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Patient Care

Stories from the Streets: More than a Transport

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It’s Sunday, 1230 hours, and we’re dispatched to a home on Wickenden Street for an emotional female. We arrive on scene to find a female crying on the front stairs. She points to a door. It leads to a basement. At the bottom of the stairs, next to the washer and dryer, is a boy hanging dead from the ceiling joist. He has only been dead for a short time.

It’s Sunday, 1258 hours—the same day, just a few minutes later—and we’re dispatched to a home on Potters Avenue for an emotional, suicidal teenager.

Did I take the threat seriously? You bet I did. And every one that followed. It helped me to have a plan.

Strategies for Helping a Suicidal Person

When called for a suicidal person, my main objective is to get them from wherever they are to where they need to be—a hospital with psychiatric facilities. The only training I had for dealing with suicidal patients came at the end of ropes, neckties, extension cords, bullets, bridges, opiates, razors and trains. And poison. Seeing the result of a person’s decision to take their own life prompted me to do anything and everything I could to learn how to be of help to somebody who’s suicidal. Seeing the bodies of people for whom help never came made the threat real, immediate and very much a possibility.

A person contemplating suicide needs professional help. By calling 9-1-1 they, or the concerned party who made the call, expect that help to arrive. They do not expect an EMT or paramedic to respond with little or no idea how best to help, or a provider whose own ideas about suicide cloud their ability to assess, treat and transport that suicidal person. They do not need a person who is there simply to get them from point A to point B. They deserve somebody who cares, somebody who understands the gravity of the situation, somebody with a plan. I do not want anybody to die by their own hand, and the small amount of time I have with a suicidal patient may be the time that matters to the person thinking about doing it.

Here are a few ideas I’ve developed into a working plan, based on resources I found at Helpguide.org and Suicide.org, in an effort to learn all I could about saying the right things to suicidal persons:

Listen: Never act shocked or disapproving.

Comfort: “You are amazing, unique and awesome; I like you, a lot of people like you.”

Respond: “Ending your pain and ending your life are very different courses of action.”

Ask:

  1. Are you “suicidal?”
  2. Do you have a “method?”
  3. Do you “have what you need?”
  4. Have you figured out “when?”

Connection Counts

Let the person know you’re deeply concerned. Do not be afraid to talk about suicide, and let the person vent, shout, swear, cry, tell you their plan—anything but be alone.

Find a way to convey this simple fact, which may keep them alive: you have witnessed suicide and felt its repercussions, you have helped family and friends who have discovered the bodies, and you, as the person behind the uniform, still feel the effects of the devastation each and every person you’ve responded to who successfully committed suicide has left behind. Let them know how you feel, even as a stranger to the people who gave up, and that you mourn the loss of their presence and the life that could have been lived had the proper help arrived in time.

Perhaps your voice will be the one that makes the difference, turning the switch in their heads back to living. Our words and actions are incredibly powerful. We may be outsiders but we have the opportunity to be perceived as confidantes, and maybe even a person who truly understands.

Michael Morse, EMT-C, is captain of Rescue 5 in Providence, RI, and has served on the city's busiest engine, ladder and rescue squads as a firefighter, rescue technician and lieutenant during his 21-year career. He is the author of the books Rescuing Providence and Responding.

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