Validation of the suicidal behavior exposure scale in first responders

Background: First responders (e.g., emergency medical technicians, firefighters) may be at higher suicide risk than the general population due to frequent exposure to suicidal behaviors of others. Aims: We aimed to confirm the factor structure, scale reliability, and convergent validity of a new measure of suicidal exposure, the Suicidal Behaviors Exposure Scale, in first responders. Method: Using a cross-sectional web-based […]

Understanding capability and suicidal ideation among first responders

Objective: The present study seeks to determine differences in lifetime suicidal ideation, dispositional capability, acquired capability, and practical capability among those who have and have not served as first responders, and among subgroups of first responders. Methods: Data were collected as part of a large online (n = 3,500) study seeking to understand firearm ownership in the United […]

The association of sleep disturbance and suicide risk among firefighters: Exploring emotion regulation dimensions

Aim This study explored the extent to which emotion regulation dimensions statistically mediate the association between sleep disturbance and suicide risk among firefighters. Method Participants were 865 firefighters working for a fire department in an urban area in the southern U.S. Bootstrapping was used to test the indirect effects of sleep disturbance on suicide risk […]

Ambulance clinicians’ responsibility when encountering patients in a suicidal process

Background Even though the traditional focus in emergency care is on life-threatening medical crisis, ambulance clinicians frequently encounter patients with mental illness, including suicidal ideation. A suicide is preceded by a complex process where most of the suicidal ideation is invisible to others. However, as most patients seek healthcare in the year before suicide, ambulance […]

Health outcomes of psychosocial stress within firefighters: A systematic review of the research landscape

Background and Objectives Much of the research surrounding firefighter health has concerned the hazards intuitively associated with the occupation, such as physical, thermal, and chemical risks. However, an additional aspect of their work environment, psychosocial stressors, has begun to attract a growing level of attention. Work-related psychosocial stress may best be described as mental and […]

Time series analysis of the suicide attempts assisted by firefighters from 2017 to 2021 in Sao Paulo, Brazil

Objective: This study aimed to analyze the time trends of suicide attempts assisted by the Fire Department of the Military Police of the State of São Paulo (Corpo de Bombeiros da Polícia Militar do Estado de São Paulo —  CBPMESP) from 2017 to 2021, between sexes. Methods: This is an ecological study of 11,435 suicide […]

Network analysis of distress, suicidality, and resilience in a treatment seeking sample of first responders

Introduction First responders are routinely and regularly exposed to traumatic events that can clinically manifest with a symptom constellation of posttraumatic stress disorder (PTSD), generalized anxiety, depression, and suicidality. Methods We used network analysis to examine baseline data from treatment seeking first responders (n = 308) to examine the interrelatedness of those constructs, including a measure of resilience. We […]

The role of bystanders in the prevention of railway suicides in New South Wales, Australia

Background: Bystanders can play a key role in preventing railway suicides by taking direct action or by raising an alarm. Aims: The study investigated in this context: (1) the prevalence of preventative actions by bystanders; (2) the relationship, if any, between first-hand preventions by bystanders and the degree of ambiguity around the imminence of danger; and (3) the […]

Mental disorder symptom among public safety personnel in Canada

Background: Canadian public safety personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police officers) are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and […]

The Ruderman white paper update on mental health and suicide of first responders

This update of our White Paper published in 2018 is intended to keep the issue of mental health of first responders in the focus of public attention and facilitate access to services, programs, and resources for all members of this group. The Ruderman White Paper Update on Mental Health and Suicide of First Responders […]

The first 72 hours: Suicide loss survivor experiences with early responders

Exposure to a suicide carries risks for loss survivors including significant and long-standing emotional distress. Early responders play a critical role in shaping survivors’ experience and trajectory for seeking support services. Yet, few prior studies explore the nuances of early responders’ interactions with loss survivors. The current study explored suicide-bereaved adults’ experiences with early responders […]

Helping our heroes: An evaluation of mental health and organizational policies surrounding suicide prevention and postvention strategies for Nebraska first responders

Suicide is ranked as one of the leading causes of death in the United States. Over 40,000 individuals die by suicide each year (Stanley, Hom, & Joiner, 2016; Vigil et al, 2021), and, in 2020, it was ranked in the top 9 causes of death for all ages (10-64), and second for those 10-14 and […]

Virtual trauma-focused therapy for military members, veterans, and public safety personnel with posttraumatic stress injury: Systematic scoping review

Background A necessary shift from in-person to remote delivery of psychotherapy (eg, teletherapy, eHealth, videoconferencing) has occurred because of the COVID-19 pandemic. A corollary benefit is a potential fit in terms of the need for equitable and timely access to mental health services in remote and rural locations. Owing to COVID-19, there may be an […]

Reducing the impacts of exposure to potentially traumatic events on the mental health of public safety personnel: A rapid systematic scoping review

Police, firefighters, and emergency medical technicians and paramedics are frequently exposed to potentially traumatic events (PTE) in their work as public safety personnel (PSP). PTE are a risk factor for posttraumatic stress disorder, depression, anxiety, substance abuse, and suicidal ideation. This systematic rapid scoping review summarizes evaluation research on psychosocial interventions to reduce the negative […]

Emotional exhaustion and its relationship with suicide risk in emergency responders

The purpose of the current study was to evaluate the relationship between emotional exhaustion and suicide risk in emergency responders. Participants included 643 actively employed emergency responders who responded to an online research based survey. Participants were administered the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1981) and the Suicide Behaviors Questionnaire (SBQ-R; Osman, Bagge, Gutierrez, Konick, […]

Suicidal ideation, plans, and attempts among public safety personnel in Canada

Substantial media attention has focused on suicide among Canadian Public Safety Personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police). The attention has raised significant concerns about the mental health impact of public safety service, as well as interest in the correlates for risk of suicide. There have only been two published studies assessing lifetime […]

Suicide among ambulance service staff: A review of coroner and employment records

Background: There is growing evidence to suggest that suggest that Ambulance Service (AS) staff may be at increased risk for suicide, however few studies have explored risk factors within this occupational group. Aim: To investigate factors commonly associated with ambulance staff suicides. Method: Eleven AS trusts across England and Wales (UK) were asked to return […]

Responding to grief, trauma, and distress after a suicide: U.S. national guidelines

These guidelines provide a unified, far-reaching blueprint for the development of suicide postvention at all levels of U.S. society. Populations: Racial and Ethnic Groups, Attempt Survivors and Other People with Lived Experience, Survivors of Suicide Loss Settings: Schools, Health Care, Behavioral Health Care, Outpatient Mental Health, Substance Abuse Treatment, Colleges and Universities, Faith Communities, Family Members and Caregivers, First Responders About Suicide: Behavioral Health Disorders, Depression/Bipolar, Post-Traumatic Stress Disorder (PTSD), Substance […]

Responding to a suicide death: The role of first responders

Effective response by first responders in the immediate aftermath of a suicide death can play a critical role in reducing risk and promoting healing for family, friends, and the larger community by helping people who are newly bereaved to cope with the immediate crisis, created by the death. They also can lay the foundation for […]

Characteristics of the traumatic stressors experienced by rural first responders.

First responders routinely experience work-related events that meet the definition of a traumatic stressor. Despite the high exposure to traumatic events, prevalence rates of posttraumatic stress disorder (PTSD) are relatively low. This discrepancy points to the potential value of identifying factors that distinguish those traumatic stressors that produce ongoing traumatic stress symptoms from those that […]

The Ruderman white paper on mental health and suicide of first responders.

The unparalleled bravery of first responders is brought to the attention of the public following huge and tragic events, such as the recent incidents of terror in Parkland, Las Vegas, Orlando, Sandy Hook, and more. However, public discourse seldom acknowledges the fact that first responders witness tragedy and horror regularly, if not daily. Constant exposure to […]

Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters.

Objective Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)—the fear of anxiety-related sensations—is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk. Method […]

A systematic review of suicidal thoughts and behaviors among police officers, EMTs, and paramedics.

First responders, police officers, firefighters, emergency medical technicians (EMTs), and paramedics, experience significant job-related stressors and exposures that may confer increased risk for mental health morbidities (e.g., posttraumatic stress disorder PTSD, suicidal thoughts and behaviors) and hastened mortality (e.g., death by suicide). Inherent in these occupations, however, are also factors (e.g., camaraderie, pre-enlistment screening) that […]