First responder suicide, depression: A preventable public health crisis
She reached through the unrecognizable car to a woman, who was screaming not because of the pain caused by her contorted body, but because she could see life had been drained from her husband. He was on scene before fire-rescue and can still smell, taste and feel the over-chlorinated water as he frantically attempted CPR on the 5 year old, who felt about as heavy as his daughter after a long day at the park. Others remember the close call from a fully engulfed fire or the scuffle with a driver who had a warrant.
The mission we ask our first responders to meet carries so much responsibility. Run toward a fire, or through a dark alley. Comfort when there is nothing else that can be done. Carry the smells, sounds and what could have been from one call but trained to, at least we thought, successfully compartmentalize feelings before arriving at the next scene.
While we understand scenes of mass shootings are a carnage beyond most training and experience, as it turns out the daily mission for our first responders and the predictable reflection as to what could have been done differently or what could have happened badly in a split second are causing an overwhelming negative impact on too many of our first responders. These encounters, which play out over and over in quiet moments, are taking more first responder lives than onduty deaths and not just by a small margin.
A recent white paper issued by the Ruderman Family Foundation, analyzed the disorganized reporting and data of suicides among our law enforcement and fire rescue first responders and concluded a significantly increased risk for and prevalence of suicide, depression, addiction and PTSD as compared to the general population. The barriers to seeking help center around stigma resulting from real or perceived professional consequences and other pragmatic challenges. In addition, the study suggests a lack of public awareness of this crisis is based upon under-reporting in the popular press, maybe paradoxically rooted in a well-intentioned sensitivity resulting from the stigma associated with suicide. Loved ones often encounter barriers when attempting to raise awareness where professions celebrate the lives of those lost in the line of duty as heroes without recognizing those who are overwhelmed by job related stresses are still heroes, too.
Popular shows and movies have further reinforced images of toughness and emotional invincibility, adding to the inability or unwillingness of first responders to report how they are feeling. Like our historic under-recognition of military service PTSD, popular expectations of mission-based hardness, while ignoring the very real after-effects, have contributed to this problem.
But things are changing. National leadership of the professions have begun efforts of raising awareness, attempting to overcome barriers to accessible mental health support, creating data driven best practices for supportive assessments, and trying to tear down the cultural barriers which equate needing help with weakness. The City of Boston, in the aftermath of the Boston Marathon bombing, both in terms of first responders seeing war-theater carnage and the aftermath for those pursuing the terrorists, is reportedly leading the nation in best practices.
Alarm bells have been ringing for far too long. We must support our first responders, not only with the righteous accolades for heroism we popularly associate with the patches and badges, but with real and analytical understanding of what they endure, access to meaningful mental health resources and a cultural shift to protect them from the very mission we ask them to accomplish each day. We owe our first responders nothing less.
Alarm bells have been ringing for far too long.