PST 321 INSTRUCTOR'S NOTES WEEK NINE-
DEALING WITH THE SUICIDAL INDIVIDUAL

Welcome to week nine. This week we are dealing with a topic that can be very emotional for some people, suicide. I posted on the introduction page to this class that we would be dealing with the topic of suicide during this class. If you have concerns about how this topic might be too emotionally close to you, please let me know.

In week one I mentioned that most of my call outs are to deal with suicidal persons. So the odds are high that if you work in an emergency response field, you probably will come in contact with individuals that are suicidal. While it is never a good idea to generalize a complex subject, enumerating the three main types of suicidal persons establishes a statistically valid list of the types of people that commit suicide. It is very important to understand that these are people that follow through with suicide, not people who attempt suicide. This list is based on statistics and from personal experience. In my years as a negotiator every single suicidal person I dealt with fell into one of these groups:

1. Persons suffering from psychosis: 93 to 95 percent of the people that commit suicide are suffering from some form of psychiatric illness. The odds are very high that if a telecommunicator is dealing with a truly suicidal person that this person is going to be mentally ill. Therefore, it is important that telecommunicators prepare to deal with persons with mental illness. In the last two weeks we have been studying different types of emotionally disturbed people. There are other steps you might want to take in order to prepare to deal with suicidal persons. First, you might want to consider volunteering to work a suicide hotline. Some of the best training I received when I first started out as a negotiator was working on a suicide hotline. Most places will require you to take their training class before you begin working the phone lines. The class usually consists of one day of training that will give you basic instruction in how to deal with suicidal persons and will cover the policies and procedures for the organization. In my opinion it is time well spent. Second, you might want to do some reading and basic research on suicide. The bibliography section of this site offers a list of contemporary literature on the topic. I have read every book listed so allow me to offer some insight. If you are interested in a “quick” study of the topic, the Eric Marcus book (Why Suicide?) will give you a great deal of information in a small package. His book is only 240 pages and packed full of (many times bulleted) information. Marcus is a vicarious victim of suicide. His father committed suicide when Marcus was twelve. His book is excellent if you are looking for a quick read that will give you a great deal of information. George Colt’s book, The Enigma of Suicide, is another excellent book on the topic of suicide. While it is much more lengthy (575 pages) than the Marcus book, it is the one book that I recommend to all negotiators who take my class on suicide. Edwin Shneidman is considered the father of suicidology (the study of suicide and its prevention). He has written several books on the topic. I would recommend any of Shneidman’s books if you are planning some college level research on the topic.

2. Persons under the influence of alcohol: Studies show that 35% of suicide victims have a BAC of .10% or greater (Seventh Special Report to the U.S. Congress on Alcohol and Health, January 1990.) Most suicidal persons call outs that I get involve people under the influence of alcohol. Because alcohol is a depressant drug, many times it can be the catalyst that pushes someone into a major depressive episode. The DSM-IV refers to this as a Substance-Induced Mood Disorder. Because of the depressant qualities of alcohol, Telecommunicators should make a special effort to determine if a person they are in contact with (which they suspect to be suicidal) is under the influence of alcohol. This can be difficult to determine if the subject refuses to tell you. Many times you may assume someone is under the influence, only to discover they are actually suffering some type of mental disorder. Try to determine from the subject if he is “on something.” I have accomplished indirectly by mentioning alcohol while talking to the subject and seeing if he responds to the topic. The reason this is so important is the fact that it assist whoever is in command of the scene in determining the best course of action.

3. Persons on controlled substances: It can be very difficult to determine if a suicidal person’s actions are being motivated by a mental illness or if they are under the influence of a “mind altering” substance. Because of a fear of arrest, the subject may not be honest when asked if they are “on something.” There is also a very high statistical chance that the subject may be “on something” and mentally ill. A person that is under the influence of a mind-altering substance can be completely incoherent and impossible to communicate with logically. Because of the inherent unpredictability of a person that is “high” it is best to try to get the suicidal person to a controlled environment as quickly as possible. The telecommunicator should not attempt to “talk some sense into” this person. The goal in speaking to this person should be to delay him until he begins to come down off whatever he is on, or until the police can safely take him into custody and get him in a controlled environment until he is stable.

Most suicides in this country are carried out using a firearm. Guns account for nearly 60 percent of the over thirty thousand annual suicides. Of all the most common methods of suicide, suicide by firearm also places the responding officer at the greatest risk of injury or death. In the past few years, a new form of suicide has surfaced that could potentially impact any officer. Victim precipitated suicide or “suicide-by-cop” is becoming more common every year. Because of the contemporary nature of this form of suicide, the number of occurrences each year is difficult to determine. However, it is quite obvious that the number is growing every year. Telecommunicators should learn to recognize some of the clues of suicide-by-cop. This will allow you to give an informed opinion about someone you have been negotiating with in regards to the potential for a suicide-by-cop situation. The following list is a good standard to follow in determining if someone is planning a suicide-by-cop situation:

The suspect, is often in a barricade situation, refuses to negotiate with authorities.
Has just killed a "significant other" in his life, especially his mother or child.
Has recently learned or perceives that he has a life-threatening illness or disease.
Recently experienced one or more traumatic events in life affecting him, his family, or his career.
Has recently given away money or personal possessions.
Has a criminal record indicating past assaultive behavior.
Presents no demands that include his escape or freedom.
Says he will only surrender in person to the officer in charge, chief or sheriff. (This is a major red flag)
Indicates an elaborate plan for his death that has taken prior thought and/or preparation.
Indicates he wants to go out in a "big way."(Another red flag)
Expresses feelings of hopelessness/helplessness.
Provides authorities with a "verbal will."
Demands to be killed by officers. (Red flag)
Sets a deadline for authorities to kill him. (Red flag)

While I do not believe that it is a good idea to use a “check list” when dealing with a hostage or suicide situation, the list above should be used as a reference based on research done on past incidents of suicide-by-cop.

I would like to take just a few moments to cover some of the misconceptions concerning suicide. All of the statements listed below are false. And yet many of them are common beliefs that people have concerning suicide.

People who talk about killing themselves will not do it.
Young people are more likely than older people to kill themselves.
Suicide occurs more often during winter or bad weather. (Most suicides occur in the Spring)
Most people leave suicide notes. (Only about 20% do)
Minorities commit suicide more often than whites. (Only one minority out ranks whites, Native Americans)
Once a depressed person begins treatment for clinical depression they probably will not commit suicide. (Actually, the opposite is true. There is a greater chance of suicide after the person starts counseling for clinical depression)
Women usually commit suicide by overdose. (While this was true prior to 1980, today most women commit suicide with a firearm)
Men attempt suicide more than women. (Women attempt suicide more. Men do succeed at the act 4 to 1 times more often than women)
Insurance doe not pay benefits to the families of suicides. (Full benefits as long as the policy has been in effect for at least two years)
The Bible says that suicide is a sin.

That last one concerning the Bible is the one I hear most often. I try to avoid religion as a topic of discussion, especially in my classes. However, this is such a common topic with suicides, I would be remiss not to cover it. Let me begin by saying that if you have a suicidal person that believes he will go to hell if he commits suicide, obviously it would be best to not tell him otherwise. Just because the Bible does not specifically proscribe suicide, does not mean that certain (Bible based) religions will not adopt a stance that if you commit suicide you will go to hell. Other religions do consider suicide a sin that will send a soul straight to hell. Islam, for example, forbids suicide. If a person believes that he will go to hell if he commits suicide, this belief could be a deterrent. Therefore, do not tell him otherwise. My father once told me to never discuss religion or politics with anyone. This is good advice and it applies to negotiations. Try to avoid these topics when you are negotiating. Do not bring up religion as a topic in order to convince a person that suicide is a sin and they should not do it out of concern for their soul. Even if you know you share the same religious beliefs as the subject, you could differ in this one area. The best way to build rapport is to determine where the subject is and go to him, not state your own feelings and hope that he agrees. If the subject states that he is afraid to kill himself because he knows he will go to hell, then it would be permissible to use that statement to your advantage. However, avoid the topic otherwise. I challenge anybody to sit down with a stranger and discuss religion or politics in depth and not get into an argument. Because of the high level of emotion with the topics, both should be considered taboo topics during negotiations with a suicidal person.

There is one very important point that needs to be made concerning suicide. If someone has decided he is going to kill himself, then many times nothing can be said or done to prevent it. I say this because some people take it very personally when someone they are negotiating with commits suicide. You should never second-guess yourself about these things. Just know that no matter what you said or did not say, there was nothing that could have been done to prevent it. I suggest you give this some thought and determine how you will deal with it if someone you are talking to does commit suicide. I have friends that are negotiators that have had a person commit suicide while they are on the phone. This can be very traumatic. There is little you can do to make it completely emotionally painless. However, coming to grips with the situation before it happens will help you to deal with it. I have been fortunate in this regard to have never lost a person during negotiations. However, I go into every single situation with the understanding in my mind that someone could die and that there may be absolutely nothing I could do about it. This is my way of dealing with the situation. I am not a psychologist. I cannot tell you how best to deal with it. However, in my opinion I think that it is best that everyone determine how he or she will deal with it because everyone is different.

Negotiation Golden Rule # 8: “There is no life so miserable but it may be worthy of our endeavors to save it.” Royal Humane Society Member

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PST 321 INSTRUCTOR'S NOTES WEEK NINE- DEALING WITH THE SUICIDAL INDIVIDUAL

PST 321 INSTRUCTOR'S NOTES WEEK NINE-
DEALING WITH THE SUICIDAL INDIVIDUAL