Preventing Suicide and Promoting Mental Health in EMS

As suicide rates in first responders continue to climb, it becomes increasingly important to educate EMS employees on mental health, a webinar presented by Code3 CME and the Code Green Campaign said.

“Calling a Code Alert on our Mental Health,” presented in late July by Ann Marie Farina, founder of the Code Green Campaign, and Judson Smith, vice president and founder of Code3 CME, discussed the widespread issue of suicide and mental health issues in EMS and what we can do to help.

The webinar covered statistics about mental health in first responders, how employees can learn resilience, how you can help someone in crisis and how to ensure your agency is active in changing its culture.

Farina says although there hasn’t been a lot of data collected, rates of suicide, depression, PTSD and substance abuse are all suspected to be higher than normal in the first responder community.

In a poll of webinar attendees, 58% said they knew a first responder who had committed suicide.

Farina says some of these increased rates can be attributed to stigma associated with mental health issues in EMS, the “macho culture” that surrounds many agencies and chronic exposure to stressful situations without being taught job-specific coping skills. When EMS practitioners begin their education, they’re taught what to do on calls, but aren’t taught about self-care or how to destress after a bad call, Farina says.

Farina attributes some of the hesitance to discuss mental health issues in EMS to the “macho culture.”

“We’re seen as the strong ones who show up and are in control and know what’s going on,” Farina says. “Any deviation from that can be seen as failure.”

Another reason mental health issues are not often discussed can be a general negative tone taken toward psychiatric patients, Farina says. Often, they don’t fit well into the model of EMS, but there isn’t really a better option that fits what they need. This can lead to resentment and frustration, Farina says, which sometimes boils over into degrading these patients: “We see this category of patients and are scared of becoming them."

Farina says one way to help promote proper mental healthcare in the EMS workplace and to lower rates of suicide is to erase this negative tone taken toward this group of patients. If you’re a manager or an administrator and you see employees taking a negative tone toward psychiatric patients, speak out, Farina says. If employees see that this behavior is tolerated, they’re much less likely to come out and discuss any issues they might be having, she says. Testing community paramedicine programs can also help, because this eases the burden of paramedics and helps them not have to respond to calls that might be out of their scope of care.

For managers or administrators, Farina says there is a multitude of ways you can promote mental wellness in the workplace and prevent suicide by employees:

• Actively listening when employees present a problem or want to talk to you;
• Being knowledgeable on the various treatment methods for mental health issues so you can suggest a plan of action for an employee in need;
• Promoting a culture where employees feel safe telling you about mental health issues.

“Make sure they understand that them getting help is not going to jeopardize their job or their career,” Farina says.

There are also steps other employees can take to help to their colleagues. Farina says knowing the warning signs of suicide, such as sudden changes in mood, increased stress, making end of life plans, giving away belongings or frequently missing work, is important for all employees. Farina also suggests saying something if you see something you think is strange. When talking to someone, start simple, Farina says. Ask how the person is doing and if you’re concerned, ask them directly if they are struggling or if they are considering suicide. When talking to people, try to avoid making the answer yes or no, Farina says. For example, instead of asking “are you mad?” try asking an open-ended question such as “how are you feeling?”

Although statistics show that first responder suicides are on the rise, Farina says with work, it’s possible to buck the trend and promote a culture of mental wellness in the EMS workplace.

To listen to the whole webinar, click here.

For more information on Code3 CME or the Code Green Campaign, visit their websites at code3cme.com or codegreencampaign.org.

For resources and articles on mental health in EMS, check out EMS World’s Suicide/Mental Health Resource Toolkit.