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Trouble In Mind
- 2. What we see
- 3. Then this
- 4. Now what?
- 5. Triggers • Can be anything- complex on emotional status and prior well-being • One event or several events over a career • Death- especially unexpected • You know the patient • Multiple fatalities • Children-senseless tragedy • The negative change in our practice • End of career issues • Sleep deprivation- all in lifestyle
- 7. Ongoing emotional pain • Thoughts of suicide • Addiction • Bullying-outward anger
- 8. How big is the problem? • 57 suicides in fire/ems in 2013 and again in 2014- we know this is under-reported • JEMS Survey- 36% had thoughts 6% attempted • Depression, helplessness, suicidal thoughts are much more common. – Stop signing up for call – Personality changes – Become unsure of skills on calls – Feel inadequate
- 9. Some will look to substances to mask the pain • Addiction is on the rise in America and fire/EMS is not immune • Punishment for addiction, especially with drugs remains strong in our culture • Addicts need help, not felonies, loss of job or incarceration • Alcohol most common in Fire Service
- 10. In the month before their death by suicide: •Half saw a general practitioner •30% saw a mental health professional In the 60 days before their death by suicide: •10% were seen in an emergency department People At Risk For Suicide Are Falling Through the Cracks in Our Health Care System
- 11. You may be the person to identify the risk of suicide or self harm • Despondent • Talking about death • Getting life in order-will, visiting family etc. • Sudden calm demeanor • Increased use of drugs or alcohol. • Buying a firearm
- 12. Some will become angry • Bully others to hide the pain • Behave this way to cover own feelings of inadequacy • Constant complaining and anger on the job • Hating to come to work
- 13. What to do? • Do not leave person alone- get family and other friends involved • Get friend to a doctor- ER if necessary • Make effort to remove medications and weapons from the home • Non-judgmental, loving, caring, genuine. • Crisis intervention • Suicide prevention help line
- 14. Some reach for substances • Alcohol by far the most common • Some will become addicted to opioids – By initial prescribed medications – By using and diverting to cover emotional pain
- 15. What should we do when something happens? • Open lines of communication encouraged • It is not a weakness to be human • Allow and encourage fellow members to be open with struggles without fear of punishment • Have a plan in place to implement when a member needs help • Be vigilant- act on suspicion.
- 16. CISD • Should be done ASAP after event. Should be within 72 hours for sure. 24 hrs optimal. • Needs to be done by trained individuals. • 63% of EMS surveyed say this helps significantly
- 17. EAP • Your service should arrange to have an Employee Assistance Program in place. • This is for those continuing to struggle after CIDS. 58% say this is helpful.
- 18. Florian Program at Rosecrans • Started by Chicago FD Batallion Chief • Specific in-patient program for Fire or EMS personnel dealing with PTSD, suicidal thoughts, addiction etc due to stress of the job. • In-patient stay. In Rockford, so close.
- 19. My personal take after 40 years • We respond to situations routinely that are painful and make no sense • We live in a fallen/broken world • Humans are wonderful and beautiful creations that mess up constantly. • Evil is alive and well in the world • The further we exclude God from our society and personal lives, the worse things will be
- 20. • What we do takes a special skill set. • We were created to do this job. • It is a PRIVILEGE to care for others at their worst possible moments. • We have wonderful opportunity to help and change the world one patient at a time. • This task is increasingly difficult-we must take care of our own.
- 21. BEST ANSWER • G R A C E !
Notas do Editor
- People at risk for suicide are being seen in health care settings. But often no one asks or intervenes. Comprehensive approaches to suicide care are needed in healthcare because many people who are actually receiving health care are dying from suicide. In the month before their death by suicide, about half saw a general practitioner. And 30% saw a mental health professional. Many were seen in emergency departments shortly before their deaths as well. Health care professionals often fail to ask about suicide risk either because they were never trained to, don’t know how to recognize suicide warning signs or risk factors, don’t know what to do if someone is at risk for suicide, or believe erroneously that the person at risk would just tell them if they were feeling this way. If we could improve suicide identification and care in primary care settings, where most people receive their care, or in emergency departments, where most people go when they are feeling suicidal, we would have the potential to save lives.