Responding to the problem of suicide in public safety

September 7, 2021

by Dr. Anna Courie - Director, Responder Wellness, FirstNet Program at AT&T and Holly MacDonald - FirstNet Intern

You wake up each morning, put on your uniform, say goodbye to your family or loved ones, and go to work. Perhaps it’s going to be a routine day. But you know that even a routine day can quickly take an unexpected turn. Who knows what to expect? But you are brave, selfless, dedicated; willing to put yourself in the line of fire for your community.

You see tragedy often, sometimes on an unimaginable scale. And you witness horrors that many cannot fathom. You do all you can, yet sometimes don’t make it in time. While those of you on the front lines understand the potential for danger you find yourself in, the effects of such a mentally- and physically-demanding job can create lasting mental health issues. 

So, it’s not difficult for first responders to develop mental health issues. First responders see death, grief, injury, pain, and loss more frequently than the average American. This exposure can result in emotional trauma. And left untreated, this trauma could result in serious mental health issues, including suicidal ideation and suicide1.

Suicide is the 10th leading cause of death in the U.S. Suicide rates increased 33% between 1999 and 2019. And certain factors, such as occupation, can change your susceptibility to suicide or suicidal thought2. Many of these risk factors weigh heavily on the first responder community simply by the nature of their work. Stress can manifest as acute or incident related; chronic, which means occurring over a period of time; occupational, and post-traumatic. Yet, when it comes to first responders, statistics fall short in depicting the severity of the issue3.

First responders are at a higher risk for suicide than the general population, according to the Centers for Disease Control and Prevention. Law enforcement officers and firefighters are more likely to die from suicide than in the line of duty. And EMS providers are 1.39 times more likely to die by suicide than the general public. These higher-than average suicide rates, coupled with inadequate resources for trauma-informed mental health support, and the stigma surrounding suicide contribute to a growing problem.

Public safety is in dire need of feasible and sustainable solutions informed by evidence.

Some of these solutions can include:

  • Implementing peer support groups within the first responder network
  • Bolstering mental health programming in organizations
  • Implementing suicide prevention frameworks
  • And changing the cultural discussion regarding suicide and other mental health issues

Knowing what to look for and what to do about signs of suicide is crucial. And we must prioritize education on the matter. Implementing feasible solutions will improve work life and offer support to those who need it. This preventative solution will ensure we address the mental well-being of first responders across the country. By understanding the problem, facilitating awareness, analyzing the factors involved, and developing evidence-based solutions, we can generate successful prevention tactics and give first responders the support they deserve.

Suicide is preventable. And there is much the first responder community can do to prevent suicide within its own ranks. Evidence based resources are available at multiple levels to address suicide prevention.

  1. At the individual level, resources such as The National Suicide Prevention Lifeline or the Crisis Text Line can help. Both are 24/7 services that can aid distressed individuals with suicide prevention and crisis resources.

  2. Should someone be worried about a family member, resources such as The Suicide Prevention Resource Center and The CDC are available. Both of these resources can help family members identify what to look for as well as what to do should they witness any concerning behaviors.

  3. At the organizational level,  The IACP Suicide Prevention Framework and The IAFF are great resources to better understand and prevent first responder suicide within the organization.

Raising awareness is the most effective way to create sustainable changes. Failure to address mental health issues among first responders can lead to other various issues. This includes failure to complete tasks, poor decision making, and inability to assess risk4. These consequences of mental illness can escalate the danger on the job. And first responders are more susceptible to suicide just by virtue of the risk factors, many of which come with the job.

However, there are steps you can take to combat this. Decompression sessions, suicide prevention training, and peer-to-peer counseling can help. Changing the cultural narrative among first responders can be a positive change. Reminding first responders that while bravery is commendable, mental illness does not equate to weakness, but rather strength. By identifying and implementing solutions, we can help to support our law enforcement officers, EMS, fire personnel and other public safety workers the way they support our communities.

To those first responders reading today, we thank you, sincerely, for your service, and encourage you to check in on your peers and yourself. When you notice symptoms of depression, anxiety, feelings of despair, inability to concentrate or make decisions, or thoughts of self-harm in yourself or those around you, seek help. Take a moment to familiarize yourself with the support your organization offers. Know what steps you and those around you can take should you start to feel hopeless. And know you do not need to hide your mental health struggles from the world, as they only make you stronger.

Dr. Anna Fitch Courie, Director of Responder Wellness, FirstNet Program at AT&T, is a nurse, Army wife, former university faculty, and author. Dr. Courie has worked for over 20 years in the health care profession including bone marrow transplant, intensive care, public health, and health promotion practice. Dr. Courie holds a Bachelor’s in Nursing from Clemson University; a Master’s in Nursing Education from the University of Wyoming; and a Doctor of Nursing Practice degree from Ohio State University. Dr. Courie’s area of expertise is integration of public health strategy across disparate organizations to achieve health improvement goals.