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Suicide is a broad challenge for responders

The second in a series on suicide in Ridgefield.

For police, handling suicides — from threats and attempts to lethal acts — tests officers’ ability to assess and defuse situations that range in severity, to investigate potential crime scenes and to work with compassion.

If someone calls in a suicidal state, “we try to get them to calm down, try to get them to give us the pertinent information, where they are,” said Capt. Tom Comstock.

“Obviously you want to ask the question of how are you going to do it. If they have a handgun, we’re not going to send our people in to get shot if they decide to take a few people with them.”

Gunshots, typically in the head or chest, have been the most frequent method of suicide in Ridgefield. Of the 42 lethal suicides here from 1990 through earlier this month, guns were used in 18 cases, according to data from the state’s Office of Chief Medical Examiner.

In non-lethal attempts where safety is a concern police have to clear the scene before paramedics can enter.

“These are situations where we will actually stage just away from the scene while the Police Department goes in and evaluates the circumstances… so that we’re not walking into a dangerous situation — that’s where their training comes in.”

Whether an injury is self inflicted or not doesn’t change how it’s treated medically.

“The key is that we treat what we find,” said Fire Chief Heather Burford.

However, the method of injury does give medics a starting point for treatment.

“Everybody who is EMS-trained goes through training that is specific to suicide,” Chief Burford said. “You find somebody that is hanging and it’s obvious what kind of injuries that person is going to have.”

Suicide deaths ruled hanging, often recorded as “asphyxiation,” were the second most common, accounting for 15 of the 42.

Dispatchers try to keep a suicidal person on the line while sending officers.

“A lot of it is stalling for time and asking questions and trying to get as much information as possible,” Capt. Comstock said. “Is it one person and they have support, no family?

“People are usually crying for help and they want to talk,” he said.

Non-lethal attempts are far more common than lethal suicides, though firm numbers are elusive. The American Foundation for Suicide Prevention (AFSP) reports there are between eight and 25 attempts for every lethal suicide. National Institute for Mental Health (NIMH) figures put that number at 11.

Second-hand concerns

Sometimes police get calls from concerned family members, friends and acquaintances when there may or may not be a serious threat.

“We get a lot of information second or third hand,” Capt. Comstock said.

“Something like, ‘Oh yeah, I had a bad day today, I want to kill myself,’ ” could be a harmless exaggeration that is misinterpreted, he said. “Even with that we have no problem with knocking on a door… We don’t mind that because it gives us a history.”

People who have attempted suicide previously are in a higher risk category for lethal suicide.

“If this person is calling and saying it’s my 30-year-old son and he has a history, we might be breaking down the door.”

Suicidal people are taken to the hospital for evaluations.

Health professionals report that suicide attempts are often linked to existing psychological disorders, whether diagnosed or not, which often can be treated.

The NIMH estimates 90% of people who die by suicide suffer from depression or other psychological disorders, substance abuse, or a combination of the two. Depression is among the most treatable psychiatric  illnesses, with 80-90% of patients responding positively to treatment, the AFSP reports.

Investigating amid tragedy

In lethal suicides, officers have to conduct their investigative work while dealing compassionately with friends and family of the victim.

“Just because people think it was a suicide, we don’t treat it that way,” Capt. Comstock said. Officers have to investigate before they can rule out foul play, which friends and family members may not welcome, he said.

“That’s the fine line of trying to be respectful to the family and trying to do our job,” Capt. Comstock said. “You don’t want everybody’s fingerprints in there and boot prints and DNA” contaminating the scene.

When it comes to notifying families of a suicide, like any death, Capt. Comstock said, officers are trained to be matter-of-fact to avoid confusion.

“We’re trained at the academy, you don’t use phrases like, oh they passed over, they passed away. Then people think, oh okay they’re in the hospital, they’re fine.

“When people are in that sort of shock, you have to use those terms: They’re dead.

“We don’t mean to sound callous or anything, but that’s the only thing that gets through.

“Then we can get across to them, what do you need from us? Can I call the church, the synagogue?”

Support for responders

While dealing with people’s tragedies is a frequent part of their work, it can take a toll on responders.

“Some guys might have nightmares about it and other guys it’s another day,” said Capt. Comstock. “It’s the same with our dark humor sometimes.”

“It can be pretty traumatizing, especially when it involves kids and younger people,” Chief Burford said. “We’ve had some very young people in the community who have committed suicide by hanging and of course that can be traumatizing to anybody.”

However, she added, “For the most part, our threshold is higher than the average public. We see these incidents quite a bit; we see a lot of tragedy.

“There’s a certain expectation that in this line of work, you are going to see things that are unpleasant, and I think going in understanding that is part of your profession.”

“What happens with us — and this doesn’t matter if it’s an intentional suicide situation or an injury — responders tend to relate to those injuries closest to our own family members,” said Chief Burford. For example, if a medic has a teenager at home, responding to a teen suicide might rattle that responder more deeply, she said.

“The other thing, because we are a very tight knit community, very frequently somebody is connected somehow to that person. It’s a friend, it’s a neighbor, it’s somebody that I do business with. That might not exist in a bigger city.”

The most basic support network firefighters and police have is their peers.

“As a supervisor you’re trained” in looking out for fellow officers who have responded to a traumatic event, Capt. Comstock said. “You check with the guy, say ‘hey how are you doing?’ You work with a guy eight hours a day, you kind of get a feel for him.”

Families of police officers even attend family nights at the police academy and learn to support officers and understand the stresses their job can put on them.

If an emergency responder needs more than peer and family support, there are Employee Assistance Program (EAP) services they can access, including counseling and other support programs.

Sometimes after a major event, EAP counselors are brought in for the entire department.

“When we lost Brandon, we brought EAP in for the entire group to talk about emotions that we might be feeling,” Chief Burford said, referring to firefighter Brandon Lauf von Koschembahr, who died in a fatal 2009 car accident.

Both Chief Burford and Capt. Comstock view the idea that emergency responders shouldn’t acknowledge that their work wears on them is an old-fashioned one.

“It used to be that you had to be tough, you had to handle these things on your own. That usually meant resorting to alcohol and resorting to other avenues that are unhealthy,” Chief Burford said.

That mentality has changed.

“That whole tough-guy macho thing you just don’t see that as much,” Capt. Comstock said.

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