From the Guidelines
First responders are at a higher risk of suicide due to chronic exposure to traumatic events, high workplace stress, and a culture that stigmatizes seeking mental health support, and therefore, comprehensive approaches including regular mental health screenings, confidential counseling services, and peer support programs are crucial to address this issue. The risk of suicide among first responders is a significant concern, with factors such as post-traumatic stress disorder, depression, and substance use disorders contributing to this elevated risk 1. According to the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guidelines, screening all patients for suicide risk and conducting a multifactorial psychiatric evaluation for those identified as having an increased risk is essential 1.
Some key factors to consider in addressing the increased risk of suicide among first responders include:
- Chronic exposure to traumatic events
- High workplace stress
- Irregular sleep patterns
- Culture that stigmatizes seeking mental health support
- Ready access to lethal means
- Knowledge about effective suicide methods
To mitigate these risks, effective interventions should include limiting access to lethal means during crisis periods, providing adequate time off for recovery after traumatic incidents, and ensuring first responders have resources for managing stress, such as mindfulness training and healthy coping mechanisms 1. Additionally, creating a workplace culture that normalizes discussing mental health challenges and seeking help is crucial. Early intervention is key to preventing the progression from occupational stress to suicidal thoughts and behaviors. Further research is necessary to establish the effectiveness of community-based suicide prevention strategies, such as gatekeeper training, crisis lines, and peer-to-peer counseling 1.
From the Research
Increased Suicide Risk among First Responders
- First responders, including police officers, firefighters, emergency medical technicians (EMTs), and paramedics, experience significant job-related stressors and exposures that may confer increased risk for mental health morbidities, such as posttraumatic stress disorder (PTSD) and suicidal thoughts and behaviors 2.
- Studies have documented elevated risk for suicide among first responders, with findings revealing that first responders have an increased risk of suicide compared to the general population 2, 3.
- A systematic review of 63 quantitative studies examining suicidal thoughts, behaviors, and/or fatalities among first responders identified population-specific risk and protective factors, and pinpointed strengths and weaknesses of the existing literature 2.
Risk Factors and Characteristics
- First responder decedents made up 1% of all suicides, with over half of first responders (58%) being law enforcement officers (LEOs), 21% being firefighters, 18% being EMS clinicians, and 2% being public safety telecommunicators 3.
- Compared to non-first responder decedents, more first responders served in the military (23% vs. 11%) and used a firearm as the method of injury (69% vs. 44%) 3.
- Intimate partner problems, job problems, and physical health problems were the most frequent circumstances among first responder decedents for whom circumstances were known 3.
Capability and Suicidal Ideation
- First responders reported more lifetime suicidal ideation and higher acquired, practical, and dispositional capability than did non-first responders 4.
- Law enforcement officers (LEOs) reported more lifetime suicidal ideation than emergency medical technicians (EMTs), while LEOs, EMTs, and firefighters did not differ in terms of capability for suicide 4.
- The mechanisms driving the increased rates of suicidal ideation and capability among first responders are unknown, but are likely due to a combination of personal and occupational factors 4.