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

Abstract

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 may inoculate against the development or maintenance of psychiatric conditions. Several reviews of the literature have documented the prevalence and potency of PTSD among first responders; the value of these extant reviews is considerable. Nonetheless, the literature has not been systematically described with regard to suicidality. In this systematic review, we present 63 quantitative studies examining suicidal thoughts, behaviors, and/or fatalities among first responders; identify population-specific risk and protective factors; and pinpoint strengths and weaknesses of the existing literature. Findings reveal elevated risk for suicide among first responders; however, studies utilizing more rigorous methodologies (e.g., longitudinal designs, probability sampling strategies) are sorely needed. First responders have an armamentarium of resources to take care of others; it is the duty of researchers, clinicians, and the public to aid in taking care of their health as well, in part by reducing suicide risk.

Insomnia and suicide-related behaviors: A multi-study investigation of thwarted belongingness as a distinct explanatory factor

“…As noted, past research has demonstrated markedly elevated rates of suicidal ideation among firefighters (Stanley et al, 2015), and a recent systematic review of the literature revealed that few studies exist examining correlates of risk for suicidality among this unique population (Stanley et al, 2016). Only one study of which we are aware has previously documented insomnia as a correlate of suicidal ideation among firefighters (de Barros et al, 2012); this study was limited to firefighters in Brazil, and did not examine mechanisms such as thwarted belongingness (cf.…”

Chronic pain among public safety personnel in Canada

“…Third, the reliability and validity of web-based selfreports remains ambiguous 41 ; nevertheless, the high frequencies and relatively large sample appear to justify research with more robust assessments (e.g., interviews; random sampling). Fourth, the PSP category groupings were based on previous research 29,42,43 but could not account for potentially important differences within some categories (e.g., paramedics verses emergency medical technicians). Fifth, future research should simultaneously assess the interactive effects of mental health and chronic pain, given the substantial evidence of comorbidity [44][45][46][47] and potentially increased risk from mutually maintaining factors.…”

Impact of new traumatic or stressful life events on pre-existing PTSD in traumatized refugees: results of a longitudinal study

“…High-risk populations such as war-affected people, refugees, firefighters, or police officers often experience traumatization sequentially (Harvey et al, 2015; Levy-Gigi, Richter-Levin, Okon-Singer, Keri, & Bonanno, 2015), which has a significant impact on the development of mental disorders, for example, PTSD, depression, and anxiety (Kartal & Kiropoulos, 2016; Pinto, Henriques, Jongenelen, Carvalho, & Maia, 2015; Stanley, Hom, & Joiner, 2016). Several studies have provided evidence that individuals suffering from PTSD in the aftermath of an initial trauma are vulnerable to increased PTSD symptoms after subsequently experiencing a new traumatic event (Bramsen, Van Der Ploeg, & Boers, 2006; Fossion et al, 2015; Hantman & Solomon, 2007; Kinzie, Boehnlein, Riley, & Sparr, 2002).…”