EMS and Suicide Aftermath - @ JEMS.com

EMS and Suicide Aftermath


Susan Thornton | | Friday, January 16, 2009

DOUGLAS COUNTY, Colo. -- Last November, there were four teen suicides in Douglas County. The youths left behind stunned and grief-stricken families and friends. They also left behind first responders - the emergency medical services employees and police - to suffer the "splashover" effect of responding to suicides.

Ironically, suicide is a "fact of life" for Colorado first responders, who encounter it all too often. Nationally, suicide claims 32,000 people each year, with another 500,000 hospitalized for attempted suicide. Colorado ranks No. 6 in suicides per capita in the United States.

Wayne Zygowicz, EMS chief for Littleton Fire Rescue, recently spent six months researching the subject while earning a master's degree. He found that few jurisdictions across the nation provide much suicide training for first responders, and few have developed standard operating procedures or crisis intervention plans.

Zygowicz surveyed 190 firefighters and police officers in Littleton, and 125 firefighters in 31 other states. All of the Littleton firefighters who responded said they had been on a suicide call and 97 percent had responded when the suicidal person died. Sixty-three percent said the experience left them with changes in their sleeping or eating habits and emotions, and almost all remembered details of the suicide long afterward. In addition, one-third had felt personally threatened while on a suicide call.

Survey results for police and firefighters in other states were similar. Nationally, only 3 percent of fire departments reported providing training in dealing with suicide.

What started Zygowicz on his exploration of this dark topic was a suicide that occurred last September at Littleton Fire Station 13, where an elderly man killed himself on the lawn. Shaken by that event, Zygowicz realized that in his 27 years in the fire service, he'd never had any training about what to say to people who had attempted suicide or to families devastated by grief.

As part of his master's degree coursework, Zygowicz developed a training program that helps first responders know what to do when they encounter a suicidal person.

"Talk to the person in the ambulance on the way to the hospital. Show compassion," he urged firefighters in a recent training session. It may ease the person's anxiety and begin the healing process.

First responders should recognize suicidal warning signs. "Ask if they have access to lethal means at home," he said.

"Have they prepared their will? Do they have a suicide plan?" If so, these are indications that the person may attempt suicide again, and should be reported to physicians at the emergency room.

Zygowicz has also developed a plan for what to do when suicide has been successful and first responders need to support the family. Then the area becomes a potential crime scene and must be sealed off until police arrive to investigate. Family members should be shielded from the scene and children and pets cared for. Zygowicz suggested phrases EMS can use to avoid re-traumatizing grieving family members.

"Families say they remember forever what first responders say and do at the time of a suicide," he said.

He has also developed a "standard operating procedure" to guide the actions of Littleton firefighters when called to a suicide scene. His plan may not be a good fit for every fire department in Colorado, but it's a start. It's shocking that there is no standardized training program and no standardized operating procedures for firefighters in place across the state.

Depression is a major cause of suicide, and Zygowicz attributes the lack of training to the stigma that society attaches to mental health issues. It's time to move past that stigma. It's time to put essential tools in place for Colorado's first responders.

Susan Thornton (smthornton@aol.com) served 16 years on the Littleton City Council, including eight years as mayor. Her column appears twice a month.

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