Podcast: A World Where LivingWorks
Episode FIVE Transcripts ‘First on the Scene’ from LivingWorks Podcast: A World Where LivingWorks
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Welcome to A World Where LivingWorks, stories of science and survival bringing together our heads and our hearts to build a suicide safer world, talking openly about suicide is so important but we also recognise that listening to this series may bring up some tough emotions, if so please talk to a trusted family member, friend, or local support service about how you are feeling.
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Kim Borrowdale: You’re listening to A World Where LivingWorks and I’m your host Kim Borrowdale.
First of all I’d like to acknowledge the traditional owners of the beautiful land wherever you are listening today. I’d also like to acknowledge everyone out there who have been impacted by suicide, the pain it brings to our lives, and the desire to make positive change for all of us to live well.
Today’s episode is all about living well in the first responder and emergency services workforces and asking that all important question, when it comes to suicide how are we protecting the lives of those who protect ours?
I’ll be talking today with retired FBI Agent and LivingWorks instructor Agent Paul Bertrand, so welcome Paul.
Paul Bertrand: Thank you very much.
KB: Also joining in the conversation from the UK it’s Andy Chapman. Andy is a former police officer with many years of his 30-year policing career spent as a hostage negotiator, where he often negotiated at length with people planning to take their own lives. Andy is also a safeTALK trainer and now the Suicide Prevention Lead for the City of York, a warm welcome to you too, Andy.
Andy Chapman: Thank you, good to be here.
KB: So, in terms of both of your professions, the FBI, working as a hostage negotiator, I’m embarrassed to say that most of my knowledge of these two activities comes from watching crime dramas on TV, I’m sure for my benefit and a lot of our listeners, we’d love to hear a little bit more about your professional background, the work that you’ve done in both of these organisations and the work you’re doing today and also just a bit about your why, how’d you end up becoming a trainer or instructor and working in suicide prevention.
So perhaps Paul we’ll start with you, tell us a bit more about your background.
PB: Ok, I spent approximately 21 years as an agent in the FBI and I’ve spent the last year as an instructor at the FBI academy at Quantico, Virginia. During the time that I was an agent from 1998 until 2019, when I was investigating cases, I investigated white collar crime, specifically like securities fraud and investment frauds, bank fraud, mortgage fraud that sort of thing and then when I moved from Los Angeles which was my first office over to the East Coast and took some jobs at the FBI academy and from there the last 4 ½ years of my career I spent as a Regional Program Manager in the Employee Assistance Program for the FBI and that’s specifically where I got into the world of suicide intervention.
KB: Thank you very much Paul, that’s a great introduction. We’ll come back to a few of those experiences shortly, but first if we could just hear from you, Andy, about your personal/professional background and how you got into this line of work.
AC: Yeah, I joined the police service at the age of 19, a very unworldly, naive young man, knowing nothing really I realise now and as any police officer would testify the types of incidents that we attend as a uniform response officer are very varied and sometimes very traumatic and I grew up very quickly as a result of that role. I attended many incidences of sudden death, many incidences of people in distress, an awful lot of policing even in those days related to mental ill health and crisis management and the need for us to work in partnership with lots of other services and indeed with the person themselves, so I had a very broad, very quick experience of suicide and suicide ideation and very quickly connecting with people bereaved by suicide by giving death messages to people, loved ones.
Obviously that’s part of the policing role in any case, the police service deals with death unfortunately, it’s part of the role and it was you know, not a prominent part of the role, attending suicide but it was on occasion, I rememember the first incident I went to as a 19-year-old and that will stay with me forever.
But throughout the course of my career I became a response officer, I was a liaison officer, so I was deployed to bereaved families to support the investigation and support families who were going through the very worst of times and then later in service, I’ve been promoted a couple of times, I became the hostage negotiator, crisis intervention/negotiator trainer with the Metropolitan Police and negotiating techniques are shared very much with the USA and Australia, we are very similar models, we train together, some of my former colleagues have attended the FBI course and negotiation is ultimately is about listening, is about communicating, very similar to LivingWorks models and the training that we deliver with LivingWorks now about compassionate person-centred approaches.
So on retirement back in 2015, I didn’t really have a plan, I served 30 years and then a role came up with the health service within the locality of suicide prevention, I didn’t know there was such a role, in fact there wasn’t prior to them advertising that role in line with the national strategy to reduce suicide within the UK and that involves a public health approach to suicide prevention which was very new to public health as well, but to start with it, each of it was related to an audit of coroners files, so myself and colleagues reviewed, examined, and scrutinised many files I was familiar with as a police officer but obviously looking at it through a different lens and trying to work out what the demographics were, what the scenes were, what the lifestyle causes and triggers were, what contact people have had with services prior to taking their own lives and that was a fascinating if not difficult experience to look at those files on paper and to try and piece together the lives of individuals who had reached a conclusion that suicide in their view was the only option and that really inspired me to be more involved and I’ve had an awful lot of involvement with bereaved families and people who are at risk or have had episodes of suicide ideation themselves and to try and put together a jigsaw.
It really is a jigsaw to work out how we can save lives through that sort of standing and knowledge of what those individuals have been through and what their triggers were and what the pressures were and that’s resulted in me working in York now, which is a part-time role where I try and put lived experience at the heart of everything we do, we’ve got a strategy, we’ve got a plan but actually hearing the stories from most people who have either bereaved by suicide or those who have had their own thoughts of suicide and more importantly who’ve come out the other side, most of them have recovered and I try and put hope, right the way through, stories of hope, stories of people with adversity but actually coming out the other side and realise that life is worth living, is what we are trying to deliver, it’s all about partnership work, it’s all about everybody bringing their skills and expertise and experience to the table and working together and that’s what our plan is all about alongside the training which is where LivingWorks comes in of course, because training, education, and the knowledge and understanding are crucial and that’s why now I use my police background, along with what I’ve learnt in the last five years to encourage and to influence partners to take suicide seriously and most importantly probably is trying to tackle the stigma which is a huge barrier to progress and a huge barrier to people’s recognition that everyone has a part to play, which is a key LivingWorks message of course.
KB: It’s so interesting that, listening to you talk, the skills that you needed to use in your policing career and in hostage negotiation, you know trying to understand, trying to figure out, see what’s going on with people that are in these vulnerable situations, it’s really interesting to hear about your career coming that full circle.
AC: Yeah, absolutely yeah.
KB: And Paul what about in the early days of your career in the white collar crime area and things like that, did you, was mental health and suicide topics that came up in that area of work, or what sort of things did you come across in that environment, in relation to stresses and how the mental health of that sort of work?
PB: It’s interesting, oddly enough white collar criminals, those are people that primarily let greed take over and they steal money in one form or another and they’re really not the type of people who have ever thought of themselves as going to prison and so when people who commit white collar crimes get caught, often times they find themselves vastly unprepared, so suicide becomes an option for them relatively quickly and I don’t know the difference in suicide rates between violent criminals and white collar criminals but I do know that white collar criminals kill themselves surprisingly often, I think by the time an investigator has investigated white collar crimes for a while, they know of people of criminal subjects in the white collar crimes who have killed themselves or who have attempted suicide and it usually happens sometime before sentencing, so they’ll make it to the point where they’re found guilty but they won’t make it to their sentencing, they’re so scared of going to prison, that they’ll decide to take their own lives.
KB: In both of your professions there’s the mix between the mental health training and suicide prevention training that you get for your profession to then work with people in the community and work on the cases that you work with, so it’s sort of that outward facing, so you’re dealing with other people who are experiencing suicidal behaviour, then you have the flip side of managing your own mental health and perhaps suicidal thoughts of yourselves, your colleagues, and dealing with the stresses of that type of job.
What across the years have you seen in terms of training in both of your organisations or as you said earlier Andy, a stigma, have you seen a difference in the balance of those two areas, so what sort of approach there’s been for both you as professionals working outwards, but also the workplace care of your own mental health? Andy, do you remember when you first started, maybe not when you were 19, I can’t imagine the level of training at that time, but do you remember when it started being something of more of a conversation or did you always have debriefing processes with those incidents?
AC: The police service in the UK went through different phases of recognising the impact of trauma and for some time, I don’t think in the early days when I was dealing with some incidents there was any real debrief, you relied on your colleagues and maybe a supervisor and of course that varied according to individuals but over those earlier years, there was the introduction of welfare departments, there was the introduction of debrief or what we call defusion, which was a group peer lead or facilitated group session to discuss the incident, to discuss a traumatic scene or investigation and that of course the police officers received very varied responses and were very engaged and some quite the opposite, in fact some people reported that it had a detrimental effect on their health that they’ve always been able to compartmentalise issues or incidents or scenes and then to revisit them in a group setting where they didn’t feel quite comfortable. The organisation evolved really over a period of time and it’s changed how it’s reflected quite a number of times and there has always been a recognition that it’s important to talk about the incidents, have a shared and safe space and sometimes whether or not if people engage is down to their own personality, how they deal with it.
I saw many occasions, officers, particular traffic officers or detective sergeants for example who routinely went to very serious, traumatic incidents and they disengaged often from any support that was offered, it might have been cultural, feeling that they didn’t need it, they dealt with it in their own way and then we saw, over the years I saw a cumulative effect on people, late in service who had never sought the support, could never engage with that support, didn’t think it was for them and then you saw the damage caused, you know 25 years service, 28 years service were, that perpetual attendance of incidents and not dealing with it, not talking about it, not accepting what it was and the impact it can have on you, that caused catastrophic consequences for some individuals who ended up not being able to fulfil their full service, you had to leave on ill health, you have significant mental health issues arising really from trauma and I think maybe the experts have only quite recently realised the impact of trauma on their wellbeing, even if it’s remote, even if it something you attended as a responder not a personal trauma, the line between the two is very vague, because something that is happening to other people, suddenly happens to you when you attend that incident and you’re part of it and you’re involved in, so I think this is still a work in progress for many services across police service, ambulance service, fire service, across the world, certainly in the UK, there is a real recognition, but the culture and I dare say male-dominated environments are not helpful I’m afraid because of the stigma that is related to some roles and the fact that we’re police, we should be able to deal with that, we’re emergency services that is what we do.
Even from my own experience, I’ve shared that culture, I’ve shared that attitude for a long time and it wasn’t really until I trained to be a negotiator that I became more self-aware, you know emotional intelligence is something you just can’t learn through your mistakes, but emotional intelligence is vitally important and to have more reflective training where you can see how you perform, see others perceive you, your language and your attitude, all sorts of things including self is so important and self-awareness and emotional intelligence improve when you learn how to communicate with somebody more effectively, so negotiating is about person-centred approaches, it’s about compassion, it’s about leaving the uniform behind and being the authentic you, which in a police service is very difficult to do, to be the authentic you and it took me quite a long time to be that authentic person, on a bridge, on a risk location because you have authority and you a persona of an ego from the role that you do and the people in crisis can see through that and it’s not until you become the individual, the person, that you build a rapport and it’s that rapport with somebody that is so vital in saving their life on a particular occasion and later in due course and that’s important within the service and outside the service, you know, if you got a good level of emotional intelligence within a group of people and you are able to share feelings in a safe environment and know that others are feeling the same way as you, then it’s much more helpful than to think that you’re unique, that you’re responding differently, that something that has affected you, why hasn’t it affected my mates, why am I losing sleep at night over that incident why no one else seems to be, actually we are all human, we all deal with things in different ways and actually those people probably are still living with it but don’t like to say because that’s our culture and we just go to the next incident and the next job and the next job and the next job and it’s that cumulative effect that can cause real damage unless you acknowledge it and perhaps do something about it sooner rather than later, I think.
Things are improving rapidly I think, but not quite there yet but some of the reasons for that is the officers themselves are not quite ready for it, they’re a little bit indoctrinated and they’re not quite prepared to do feelings and that’s the difference in what I am now to what I was like five or 10 years ago, is I’m much better at feelings and expressing them and not feeling embarrassed about being tearful or being stressed or being affected by something that I’ve encountered and that takes experience and self-awareness.
KB: Absolutely, and what about Paul in the FBI you spent a lot of years working in the EAP, Employee Assistance Program, did you experience and did you hear about a similar response to trauma and the stresses of that sort of role and what can you tell us about the environment as a culture, what it was like when you were working there, how it’s changed over the years? Is it a similar situation to what you see in the police force and what Andy’s been talking about with the traumatic experiences, the on-the-job culture, you’re striving to get that job done, you’ve got a very structured work environment, is that similar in your experience?
PB: Very similarly to what Andy was saying, we have seen things change over the years but first of all in the FBI, agents learn how to interview people but they don’t necessarily learn any sort of mental health tricks or how to deal with suicidal people per se, the only people that would formally get that training would be our negotiators as well and oddly enough, just on a side note, since we brought ASIST and safeTALK to the FBI from LivingWorks, our negotiators have been coming to the ASIST training quite a bit in large part and the training does marry up very well with what they had been getting, it’s just some are finding the ASIST steps even easier to implement and to use rather than the training that they had have before but with that said, the FBI does respond to pretty much all of the mass casualty events in the United States and actually over around the world, different bombings and such, but any time there is a mass shooting or a mass casualty, the FBI will go and will end up being the people that actually process that scene for days or weeks on end and so we do expose people to every horrific crime scene that you can imagine as well as some pretty horrific investigations and some people go through it for years without necessarily having any visible impacts and it is interesting going back to what Andy was saying, all of a sudden maybe they’ll come across a scene, like one scene that’s coming to my mind, something people don’t think about is these agents and the other professional staff live in these communities where they end up investigating a lot of times, whenever a personal connection is made and it doesn’t matter what it is but any sort of personal connection that the investigator internalises between something they are seeing and something in their own live, we notice it really tends to make an impact on them.
I’ll give you as an example, in might be possible to process say all the debris of a plane crash with no worries whatsoever, but then all of a sudden, when you are opening up all of the luggage and inside the luggage you happen to see the same size of clothes that your children at home wear, it’s that personal connection that can bring out that adverse reaction and so through the years in the FBI, we’ve tried to get better and better and better at our response from an employee assistance perspective for our own employees. So, now we actually have a system in place where during these responses to these mass casualties or these crime scenes what have you, while the investigators are investigating the crime scene and gathering evidence and processing everything, the Employee Assistance Program is actually there, I like to say kind of in the next tent over and they’re keeping an eye and offering psychological first aid to everyone who’s there through the days or weeks, however long it might take and that centers on a lot of things like physical comfort and safety and helping make sure things are taken care of on the home front, making sure that food and coffee is there and of course lending a listening ear and then after the operational phase is over, is now when we’ve really gotten into what we call the Crisis Intervention Program and that’s where we send a team and we’ll offer a psychoeducational meeting for all the employees that were involved in a particular scene first and then we’ll break them into different groups and we’ll have different process groups lead by licenced clinicians that will go through, the different groups will be people who were similarly exposed because we found out that we could vicariously expose people by getting our groups wrong if we put people that hadn’t been exposed to a particular tragedy in with people who had been exposed to it and so now we’re very meticulous as far as getting the right people into the right process groups and then we offer individual counselling and follow up as well.
And so as far as the mass casualty type events, we have a very thorough system in place now, we’re not quite there yet as far as the individual mental health of employees, you know during their careers, like Andy said, there is quite a stigma among employees and the stigma in the FBI is made worse of course for a couple of reasons, one we have the normal fitness for duty reasons that agents never quote unquote ‘want to lose their gun’ for not being mentally healthy and then on top of that we have our national security clearances and there is a stigma that ‘oh my gosh if I express that I might be having trouble with my mental health they could affect my ability to keep a clearance’ and so we’re working hard to overcome both of those because the FBI believes wholeheartedly that it’s much better for employees to get the mental health help that they need rather than not too, it’s just convincing the employees sometimes is a little bit difficult and so that’s where different programs like ASIST and safeTALK come in.
KB: Wow, I love that the EAP is the next tent along, that’s a really smart approach to it and I’m sure people welcome that change.
I talked recently to some Veterans and retired service people who were in the military and they talked a lot about the strengths that they got from that particular work environment and team environment, in your workplaces, what sort of things do you think work in favour of first responders and police environments and the strengths that people can draw on in those workplaces when it comes to mental health and resilience? Paul.
PB: The post-traumatic growth is a real thing and over time in my experience, what I’ve seen is most people develop resilience over time, in addition to the normal factors of resilience that they bring with them. Exposure to traumatic events does help build resilience and people get better at it, it doesn’t take away the damage of the one scene where I said maybe makes a connection with a person but generally over time you can see that the people who have been exposed to traumatic events through the years are generally very resilient and very healthy, very strong and they do tend to look out for the younger ones as well, you will see like an older employee may notice when someone younger or newer to it gets a little look in their eyes, you can tell when they are being bothered by something and those people will take them and offer help and let them know that they are normal and what they’re going through is expected for the situation that they’ve been put in and then they are getting better at about trusting the process too and helping people get to where the professionals are so they can talk to.
KB: Absolutely, regardless of the pressure of the position, everyone is still a human being underneath, so it’s great to hear that mentoring works in your organisation. And Andy, what would you say are the strengths and the protective factors that you see in the police?
AC: Well I think it’s actually about being parts of something, which you could put in any organisation probably and any societal culture really but being in the emergency services and being part of the police family as we would call it, being part of the FBI family or an emergency or an ambulance family, being part of something really helped, particularly if you’re dealing with something that is stressful or it’s for the greater good, so the police service brings a pride of doing your best, doing stuff that the general public just got no clue really what police officers deal with and I would say it’s the same for the other emergency services, but my experience as a police and they would just be appalled by what a police officer routinely faces in terms of behaviour towards them, in terms of level of aggression, in terms of the unlawful behaviour of others, in terms of the trauma that we’ve talked about but knowing that you are part of the service, part of a team, part of a wider organisation but more importantly part of a small group on a shift, working as a band or a team or whatever you call it section and this idea of being in this together, we’ve been through this together, we’ve responded to that, we put that bad person away, we’ve arrested a bad person, we’ve helped a good person in very unfortunate circumstances, we’ve done a job that had to be done and it’s basically what it is, that idea brings you together as a team and that connectedness is so important to feel that I’m not on my own and you can leave at the end of the shift knowing that even when you get home and try and talk it through, if you feel that way, with your family or friends, they will never understand what you’ve been through, which is why the police service is so close, because all you need to do is pick up the phone or go in on the next night shift and you’re there amongst people who went to that incident with you the day before and now you’re putting yourself up there to go the next one and the next one and that’s why police, because we work shifts, we socialise together.
The police service generally works hard and plays hard and that in some ways is a different story and that can have risk as well of course, and that playing hard but in terms of connectedness, in terms of resilience, like Paul said, going to more and more incidents, does make you more resilient, it can have the impact of actually being detrimental to your health long term, but one thing that shocks you one day, in six months time or in six years time, when you go to something similar, won’t be quite the shock, won’t be quite of the same effect, it might keep you awake for a day, instead of keeping you awake for a week because you are getting used to it and one of the difficulties is, never become complacent, you never become desensitised but actually something happens to you and yeah this is what we do, this is what we deal with, if I collapse, if I can’t cope with this, then who else is going to do it and you do the door knock and you pick up the pieces of a traumatic incident and you just get on with it and whether you put your own thoughts aside while you deal with that and then experience those later, might be the case but being part of something and we know from LivingWorks modules and from the work that I do being part of it, feeling part of the community, feeling like you belong, feeling like you have a purpose, it’s such a protective factor, whatever the context, as soon as you lose that, as soon as you lose some sense of self and worthlessness, then you lose some of your own strength and that can be really damaging and it can inevitably present risk factors.
That’s what I would say, you’re part of a service, you’re serving the public, you’ve got authority and the public puts that trust in you and that in itself brings strength and as soon as some of that is undermined, then it can cause risk that officers have anybody else, so it’s really important to have that sense of who you are and your contribution to society in the work that you are doing.
PB: Just following up on something you said there Andy, as far as that sense of belonging and losing that, something that we’re just starting to take a look at which is just kind of fascinating to me, is the whole idea of the effect of adverse childhood experiences on agents and law enforcement in particular, and that feeling that the way that people grew up with those adverse experiences affects their developing that role of protector or guardian and getting into law enforcement as a field in the first place and I know that in the FBI we have plenty of instances of people who did have those adverse childhood experiences and did come into the FBI and they spend their entire adult lives protecting people and investigating crimes and keeping people safe and then as they get older towards the end of their career, we are finding too, that a lot of those issues, even left over from way back in childhood have never been dealt with and as the end of that career comes that sense of what Andy was just saying, of just losing that belonging, it brings all of that old stuff back up to the surface as well and so like I said, we’re just starting to take a look at that and to try to even figure out ways to address it but it would definitely be worthwhile to take advantage of the time when they are members of that law enforcement team and they do have that comradery and that belonging before it is that time to retire where they lose that part of their identity and are left not only navigating a career end or a career change but also the loss of their group and still having unresolved issues from their past that they never dealt with.
KB: That’s really interesting, starting to address some of those issues while they’re in that protective environment so you’re going into the transition points in a more protected fashion.
Speaking of transition points what about your transitions out of active service into other roles, you personally, which you don’t necessarily need to tell me the details of, but is there work actually in your fields to help people with the transition from that active team out into other roles or retirement
AC: Retirement is a particular significant issue I think for me, my service traditionally has a pre-retirement course for years before retirement which is unfortunately not a great model because it’s centered around finance and they bring a finance company in, how to use your pension and how to invest in this and how to pay your mortgage, I think really they could focus more on the emotional factor, there is no doubt that there is a real wrench when you leave a service culturally within my service, there is this attitude of counting down the days which I don’t think people actually do but as soon as you join, people ask you how many years have you got to do, almost like it’s a life sentence, I’ve only got 18 to do, I’ve only got 12 to do and I never did that, I made a point of, I enjoyed, I loved my service and I miss it now with a yearning which really surprised me and that really surprises my current colleagues who are currently in the service who are saying how could you miss this, but they don’t know what they will miss and how much they will miss certain elements, certainly not all elements of course but I think we need to be very careful with retirement as well, the armed services in the UK have a much better glide path towards that end of service date, in terms of skills, in terms of support, in terms of accommodation and yet the police service seems to be a cliff edge, you leave and then you’re gone and you might keep in touch with colleagues or you might not and you might go back into a role which very similar, in some ways I recognise in myself that I’ve gone into this role because I’m missing the police service, there is an element of providing support and making a difference, improving training but actually it’s a real risk, any element of transition whatever life phase you are causes change and change can make us all more anxious and more stress, you like the familiar even if the familiar is traumatic at times and then suddenly to the not belonging, to the looking outside of the service into it and not being part of that family in the same way, is very important and that’s the case, not just for police service, for any organisation where people are looking at retirement.
I think the added stress for me if I look at the personal side of it, towards the end of my service I had some issues around anxiety and some of that was definitely post trauma related, definitely because I had flashbacks about a particular incident, but also there was an element of dropping the ball, an element of you’re carrying risk all the time and I was in a management role where I was looking at safeguarding and risk management constantly and making decisions constantly about the safety of other individuals and the employment and the resources, inevitably when you are looking at a police pension, police retirement, you are looking at a relative year and think, the culture is, oh look once retirement happens, life will be wonderful, harmonious but actually in between then and before that is a time where you might drop the ball, you might make a significant error and lives might be at risk or disciplinary proceedings might occur or you might have made a significant mistake which will change your future and you know I recognised an element of catastrophic thinking within my psyche in those years before I finished, I think caused by trauma from years before and I still carry that catastrophic thinking now, it’s still, I have to check myself and think, this is not you thinking this, this is those thoughts and yet because I’ve got that level of self-awareness to try to dismiss them or at least manage them, I can deal with it, but if you’re stressed and you’re dealing with something that is so difficult and it’s down to your decision, then that can be a very difficult position to be in, and it may cause you, not in my case, suicidal thoughts, but certainly high anxiety levels which in turn reduce your performance and make it more likely to make a mistake, so we are all a product of our experiences and for the most part I’m very grateful for mine, it’s a privilege to be a police officer, but it’s certainly caused some real damage that it wasn’t until I started to unravel it and have some EMDR intervention for example that specifically looked at some of the trauma incidences that I had been involved with that I realised what damage had been caused and how I could better manage that because we float through life assuming certainly early on in our service that we’re untouchable, we’re Teflon, nothing will affect us, same as teenagers, that actually continues into serve as police officers, they think I am superman/superwoman, I can do this and it’s not until something hits you like a ton of bricks, that you realise, like you said we’re human and we have feelings and we’re not being vulnerable and yeah transition periods, whatever role or retirement or if you’re going into a new job where you are not quite as competent as you hoped you might be, you can have those underlying effects that you hopefully recognise it at the time and you might not until later.
KB: Paul, in terms of the transitions to retirement or coming out of service what about those other changes in life that Andy was saying at different points, how do you manage with FBI agents going out to different assignments or maybe similar to the police, having regular hours or different jobs that might go over long period of times, how do you manage the support system outside the workforce? Do you have processes in place or offer training and support to families and carers and the people around the agent?
PB: So I would say a little bit would be the answer to that, and that is that we do offer the Employee Assistance Program I guess you would call them, psychological services to family members as well to the employees, so that for instance spouses, children, parents, brothers, sisters that are all eligible to receive the same sorts of counselling and mental health services that everyone else is and some people do take advantage of that.
But you know one thing, to follow that up on something Andy said that I thought was very important, it relates to directly to the emotional health of law enforcement and you know during the job most law enforcement personnel do get into their job and they love their job, and you might say that they are on a high while they’re at work and then when they go home at night, maybe they’re not on that high anymore, maybe in fact they get in the house and then sit in the chair and watch the TV and maybe you know have a few drinks and maybe they start to get into a cycle and you can see where the job never really suffers because they like it but all of that outside stuff might suffer a lot, maybe all of a sudden they find themselves after a few years not engaging in nearly all of the activities that they used to engage in before they were in law enforcement or when they were young and it becomes this rollercoaster of going to work and then going home and unloading and what people don’t necessarily realise is that all of those other outside relationships suffer and all of the other people in their lives will move on, they will fill that time doing other things and so then like you said, when separation and retirement comes and you take away all the highs of that rollercoaster, and now all of a sudden there are all lows because all of those people are filling their time doing other things, it really can be catastrophic, but in the FBI we have this similar thing where there is a meeting a couple of years out and it is mostly centered on finance and then we do have different organisations like organisations of like retired special agents or that and they do their thing, like you know having monthly meetings and have newsletters and the rest, but I think there could be an awful lot more work to be put into the emotional impacts of retirement, especially given the topic we’re talking about today and we do have a number of suicides among retired personnel.
KB: You talk about the stresses and the risk factors and some of the strains, in terms of suicide prevention training specifically and building that capacity within your organisations, within your counties, what do you think is working well? So tell me some good news stories about the things that you’ve seen over the past several years that are really making a difference and what you’d like to see more of in these environments?
AC: Well I mentioned earlier that I’m using lived experience at the heart of the work that we do. I made an awful lot of contacts with people who are bereaved by suicide or have their own thoughts and experiences of suicidal attempts and I’ve use those stories to great effect in a conference that we held the last four years, we’ve had the last few conferences with 160 people attending and often lived experiences is used as a bit of a token gesture, you’ll have academics and clinicians and senior management talking at a conference and then occasionally they’ll bring somebody in with lived experience of suicidal thoughts or bereavements or mental ill health and the audience recognises it simply as a token gesture, it’s one 20-minute example at the end of a full day.
Where I turned that on its head and I’ve used lived experience, even before I retired, I brought in a young lady who had been talked off a bridge, not by a negotiator but by a uniformed officer and she had significant incidents of self-harm and psychosis and I invited her in to talk to my shift, in a safe environment, she came with her mental health worker but she didn’t want them in the room and she spoke to my team of about a dozen, 15 officers about her experiences, about the scars on her arms, about her tattoos, about her experiences of being arrested and some very bad, but some awfully good, she credited the police for saving her life on a couple of occasions, but then a sentence later said how appalling she’d been treated once she’d arrived in custody.
So everybody’s experience of the police is different and those with mental ill health have some particularly difficult times with the police even though often the police are the only people that will intervene and like I said, she acknowledged that the police had literally saved her life. So I put lived experience there as much as I possibly can because I think there is so much for us to learn, including myself, I’ve learnt an awful lot by hearing people’s accounts and I try, even when I’m delivering safeTALK, I’m not an ASIST trainer, I’m a safeTALK trainer and I find that there is so much disclosure when people are in a room, after half-an-hour of ice building and thinking of co-trainer talking, the people are very keen to disclose and I found it particularly validating to have somebody at the back of the room nodding and grinning about what I am saying, validating what I’m saying about we must talk about suicide, we must talk about difficult conversations and ask directly and it’s so important to have that in every room as there always is.
I’ve used safeTALK a lot, I’ve encouraged people in the police service to attend ASIST as well, I would never mandate training like that, it would always have to be to the willing people who want to attend training. I have tried to deliver training to a group of police officers and a third of them will sit there arms folded as if you can’t talk to me about feelings, I know this, I know about suicide, the other two thirds are more engaged, more open minded, and those are the people that I would hope to reach really and it’s been my view very successful, we’ve had some great feedback from people who have done safeTALK and then have gone on to do ASIST and have found it really valuable.
At the moment in the absence of face-to-face training, I’m offering the Start program from LivingWorks as well, and it’s really helpful as well and it’s encouraged more and more conversation so my role is actually about partnership working, it’s about multiagency approach, it’s about accessing mental health services, physical health services and voluntary sector and the police and emergency services, and of course with a police background I’ve tried to encourage as many uniformed and police officers as possible to attend the training and for the most part, they’ve enjoyed it, they find it very valuable, I had a couple of negotiators go on it, trained negotiators go on it and said it was a different perspective and it is, it’s similar to negotiator training but it’s more specific.
A combination of training alongside lived experienced are much more closer working partnership, sharing information, really we need to talk more openly about suicide, we need to approach people to take the training because the stigma that we’ve mentioned at the outside of this discussion is crippling us, people do not want to talk about suicide, they don’t want to go there, they’re reluctant to do that in relation to their client, to their front line operation, they’re even more reluctant to do that in relation do that to their own loved ones, it’s often too painful for them, they can’t contemplate the fact that their loved one might be at risk and therefore the more we talk about it, the more we change language.
You know one of my big bugbears within the UK and I don’t know if it’s the same Paul in the US, is the term ‘commit’, people using and associating the term ‘commit’ with suicide which in the UK is irrelevant since 1961 we had a suicide act legislated which said it’s not a crime to take your own life and yet we continue to perpetuate stigma by using the term ‘commit’, which is associated with a crime and bereaved families in particular really object to using the term ‘commit’.
I’ve heard a senior coroner talk at a big conference and several times he used the phrase ‘commit suicide’ after his talk there was a queue of people wanting to, lining up to talk to him, to challenge his language and say, you really must update your language and phraseology because you are just perpetrating the stigma which is one of the big reasons why people don’t feel inclined to open up and to seek help when they need it. It’s been fascinating to see the police service from outside the service and be part of the agency and I see the can do attitudes within the police taking other services with them, we’re doing this, if you want to come with us and by all means but we’re the police, we’re going to do this, but it’s been an really interesting journey to see the attitudes to suicide, now that I have been on the other side effectively and how language, phraseology, because I think a lot of suicide prevention is about attitude, changing attitudes, changing our approach, being more compassionate and actually working with the person rather than working or doing something to the person, I think that’s the basic principle of ASIST and the other LivingWorks models, you work in collaboration with people and don’t just do it to them, you do it with them and hopefully you’re both in agreement.
KB: Absolutely, I love that you’re experiencing both sides, so York is very lucky that you have that experience in the police and then as you say, it must be fascinating to see it from both sides.
KB: And Paul, what about you? What’s working well, what do you want to see more of in your environment?
PB: You know, I say a lot to a lot of different audiences, that the difference between someone who is thinking of suicide and someone who is not thinking of suicide, is a thought, and people have thoughts all the time and I don’t think people are willing to even be honest that they have had thoughts of many different things and I try to always put it in terms that people would really understand.
Like for instance we hear a lot that maybe one out of 20 people is contemplating suicide in any time period but then it sounds like, ok my odds of being the one in 20 are rather small and maybe even the odds of me knowing the one in 20 are rather small, but when we took a look at an organisation by size and figure out how many people that is, it can be really eye opening. For instance, the FBI has almost have 36,000 people in it, well if only one in 20 are contemplating suicide at any given time, that comes out to about 1,800 people and when I say, hey there is a good chance we have 1,800 people wandering around the FBI at least thinking of suicide, you could see the eyes in the room really open up.
For the last several years we’ve really been trying to change our approach a little bit in the FBI towards suicide, we have had a suicide prevention initiative going for years, which consisted of things like posters in all the common areas, looking for warning signs and risk factors and that and where to get help, we’ve had speakers come in through the years, emails sent by the executives to the workers, like normal things you might associate and my own feeling on that and a feeling that I think has become more accepted in the FBI is that people don’t generally don’t kill themselves in the clinicians office. Where the people are actively suicidal is where they are and so we’ve really changed our focus to try to get people trained in suicide intervention to where the people are, in the squad spaces, like Andy said, hanging out outside of work, we want people to be part of every gathering that are trained in suicide intervention, so they’re more likely to see those invitations and take that first step in knowing how to intervene.
What I noticed in the FBI is that before people are trained, they want to avoid the topic more than anything else, the last thing they want to do is get involved in a conversation with someone who might be looking out of sorts, and so through bringing suicide intervention training, specifically safeTALK and ASIST to the workforce, we feel like we’re surrounded with very smart, very capable, very hardworking people who devote their lives to helping others, all we need to do is give them the training to be the eyes and ears and the helpers in the field and then they can worry about getting the people thinking of suicide to where the clinicians are and where the long-term help is, more as part of their safety plan, it always drives me crazy when there are suicides and the management’s first response of an organisation is to maybe hire another counsellor or two and I keep thinking, ok that’s nice but wouldn’t it be a better use of resources to train the people that are where the people that need the help are all the time, so that they can get them to those mental health type resources.
So we’ve taken on kind of an aggressive posture in the FBI lately, our goal is to train a thousand employees in ASIST each year and 1,500 employees in safeTALK, and we’re in our third year now of the ASIST training, so far, it’s going very well, the anecdotal stories we get back are huge and it’s inevitable that every class within a few months, people are emailing the teachers and telling the stories of when they used the ASIST outside of the classroom.
KB: Wow, that’s amazing.
AC: Yeah, absolutely. I’d be delighted our numbers in terms of our service in North Yorkshire are much lower than that of course, but I’d be delighted to get that sort of ratio trend that you’ve got that buy-in from senior management recognising the value of ASIST, I would stand on them, we have a minster [church], a York minster, I would stand on the roof of the minster and shout, please get this, your staff trained in ASIST, but even safeTALK, the conversations I have with people at safeTALK are really valuable. Yeah go on Paul, sorry.
PB: You know, I was just going to tell you Andy, what works for us is really targeting the decision makers that hold the purse strings and actually inviting them to attend and once I had executives start to attend the programs, they became cheerleaders for it and started saying, now we have to get this implemented, before they attended, they might say things like, oh why can’t our Employee Assistance Programs just put together an suicide prevention program and like they just didn’t have an understanding of what a professional intervention class, a certification can actually do, and it’s different than hearing somebody talk about suicide awareness for an hour, like while both are helpful, one is definitely skills building and that’s where we’ve started to shift our approach.
AC: Yeah, well that’s really helpful, I found that they give the training on emotional wellbeing or mental health or even suicide, they give it to a training team, who are used to fixing up a package and saying, ok go and prepare something and then deliver that and of course you’ve got to have the knowledge and understanding and the resilience to be able to deliver that but you inadvertently are becoming a cheerleader for me because I’m going to quote those three letters FBI, the FBI are training 1,000 people a year in ASIST, I’ll definitely be using that, the FBI of course has an international reputation and I’ll certainly pick up on that because you know I would train all emergency services or a third of them in ASIST and a lot more in safeTALK because it’s about emotional intelligence as I said before and the opportunity to have those conversations.
I find it much easier in multidisciplinary workforce, that multiagency group, training 30 police officers in one go, I would find very difficult training two or three or four police officers a month, ambulance, mental health workers, drug and alcohol workers, youth workers, teachers, people are more able to disclose and share than if they are in a room with their colleagues or with their managers and I think that is one of the beauties of ASIST, is that if you train a multiagency group that doesn’t really know each other, after two days they get to know each other really well but they get other people’s perspectives, which is so valuable, so yeah.
KB: I was just going to say, if the FBI leadership teams and decision makers can make time for training, then I’m sure every organisation in the world could probably get their leadership team to make time.
PB: One trick to it, of having success, is we don’t have unlimited money, somebody like me doesn’t have any money, so I actually have to do a lot of convincing right, we do in order to get budgets and we’re always approving things a year out and all of that, the regular government red tape. One thing we did that was immensely helpful was to train our own inhouse trainers, and so we have a small army of 16 ASIST trainers that we train through LivingWorks in the FBI and 10 safeTALK trainers and so we use those people to teach and that way each trainer only has to teach, you know, three to five classes per year and the safeTALK trainers maybe five classes per year and we get our numbers indefinitely, you just have to look for ways to save budget, you know.
AC: Absolutely. Yeah, and that’s what I’m trying to deliver across our city is more multiagency, some people come already skills, some people don’t, they’ve had no experience or very limited experience about having the conversation, I’m always astounded how long it takes to convince professionals in certain roles to actually use the word suicide, how they shy away from it, they want to use euphemisms, they want to use anything but the actual word and it’s amazing how half a day’s training can change attitudes and some of the feedback that the course receives is just, why wouldn’t you train staff in this, what else would you prioritise and then the police service, I do find some resistance because they’re saying that that’s not our role, that’s not our job, there are other social services or mental health professionals, but like we said at the start, naturally the police encounter mental ill health and crisis and people in distress routinely, they are the frontline staff who would generally be going to those incidences and whilst they would argue that their role is prevention of crime, public safety, more and more of their role is about mental ill health and the more that society becomes fractured, the more that social services are reducing capacity because of finances and now more recently because of COVID, the more police officers are attending these persons in distress or person vulnerable incidences and if they don’t have the communication skills and the right attitude, that can be really dangerous because there might be one opportunity to reach somebody, one opportunity to ask the question of somebody, that others might not have, so I think it’s vitally important that we reach police services.
Interestingly enough there is a national move now within the police service to reduce suicide amongst its ranks and files, we know, we recognise, similar to what we’ve seen in New York, that there are high numbers of police service suicides and there might be something about the culture, there might be something about trauma that people are dealing with, and there is now a national appetite to actually look at this more holistically and work on a strategy, I think it’s early days but I think that’s the case in the US as well, there is work ongoing to reduce suicide amongst police because we are a vulnerable population group ultimately, not only because of what we deal with but like you say, some of stuff, some of the baggage that we’re carrying from the days before we joined, people join the service to make a difference and often they want to make a difference because they’ve experienced something themselves, I’ve encountered quite a few police officers who were bereaved by suicide, never told the service, never mentioned it to the service that they’d lost a parent when they were a child or lost a sibling, I think it’s really important that as we look at reducing police suicide, that we look at the whole person, we aren’t just focused in on what they are doing and dealing with from a trauma point of view but we look at their...are they drinking too much, are they taking drugs, are they in debt, what are their relationships like, what issues has the jobs caused but what issues are they causing the job because you do get people with mental ill health or pre-existing conditions that join the service and we’ve got to manage them, so it must be a whole-person approach.
One of the things I would say, I think it’s really important is, we talked earlier about how important it is to be part of something, as soon an officer becomes not part of something, as soon as they lose their gun, as Paul was saying, as soon as they are looking at disciplinary or are looking at ill health retirement, or even an injury, if they are in a role which is isolating in itself, I was a dog handler briefly and that’s quite an isolating role and if you are in a role which is not part of a team, we’ve got to pay particular attention to that and know that a dog handler for example, who can’t go operational because of an injury, loses his dog, the dog is given to somebody else and that is such a bond, you know, it’s really important to recognise the impact of a disciplinary notice or a notice of saying, so you’ve been off sick for six months, you’ve gone onto half-pay, that arriving through the door with no preface, with no explanation beforehand can be really devastating for people, it can often be the final straw, but when you are resilient you will take it in your stride but when you’ve got depression, diagnosed or not, or when you are experiencing significant pain because of an injury on duty and you’re not able to go to work, the organisation often does things unknowingly, they send a letter and they take it down to half-pay, they take your warrant card, your identification off you, you lose your worth and that sense of self-worth is so important if you don’t feel part of something, the organisation could cause that damage, just in a clumsy way in response to some circumstances and the way it disciplines people. Some people don’t deserve to carry a card, they don’t deserve to be in the job, but actually losing your role and being accused of a criminal act can be devastating for somebody as well, so we just need to handle that much more carefully than the examples I could give.
KB: Yeah, definitely both of you have talked a lot about what is known in an organisation and that’s a great example of you can put these processes in place around natural transitions within the workforce and different stresses, but what is known in the workforce, and also some of those process that may be excused as administration but have other impacts, so it’s a great point to actually look at where those stress points are and what you know about your workforce and reactions to things.
Now I could probably make this a 16-part series and talk to the two of you for the next couple of weeks but I’m conscious that we should probably wrap it up soon, but I wonder, is there anything that you’d like to share, there are some great take aways for me, like even just what you just said before Paul about the difference between a suicidal person and not, is just that thought, that’s really motivated me to be sharing that phrase as well, is there something else that you want to leave us with or a point that we haven’t covered perhaps today that you would like to cover, one final thought from both of you. Paul.
PB: You know, Andy touched on earlier, the whole idea of being authentic and I think this applies across every situation, not just mental health or suicide, and that is what we try to tell police officers, you know when they are going into senior leadership roles, that law enforcement are the most sceptical people that exist, they make their living being sceptical and questioning everything and so they can smell a mile away if you’re not being authentic.
I try to tell people that are getting nervous speaking in front of other people, or making presentations, that really it’s nothing more than a conversation between you and the people you are talking to and if you’re authentic and genuine, people see it and they believe that you’re having a conversation and so that if you can believe you’re having a conversation, it’s just a conversation and so bringing that back around to suicide intervention, obviously I have a lot of conversations with people who are thinking about suicide and Andy does as well, it’s just a conversation and it’s nothing to treat differently, just a willingness to talk about it as if you were talking about sports or talking about social activities or whatever else is going on, really mix the conversation—not all that uncomfortable—, of course the stakes are maybe a little higher but usually they’re not, in other words you know, in ASIST, they teach about that river of suicide and there’s an awful long way in that river between when people first start having thoughts that maybe the world would be better off without them to that part where they are actually attempting to take their own lives and there’s an awful lot of room in there for conversation and so I try to tell people just be comfortable, it’s just a conversation and only good can come out of it, so go ahead and do it, it’s not something to be avoided by any means.
KB: Fantastic, thank you Paul.
AC: Similar to that, along that scene of being authentic, it took me quite a long time probably even after training as a negotiator to be that authentic person because as a police officer, even as any individual, you carry an ego around with you, I was an ego of my rank, I was an inspector, an ego of being a negotiator, and from day one of training they told us to put ego aside, don’t come into a negotiation with your ego and yet inevitably you do, you want to be the person that gets the person down safely, you want to be the person that has the right words to say but it’s really important that you come with a person-centred approach and that you’re compassionate and that you are authentic as we’ve identified.
In the early days of being a negotiator, I was quite embarrassed and very self-conscious until I realised that I was more effective when I wasn’t, when I didn’t care about the firearms team behind me, or the shields team behind me, we’d been there hours on a point waiting for somebody to come down and it wasn’t until I had become Andy-the-person negotiating rather than Andy-the-police-officer negotiating, that I became truly effective in what I was doing and actually I use the word soft, because I felt soft at times, I felt as though, oh they’ll laugh at me if I say that stuff but after a while I cared not, the only person who I cared what they thought about was the person I was engaging with, the firearms team behind me, the police officers behind me, sometimes they were helpful and sometimes they were very less than helpful, but it’s really important that you come as an individual, you don’t come with your rank or your ego, with your training, with your background.
One of the trainers introduced me to a phrase, negotiating in the same way as ASIST and safeTALK, it’s all about listening, the power of listening and his little motto was, in fact he put it on his business card eventually when he left the service, ‘Listen, they are just scared’, ‘Listen, they are just scared’, whoever you are talking to, whoever is in crisis, whether that me a hardened criminal or a first time offender or somebody who has never encountered the police service before and are simply in crisis, they are just scared and they are so scared that their life is at risk.
It is an attitude change, it is about going in there with an authentic approach and you asked Kim, on the briefing about give us one example that will stick with you forever, I stewed over that because there are several that stay with me and I’m particularly proud of what I’ve done since I’ve left the service to try to answer suicide prevention agenda, get people trained but I remember standing on a bridge with a father, who had children the same age as me, and he was definitely intent on taking his own life, he didn’t think anybody was going to see him, he causally, well not casually, walked off to a location, where he was able to take his own life and it was only by sheer chance that somebody spotted him and called in the police and then that man engaged with me for about six hours and I was the most authentic person I have ever been on that occasion talking to him and it was almost like an out of body experience, listening to somebody describe his inner most demons and how he felt that he had let his family down and how death and suicide were his only option and for me to self-disclose and to listen empathetically and to show the level of compassion which just sort of raised up in my own body, I could almost literally feel it taking over, to then come up with the words that I was able to share with him and say, I have no idea to this day what I said, but I saw the change in his attitude, I saw some kind of change in his body language as a result of whatever those words say and he came down and it will stick with me forever.
I like to think I’ve saved life, I like to think combination of team, because it’s all about team in negotiation, and it’s about the person at risk as well, but on that occasion, I saved that man’s life, simply by uttering the words, whatever they were, and those words we use in ASIST and safeTALK and I can be me when I stand in front of a safeTALK group that I’m teaching, I can share that I have experienced mental ill health myself, I can share that I have had feelings of dread, I can share that I have not been as good on point when my family have been ill or when I’ve had personal issues going on, but I’m not quite the person that should be on point, so I am authentic and I think that is so vitally important to make a different rather than trying to pretend and be somebody else, we’ll be seen through from day one and we’ll never build that rapport and we’ll never be able to have those vital conversations that save lives, so ASIST has been really valuable and safeTALK in delivering it, really valuable in allowing me to continue those conversations and train a new generation of police officers and other services that are coming behind us. So thank you for the opportunity to tell you about that.
KB: Thank you so much, that’s such a powerful example and the fact that both of you have had thoughts around authenticity, I think that means so much and I really appreciate what you’ve shared, it’s so interesting to hear about your professional background but also the insights that you’ve had since and across the years, both on your insights into the workforce and how that operates and the cultural change and the reduction of stigma but also your personal reflections.
Thank you so much for your time and insights today, I really appreciate it and I know our listeners will too.
PB: Thank you very much.
AC: Thank you, thank you.
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