First Responders

Asking About Suicide Is Vital for First Responders and the Public They Serve

Suicide risk assessment is a first step in suicide prevention, and it’s a critical skill for first responders.

  • Police officers, firefighters, emergency medical technicians (EMTs), and paramedics often work on the front lines of suicide prevention. They are called into situations in which a person may be suicidal — even if not reported as such — and they serve as a resource for people who are experiencing serious emotional, mental health, and substance use issues. Properly assessing a person’s risk for suicide helps first responders determine next steps and save lives.
  • Statistics show first responders may be at a heightened risk for suicide themselves, because they work in high-stress jobs with repeated exposure to traumatic events. That’s why the ability to recognize suicide risk is so vital within their own departments or units.

More police officers die by suicide than by gunfire and traffic accidents combined, according to data collected by The Badge of Life, a Connecticut-based suicide prevention organization for police officers in the U.S. and Canada.

A fire department is three times more likely in any given year to lose a firefighter to suicide than to a death in the line of duty, the National Fallen Firefighters Foundation reports. A national Florida State University study of more than 1,000 firefighters found that nearly 50% had suicidal thoughts at some point during their career, and about 16% reported one or more suicide attempts.

A survey of EMTs and paramedics in the U.S. found that 37% had contemplated suicide and 6.6% had attempted it. A survey of Canadian paramedics found that about 28% had contemplated suicide and 60% knew of a paramedic who had.

The Columbia Protocol Is Helping First Responders Save Lives and Target Resources

Suicide is preventable, and asking the right questions to identify who is at risk is a critical first step to stopping it. Whether used within first responders’ departments or in their service to the public, the Columbia Protocol — also known as the Columbia-Suicide Severity Rating Scale (C-SSRS) — is the ideal risk assessment tool because it’s:

  • Simple. Ask all the questions in a few moments or minutes — with no mental health training required to ask them. First responders can ask the questions of a colleague they are concerned about or someone they interact with on one of their service calls, typically using the two- to six-question version of the protocol.
  • Efficient. Use of the protocol redirects resources to where they’re needed most. It reduces unnecessary referrals and interventions by more accurately identifying who needs help — and it makes it easier to correctly determine the level of support a person needs, such as patient safety monitoring procedures, counseling, or emergency room care.
  • Effective. Real-world experience and data show that the protocol has helped prevent suicide.
  • Evidence-supported. An unprecedented amount of research has validated the relevance and effectiveness of the questions used in the Columbia Protocol to assess suicide risk, making it the most evidence-based tool of its kind.
  • Universal. The Columbia Protocol is suitable for all ages and special populations in different settings and is available in more than 100 country-specific languages.
  • Free. The protocol and the training on how to use it are available free of charge for use in community and healthcare settings, as well as in federally funded or nonprofit research..

The C-SSRS in Action

Many police departments and other emergency services throughout the United States have implemented the Columbia Protocol as a tool for everyday use. Utah’s largest fire agency — the Unified Fire Authority — has employed the tool for its firefighters, paramedics, and EMTs. Tennessee has adopted the protocol as a statewide crisis assessment tool and has encouraged first responders to use it. A Rhode Island Senate commission recommended that first responders use the Columbia Protocol to help reduce emergency room overuse.

Police officer administers the Columbia Protocol

This demonstration shows how police officers can use Columbia Protocol questions on a call to help determine the level of assistance a person needs.

“First responders are in a unique position to determine the course and outcome of suicidal crises.”

World Health Organization’s Department of Mental Health and Substance Abuse in its report, “Preventing Suicide: A Resource for Police, Firefighters and Other First Line Responders”