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Suicide Prevention in the Fire Service
December 11, 2013
Depression and Suicide Prevention in the Fire
Depression and Suicide Prevention in the Fire/EMS Services
Teresa Meunier, Assistant Risk Manager, Risk Management and
Prince George's County Fire/EMS Department
According to the National Institute
of Mental Health, suicides are preventable. Over 90% of people that have
committed suicide were suffering from clinical depression or some other
diagnosis of psychiatric illness and/or substance abuse, which are treatable
In July 2011, the NFFF hosted a summit on depression and suicide
in the fire services and they were extremely fortunate to have the nations'
preeminent subject matter experts share their knowledge about suicide, and how
this information might influence our industry's understanding of these sad but
important topics. In October 2013, they convened another meeting to
develop a strategic plan for moving this issue forward. Enhancements to
Firefighter Life Safety Initiative 13, The Everyone Goes Home (R) Behavioral
Health Initiative, firefighters and their families must have access to
counseling and psychological support.
Suicide is a complex phenomenon that is not well understood,
even by many professionals called to deal with its prevention and intervention.
Though often described as being among the leading causes of death in the United
States, suicide is not technically a cause, but rather a mode of death, a
medico legal determination regarding intent. Based on population rates,
we are three times more likely to see suicides than Line of Duty Death (LODD).
This document is intended to provide quick reference material
that may help you recognize the warning signs of suicide, and provide you with
the knowledge that will allow you to overcome the fear and anxiety, and will
help you to act quickly should a crisis arise. Remember it takes an act
to stop an act.
are many myths out there about suicide and it is very important that you know
the difference. Listed below are just a few examples of each.
People who talk about it, donât do it.
Most suicides are done within a week of verbally communicating
No one can stop a suicide, it is inevitable.
If people in crisis get the help they need , they will
probably never be suicidal again.
Confronting a person will only make them angry and plant the
Asking someone directly about their intent, lowers their
anxiety and opens up communication, thereby lowering the risk for an
Professionals are the only ones that can stop a suicide.
Suicide is everybodyâs business and anyone can help.
The interpersonal theory of suicide proposes that suicide
results from three mental states:
to engage in suicidal behavior
The American Association for Suicidology devised the mnemonic IS
PATH WARM to help people remember the warning signs for suicide:
I - IDEATION - refers to suicide or death ideation -
thinking about killing oneself or wishing for death
S - SUBSTANCE ABUSE - is a significant risk factor for suicidal
P - PURPOSELESSNESS - is the feeling of being without purpose or
A - ANXIETY/AGITATION - or feeling like you are "crawling
out of your skin," is also seen in people at
acute risk for suicide.
T - TRAPPED - Feeling trapped is reported by people at risk for
H - HOPELESSNESS - Feeling hopeless is reported by people at
risk for suicide
W - WITHDRAWAL - from family, friends, and co-workers is seen
frequently prior to suicide attempts
A - ANGER - significant anger and rage can be precursors
to suicide attempts
R - RECKLESSNESS - reckless behavior and significant mood
changes are also signs of risk for suicide
M - MOOD CHANGES
Dr. Paul Quinnett, Clinical Psychologist, and author of Question,
Persuade, Refer (QPR), developed an organized approach that anyone can use to
react instinctively when dealing with a crisis. There is a technique
behind the acronym. QPR Gatekeeper Training is not just for psychiatrists,
psychologists and social workers to save lives. Like CPR, QPR uses a
"chain of survival" approach in which a gatekeeper learns to
recognize early suicide warning signs. Peers can utilize this skill set
to potentially save a life. When you apply QPR, you plant the seed of
hope and hope can prevent suicide.
The steps listed below are an example of the approach suggested
in the QPR Gatekeeper Training that can be done on-line. For additional
information regarding the training, you can contact the Risk Management and
First you should recognize risk factors and clues. Listed
below are a few examples of each:
Factor(s) - Drug or alcohol use or relapse after a period of recovery,
unexplained anger, aggression.
Verbal Clues - Direct verbal clues such as making statements like I have
decided to kill myself. I wish that I was dead. I am going to end
my life. Iâm tired of living; my family would be better off without me.
Clues - Past attempts, Moodiness, Helplessness, Hopelessness, Burdensomeness,
Worthlessness, Co-curring depression.
Clues - Diagnosis of any major mental illness, sudden unexpected loss of
financial security, untreated depression leads to fear of becoming burden to
risk factors and clues are evident, you move forward with QPR.
Question their meaning to determine:
intent or desire
the person to accept or seek help
the person to appropriate resources.
Question - Don't
wait to ask questions. Be persistent. Talk in private. Speak
directly and not in long sentences. Let them talk freely and listen
actively. Give yourself plenty of time. You can use a direct approach EX:
When people are upset as you seem to be, they often think about suicide.
Never say, youâre not thinking about suicide, are YOU? You can also
use a less direct approach: Have you been very unhappy lately? Do
you wish you could go to sleep and never wake up?
Persuade - The
first step is to listen to the problem and give your FULL attention.
Suicide is not the problem, only solution to the perceived insoluble problem.
Ask them if they will go with you to get help? Ask them if they
will let you go with them to get help?
Will you promise me not to kill yourself until we find someone
to help? Make them commit to that.
Refer - The
best way to refer someone to help is to take them directly. Remember get
a commitment from them.
Effective QPR would be to tell them you want them to live and
you are on their side. We will get through this together. Get
others involved (Family, Friends, Brothers, Sisters).
If they refuse help, seek consultation from a
professional. If you are in a crisis and need immediate assistance, you
should contact a mental health professional, such as EAP/VAP (301)
883-6270, APS Healthcare 1 (877) 334-0530, or calling 1-800-273-TALK (8255) for
Fire/EMS Stations and work sites should post the 1-800-273-TALK number for the
National Suicide Prevention Hotline and firefighter/medics should know when to
use or encourage others to use this number.
For more information go to:
FIRE MARSHALS OFFICE EMPLOYEE CHARGED IN FATAL CRASH
An employee of Manitoba's fire commissioner's office has been
charged in connection with a crash that killed two teenage boys on the
Trans-Canada Highway in October.
Timothy Langevin has been charged with two counts of dangerous
operation causing death and two counts of dangerous operation causing
bodily harm, RCMP announced Tuesday.
According to police, Langevin was driving a fire commissioner's
office pickup truck that rear-ended a car on the highway, about three
kilometres west of MacGregor, Man., on Oct. 5.
2 teens killed in crash involving fire commissioner's truck
Four people were inside the car that was struck, including Charles Friesen, 17, of Austin, Man., who was pronounced dead at the scene, and Daden Bruhm, 14, of Sidney, Man., who died in hospital.
Two adult men who were also in the car sustained non-life-threatening injuries.
The Manitoba Office of the Fire Commissioner has confirmed that the
driver of the pickup truck was an on-duty employee at the time of the
crash. The truck was not responding to an emergency, officials said.
Tim Langevin is listed as a contact person for the Youth Firestop
program, an anti-arson education program targeting children, according
to the website of the Manitoba Office of the Fire Commissioner.
Langevin appeared in provincial court in Portage la Prairie, Man., on Monday and is scheduled to be in court again on Jan. 24.
RCMP have said alcohol is not a contributing factor in the crash.
2 TN FFs INJURED IN APT. BUILDING COLLAPSE
Both Firefighters injured while battling a large apartment fire in South Knoxville Wednesday night are out of the hospital.Knoxville
Fire Department spokesperson D.J. Corcoran said one of the Firefighters
has a concussion while the other had to get stitches.Corcoran said officials will be out investigating the scene of the fire on Thursday.Original Story:A large apartment fire sent two Firefighters to the hospital and forced more than a dozen residents to evacuate Wednesday night.The fire broke out in South Knoxville on Sevier Avenue near the James White Parkway around 8:30.The
Knoxville Fire Department says part of the roof of the building fell on
two Firefighters who were hospitalized with non-life threatening
injuries.Firefighters say the fire started in the upper floors of the building, but no cause is known yet.None of the 14 residents of the apartment building were injured. The Red Cross has offered to take them...
Medic injured when struck by car after football game - Massachusetts
FOXBORO, Mass. â A paramedic was injured after being struck by a vehicle following Sundayâs Patriots-Browns game at Gillette Stadium.The Sun Chronicle reported that the paramedic, who was among emergency responders attempting to help a man who had fallen down an embankment on a highway, was taken to a hospital where he was treated and released.The crash happened about an hour after the end of the game, according to the report.Fire Chief Roger Hatfield reminded motorists to slow down and move over any time they encounter emergency vehicles along the roadway, according to the report.&nb...
Wallington ambulance crashes in Wood-Ridge, 5 sent to HUMC - New Jersey
A Wallington ambulance with its lights and siren on hit a parked car and a stopped vehicle in Wood-Ridge yesterday afternoon, sending five people to the hospital with what police said werenât life-threatening injuries.The crash occurred just before 3 p.m. at the corner of Valley Boulevard and Lincoln Avenue.The Wallington Fire Department ambulance was taking a patient to Hackensack University Medical Center when, the driver told police, he was cut off by another vehicle while heading north on the Boulevard.The ambulance veered into the southbound lane, where it first struck a parked vehicle, according to a police report.It then âproceeded up onto the sidewalk and continued traveling northbound into the intersection of Lincoln Avenue,â where it âstruck a vehicle that was stopped at the stop sign,â Detective Joseph Rutigliano Jr. told CLIFFVIEW PILOT.âWitnesses report that the ambulance was traveling with the lights and sirens activated,â Rutigliano added.The three occupants in the ambulance and two in the car stopped at the corner were taken to HUMC by ambulances from Wood-Ridge and Hasbrouck Heights.&nb...
Ambulance driver charged with DUI - Chicago
An ambulance driver is accused of being drunk when he crashed into another vehicle.John Lara is charged with aggravated driving under the influence causing an accident resulting in bodily harm, disobeying red light, failing to reduce speed, negligent driving, and failing to carry or display a driverâs license.Police say Laraâs blood alcohol level was three times over the legal limit when he ran a red light and hit a pickup truck at Montrose and Clark on Monday.A witness says the ambulance had its lights and sirens on, as it approached the busy intersection.âHe came up to the intersection with cars that were westbound and eastbound continuously on Montrose,â said witness Nick Mendez. âI just watched and the ambulance didnât slow down at all. It was as if he had a death wish.ââLara had glassy eyes and slurred speech, according to the police report.â(Lara) was unable to explain where he was going or why he was using his emergency equipment when there wasnât a patient in the ambulance,ââ the report said.â(Lara) repeatedly covered his mouth in an apparent attempt to hide the strong odor of alcoholic beverage,ââ according to the report.Police say Laraâs blood alcohol level turned out to be .271, which is more than three times the legal limit for driving....
Ambulance driver charged with DUI after crash - Chicago
By Rosemary Regina Sobol and Kim GeigerTribune reportersPolice say a suburban ambulance driver was three times over the legal limit for alcohol when he ran a red light, his emergency lights and sirens on, and crashed into a pickup truck in the Sheridan Park neighborhood on the North Side.John P. Lara, 31, has been charged with aggravated driving under the influence causing an accident resulting in bodily harm, disobeying red light, failing to reduce speed, negligent driving, and failing to carry or display a driver's license, according to authorities. He was ordered held on $300,000 bail. Lara has arrests dating back to 2002 in Cook County for forgery, unlawful use of a weapon and impersonating a police officer. He also has a history of moving violations, and was stopped in Louisiana seven years ago on suspicion of drunk driving. He has been a licensed emergency medical technician in the state of Illinois since February of 2011.Around 10:45 a.m. Monday, Lara was traveling south on Clark Street in a Care 1 ambulance from Arlington Heights when he hit the pickup going west on Montrose, according to the police report. Responding officers approached the ambulance and found Lara still behind the wheel and the engine running, the report said.One of the officers smelled a âvery strong odor of alcoholic beverage,ââ and noticed that his eyes were glassy and his speech slurred, the report said. When the officer asked what happened, Lara said he was on his way to Advocate Illinois Masonic Medical Center to pick up a patient, according to the report. When they asked him where his partner was, he told them he was alone in the ambulance and was going to pick up his partner at the hospital, the report said. But when Chicago Fire Department paramedics were treating him, Lara was âunable to explain where he was going or why he was using his emergency equipment when there wasnât a patient in the ambulance,ââ the report said. One paramedic told officers the driver ârepeatedly covered his mouth in an apparent attempt to hide the strong odor of alcoholic beverage,ââ the report said. The paramedic told police said the ambulance driver became âvery uncooperativeââ and belligerent with her. Lara was taken into custody and treated at Illinois Masonic, where his blood alcohol level was found to be .271, more than three times the legal limit for driving, .08, the report said.Evanston chiropractor Nick Mendez said he was headed to his Lakeview home to walk his dog while on a break from work when he saw the ambulance in front of him as they were both headed south on Clark Street approaching Montrose Avenue. âHe was full lights and sirens,ââ Mendez said. âHe came up to the intersection with cars that were westbound and eastbound continuously on Montrose. I just watched and the ambulance didnât slow down at all. It was as if he had a death wish.ââMendez said the ambulance hit the passenger side of the pickup truck. âI pulled around and I kind of aided the victim out of the pickup truck. He was kind of going in and out of consciousness. He was able to walk and I just helped him in my car, where we warmed up,ââ Mendez said. The man, who was 43 and appeared to be a construction worker driving a company vehicle, told Mendez he felt as if he was going to pass out.âHe thanked me, oh absolutely,ââ Mendez said. âWe sat in my car for a little bit and spoke. He asked me, âWhat happened? What happened?â ââWhen Mendez told him an ambulance hit him, the man said, âIt seems like it came out of nowhere,ââ Mendez said.Mendez called 911 and the dispatcher told him help was already on the way. Paramedics arrived and began treating the truck driver and talking to the ambulance driver. Joseph Baron, director of Care 1 Ambulance in Arlington Heights, said it was âtoo earlyâ in the investigation to comment. âItâs premature...I havenât seen the police report yet,ââ he said.Baron declined to say if Lara was still employed with the company. Care 1 began operating in July, according to the state Department of Public Health. This is not the first time Lara, of Lockport, has been stopped for allegedly driving drunk, according to records obtained by the Tribune.In January of 2007, Lara was pulled over south of Baton Rouge, La. for traffic violations, according to an arrest report. The officer reported a "strong odor of alcoholic beverage, slurred speech, swaying."Lara refused a Breathalyzer test and his Illinois driver's license was consequently suspended from May 8, 2007 until Nov. 8, 2007. Records also show that Lara was stopped at least four times in Illinois for driving without a valid license: twice in October of 2001, then in February of 2002 and January of 2005, records show.When he was arrested, Lara had a valid Class D driver's license.His record also includes several criminal arrests, including in 2002 by Metra police on a felony forgery charge. He pleaded guilty to misdemeanor theft and received probation, according to court records.In August of 2004, he was arrested by Chicago police on a charge of interfering with a police officer. In March of 2005, Park Ridge police arrested him for felony unlawful use of a weapon. He later pleaded guilty to impersonating a police officer in both cases and was sentenced to 30 months probation. He was found to have violated his probation and ordered to serve 18 months in Illinois prison.Melaney Arnold, a spokesperson for the Department of Public Health, said background checks are not required of EMT license applicants. The state pushed lawmakers in Springfield to require background checks as a condition of issuing and renewing EMT licenses, but the proposal was not approved....
Ambulance crash victims identified - Georgia
By Troy WashingtonEARLY COUNTY, GA (WALB) -GSP troopers say a Miller County ambulance was traveling northbound on Highway 45 headed to Miller County hospital when the driver tried to pass a fertilizer spreader, which was going north.The spreader was making a left and collided with the ambulance. Officials say the patient that was being transported, 84-year-old Leila Duvall died. She was being taken to the hospital for flu-like symptoms. "The ambulance got in the northbound lane to pass the farm equipment as it entered into the northbound lane to pass the tractor, the farmer decided to make a left turn," said GSP Investigator John Vanlandingham.That's when the two collided, the ambulance traveling off to the east side of the road and overturning while the piece of farm equipment stayed where it was struck. The paramedics and the farm worker were okay, but Duvall was not."The patient was fine initially but upon impact and with the overturning of the ambulance was tossed around in the back of the ambulance," said Vanlandingham.She died on the scene as a result of those injuries."That's when they assessed her after the crash and determined that she had passed away because of the accident, as a result of the impact and the overturning of the ambulance," said Vanlandingham.The driver of the ambulance, 26 year old Adam Brackin, was taken to the hospital for minor injuries, and the driver of the fertilizer spreader, 35 year old Eric Jenkins, stayed on the scene with investigators. Jenkins was not injured. 27 year old Amanda Higginbotham, an EMT in the back of the ambulance, was also not hurt. Officials say it isn't clear who is at fault for the accident."We haven't determined who was at fault but we do have SCRT on the scene and they will be doing a more in depth investigation to determine who was at fault."Investigators spent hours scouring the scene, looking for anything that could help them to determine just who was at fault for the collision that claimed one life.The Georgia State Patrol Specialized Collision Reconstruction Team is investigating the crash. ...
Obamacare Tonight on TV, Action Tomorrow (The Secret List)
Two action items related to the issue: NOTE: Please scroll down for a clear explanation of this issue from
Check out Fox News tonight at1900 hours (eastern), as NVFC
Chairman, Chief Phil Stittleburg is being interviewed regarding volunteer
Firefighters and the impacts of ObamaCare. Phil is a highly respected veteran
Fire Chief and Attorney and is all over this issue. The interview will be
during the program âOn the Record with Greta von Susteren."
As per the IAFC, Rep. Lou Barletta (R-PA) and Senators Mark
Warner (D-VA) and Joe Manchin (D-WV) have worked together to introduce
bipartisan legislation (H.R. 3685/S. 1798) to exempt fire departments from a
requirement to offer health insurance to their volunteer firefighters and
emergency medical personnel.
The Protect Volunteer Firefighters and Emergency Responders Act will amend the
definition of âemployeeâ under the Patient Protection and Affordable Care Act
(PPACA) to create a clear exemption for nominally compensated volunteer
firefighters and emergency medical personnel.
The PPACA (P.L. 111-148) was passed in 2010 and contained many reforms to the
American healthcare system. One of these reforms requires certain large
employers to offer health insurance to their full-time employees. In September
2013, the IAFC sent a letter to the Internal Revenue Service (IRS) to express
concern that the IRSâ classification of volunteer firefighters as âemployeesâ
could potentially require certain fire departments to offer their volunteers
health insurance under the PPACA.
Upon introduction of the new legislation, IAFC President and Chairman of the
Board Chief William Metcalf stated, âThe IAFC strongly supports this
legislation to clarify the status of volunteer firefighters under the Patient
Protection and Affordable Care Act. This is a bipartisan issue that could have
serious impacts on staffing at fire departments across the United States. The
IAFC looks forward to working with Congress and the Administration to help
ensure fire departments of all types are able to continue saving lives and serving
Time to get crack'n if this is an issue for you, your members or your
department or company.
H.R. 3685 has 31 cosponsors, and S. 1798 has 5 cosponsors.
SO...Just Don't Sit There!
Contact your members of Congress and ask them to cosponsor this legislation.
IAFC has posted online draft letters to representatives andsenators (Word doc)
for you to use.ABOUT
The Congressional Fire Services Institute (CFSI), the
National Volunteer Fire Council (NVFC) and the International Association of
Fire Chiefs (IAFC), are currently working with members of Congress and the
Administration to address the potential impact that the Patient Protection and
Affordable Care Act (PPACA) could have on volunteer fire departments throughout
According to the Patient Protection and Affordable Care Act
(PPACA) (P.L. 111-148), employers with more than 50 full-time employees (or
their equivalents (FTE)) must provide health insurance to employees that work
more than 30 hours per week. Unfortunately, the Internal Revenue Service has
ruled that volunteer firefighters that receive nominal benefits from their fire
departments (including stipends, end-of-the-year banquets and awards) count as
"employees" of fire departments. An unintended consequence of this
IRS ruling is that fire departments may have to provide health insurance to
volunteers that serve more than 30 hours per week at their local fire
department. The effect of this provision could cause serious financial hardship
to fire departments. Many volunteer fire departments rely upon local donations
and fundraisers to fund their basic operations. The addition of a requirement
to provide health insurance would present a serious financial challenge to
Although the final regulations have not been codified, the
aforementioned organizations are working with a bipartisan group of members of
Congress to address this potential consequence of the PPACA. The NVFC, IAFC,
and several members of Congress have sent letters to the IRS asking
Acting-Commissioner Werfel to release regulations or guidance stating
volunteers who receive nominal compensation will not be considered employees
under PPACA. On December 10, 2013, Senator Mark Warner (VA) and Congressman Lou
Barletta (PA-11) introduced the Protecting Volunteer Firefighters and Emergency
Responders Act (H.R. 3685 and S. 1798). The legislation ensures that volunteers
are not counted as full-time employees under the shared responsibility requirements
contained in PPACA. CFSI, NVFC and IAFC will continue to
provide updates to the fire service as these efforts are being addressed on
Capitol Hill and within the Administration. Please visit these website
sites (www.cfsi.org, www.nvfc.org, www.iafc.org) for the latest
Take Care. Be Careful. Pass It On
The Secret List 12-11-13/1611 hrs
CIVILIAN TEXTING LEADS TO CLOSE CALL ON THE HIGHWAY
Sunday Dec 8, 2013 Hancock Fire Company, Hancock Md. was dispatched to a Personal Injury Collision on I-68. Roads were snow-covered and very hazardous. The accident was located at the bottom of a mountain. The rescue squad, first on the scene, advised a tractor-trailer had jackknifed across all lanes of the interstate. I was on the first arriving engine and not being needed at the incident scene, we stopped halfway down the mountain to stop traffic. We had taken the middle of the highway so people behind us were able to stop. After putting on highly reflective vests, we got out to advise those drivers to continue on slowly and be prepared to stop in the back up traffic a little further. We were in the process of getting flares and cones to warn oncoming traffic. Most slowed down and was able to stop. As I was moving up the hill to provide early warning, I observed an SUV traveling to fast towards me. They hit the brakes and began to slide towards me and the guardrail. As the end of the guardrail was near me, I ran to the other side of the guardrail. There was space between the guardrail and the opposite lane traffic. The car hit the guardrail and continued to slide past my position. I warned the crew remaining in the engine but the vehicle did not strike the engine. When I got to the vehicle, the young female driver, with cellphone in hand, was texting. The next unit arriving was assigned to stop traffic at the top of the mountain and advise drivers to go slow and be prepared to stop on the mountain. Know your escape pathways ahead of time. Develop early warning signs as quick as possible. Do not get out of your vehicle unless absolutely necessary. (We had to tell motorists to get back in their vehicles....
Concord Volunteer Fire Department
12573 Richmond Hwy
Concord, VA 24538