Law Enforcement Suicide Prevention

Introduction

Organizations like the Tema Conter Memorial Trust in Canada and Reviving Responders in the US have highlighted the skyrocketing rate of suicide among first responders, including police officers, paramedics and firefighters. In 2015, there were over 100 suicides by law enforcement officers in the US. (Kulbarsh, 2016) They note the high incidence of PTSD among law enforcement officers and the stigma that prevents them from seeking support.

One way to reduce law enforcement suicide is through police academy training that provides all officers with suicide awareness training. This helps reduce the stigma of receiving mental health support and gives police the opportunity to act as peer supporters for their colleagues.

Overview of Curriculum

The material below comes from the Basic Course for Police Officers authored by the New Jersey Police Training Commission (2016). This 262-page manual provides a complete review of the curriculum that police officers in that state learn during their 24 weeks at the Academy.

One of the instructional units is named “Suicide Awareness and Prevention for the Law Enforcement Officer”. The description is as follows:

The trainee will understand the causes, symptoms, warning signs and risks associated
with officer suicide, and will identify appropriate intervention and prevention strategies
to effectively deal with this issue.

The outcomes of this module are as follows. Once completed, the police recruit will be able to:

• Define suicide
• Identify demographics associated with law enforcement suicide
• Know stressors that contribute to suicide
• Explain risk factors associated with suicide
• Identify warning signs associated with suicide
• Understand suicide myths
• Explain and apply the AID LIFE acronym for intervening with suicide
• Identify obstacles to effective suicide intervention
• Note professional resources helpful to an officer
• Identify strategies to prevention law enforcement suicide

The content from these modules is summarized below, but I’ve added references where appropriate to back up the un-cited information. The goal is to provide added-value and confirm the veracity of the material.

Defining Suicide

Suicide is defined as the intentional taking of one’s own life (Stedman, 2016).

Demographics of Law Enforcement Suicide

• There are more deaths to police suicide than in the line-of-duty (Kulbarsh, 2016)
• The police officer life expectancy is less than the general population (Violanti, 2013)
• The suicide rate is approximately 14 deaths per 100,000 (Badge of Life, n.d.) compared to 13 per 100,000 in the general population (AFSP, 2014)
• Although the curriculum maintains that the divorce rate is higher among police officers, the opposite is actually true. The divorce rate is slightly lower, at 14.47% versus 16.96% for all professions over the lifetime (Roufa, 2015)
• The rate of substance abuse is higher among police officers (Cross & Ashley, 2004)

Stressors Contributing to Law Enforcement Suicide

In addition to the normal stressors such as depression, anxiety, substance abuse and relationship issues, the curriculum identifies some specific job-related stressors. These include:

• Discipline issues (internal affairs and/or
  criminal investigations); and
• Management issues (assignment – lack of promotion – supervision);
• Retirement (loss of identity and sense of belonging).
• Shift work;
• Sleep deprivation;
• Unfulfilled job expectations;

Risk Factors Associated with Law Enforcement Suicide

This section identifies historical, demographic risk factors that may increase suicide. These are listed below, and correspond to those in the SAD PERSONS Scale and the CPR Risk Assessment:

• Knowledge of and access to lethal means;
• Age;
• Gender;
• Ethnicity;
• Previous history (self or family member);
• Cumulative stressors;
• Feeling of hopelessness and helplessness; and
• Lack of intervention resources.

Warning Signs of Law Enforcement Suicide

Warning signs, as defined by the AAS (n.d.) are items that represent an imminent, increased risk (active factors) rather than the stable historical factors that don’t necessarily represent increased risk. For instance, being a male does not itself mean someone is suicidal, but being a man does increase the chances someone will die.

The warning signs listed in the curriculum (reproduced verbatim below) represent a mix of risk factors and AAS-type warning signs.

• Depression:
  • Attitude of hopelessness and helplessness;
  • Unexplained changes in appetite, weight, appearance, and/or sleep habits;
  • Difficulty making decisions;
  • Difficulty concentrating;
  • Overly anxious;
• Previous suicide attempt;
• Increase in the use of alcoholic beverages;
• Overly aggressive or violent behavior;
• Any changes in mood or behavior that are out of the ordinary, including a neutral mood;
• Changes in work habits;
• Behavioral clues of suicidal thoughts:
  • Giving away possessions;
  • Making a will;
  • Talking about a long trip;
  • Sudden interest or disinterest in religion;
  • Substance abuse relapse; and
  • Taking inappropriate duty-related and personal risks.
• Anger / irritability; and
• Concern expressed by family / friends / colleagues about a specific individual;

Identifying Common Suicide Myths

The myths that are discussed here include:

• People who talk about suicide won’t attempt
• Talking about suicide with someone does not reduce their risk
• Warning signs are not present before a person dies by suicide
• Suicidal individuals must have a mental illness
• Suicidal individuals are beyond help
• Suicidal individuals are committed to dying

See my article on suicide myths for a more complete discussion of these

AID LIFE for Suicide Intervention

AID LIFE is an acronym that is given in the training for a simple intervention procedure. The steps in AID LIFE are as follows:

• A – Ask if the individual is thinking about suicide
• I – Intervene immediately. Listen and let the person know they are not alone.
• D – Don’t keep their suicidal thoughts a secret. Seek assistance
• L – Locate help. This can include a supervisor, chaplain, physician, or other members of their support network. (Including crisis workers or the Emergency Room.)
• I – Inform the Chain of Command. This can help get important resources like counselling in place.
• F – Find someone to stay with the individual. (Dustin’s note: I’m actually not a big fan of this one, it shows up in the Marine Corps suicide awareness program as well; this is more important for high-risk, imminent suicide than it is for someone who may be low or moderate risk.)
• E – Expedite. Get help now, rather than delaying it.

Obstacles to Effective Suicide Intervention

These obstacles are reproduced directly from the manual and include a variety of police-specific and more general obstacles to effective intervention with police officers who are struggling with suicidal thoughts.

• Fear of stigma, isolation, humiliation, suspension, job loss;
• Fear of change in duty status;
• The police culture; (seeking mental health support may be perceived as a character weakness)
• Denial that there is a problem; (by the officer, peer officers, supervisors, the command staff)
• Reluctance of the officer to seek help for fear of the officer losing control of the situation;
• The officer’s fear that confidentiality will not be maintained;
• The officer’s distrust of management;
• Supervisors and peers who protect or shield a troubled officer; and
• Lack of knowledge by a troubled individual about the availability of counseling resources, and concern about being able to afford such services.

Professional Resources for Law Enforcement Suicide

Although this is a New Jersey Police manual, the resources presented are general enough to be a good reference. The resources that are recommended include:

• Crisis Line
• Employer Assistance Program (EAP)
• Faith-based support (e.g. Chaplain or Church official)
• Hospital emergency room
• Mental Health Counselling (in person or otherwise)
• Peer Support (from another officer or supervisor)

Strategies to Prevent Law Enforcement Suicide

The following 4 strategies are generally recommended for preventing suicide by both law enforcement officers and the general public. They include:

1. Understanding the risk factors and warning signs of law enforcement suicide
2. Using available resources and building a support network
3. Challenging the stigma in seeking support
4. Using the AID LIFE mnemonic

Other Police Suicide Prevention Programs

Together for Life was developed by Psychologists as a comprehensive suicide prevention program in Montreal. This program includes a half-day training session for all officers, a confidential telephone helpline, a full-day training session in more in-depth techniques for supervisors and awareness materials. Mishara & Martin’s 2012 evaluation showed:

• 99% of those who attended the sessions said they would recommend the sessions to a colleague
• 84% of supervisors were aware of the program
• Positive increases in knowledge of risk factors and warning signs, and how to intervene
• A nearly 80% decrease in the rate of Montreal police suicides (versus no change in the rate of police suicides in other police services in Quebec)

Badge of Life: Psychological Survival for Police Officers (Levenson, O’Hara & Clark, 2010) makes “emotional self-care (ESC)” the focus of a series of training modules delivered to police officers, along with mental health screenings and the delivery of peer support by other officers and the use of Critical Incident Stress Debriefing (CISD).

Police Organization Providing Peer Assistance (POPPA) (Dowling, et. al., 2006) is a New York Police Department (NYPD) based program for preventing suicide. It combines a confidential helpline, support groups, printed suicide awareness and intervention materials distributed to all police officers, and tools to assess resiliency and stress. Applied Suicide Intervention Skills Training (ASIST) is also provided yearly.

Additional Resources

The book Police Suicide: Tactics for Prevention provides a comprehensive review of police suicide causes and potential interventions to reduce suicidal behaviour in this group.

References

American Association of Suicidology. (n.d.) “Warning Signs | American Association of Suicidology” Retrieved on September 4, 2016 from http://www.suicidology.org/resources/warning-signs

American Foundation for Suicide Prevention (AFSP). (2014) “Suicide Statistics — AFSP” Retrieved on September 4, 2016 from https://afsp.org/about-suicide/suicide-statistics/

Badge of Life. (n.d.) Police Suicide Myths. Retrieved on September 4, 2016 from http://www.badgeoflife.com/myths/

Cross, C.L. & Ashley, L. (2004) Police Trauma and Addiction: Coping With the Dangers of the Job. FBI Law Enforcement Bulletin. 73(10) Retrieved on September 4, 2016 from https://www.ncjrs.gov/App/Publications/abstract.aspx?ID=207385

Kulbarsh, P. (2016) “2015 Police Suicide Statistics” Officer.com. Retrieved on September 4, 2016 from http://www.officer.com/article/12156622/2015-police-suicide-statistics

New Jersey Police Training Commission. (2016) Basic Course for Police Officers.

Roufa, T. (2015) “What is the Divorce Rate for Police Officers?” The Balance. Retrieved on September 4, 2016 from https://www.thebalance.com/what-is-the-divorce-rate-for-police-officers-974539

Stedman, T. (2016) Stedman’s Medical Dictionary (28th ed.). Philadelphia: Lippincott Williams & Wilkins.