Studies: Suicide rates, risk of assault on the rise for emergency responders

Recently published research suggests that emergency responders—those who are first to treat individuals in crisis, such as overdose victims—face various increased health risks themselves, a byproduct of the high-stress environments in which they work.

EMTs in Arizona have a 39% higher risk for suicide than the state’s general population, according to a study published by researchers at the University of Arizona College of Medicine – Phoenix. Findings of the study, which covers a five-year period ending in December 2015, were published in Prehospital Emergency Care.

Bentley Bobrow, MD, associate director of the Arizona Emergency Medicine Research Center – Phoenix and professor of emergency medicine at the UA College of Medicine – Phoenix, told Behavioral Healthcare Executive in an emailed response that the research team that conducted the study does not have data as to why EMTs have completed suicide at higher rates, but noted that past studies have linked the increased stress that comes with witnessing dying patients with a potential increase in suicidality.

UA medical student Neil Vigil, lead researcher on the study, said in an email that lifetime exposure to physical pain or provocative life experiences can desensitize individuals to the fear of death, thereby increasing their capability of self-harm.

“Using this framework, I do think that repeated exposure to near-death experiences and deaths from opioid overdoses could potentially play a role,” Vigil said, though he noted the theory linking increased exposure to overdose-related deaths with increased suicidality has not yet been studied.

While data on the effects of increased exposure to overdose cases has not yet been compiled, two recently released studies show emergency responders are more frequently becoming targets for violence while on the job. A national poll of 3,500 emergency physicians across the US finds that 47% report having been physically assaulted at work, with 60% saying incidents have happened within the past year. The study was released by the American College of Emergency Physicians. Among its other findings:

• 27% of emergency physicians who have been assaulted within the past year say assaults have occurred more than once
• 27% of those assaulted were injured
• 97% say a patient committed the assault, while 28% say they had been assaulted by a family member or friend of the patient

Nearly 80% of respondents say patient care is being affected. Meanwhile, a separate study of emergency physicians in Michigan, published in the Annals of Emergency Medicine, found that 8.1% of respondents are “constantly fearful” of becoming a victim of violence (compared to 1.2% in 2005) and 21.9% say they are “frequently” fearful vs. 9.4% in 2005.

The Michigan study goes on to suggest that illicit substances play a significant role in emergency department violence. Half of emergency physicians polled report that at least half of all assaults are committed by individuals seeking drugs or are under the influence of drugs or alcohol.

Building resiliency

Vigil, who worked on the EMT suicide rates study at the University of Arizona, has begun developing resources in hopes of helping emergency responders strengthen their resiliency in the face of the high-stress situations created by their work environments.

Vigil has teamed with the Arizona Department of Health Services to create an EMS resiliency website that offers educational materials and resources in a condensed format for EMS personnel. The website also includes tools to measure person risk factors for suicide, such as screenings for depression, PTSD, and substance and alcohol dependence.

A link to the site has been sent to all registered EMTs in Arizona who have a valid email address on file.