First re­spon­der sui­cide, de­pres­sion: A pre­ventable pub­lic health cri­sis

Sun Sentinel Broward Edition - - VOICES & OPINION - By Mike Ryan Mike Ryan is a past chair of the Broward League of Cities’ Pub­lic Safety Com­mit­tee, cur­rent co-chair of the Broward County Con­sol­i­dated Com­mu­ni­ca­tions Com­mit­tee, cur­rent co-chair of the Broward League of Cities’ School and Com­mu­nity Pub­lic S

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.

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