Provider wellness: Suicide and mental health in EMS

Valuable lessons learned from the tragic death of a medic for EMS management in supporting and connecting with staff

This article originally appeared in the October newsletter of the National EMS Management Association and is republished here with permission.

By Ted Fessides, deputy chief, Cranberry Township Emergency Medical Service

July 5, 2016, is a night I will never forget. I got the call shortly after 10:30 that night that Phil, one of our full-time medics, had just taken his life in the staff parking lot. I was dumbfounded and in disbelief. I could not believe that Phil, a kid I had known since he was 16 and had first gotten into EMS with, would do such a thing. I was in such shock that I called him after hanging up with my crew chief, hoping and praying this was a sick joke and that he would answer. Sadly, he did not.

We immediately called upon our mutual aid services to staff our service area for the night and called the Critical Incident Stress Management (CISM) team in to do a debriefing with the on-duty crews who had unfortunately had to discover this tragic event.

Phil was not a statistic, but a person, a very funny, sometimes pain-in-the-you-know-what person that often times would have me shaking my head or laughing with tears, often both at the same time.
Phil was not a statistic, but a person, a very funny, sometimes pain-in-the-you-know-what person that often times would have me shaking my head or laughing with tears, often both at the same time. (Courtesy photo)

By all accounts, no one saw this coming. Phil had shown up for his shift that day and nothing was out of sorts. The crews reported he had turned in early that night and gotten up at some point to go outside and smoke around 10:00. Once he didn’t return, a crew member went out to check on him and saw that the dome light was on in his truck. Upon walking down to investigate, he discovered the tragic scene.

No textbook response for suicide in EMS

There is no book or website out there to assist when this kind of tragedy besets a service. We just had to wing it. We sent the other on-duty crew and Phil’s partner home for the night with the instruction to let us know when they were ready to return. We came in at 6:00 a.m. to catch the next on-duty crew to let them know of the events that happened, and that counseling was available and if they did not wish to work that day to go home and we’d figure out coverage.

We brought the CISM team back out and they stayed throughout the day to assist anyone in need. We shut down the non-emergency side of our service for the rest of the week and just let the crews focus on themselves and their reaction to the event without being concerned about non-emergency transports. 

After making contact with Phil’s wife and grandmother, we awaited word on the funeral arrangements in the days to come and all members of management made themselves overly available to the crews. That coming weekend, we got word of the arrangements and burial which happened to fall on our community’s annual Community Days. We once again reached out to our fantastic mutual aid services for assistance with staffing and there were so many offers from so many services that we had to turn people away. I cannot say enough about the wonderful agencies around us that offered us help and assistance that week. The community also had the word leak out to them and donations of food besieged the service.

Lessons learned from the loss of a colleague

That week was one of the longest and toughest of my life. Looking back, we were so busy that week taking care of the family and the crews that we didn’t really have a chance to take it all in, not sure if that was for the best or not. For as horrible as that event was, some very important lessons came out of it.

  • EAP Program: We always thought we had done a good job taking of our crews, we had an Employee Assistance Plan in place for quite a few years, quarterly staff meetings where crews could air their grievances openly and good relationships with our staff. Phil had actually come to us a few months before the incident to let us know he was struggling and we got him set up with EAP and talking to a counselor, and he had stated that he felt that it was really helping him. That’s why it came as such a shock when he took his own life, when we felt we had taken all the necessary steps to get this young man the help and assistance he needed.  In the end, remember you are managing and leading people, not materials or supplies and they need to be treated as such. If your organization does not currently have an EAP program in place, I strongly encourage it.
  • Get out of the office: Get out of the office and get to know your staff. I know this is easier done in smaller organizations, but it can be done in larger ones as well, whether it be cookouts at various stations, coffee with the chief, etc. This time with staff gives an open opportunity to hear what is going on and address issues when they are smaller and more manageable. 
  • Mutual aid network: If you don’t have a good relationship with your mutual aid EMS services, make that a top priority! It’s 2017 and we are all here for the same mission, to deliver the best patient care possible to our community, hospitals, nursing homes, etc. We would have never survived such an incident if it would not have been for the help and assistance that our mutual aid services offered. 
  • Don’t forget about yourself: Take care of yourself! Your team members look up to you and need you in top physical, mental and emotional shape. Looking back, the only thing I would have changed is that after the funeral was over, I would take a couple days off to let myself decompress and take the time to think it through and let it sink in. That week went by so fast. It’s a blur looking back and I know I never gave myself the time or opportunity to grieve. We all need that, even white shirts.

Admitting there is a problem with mental health in EMS

Looking back, I feel that we did the best job possible considering the circumstances, like I said, there is no book out there that I know of on how to deal with a suicide of one of your employees while at work. We had to wing it and make a lot of critical decisions with little-to-no time to really think them through.

Once the dust settled, the best “atta boys” we received was from one of our more, shall I say, always ready to complain employees. This employee wrote us all a very nice long email thanking us for the way we had handled that hell week. That was huge to me because this person rarely has anything nice to say when it comes to management of the service.

It also really got the ball rolling when it came to openly discussing this matter in public. We have had a rash of these incidents in western PA for EMS, fire and law enforcement over the last few years. People were finally ready to admit there was a problem and were talking publicly about it. We had the folks from Code Green come out and do several sessions open to all public safety members and the sessions were packed. The times have changed and, until we as leaders have the courage to admit there is a problem with the mental health of our providers and be willing to change and look for new ways to connect and help with our staff, sadly this will continue to happen. 

A face to this story

Finally, I want to put a face with this story. Phil was not a statistic, but a person, a very funny, sometimes pain-in-the-you-know-what person that often times would have me shaking my head or laughing with tears, often both at the same time. I can think of no better picture to sum up Phil. Stay safe everyone.

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