Suicide And Mental Illness In Emergency Services

[x635 4,066]

One of the most taboo subjects in emergency services is suicide and mental illness. Yet, it continues to take countless lives every year from our ranks, and I feel nothing's being done about it. And there aren't even any statistics kept because it's kept so "hush hush".

Mental health awareness needs to become part of an officer's training to recognize signs. Additionally, the firefighter should be afforded the opportunity for counseling whenever he/she needs it, not just a "CISD"

With it all built up, our job is one brutal job over the course of time. Lots of things can contribute to our mental health, such as divorce, failing tests, getting laid off, etc. How do you know that one call in particular has been on our partners mind for years, and they've been struggling with it, and are tired of it?

We need to end the stigma, harassment, and discrimination of mental illness, especially around the "kitchen table", so that people can get the life improving and life saving help they need without being ashamed. I'm sick of seeing friends die because no one saw the warning signs or they were to ashamed to admit they needed help.

Here's a great website for it, that is really working hard for the cause. It is championed and run by Glenn Close of Bedford.

http://www.bringchange2mind.org/

[v85 212]

Unfortunately it seems we have a long way to go with ending the stigma of mental illness in emergency services.

I have seen people fail psych tests to become police/firefighters etc because they took ADHD medication or saw a counselor for a parent's divorce etc at age 7.

Also, what happens what happens when someone who is a good police officer/firefighter/EMT has CIS stress issues and can't work the road anymore, espeically in volunteer agencies without retirement? Will the department be willing to find an inside position for them? or are they just dismissed?

Edited August 6, 2013 by v85

[SageVigiles 1,194]

This isn't a "new" phenomenon in public safety, but its sure garnering more attention as of late. I'm hearing a lot about CISD and Psychological First Aid in regional planning and preparedness meetings at work, and a lot of Medical Reserve Corps units are starting to get involved in this. My feeling is that most of us as responders do not have the time to become trained behavioral health professionals, but we need to train our people to recognize issues and be able to direct our peers to the help they need. Employee Assistance Programs are a great start, and for large-scale incidents there are a lot of other resources out there:

CT Critical Incident Stress Management Team:

Specific to first responders

http://www.ctcism.org/

CT Dept. of Mental Health & Addiction Services / Dept. of Children and Families Regional Response Teams:

Not necessarily specific to responders, played a HUGE role in the Sandy Hook incident

http://www.ct.gov/dmhas/lib/dmhas/publications/dbhfactsheetr5.pdf

Line-of-Duty State Response Teams (LASTs):

Specific to Line-of-Duty Deaths in the fire service

http://firehero.org/resources/departments/last/LASTBrochure.pdf

The FBI's Office of Victim Assistance also has great resources to tap into, though its usually only available after violent incidents, etc.

[antiquefirelt 994]

I have seen people fail psych tests to become police/firefighters etc because they took ADHD medication or saw a counselor for a parent's divorce etc at age 7.

While I have no educational basis to back this, my sense is that those are two pretty different issues. Seeing a counselor for a potentially difficult issue to ensure there are no lasting mental health effects makes sense to me. On the other hand prescribed medication for ADHD mean a diagnosed issue. While this issue may not be a dangerous one(prone to violence) it does raise a flag to ones ability to stay on task? Again, wouldn't be our call from a hiring standpoint, but if the psyche eval found this, I could understand it's validity.

[v85 212]

Also, I thought there was research out their that said CISD, or at least mandatory CISD ended up doing more harm than good?

I know several people wrote into JEMS after they did a pro-CISD article bringing this fact up

EDIT: As far as the ADHD comment was concerned, I know of at least one specific case where someone was on medication for ADHD, didn't disclose it, and went on to serve honorably in the US Army ABN during Operation Iraqi Freedom/Operation Enduring Freedom. Had they disclosed the fact they were on medication as an elementary school child, they would have been kept out of the Army.

I just don't think it is right, that one has a better chance of being hired with criminal arrests (that were plea-bargained to violations) as a teenager or young adult, then with having seen a psych doctor as a small child

Edited August 6, 2013 by v85

[mstrang1 213]

While I have no educational basis to back this, my sense is that those are two pretty different issues. Seeing a counselor for a potentially difficult issue to ensure there are no lasting mental health effects makes sense to me. On the other hand prescribed medication for ADHD mean a diagnosed issue. While this issue may not be a dangerous one(prone to violence) it does raise a flag to ones ability to stay on task? Again, wouldn't be our call from a hiring standpoint, but if the psyche eval found this, I could understand it's validity.

ADHD is one of the most over diagnosed disorders. I know someone was put on ADHD meds by a GP as an adult, then quickly taken off them once he saw an actual psychiatrist, who thought that the MD was nuts for prescribing them to him. He told me that the psychiatrist told him that, in his opinion, 75-80% of the people prescribed ADHD meds don't actually need them.

[x635 4,066]

This isn't a "new" phenomenon in public safety, but its sure garnering more attention as of late. I'm hearing a lot about CISD and Psychological First Aid in regional planning and preparedness meetings at work,

I'm not talking about response to specific incidents, I'm talking about chronic, long term things. Depression, anxiety, etc. Just a career in EMS alone without any "major" incidents can (and has) taken it's toll.

And these teams don't do anything PRO-active to get out there and address the issue before it becomes life threatening. Many benefit plans include EAP, but most of them are a joke. Some cities are starting mental health units or contracting with similar to provide an array of needs catering to stress and mental illness specific to emergency responders, their jobs, personal lives, etc. T

There is also a lot of drug and alcohol abuse, and it killed one of my mentors recently, which was ultimately caused by his heroics on the job. That department doesn't recognize mental illness or substance abuse as a legitimate medical condition, and often use it to make fun of someone or use it to bully or harass them..

When was the last time anyone saw a suicide or mental health hotline or awareness poster posted in a firehouse, precinct, or EMS Station?

[Just a guy 493]

I found this on officer.com, it's a pretty good read.

http://www.officer.com/article/10850327/police-suicides-drop-in-2012

It's saddens me to think that there were 126 of my brothers and sisters out there that felt they were so alone and that things were so bad that they had no choice but to take their own life.

It is incumbant on us all to keep an eye on each other and to offer a helping hand or a kind word or an offer to talk if we see someone that may be in need.

We are all quick to ball break which most certainly has it's place in the emergency services but maybe if we were all as quick to notice the warning signs of a coworker in distress, something can be done to save a life.

The YPD dealt with this in 2005 when one of our brothers took his own life. We now have a peer counseling team made up of specially trained cops and supervisors that are available 24/7 to assist a cop in need. Yonkers also has an EAP program where all city workers can seek help.

[antiquefirelt 994]

ADHD is one of the most over diagnosed disorders. I know someone was put on ADHD meds by a GP as an adult, then quickly taken off them once he saw an actual psychiatrist, who thought that the MD was nuts for prescribing them to him. He told me that the psychiatrist told him that, in his opinion, 75-80% of the people prescribed ADHD meds don't actually need them.

This I do not doubt, but realize that a large part of us likely no very little about most mental health issues unless we've had direct exposure to them. Similarly the post above noting exemplary military service in the face of a previous ADHD diagnosis, proves that some people can function fine while others in the mental health profession have determined that as a group these folks are more likely to have issues, hence the "no hire" practice. For every standard reason someone shouldn't be hired (medical history, mental health, criminal history. etc) there are exceptions that have gone on to serve as model employees without issue, but until those numbers disprove the statistical data showing the risks, the prohibition will probably remain.

I feel like an "old timer" I guess but there are times when I see ADHD as a name and disorder given to allow blame to be placed other than where it truly lies for kids and adults who were never disciplined. I know that there's likely tons of proof that this is a true "thing" but I'd have to agree that it appears to be an easy route to explain away why little Johnny can't sit still or shut up during class. Instead of treating this the way they did 25+ years ago, everyone points fingers and makes up excuses, so off to the doctor for the new "mother's little helper". OK , sorry for the harsh critique, as I said ADHD is likely a true mental health issue but from personal experience the true cases vs the sheer number that are "diagnosed" seems disproportional to the way "it used to be". OK, gotta go, time for Matlock.

[v85 212]

I personally think that the rise in ADHD/ADD is related to this. Years ago, when school class sizes were smaller, and teachers didn't teach to the test, they could spend individualized time with each student.

Now they can't do this, so teachers teach to one predominant learning style, and all other students are medicated/forced to try to fit that learning style.

[antiquefirelt 994]

I personally think that the rise in ADHD/ADD is related to this. Years ago, when school class sizes were smaller, and teachers didn't teach to the test, they could spend individualized time with each student.

Now they can't do this, so teachers teach to one predominant learning style, and all other students are medicated/forced to try to fit that learning style.

Of course they used to send you to the office if you acted out, send you to a 'slower" learning class if you couldn't keep up or call your parents and have a meeting if you were otherwise not cutting it. Too often now teachers are scared to single a student out in any negative way as the parents suddenly shift the tables and make the school treat the kids special, as it couldn't possibly be the kids fault, heaven forbid theirs for not instilling some of the most basic lessons at home. I have three teacher I'm pretty tight with and while they all have slightly different experiences, it would appear their ability to teach is getting further and further hampered by the systems overall fear of lawsuits. In one case the teacher and her co-workers have been threatened with bodily harm and the administration will not take the case to law enforcement out of fear of legal repercussions.

While I can't directly blame all of this on lawyers specifically, I can say that a lot of or problems stem from continuing to hold people monetarily liable for things that really are out of their direct control. This speaks to hiring practices, problems in our educational system, the cost of our justice and penalization system, the cost of medical care and medications, and the list goes on.

Edited August 6, 2013 by antiquefirelt

[x635 4,066]

ADD/ADHD is a completely different issue in mental health and prescriptions today. IMO, it comes down to parenting today and the pharmas promoting a "solve it all" pill and society relying on that. Honestly, ADHD could be solved if children were still allowed to be afraid of their parents if they screw up or misbehave, and parents being parents and not "friends" with their children. But I digress.

There's a wide range of other more serious mental problems that I'm talking about that affect emergency services.

[crcocr1 8]

mstrang1, on 06 Aug 2013 - 10:47 AM, said:

ADHD is one of the most over diagnosed disorders. I know someone was put on ADHD meds by a GP as an adult, then quickly taken off them once he saw an actual psychiatrist, who thought that the MD was nuts for prescribing them to him. He told me that the psychiatrist told him that, in his opinion, 75-80% of the people prescribed ADHD meds don't actually need them.

The issue isn't one of ADHD being overdiagnosed but rather a need for medication and the stigmas attached thereto. I have ADD-Inattentive and can tell you that it is a real disorder that can be managed with medication/appropriate training. Without my medication (at times), I would have had great difficulty in law school despite the fact that the medications made me tired as I was unable to focus, driven to distractability by the air in the room, the lights, and the smallest sound. Since law school, I have practiced as a criminal defense attorney and prosecutor handled a multitude of cases.

The separate issues raised by your comment, however, is: (1) Is it appropriately diagnosed or diagnosed for the sake of convenience; and (2) if it is appropriately diagnosed with an appropriate extensive assessment by a neuropsychiatrist, is it something missed years ago (such as tumors being diagnosed as CVAs in the 1950s etc. etc. due to a lack of testing/proper knowledge at the time).

The more appropriate question raised regarding the topic is does the mental illness have a profound effect on the job allowing for discrimination at the workplace? (physically handicapped individual wanting to be a firefighter being the classic example)

Edited August 6, 2013 by crcocr1

[grumpyff 1,159]

And these teams don't do anything PRO-active to get out there and address the issue before it becomes life threatening. Many benefit plans include EAP, but most of them are a joke. Some cities are starting mental health units or contracting with similar to provide an array of needs catering to stress and mental illness specific to emergency responders, their jobs, personal lives, etc. T

When was the last time anyone saw a suicide or mental health hotline or awareness poster posted in a firehouse, precinct, or EMS Station?

For the NYPD we have POPPA (Police Officers Providing Peer Assistance) that is staffed by NYPD members and will help all ranks with personal and professional problems. It is separate from the job, but has its support, and the support of the City Council. Of course its use is not mandated (it is confidential, supposedly), but the job does have its Pysch Services, and if you get sent there by the job, it is not voluntary. They often do alcohol counseling, domestic violence classes, etc. POPPA usually visit every command (every tour) at least once a year, and every so often they will make appearances at the range to let the members know it is still available. In addition, EVERY member's locker has a sticker about 5"x8" with a list of different groups that can provide support for numerous problems that members may face. We just got a few new posters in my command on this topic. I will try to get a photo tonight when I go in.

[Just a guy 493]

When was the last time anyone saw a suicide or mental health hotline or awareness poster posted in a firehouse, precinct, or EMS Station?

I am one of two PBA reps in my precinct and I make sure that the numbers for the peer support team are always posted on the PBA bulletin board as well as a poster with a ph0one number for suicide prevention for cops.

[RWC130 594]

GREAT TOPIC AND ONE THAT NEEDS TO BE ADDRESSED!

I've always questioned why we don't have more support groups for FD, PD and EMS?

We deal with so much stress on a daily basis. Add to that family, financial and personal issues

it can become overwhelming very fast. I know this first hand having a friend who

took his own life.

Anyone who is in A.A. or N.A. knows you can find a meeting almost anywhere.

How about something like that for Emergency Services? Where you can just show up and share.

Often it's good just to talk and get stuff off your chest.

[x635 4,066]

I feel cops have it different. If you look at the stats, they have an instant suicide device that doesn't allow for much time to back out or survive.

[v85 212]

I am one of two PBA reps in my precinct and I make sure that the numbers for the peer support team are always posted on the PBA bulletin board as well as a poster with a ph0one number for suicide prevention for cops.

Both of my volunteer agencies have a EAP business cards/stickers with the phone number around, along with fact sheets about dealing with critical incident stress (what it is, importance of eating right, exercising, finding constructive ways to relieve stress, resources to contact for professional help, etc)

[grumpyff 1,159]

Here is the most recent poster from our Early Intervention Unit

and the sticker that is affixed to every locker in the Police Department. It is in your face everyday. With that said, we continue to experience suicides. There is help if is needed, it is just a matter of making the call. Also the group known as POPPA, has a separate phone line for retired members as well. I think they may be one of the few groups that will talk to retired guys

Edited August 10, 2013 by grumpyff

[calhobs 110]

In the 90's at least CISD and EAP totally sucked in NYCEMS. If you suffered from depression you were treated like dirt. You were better of killing your self then having your peers help you. I hope to God it has improved, There are many good people in EMS that need help and just don't get it.

[Remember585 815]

There's a huge difference between the mentally unstable to begin with, the overly emotional, the empathy-seeking trolls and legitimate PTSD folks, however the first three I mentioned generally get most of the attention, and the latter - and most serious we need to try and help - get overlooked, usually because nobody knows what to do for them.

[Just a guy 493]

^{the problem with PTSD is that it's most commonly diagnosed in the military and it is pretty much dismissed in the emergency services. I would bet that there are a ton of people that suffer from PTSD in the emergency services fields that go untreated.}

^{If you are struggling, reach out brothers and sisters, we are all here to help.}