SUICIDE and FIRST RESPONDERS’ ROLE WHO ARE FIRST RESPONDERS? While this is true, it is important to consider that first responders also are used as a resource by and First responders, also known as first interveners, for people who are suffering emotional, mental include a variety of public officials who deal with health and substance abuse issues. emergency situations on a day-to-day basis. This Unfortunately, most first responders are not group includes, but is not limited to firefighters, specifically trained in the area of mental illness. police officers, EMTs, paramedics and emergency Many are unaware of the common warning signs department personnel. When calls or visits are of suicide and do not know the appropriate action made for individuals needing emergency to take when they encounter someone who is assistance, whether by that individual or on their exhibiting suicidal behavior. behalf, first responders are the first professionals to come into contact with the situation. First Being the first point of contact with individuals in responders uphold a duty to shield those in their emergency situations, first responders’ community from harm. knowledge and handling of emergency situations greatly influences the end result of these crises. In WHY THE ROLE OF FIRST RESPONDERS IS SO situations involving suicide, the end result is IMPORTANT ultimately fatal if not handled properly. First responders, with the appropriate knowledge and Situations that first responders encounter may be training, can save lives in suicidal situations. of suicidal nature, especially those that are mental health emergencies. The Illinois Violent Death PREVENTION/INTERVENTION STRATEGIES FOR FIRST Reporting System indicates 72 percent of Illinois RESPONDERS suicides occurred at the victim’s residence. First responders are the initial contact in emergency STRATEGIES FOR RESPONDING TO THE SCENE situations occurring in the home. At any time, first responders may be in situations where they It is crucial for first responders to take suicide need to refer a person to a mental health facility, threats and attempts seriously. Suicide or even personally recognize and remove lethal Prevention Resource Center (2013) recommends means from someone. the following steps for taking precaution at the scene: The nature of emergency situations that first “Ensure the safety of everyone present” – this responders come into contact with is wide in includes eliminating access to lethal means. If range. Many may assume that first responders available, contact law enforcement who are deal with common themes, such as fire, theft and trained in suicide prevention to intervene. automobile accidents. Law enforcement officers should be aware of the dangers of a “suicide by cop” situation, Illinois Department of Public Health 535 West Jefferson Street Springfield, Illinois 62761 217-558-4081 www.idph.state.il.us TTY 800-547-0466 where a suicidal person threatens harm to following objectives, as outlined by the National others in attempt to provoke officers to fire at Alliance for Suicide Prevention (2012). him or her “Assess the problem and its context within the “Assess the person for need of medical treatment” workplace setting” - First responders should – Address any serious medical needs first, and examine how suicide affects their profession. if not equipped to handle mental health “Increase workplace buy-in about the consequences issues, involve somebody who is, such as a of not attending to suicidal behavior” – First mental health clinician or crisis intervention responders can talk with colleagues about the worker. If not aware of the appropriate importance of suicide prevention education. professional to contact, ask a supervisor for “Build the capacity of workplaces to engage in direction. suicide prevention” – First responders can “Establish rapport with the person” – Listen suggest trainings and print materials for the carefully and speak with the person in a non- workplace to review. confrontational manner. “Engage employers to take action and to evaluate “Assess the person for risk of suicide” – results” – Employing the above strategies, first Determine whether an attempt has already responders may capture the attention of been made while keeping them under leaders and see workplace changes. constant observation. If the person is suicidal, STRATEGIES FOR OCCUPATIONAL TRAINING arrange for them to be transported to a local hospital or mental health center. Suicide prevention needs to be a focus of a first STRATEGIES FOR THE COMMUNITY responder throughout their professional training and as a part of their continuing education. For There are many ways for first responders to example, information can be added to a training participate in community-wide suicide block at the academy or school with a brief prevention efforts. First responders can get update or refresher during the time staff received involved in local prevention efforts, such as recertification for cardiopulmonary resuscitation community coalitions. If a community has a (CPR). coalition, then extend an invitation to law enforcement and the fire services. First The 2012 National Strategy for Suicide responders can share written materials with the Prevention, a report of the U.S. Surgeon General community and include suicide prevention and of the National Action Alliance for Suicide materials in the department’s lobby. Prevention includes providing training to community and clinical service providers as a STRATEGIES FOR THE WORKPLACE specific goal. Within that goal, the following Local first responders should promote awareness relevant strategies are presented: that suicide is a public health problem that is Develop and implement protocols and preventable. As often the first people to come programs for clinicians and clinical into contact with suicidal situations, first supervisors, first responders, crisis staff, and responders must recognize how suicide affects others on how to implement effective their profession. strategies for communicating and collaboratively managing suicide risk. To promote an informed staff within their Develop and promote the adoption of core workplace/team, first responders can apply the education and training guidelines on the Page 2 prevention of suicide and related behaviors by PROTECTING FIRST RESPONDERS credentialing and accreditation bodies. Develop and promote the adoption of core Professionals who act as first responders are in education and training guidelines on the high-stress situations for much of their work time. prevention of suicide and related behaviors by Being involved with these kinds of situations health professions, including graduate and exposes them to overwhelming images, both continuing education. physical and psychological, of both the victims and surrounding individuals. UNIQUE CHALLENGES FOR FIRST RESPONDERS If an agency does not have a policy, then they are First responders are often exposed to unique strongly encouraged to debrief first responders situations related to a suicide or a suicide attempt. involved with critical incidents, including suicide. In addition to directly interacting with suicidal Many local organizations will provide the individuals, first responders also must take training at no cost. special care in their interactions with family and Co-workers, friends and family members of first friends of a suicidal individual. They need to responders can recommend Acute Traumatic convey empathy and provide support, but at the Stress Management strategies to help them cope same time may be faced with the task of asking with overwhelming work experiences. These sensitive questions in order to obtain more include: information on the situation. Encourage them to admit their connection to If an individual completes a suicide, their family the situation is creating physical and and friends become “survivors.” Interacting with psychological reactions. survivors of suicide presents the same challenges Support them in talking about their personal as mentioned, but also may pose greater risks. reactions to their work. Self-disclosure helps Survivors of suicide experience strong emotions them understand experiences and promotes following their loss and, in extreme cases, may closure. show concerning behaviors that can be classified Remind them not to forget they are a normal as suicidal. person who has experienced an abnormal event, and remind them not to feel ashamed Additionally, first responders may be approached to seek professional help. by news media for information. First responders must be aware of the danger of releasing Unfortunately, first responders’ exposure to information that may be used to glamorize or distress in their work may cause weaker criticize a victim. Out of safety to the victim, first connections in their personal lives, as they may responders must learn to react to the media in a feel like a burden when sharing work-related minimal way, as detailed media coverage grief with others. Combined with some first regarding suicide can contribute to other suicide responders’ access to firearms (police officers), the attempts. If first responders must speak with the above factors make first responders at risk for media, they should take such opportunities to attempting and/or completing suicide provide sources of assistance for others in danger themselves. If you know a first responder under of suicide. stress, familiarize yourself with the warning signs of suicide and refer them for assistance. Page 3 HELP FOR