This article will assist us in understanding the signs and symptoms associated with someone contemplating suicide or exhibiting behaviors associated with self-harm, any of which may be detrimental to one’s personal safety and wellness or those close to them. In addition, this article will provide guidance to those worried about someone in crisis – who may be unsure how to navigate this often unknown and scary arena. What this article is not – is a one-size fits all approach. Meaning if someone displays one or more characteristics, it does not necessarily mean that they are suicidal or at risk for a completed suicide. It means that we need to be proactive about officer wellness and we need to have a plan in place now, before the PERFECT DEADLY STORM arrives.
There has been a long-standing, misguided, but understandable belief that calling a clinician or taking an officer to the Emergency Department for assistance could “jeopardize their career.” In some jurisdictions and states that is still true. However, we must continue to fight the stigma related to pursuing good mental health care. Oftentimes, the stigma is so strong that many officers will choose to suffer silently, and sadly, may never receive the help they truly need. We must remember that no matter how tough life can seem, how difficult circumstances have become, suicide should NEVER seem like a viable option. In many cases, the issues an officer is dealing with can be treated and resolved and the person’s positive life balance can be restored. It certainly takes a collective effort to effectively address this significant problem and break down the stigma.
So where do we begin?
First, law enforcement agencies must directly confront the potential risk through comprehensive suicide prevention programs. This should include clinicians and other mental health professionals who are specifically competent in the law enforcement culture, participate in ongoing education, have access to appropriate and confidential resources, and peer support teams. Law enforcement leaders must step forward in a proactive, rather than a reactive manner. Law enforcement leaders are often in a position to set the agency tone and acceptance of mental health as a central component in officer wellness, however, the opposite is often the case. There are countless examples of officers who have sought help for depression, post-traumatic stress, and other family and mental health challenges, and have been met with judgement, labeling, and tragically at times, termination. True leaders will confront criticism from others, will help break through well-established cultural barriers, and will be supportive of their employees. In order for this to be successful, everyone in the department and within the officer’s inner circle must know the common risk factors for suicide. These lists are not all encompassing or inclusive, but they provide a great starting point.
IDENTIFYING RISK FACTORS
Family history of completed suicides
Depression, guilt, overwhelming anxiety or agitation
Negative view of self and the world.
Disturbance in sleep and/or appetite
Loss, death of another by any means, divorce, loss of job or job status
Public or private shame, humiliation or betrayal
calls, and not waiting for adequate back-up).
|Feeling trapped, like a failure, unable to solve conflict or problems
Addiction of any kind (alcohol, sex, drugs, gambling, etc.)
Easy access to lethal means
Feeling like a burden to others, feeling alone in the world, separating self from sources of comfort
Talking about wanting to die, writing a Will, giving away prized possessions
Acting in opposition to known behavior
Engaging in risky behavior (This may include (but is not limited to): not wearing their vest and/or seatbelts, speeding excessively to calls, and not waiting for adequate back-up).
IDENTIFYING PROTECTIVE FACTORS
|Family, friends, community connections, and a skilled peer support team
Access and involvement in the Mental Health Check-in, and therapy with a trusted mental health professional (Harvey Schlossberg circa early 1970’s)
Prevention: training in in stress inoculation, resiliency, coping skills and education
Religious prohibition: viewing suicide as sinful
Death bed promise (families with multigenerational suicides may ask for a promise from a child or sibling to not take their own lives)
Children, parents, pets (remember, while this may dissuade some, most officers who take their lives have children)
Unfinished life goals
Fear of dying or fear of being dead
It is understandable that without having a standardized process in place for seeking assistance, the fear of retribution for seeking help, or never witnessing positive outcomes – can make officers skittish of reaching out, and rightfully so. However, here is a protocol that can make a difference. Things that are long-standing are ingrained in the culture and are often difficult to overcome. So, let’s take a different look at this logically. Suicide in and of itself does not open the door to the future. In fact, it closes it, deadbolts it and will never allow the future to be an option.
We need to inquire more specifically and slightly differently when an officer automatically denies thoughts about suicide. Clinicians consciously and unconsciously want to hear the answer, “no” when asked about suicide ideation for many reasons, psychologically and pragmatically. It takes guts for anyone to ask the difficult questions and to deal with the answers. Training must be readily available to all officer’s and family members to assist in asking and then pursing the information and acting decisively on information gleaned from the answers. There are new methods available to get to these internal thoughts. Consider new instruction that will enhance your comfort level and skill set.
If an officer in crisis does not receive adequate and timely assistance, they may be at increased risk for completed suicide. So, hiding behind this belief that we will ruin a career…. that “WE” will place an officer’s career in limbo is absolutely, hands-down the wrong mindset. It is not only WRONG, it can be DEADLY. The PROBLEM is that no one wants to be the one to ask THE question(s). No one wants to be the one to step up to the plate not knowing what may happen, how things may play out. What if your courage SAVED THE LIFE OF A FELLOW BROTHER OR SISTER. Would it matter then?
LISTEN, no one is doing this career forever. No one! Whether something leads to a career being cut a bit short or a life circumstance makes you reconsider your career choices, so what! You choose: Cut a career short … or end a life forever. Now, it should be this easy when deciding to step up and help. Ask a family member if they would choose a career over their loved one.
Next, consider conducting a Suicide Inquiry. This does not require a physician or a mental health professional. The Colombia-Suicide Severity Rating Scale (C-SSRs) can be used by anyone and is available free of charge. Attached here are forms specifically designed for significant others and friends and family, and are excellent tools, though not specific to law enforcement. If you prefer, the questions below can help you gather additional information. This is for when you may notice or feel something is not right with your peer or loved one. You may not know exactly what is wrong, but you may just have a “gut” feeling that something is not right. Trust your gut.
So, continue with the information below, and be direct.
|Do you wish you could go to sleep and never wake-up?
Have you thought about killing yourself? If yes, when did that start?
Are you planning to kill yourself today?
How would you kill yourself? Have you rehearsed your plan?
How many times have you tried to kill yourself?
Do you imagine your funeral and how people will react?
Have you arranged or started the process of killing yourself and then stopped? What stopped you?
Would you use your duty weapon to kill yourself?
Would you kill yourself on department property or in your squad? Why?
Do you hope someone will stop you from killing yourself?
Do you plan to kill one or more persons before killing yourself?
Do you wish you were never born at all?
Do you believe your family and friends would be better off without you?
Do you feel you have lost your usefulness to everyone?
These questions may be a revelation to what may be secretly been going on inside of an officer’s mind. Trust me, these are not only difficult, but the questions and answers may be disturbing. Just asking the questions can be difficult, but are necessary in order to help you understand where your loved one is mentally and emotionally and assist those in need. We must STOP this PERFECT DEADLY STORM.
GETTING STUCK BY ACCEPTING “NO” AS AN ANSWER
Here is a foot in the door.
Exploring the Meaning of Passive Suicidal Ideation: Passive suicide ideation is a mental process where one is thinking thoughts about not being alive. They may be vague and with or without plans. Having suicidal ideation is not uncommon and can present in anyone’s life. Most times benign in nature, in terms of suicide thoughts leading to death, it can reveal the depth of depression and the level of anxiety someone may be struggling with. This is salient information that must be explored. Through specific questions you can kick through the no answer. Engaging the officer in a hypothetical set of questions will illuminate information not previously explored by clinicians. However, there is a small subset of individuals who use the ideational stage as a building block to construct a plan based on the intention to take their own lives. We can learn how to inquire about passive ideation and then determine the level of risk we are tasked with managing.
Determine Risk Level
Use above factors to determine immediate level of risk related to the officer planning and intending
to take their life. This can be difficult, because you have to determine whether the individual is
telling the truth. Consult a mental health professional who has experience determining risk level
You can legally and ethically break confidentiality in this situation.
If you consider the person likely to kill themselves, with available means, they should never, not even for a few seconds be left alone (e.g., bathroom, locker room, to go to their vehicle) until they are brought to a safe environment and all weapons have been secured. Remember, when discussing the law enforcement population there are always available means. Be sure to check for back-up weapons and other means like knives and pills.
Therapy, outpatient intensive treatment, or as a last resort, hospitalization may be necessary to protect and treat the officer. Again, the goal is to effectively and timely assist the officer through the crisis, and to avoid the pitfalls of the PERFECT DEADLY STORM.
Have a resource list available (additional articles and resources are available at the end of the article)) to identify culturally sensitive resources, therapist’s and programs that fit for the officer: Alcoholics Anonymous, Narcotics Anonymous, day only and half-day programs, as well as additional protocols that will fit the needs of the individual officer. It may prove helpful to follow-up with on-going therapy, family, peer support, and chaplaincy services. It is absolutely essential that the officer knows his/her Chief is supportive of them during this time. Officers are already fearful of the unknown and the “unknown” is why many choose to suffer silently. Administrators should be cognizant of their actions and refrain from appearing or being upset or angry, acting or seeming to be disappointed, and looking to terminate employment. Having officers that are well is the overall goal.
Family members should carefully document all information obtained for clinical assistance and should be aware of the officer’s motivation to act, clinical solutions tried and failed, detailed plans one may have to end his or her life, to include planning to act and where the act was to take place. The information gathered from the officer is used strictly for clinical purposes and should not be shared outside the patient/clinician relationship, unless agreed to by the patient. The Health Information Portability & Accountability Act (HIPAA) is meant to keep private health care information private. Be sure to educate yourself about HIPPA and how it protects you and your loved ones. This is a Federal Act and is only broken when an individual is harmful to themselves or others (i.e., mandated reporting). Document information gathered for legal protection. Focus on the fact that you (the family member) acted on behalf of the officer’s health. In this litigious society anyone can try to place blame. However, the legality falls on those not aiding an officer in crisis or distress.
Pay close attention to what the officer is saying as they may be minimizing their pain and even their intention and plan to take their own life. Retrieve information about their history of suicidal thoughts, previous attempts and even fantasies about how their plan will play out. Understand the best you can, the full picture. The family should be on alert and should be given specific tasks. A plan should be developed now, should weapons need to be removed from the home for safety reasons. This should be done by someone knowledgeable about handling firearms. It may be necessary to send young children to stay with friends or relatives. This will help other family members stay focused on the direct needs of the officer. A detailed plan should be developed on how to best care for the officer and specific contact numbers should be readily accessible.
This article has several aims. First, to assist officers in need, agency personnel, and families in recognizing risk factors and warning signs of those experiencing suicidal ideations and who may be actively suicidal. In addition, it aims to help recognize an officer in need or in crisis in a timely manner, while assisting them in navigating the system. Lastly, it will help individuals receive the clinical/professional assistance they need. Having to deal with issues such as these can be frightening and are often unchartered waters for many. Even professionals can struggle when assisting this population. This is partly because officers are usually the one’s in charge. Allowing someone else to be in charge and make the calls is not only scary, but can be a hit to the ego. The idea is to never give up. Educate yourself and your family on the symptoms and characteristics of someone contemplating suicide or self-harm, do daily check-ins with your loved one, keep lines of communication open and respectful, and have a plan in place. Remember, be proactive in the planning. The time to plan is not when you are in crisis. The PERFECT DEADLY STORM can present itself at any moment.
The time to STOP the PERFECTLY DEADLY STORM is NOW!
*Parts of this article were taken from Dr. Marla Friedman’s Suicide Assessment for Law Enforcement ©2015
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About the Authors:
Dr. Olivia Johnson holds a master’s in Criminology and Criminal Justice from the University of Missouri, St. Louis, and a doctorate in Organizational Leadership Management from the University of Phoenix, School of Advanced Studies. Dr. Johnson is the Founder of the Blue Wall Institute and 1 Is Too Many. She is a veteran of the United States Air Force, a former police officer, and published author. She belongs to numerous professional organizations and currently finished a three-year term with the St. Clair County Suicide Prevention Alliance as a Suicidology Researcher. Dr. Johnson speaks on wellness and resilience for the Bureau of Justice VALOR Program and is on the Advisory Board regarding curriculum review for de-escalation training and techniques. Dr. Johnson currently works as a Senior Research Associate with the Institute for Intergovernmental Research. Article correspondence can be sent to: firstname.lastname@example.org
Dr. Marla W. Friedman, Psy.D. PC, Police Psychologist is a national trainer, curriculum developer and creates video training films for law enforcement. She publishes frequently on issues of mental health, trauma cessation and suicide prevention for police and other First Responders. She has trained at the FBI National Academy at Quantico, Virginia, ICAC Task Force Teams, Field Training Officers and police departments with her focused mental health module, Building a Better Cop. She serves as an Adjunct Faculty member at the Suburban Law Enforcement Academy on the campus of the College. Dr. Friedman is the current Chairman of the Badge of Life, a 5013c nonprofit organization focusing on law enforcement mental health and wellness training. She serves as the primary architect in assembling individualized comprehensive mental health and suicide prevention programs for U.S. law enforcement jurisdictions. Dr. Friedman is the Chief Psychologist for Field Training Associates. Email correspondence: Support@badgeoflife.org
Tina Jaeckle, Ph. D. is a licensed clinical social worker in Florida and has approximately 25 years of mental health and crisis intervention experience. Dr. Jaeckle has presented nationally on issues of crisis/critical incidents, officer involved shootings, suicide (law enforcement and first responders), child abuse/homicide, domestic violence, mental illness, and high-conflict families. She serves as the mental health and training coordinator for several Critical incident Stress Management, hostage/negotiation, and crisis intervention teams and now consults with numerous law enforcement and first responder agencies across the nation. Dr. Jaeckle is also the current EAP counselor for the Jacksonville (Florida) Sheriff’s Office. Email: email@example.com