There have been multiple police, firefighter and paramedic suicides across Canada over the last couple of years and the numbers appear to be increasing. This disturbing trend requires that we examine what is happening and how we can stop such tragic events.
Recent research shows that first responders have higher rates of PTSD than the general population and difficulties with depression, substance use, relationships and physical health. All of these issues raise the risk of suicidal thoughts, if not suicide itself. To be clear, there are more first responders with these issues that do not take their lives, so it should not be assumed that someone struggling will complete suicide or is thinking about it.
In general, there are several factors that lead to thoughts of suicide and some in particular for first responders. Risk factors include a sense of hopelessness or helplessness. Perhaps these feelings relate to a desire for relief from depression or PTSD and the belief that nothing will work. Suicide isn’t about wanting to die but about not wanting to live in suffering. The psychological pain is unbearable and seemingly never-ending.
Another risk factor is the level of emotional urgency. A person’s risk goes up when they feel something must be done NOW to alleviate their suffering. They may have just received more devastating news, such as a denial of a benefit claim or that their partner is leaving. There is a push to do something. This is worsened by first responders’ ready access to weapons, medications and other means to act on their impulse to do something to escape the pain.
The stigma of seeking help is a huge hindrance to getting relief from psychological pain. First responders believe they are supposed to be able to figure things out on their own.
Another reason they might not get help is because of fear a therapist has to report their mental health issue to the police, ambulance or fire agency. This is not the case unless very specific circumstances are met: 1) the therapist has been hired by the employer to evaluate the employee, 2) the therapy records are ordered by a court (adjudication of a claim against the employer or pursuing benefits for a mental health issue), or 3) the employee is actively suicidal or is believed to be an imminent threat to self or others.
There are other exceptions to confidentiality which relate to the therapist’s duty to protect a child, elderly person or vulnerable adult from abuse or neglect. I have seen first responders for a variety of issues and have never communicated anything to their employers. Thankfully, I have never needed to.
If in doubt, it is always a good idea to talk with the therapist about what might not be confidential from your employer since it depends on the nature of how and why you are seeing them. Most therapist have no affiliation with first responder organizations even if they do specialize in that population. Even those that are affiliated can explain what the confidentiality arrangement is to ease any concerns you may have.
Several organizations were created to help first responders, including TEMA Conter Memorial Trust (www.tema.ca). It offers preventative education and connects persons across Canada in need of help with mental health professionals, works tirelessly to raise awareness of mental health issues in first responders and military members and advocates for their health.
Badge of Life Canada (www.badgeoflifecanada.com) is another great resource for connecting with support and learning more about the stories of persons who have struggled with mental health issues.
There are multiple grassroots organizations listed on the web sites of these organizations. They are made up of first responders who have struggled with their own psychological pain and those who specialize in supporting first responders (many are or were first responders themselves).
Even if a first responder is not seeking professional help, the information on these web sites could help them understand that they are not alone and that the intensity of what they are feeling will not last. It is also a good place for family members and retirees to find support.
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