Abstract
Background: Exposure to suicide is recognised in the literature as a risk factor for suicide and mental disorders. Research has extensively reported on the psychological effects of suicide exposure, especially on bereaved family members. However, professionals who came in contact with the deceased are also impacted. Much of the research on this phenomenon comes from quantitative studies and focuses on the experiences of health professionals. A scoping review of the literature revealed a paucity of qualitative research about suicide exposure among first responders such as police officers and paramedics, the professional groups most frequently exposed to attempted or death by suicide.
Aims: This thesis comprises an in-depth exploration of the phenomenological experiences of first responders who attend suicide scenes in the line of their work, aiming to understand how they make meaning of this phenomenon and the consequences this might have for their own well-being.
Method: Interpretative Phenomenological Analysis is used to investigate the lived experiences of the two distinct samples of first responders who attend suicide calls: police and paramedics. The research is comprised of three sections. In the first section, I explore the existing literature to inform and shape my methods. In the second section, I recruit and interview a sample of active or retired police officers exploring their experiences with suicide, their coping strategies, help-seeking behaviour, and their own mental health. In the third section, I explore similar topics with a sample of paramedics. Interviews are transcribed verbatim, revised, and analysed inductively to generate the themes for the two professional categories. The data from each professional group are analysed first by exploring work-related aspects of suicide exposure, and next by focusing on the relationships between occupational exposure to suicide and well-being, help-seeking, and coping.
Results: Both groups had a high frequency of suicide exposure. Many participants had not anticipated this would be part of their daily work, experiencing the phenomenon as challenging, frustrating, and sometimes shocking, and requiring skills which they felt had not been adequately taught during their training. Their general beliefs about suicide influenced the meaning-making of this phenomenon, and their attitudes towards individuals experiencing mental health crises. Participants often belittled the value of their role, perceiving themselves as powerless to change the outcome for a suicidal person.
Participants described various coping mechanisms, some adaptive, some maladaptive, that they used to “survive” the distress suicide caused them. Many described experiencing mental distress themselves following suicide exposure, but few had sought any professional help. The most common supports were peer-colleagues, as police and paramedics both perceived the uniqueness of their roles hampered understanding from 'outsiders’. Organisational culture influenced help-seeking behaviour. Whereas police culture was seen as a hindrance to seeking help, paramedic culture incentivised emotional expression among peers.
Conclusions: The findings add to the body of knowledge on the effects of occupational suicide exposure and have implications for the ways in which first responders can be better prepared and supported by their organisations and mental health professionals to manage this complex phenomenon.