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just a thought...suicide.


mcmikeguy

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I'm not sure how CISD costs nothing. The CISD staff I have dealt with were all psychologists and psychiatrists, and get paid for services.

Then it was NOT CISD. CISD is peer driven and facilitated. Head shrinkers are not our peers.

Either you or your employer is mistaken in their terminology.

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Either you or your employer is mistaken in their terminology.

Not necessarily mistaken.... different interpretation of CISD perhaps..... but I am not willing to continue to derail this thread with a back and forth commentary on your definition of CISD vs what my definition is.

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this is definitely one spot where my school got things right. (not that there were many wrong, dont misunderstand me!!!)

i did the zero-to-hero program in alberta, which included a psychology class. so insightful and useful. the therapeutic communications class was pretty lame, but there were a few gems for how to truly listen to people and actually hear what they have to say.

i've spent many many hours with a psychiatrist and councellors, and luckily never harmed myself beyond moderate anorexia. i've been stable of mind for quite a few years now, and feel quite comfortable with myself. i also feel that maybe i can relate somewhat with these patients, that it helps me to be able to connect with them so that i can get them into the unit and to the help they need.

an illness of the mind is still an ailment, which can be fatal in some cases.

i've been in the back with people post attempt, and their eyes are almost lifeless when they're that depressed. but i've never had them not agree to come with me and get help. even if they wont speak to me alot, i'm glad i dont just give them the cold shoulder in the unit, its the last damned thing someone in that state needs or deserves!

i do wish it were easier to get ahold of outside help, but i think i'm pretty lucky in alberta. if needed, i go to my doc, he refers me to shrink, and work doesnt even need to be involved if i so choose. and we have a lot of kick ass benefits without referals (even massage!!!) so i just cant see mental health not being included.

slowly, emergency services are seeing what they're doing to themselves by not supporting the mental health of the practitioners. i really think things are a changin'.

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I don't have all the psych lingo and terminology. That was my first wife's area. She was a counselor for adolescence. But from what I've picked up in the field, from her, from family, church, and personal experiences, I hope I can help.

It was actually my grandfather that gave me the advice that has always stuck in my head. "Suicide is just a permanent solution to a temporary problem." It took me a couple of years of maturing for that to sink in. Then, like a like a lightbulb, I understood it.

Even though I've been out of the field actively for a while, over the last 25 yrs. I've been on countless suicides and / or attempts. For those that actually want to do it they won't say anything to anyone. Most of the time they are the one's that you would least expect. You might think think that they are weird or if you can really notice, troubled. It is very hard to tell.

But then you have "the callers" (as mentioned before). Yes, they can become annoying and you think, "Oh NO, Not again." Especially the tenth time in four weeks situations. But you need to look at and treat them physically and psychologically. Don't just "load and go" Talk to them some. You may get some of the Boo-Hoo stories, but at least try to listen and understand. I've noticed that sometimes, when it comes to "callers" they may eventually do it. The numerous times that you have on them and they feel as if no one is taking their problems seriously, they may just do it, sort of like saying, "I told you so.", almost feeling as if you were daring them to do it.

We had one guy, who was an "on again/ off again" volunteer fireman. Occasionally he'd booze up, start calling people, then call 911. After he hung up he'd then take the pills. He know that by the time EMS got there the pills would not have taken full effect. we wondered if he got a kick out of having an NAG Tube inserted. But once he gave the wrong address. We had no idea where he was. (This was before Enhanced 911). Luckily one of the nurses he had called to whine and bawl & squall to had heard over the scanner that we couldn't find "Buzzy" (Nick name, long story) She had the presence of mind to do a "call back" on her phone. He gave her the right address. It was a very close call. Another ten or twenty minutes and he'd would have done it.

What Iamb getting at is no matter how many time you have "callers" threatening, take it seriously. Nine times out of 10 it will probably the same thing. But it just takes one SNAFU in the system that could be detrimental to the out come.

I had always talked with Buzzy, but not one on one with him boozed up, I could call him a friend, which he didn't have many of. About a year later I moved to LA and about two years later I met up with my best friend from the dept. who had made Asst. Chief at the time, we had lunch. We were catching up on different guys. He told me Buzzy died. The first thing I thought was that he went ahead and "did it". But Jimmy informed me that Buzzy cleaned up, and even got married. As long as I knew him I had never known he ever had a date. But it was a AMI that got him.

Without trying to sound like a "Jesus Freak" (a term used by a few members here). Plain and simple God and Christ is the answer. Talk to a Minister you are comfortable with. If one doesn't seem to help, then try another. I'll warn you now, you won't like everything they may say.You may hear things you don't want to here, especially if they are being honest.

I know some don't believe in Heaven or Hell, but know one thing. Suicide is a "mortal sin". If you die, how are you going to ask for forgiveness? [That is the thought that comes to me when Iamb that despaired. And believe me, losing my first wife destroyed me. Many times those thoughts came in my head. I tried the drinking scene (which getting out of was one of the smartest things I did). Unfortunately I did get into a "self destructive mode" where I didn't care what happen to me. I got out of that mode, but I am addicted to cigarettes now. One of the worst regrets in my life.

And yes, reading the Bible and praying not just thinking things in your head, has helped me tremendously since I was about 17.

I full and whole heartily agree with Dust Devil. CIST should be used. No professional psychs or therapists, just only, and only peers. Talking to your peers and those with many more years in the field can help greatly. "Debriefings are essential to learn and to let you know you are not alone in a lot of your minds. Just one thing. What is said in a debriefing (CIST) STAYS in CIST!

But if someone is exhibiting substantial personality or behavior changes, please have them see a professional. Not just for them, but for their agency,.

I'm sorry I made this much longer than I intended to. To me this is a special issue to me.

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  • 2 years later...

I think allot of the reason most EMS providers have a hard time with the suicidal calls is because they have been there. I have found that there a far larger percentage of people with untreated mild mental illnesses in EMS than in the general pop. I am not sure why that is, but over the years I have noticed there are many. In our culture, there is a strong message of "suck up and deal with it". When allot of ppl come upon the psych pt, they feel the same way; that the person should deal with it, or kill themselves, but not bother us. I am not saying it is right, but it is the way it is allot of the time. I think once an ems provider has worked through their own problems, then we ge tthe compassionate response the pt desperately needs.

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Personal opinion-

I think the reason so many providers cannot wrap their heads around psych patients and their problems is because there is so little we can actually do for them. As EMS providers, we want to fix things- ASAP- and there is little we can do for a truly disturbed individual. We cannot "see" the problem, so often times we minimize or even dismiss it's impact or importance. There can be a chemical imbalance, some sort of emotional trauma, or an extended history of personal problems that lead a person to the point in time were we encounter them. If someone is having chest pain, we can "cure' that pain with one pill. If someone is depressed, all we can offer is a sympathetic ear. Sure, if they are exhibiting symptoms from an OD or physical trauma, we know how to treat that. Therapy, counseling, trial and error with various treatments and medications- it's often a long and difficult process to get a person on solid emotional ground, and that process usually includes multiple trials and errors of medication combinations; there is no quick fix.

As for suicide in particular- we all know that a legit attempt makes folks far more likely to try again- and eventually succeed. I've had folks with extensive psych histories finally succeed after many half-assed attempts. I also had one guy who immediately after receiving a diagnosis of cancer(unknown type or stage) go from his doctor's office to the high rise building he worked as a building engineer. When he arrived at work, he made an offhand comment to a coworker about receiving the diagnosis, proceeded to the roof of the building and jumped 40 stories to his death. He went from a cancer diagnosis to dead in a matter of a couple hours. (That one was particularly disturbing)

Point is, everyone has a different threshold and tolerance for physical as well as emotional pain. A problem that may seem inconsequential to most folks can completely overwhelm another person's ability to cope. As a provider we need to look at psychiatric patients through their eyes- as much as possible. No, we should not begin talking to someone's visual hallucinations, but at least try to understand their stated concerns. Even with seriously delusional folks, there are usually nuggets of truth embedded in their rantings. Yes, many of our suicide calls are not serious. A teen girl takes 4 Motrin because she is upset her boyfriend dumped her. Is she serious about her desire to die? No, but she does need perspective, which is something we can give- at least until counseling can take over.

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"Yesterday, I felt so lost and alone. I was looking for a way out, preferably quick and something that didn’t indicate suicide. I wanted desperately to die, but couldn’t bear the thought of the extra turmoil that the stigma of suicide would create for the family. I could only see the negatives in all things. From work and study I felt like id never succeed, and if by chance I did, I would never be happy. I felt lost and vulnerable, with no one I could unburden to. All family and friends have enough stresses in their lives for the moment.

I felt like my mental stability was gone, like it was cyclical, whenever the pressure built I wanted the “easy” way out. And yet suicide is the hardest thing to do, harder than living as you have to overcome the body’s inbuilt desire for life and self preservation. Yet I couldn’t see other alternatives, all my prospects bleak. So much judgement and self loathing - my own worst enemy - like being sabotaged from within.

It seems like a game, with odds stacked against you. You get well and become complacent about maintaining good mental health. You recognise yet ignore the warning signs that the spiral is beginning again. The negative thoughts are subtle at first, then bang, you cant sleep at night. They overwhelm and paralyse you - yet in some ways like an old comforting friend. Then the battle, it rages to and fro. The warm embrace of not hurting anymore, the sweet release and freedom of death. The soul freed from its coil to search and wander the universe without limit and restriction. A call so strong and welcoming. How I long for it, yet the guilt it battles too. The people who would experience such hurt, angst and anger at my death. My soul feels the hurt and causes such compassion for them. Then conflict is severe, each side gaining ground and losing it. Like a war of attrition

The constant conflict is wearing me thin, more and more I can rationalise my death. It seems so petty, compared to war, famine and distress and suffering around the world. Yet in my local world so many people would be affected. Can I really rationalise and philosophise the hurt cause as just something that they are to experience and learn from?

This was taken form the journal of my best friend who was buried 2 weeks ago on wednesday, his parents released as part of his service so that we may better understand the thoughts of a person who is so depressed they see no other alternative.

Now, while i havn't specifically seen it in this thread, but i i will make reference to it is the downright hostility people display towards suicide. I am constantly disgusted by so called "health professionals" on and offline who chose to portray these people as being "fucked in the head", "they should just get over it" or that they were "gutless and selfish". Clearly my mates last thoughts were obviously for others and not himself. You people want to be the compassionate and ever caring health providers right up until the point where you refuse to understand anything that challenges your sense of normal. My mate didn't choose to be a victim of child abuse, and he certainly didn't choose to have depression - and for that "normal" people would choose to brand my mate wasn't a nut job, a psycho and selfish. A gutless man for choosing the so called "easy way out" of his problems

I say they are gutless for choosing to not understand.

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