First responders are killing themselves at approximately twice the rate of the general population.¹ Suicide stats have increased in every first responder job category. It’s no secret that suicide is more prevalent than line-of-duty deaths in most departments.

We can’t deny that something needs to change. While I firmly believe that we cannot prevent suicides, we can educate ourselves about spotting the signs long before the individual may attempt or complete a suicide. We should be focusing on pre-empting suicide, not preventing it. The first step is to understand how the effects of stress contribute to suicidal ideation (thinking or ruminating about taking one’s life), where the stressor(s) are and how they are impacting the officer at any given time.

But there are many challenges in first responder organizations that hinder help-seeking. Leadership, while well-meaning, often does not have the capacity to face the suicide issue head-on, mainly due to not having the resources it needs to be successful in embedding suicide awareness into the culture. And yet, one suicide results in leadership’s inability to “save” the employee and leaves the organization in a state of shock and disbelief, with deep grief and guilt; a devastating price to pay.

Training at the recruit level rarely, if ever, teaches students how to take care of themselves, especially in the area of psychological well-being. Learning the external elements of the job takes the focus away from giving each student the tools they need to know how to identify emotional responses and how to enlist help when needed.

Stigma and fear are still the overriding obstacles that must be addressed and dismantled. Getting in front of the suicide issue will require putting together a complete plan of action, from one’s beginning in the job all the way to retirement. Normalizing the psychological toll of doing the “job” requires all levels of rank to be thoroughly knowledgeable about how to start the conversation and ensure that it becomes a vital component of organizational culture.

These are just a few of the reasons why men and women are not asking for help. The question is, where do we start? There are no easy answers; however, there should be more emphasis on taking a proactive approach to this devastating problem. But how? What will it take to implement such approaches? How do we get in front of something so deep and hidden?

Simply bringing up the issue of suicide and giving it visibility does not mean that it becomes something solvable. More often than not, officers will hear that their peers are having issues with relationships, substance use or mood disorders. Very rarely will someone admit to feeling suicidal in a conversation. Rather, all the other issues that are affecting them can be assessed in terms of the potential for suicidality. If you have noticed, we are not asking about self-harm. It is critically important to create a rapport through “normal” conversation, as the give-and-take of good communication can open up themes and topics for us to explore with them.

When discussing a stress reaction, it is not about the “usual” reactions that the job requires in order to be able to function. Instead, the focus is on how these stressors contribute to reactions that may result in suicidal ideation. Thus, critical incidents can be personal or professional/job-related (or both).

What is the difference between a person under stress and a person under stress who considers suicide? You can assess the severity of stressors that you hear about every day, the longevity and chronic nature, and the critical, constant thinking about suicide that can accompany a person’s reaction to their stress.

This has less to do with the individual’s actual situation than how the person perceives the strength of his or her resources. Knowing that resourcing an individual in crisis can mitigate their symptoms and make them feel connected and accepted can reduce the likelihood of suicide. How does one do this?

1. You must be able to identify stressors and evaluate their current impact on the individual.
2. You need to assess the frequency and severity of the stressors (how deep and wide they are).
3. Identify any coping mechanisms the individual has tried, is trying or has not tried.
4. Guide the individual toward solutions aimed at mitigating the effects of those specific stressors.
5. Encourage the individual to identify doable goals and strategies for achieving them.
6. Finally, you must be able to motivate the individual to take the steps necessary to positively impact their stressors.

When speaking with an at-risk individual who is displaying extreme stress reaction or going into fight, flight or freeze, there is a desire to “fix” their situation or solve the issue for them. We all want to help someone find the fastest, easiest way to get on top of their problems and feel a sense that all is not lost. The difficulty is that we can’t. We can simply listen, assess and think about resources or other means for them to get the help they need in the immediacy. This is key. The faster they are connected, the better the outcome is likely to be. There is also a strong sense of connectedness, which has shown to decrease the likelihood of isolation and withdrawal — two strong behaviors we may notice about someone who is grappling with deep personal issues.

The conversation is bound to reveal clues or other information that can help us “hone in” on what the issues are. Actively listening and asking open-ended questions can fill gaps in information. For instance, if someone reveals that they are losing an important relationship, questions such as “Why are you thinking that you are losing him or her?,” “When did you first notice that something was wrong?” or “How did you find out about this?” not only allow the person to share more information but also enables a way to assess it for three critical things: frequency, severity and debilitation.

Regarding frequency, knowing how long the person has been dealing with the issue is important. The longer they have struggled, the more likely they have thought about suicide, simply because they can’t see any way around it. It’s not surprising that someone may have an issue years in the making that may have temporarily gotten better, then worse, then better and so forth. Doing the same thing over and over and hoping for a different result is considered insanity, but it may be the only thing they have tried, hoping that this time will be different.

How deep and wide, or how severe, is the problem? How has it affected their life and the lives of others? Perhaps it’s cumulative stressors — things that pile up over time. I had a client once who had many things happen in the span of a year. They lost family members to COVID, had some financial problems and experienced several bad calls at work. But what brought them to us was the recent death of their dog. We think of these things as “straws that break the camel’s back,” but it’s true that there may be one thing and one thing alone that pushes them over the edge. It’s important to ask the questions that will open up a discussion about all those “things” in someone’s life that even they may not think are that important, but in the great scheme of things are critical to their attitude and coping skills.

Another thing to consider is how debilitating this issue has become for someone. How has it impacted their everyday lives? Are they impaired in some way? For instance, do they experience panic attacks in crowded places, or are they unable to drive because they have to go by the scene of a gruesome incident on their way to work each shift? Chronic insomnia is another sign. Not getting sleep can be dangerous in many ways, especially when someone is feeling entrapped. Knowing how these types of situations have affected them daily can be very helpful in letting us see just how impactful their issues have become.

We must be able to hear and understand the part of a person that is actively seeking relief in the form of suicide, while also offering hope and strength with the goal of impacting their stressors as soon as possible. I like to think of it as ABC, which stands for acceptance, belonging and connection. These are the things that can keep someone safe, prioritized and cared about. And you just might save a life in the process.