family and friends. It is also important to realize these emotions in yourself to help alleviate burnout. It may be helpful to keep in mind that around 90 percent of suicides are associated with a mental disorder. When working with people who have self-inflicted injuries, it is important to treat them as compassionately as you would treat those who are injured unintentionally. Compassion also may help you elicit the information you need to treat a person injured in a suicide attempt.
Principles that may help facilitate communication when working with a suicide attempt survivor are:
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Genuiness. Sincerity on your part can evoke sincerity in the patient.
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Respect. Respect the patient, regardless of your thoughts on suicide.
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Empathy. Empathic understanding is the ability to perceive the client's understanding of life as if it were your own.
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Concreteness. Your ability to say precisely what you mean, rather than relying on abstraction, can help you determine vital information.
People who have harmed themselves may try and reach out to you— sometimes directly, sometimes indirectly. Some warning signs to watch for include:
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Talking about suicide or death.
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Giving direct verbal cues, such as "I wish I were dead" and "I'm going to end it all.”
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Giving less direct verbal cues, such as "What's the point of living?" or "Who cares if I'm dead, anyway?"
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Expressing feelings that life is meaningless or hopeless.
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History or current diagnosis of a psychiatric disorder.
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Physical illness (especially associated with chronic pain).
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Current emotional trauma.
Never leave a person alone who has attempted suicide. Some ways to help the patient include:
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Transporting the patient to the emergency room where he or she can be kept under observation.
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Helping the patient's family and friends develop a plan to have someone with the patient at all times.
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Helping the patient's family and friends make sure that lethal means are not available to the patient.
Helping Suicide Survivors
If you respond to a situation in which a person has died by suicide, you will probably be in contact with friends and family. These people are considered suicide survivors. It is common for suicide survivors to be overcome with grief, anger or disbelief. These people may be in psychological or even physical shock. It can be common to react with anger, even directed at you and others that are there to help.
You should prepare them for what will occur at the scene of the death. It is common that the suicide survivors will need emotional support, sometimes more than you can or should provide. It is best to assist the survivors in utilizing their support system such as family, friends and clergy.
You may find yourself being questioned by journalists at the site of the suicide. It is important to be sensitive to the family. Sometimes a best response is to refer the media to a specific communication officer within the department. It is important to remember to not glamorize the suicide, defame or criticize the victim, or portray suicide as an inexplicable or senseless act in which nothing can be done.
Helping Yourself and Colleagues
Job stress is common for emergency personnel due to their irregular hours and a constant need to treat patients in life or death situations. Stress and emotional weight of the work takes a toll and needs to be addressed in order to maintain professionalism and effectiveness.
It is important to watch for warning signs of suicide in your colleagues. Sometimes bystanders are able to spot the warning signs far before the person is ready to admit that they are struggling. Some warning signs include:
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Talking about suicide or death.
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Giving direct verbal cues, such as "I wish I were dead" and "I'm going to end it all.”
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Giving less direct verbal cues, such as "What's the point of living?" or "Who cares if I'm dead, anyway?"
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Expressing feelings that life is meaningless or hopeless.
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Isolation from friends and family.
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Indicating that they feel life is meaningless or hopeless.
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Giving away cherished possessions.
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Exhibiting a sudden and unexplained improvement in mood after being depressed or withdrawn.
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Neglecting his or her personal hygiene.
Post Traumatic Stress Disorder (PTSD) can occur when faced with emotional trauma. It is important to note that PTSD is a complicated diagnosis and must be diagnosed by a medical provider or mental health provider. However, PTSD can sometimes include:
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Intrusion. Flashbacks or sudden and dramatic re-experiences of a traumatic episode.
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Avoidance. Shunning or evading personal bonds with family, friends or colleagues.
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Hyperarousal. A constant feeling that danger is imminent. It can be accompanied by irritability, nightmares and insomnia.
If you suspect that a colleague is struggling with suicidal thoughts, it is important that you ask them directly and in private. Some helpful tips include:
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Expressing your concern to a supervisor. It is important that you seek help in your efforts.
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Ask your colleague to call the National Suicide Prevention Lifeline at 1.800.273.8255 or 1.800.273.TALK.
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Offer to help find or take him or her to a mental health professional.
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Help his or her family and friends develop a plan so that someone is with him or her at all times until the crisis can be resolved.
Responding to a colleague having suicidal thoughts may not be easy. However, it may help save his or her life.
Information adapted from the Suicide Prevention Resource Center.
