Firefighters: Suicide Prevention

The Firefighters Mind Shield, Social Work Matters magazine, The University of Utah, College of Social Work, 2017-2018. 
Fire fighting is the profession with the highest rate of suicide attempts, suicide thoughts and suicide completions.  In fact, more firefighters die from suicide each year than from the job.  The rate of suicidal thoughts among firefighters approaches fifty percent, while the general public is five to fifteen percent.  (This must be incident of suicidal thoughts in the past year.)  Accidental mishaps are also very high among fire fighters. 
A firefighter is provided with protective equipment; however that equipment does not often include how to protect the mind.  Mind Shield is a cognitively based, mindfulness approach.  They have been training Salt Lake City firefighters in how to protect the mind with cognitive skills.  This includes a 90-minute educational session on Brain Burn (Post Traumatic Stress.)   The second part focuses on specific tools to protect the mind.  It is geared to keeping the mind at a higher level processing and problem solving, rather than a primitive level where we react to fear.  the third part focusing on strained relationships firefighters may have.  this session involves family members so they too can be aware of the struggles. 
Results of the study have not yet been published, but about half of the firefighters of Salt Lake have received the training.

Child Abuse and Alcoholism: Is there a Connection?

These are my thoughts about an article appearing in Parenting on the Peninsula, April 2016 written by Rayne E. Golay.
The article sites studies which show that college students with PTSD have a greater chance of over using alcohol.  From their the author assumes that the PTSD is caused by child abuse.  I think it is important to realize that misuse of alcohol effects more than just you.  Alcohol, or other drug use increases the incidence of child abuse and neglect.  Parental alcoholism is often a factor in children being placed in protective custody.  When Sheri and I were foster parents, the majority of the children who came to our home was the result of parental alcohol or drug problems.
If you are having issues with alcohol or drugs, it is important to seek help.

**Pamplet Review: Helping Children and Adolescents Cope with Violence and Disasters

Helping Children and Adolescents Cope with Violence and Disasters: What Community Members Can Do
This pamphlet is available through the National Institute of Mental Health.  Trauma is an emotionally painful, shocking, stressful and sometimes life-theatening experience that may involve physical injuries but also can happen without physical injury.  (It includes witnessing events.)  This pamphlet lists the most common responses to trauma by age:
Children 5 and under: Facial expressions of fear, Clinging to parent or caregiver, crying or screaming, moving aimlessly, whimpering or trembling, returning to behaviors common to being younger, bedwetting, being afraid of the dark.
Children 6 to 11: isolating themselves, becoming quiet around friends, family and teachers, having nightmares or other sleep problems, refusing to go to bed, having outburst of anger, becoming irritable, starting fights, being unable to concentrate, refusing to go to school, complaining of physical problems, becoming depressed, feeling numb, doing poorly with school and homework, loss of interest.
Adolescents 12 to 17: Having flashbacks to the event, having nightmares or other slep problems, avoiding reminders of the event, using or abusing drugs, being disruptive, disrespectful or behaving destructively, being depressed, being angry, loss of interest in previously enjoyable activity, having suicidal thoughts.
In then provides ideas of what community members can do to help children following trauma:
Allow child to express their feelings and the event, but not forcing.  Listen to them, accept and do not argue with their feelings, help them cope with the reality of the experience.
Love and support your children, and be with them if possible.
Community members should identify and address their own feelings.
Use their buildings as gathering places.
Help identify resources and emphasize community strengths and resources that sustain hope. 
Reduce other stressors, avoid frequent moving, school pressures, transportation problems, being hungry.
Community members should help children that continue to show problematic behaviors find appropriate help.  Behaviors which should alert to finding help include: refusing to go places that remind them of the event, emotional numbness, behaving dangerously, unexplained anger/rage, sleep problems, thoughts of suicide. 
Important does: get food and water, get a safe place to stay, gel help from doctor if needed, contact loved ones, keep children with family, understand what happened and what is being done, know where to get help, meet your family’s needs.
Important don’ts: force people to tell their stories, probe for person details, say things like “It will be OK.” Say people deserved to suffer, tell others how others should feel or act, be negative
I was able to go to Los Angeles after the Northridge Earthquake and was located in a FEMA Center.  Mostly what we did was make sure people had water.  Coors had supplied water bottles for people to take.  We did anything to help people feel like they had a sense of control.  During this time I was also on the phone, and supported some of the people had experienced this trauma with phone support, the same for Katrina and other disasters.  Sometimes just a listening ear, and anything supportive statement so help the individual feel they have some control, when things don’t always make sense.
Remember, if you are worried, voice your worry.  It is OK to ask someone if they are contemplating suicide. 
Santa Clara County Suicide and Crisis line: 1-855-278-4204
National Suicide prevention line 1-800-273-talk (8255)

**Pamphlet Review: Post-Traumatic Stress Disorder (PTSD)

National Institute of Mental Health: U.S. Department of Health and Human Services: National Institutes of Health.
This is a free pamphlet available from NIMH which you can order through the internet.  If gives a very good description of what is PTSD using the criteria set for in DSM.  PTSD is an anxiety condition which manifests after someone has experienced a dangerous event, either personally or through others who are close.  The diagnosis requires one re-experiencing symptoms such as flashback, bad dreams or frightening thoughts; three avoidance symptoms such as, staying away from places, event, objects which remind you of the event, feeling numb, feeling guilt, depression or worry, losing interest in activities that were previously enjoyable and having trouble remembering things about the event; and two hyper-arousal symptoms such as being easily startled, feeling tense or on edge or having difficulty sleeping or having angry outbursts.  While it is normal to have some effect from living through a dangerous event, PTSD symptoms have usually lasted for more than a month.  In young children symptoms may include a regression in learned behavior—such as wetting the bed when they did not before, forgetting or not being able to talk, acting out the scary event in play or being unusually clingy.
There are risk factors for PTS as well as resilience factors.  Risk issues include getting hurt, living through a dangerous event, history of mental illness, seeing people hurt or killed, feeling horror, helpless or extreme fear, having little social contact, having extra stress.  Resilience factors include seeking support from other people, finding a support group, feeling good about your own actions, being able to respond effectively despite fear. 
PTSD can respond well to talk therapies.  Cognitive Behavioral therapy, with cognitive restructuring, stress inoculation and exposure therapies can help.  In some cases medications can help with feeling of hopelessness.  Zoloft and Paxil have been approved, but need to be taken with care as they have been shown to increase the risk of suicide, especially in young people. 
Mass trauma (such as an earth quake or large event) is a special incident where many people have been traumatized at the same time.  Psychological debriefing, where you talk with a group of people, has not been proven to be effective.  However helping people regain some control over their lives is helpful.  Efforts should include: getting to a safe place, seeing a doctor if injured, getting food and water, contacting loved ones and leaning what is being done to help.  In this instance, educational support can be beneficial.
Another aspect of mass trauma, is that the helping community will also be traumatized.  Special care should be taken so those helping do not break down from the stress.