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Emergency Medical Services: "Suicide Is Painless"

If you have ever seen the movie M*A*S*H, you may recall where a fake suicide was held as part of a "Last Supper" scene. The chorus of the song that accompanied that scene (and was actually the theme song for both the movie and TV show) claimed, "That suicide is painless, it brings on many changes and I can take or leave it if I please."

Unfortunately, we all know that suicide is not painless—not for the individual or those who are left behind. We also know our profession can lead our people down this path, yet it generally remains a taboo topic that we rarely discuss.

We find many contributing factors when we look at the cause of first-responder suicides. Some of these include family issues, such as death of a loved one, marital issues, divorce and financial issues. Others include the stress of our job and PTSD, suffering a traumatic injury and even becoming famous. We've seen many instances where our responders have been involved with significant calls or gained notoriety for a rescue and then committed suicide later because they were unable to deal with the post-event stressors.

When we talk about health and safety for our personnel, we need to include the mental-health aspect that's so frequently forgotten. We've become better educated about the causes and realizing the problem of suicide exists, but we still tend to lack the guts to face this issue head on. We have crisis teams and employee assistance programs (EAPs), but we walk a very fine line between employer rights and employee privacy issues. It's not an easy issue to deal with, but the overall health of the organization demands that we take a proactive stance.

My organization suffered a member suicide almost 30 years ago. She was young, had a bright future and was working for an ambulance company as an EMT while volunteering as a firefighter/EMT with us. However, she did have a mental health history and had previous attempts. She seemed to be on the right path and getting better after she became involved in fire and EMS, and she did well for quite some time—right up to the day my paramedic partner found her dead from an overdose in her bedroom at one of our resident stations. My department suffered for quite some time after that, because we believed we could have prevented it, even though we had been very much involved with her.

A neighboring department has suffered two suicides in the last six months, and the effect has rippled throughout our region as it has affected not just their department but many others around them as well. Fire and EMS is a close-knit family that extends far beyond the boundaries of just our department patch; when one agency suffers, we all suffer.

Mike McEvoy, the IAFC's EMS Section secretary, has made presentations around the United States on this issue and provides the following recommendations:

  • Every department needs a behavioral assistance program (BHAP) or EAP for members and their families.
  • Conduct an after action review following every run.
  • If you're feeling stressed, seek help from your healthcare provider, BHAP/EAP, fire department chaplain or a fellow firefighter.
  • Don't try to tough it out! This could hurt you, your family and your department.
  • Stress awareness should be part of firefighter training at every level.
  • If you see a buddy struggling with stress-related problems, help him or her out.
  • If you or a friend feel suicidal or need help now for any reason, contact your BHAP/EAP or Safe Call Now (206-459-3020 or SafeCallNow.org). Don't delay!

We must continue to work at recognizing and preventing employee suicides, and we should include it in our overall health and wellness plans. One more is one too many, and while that individual may believe suicide is painless, the lasting effects can be devastating.

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