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Unresolved Trauma as A Predictor of Death by Suicide:
QPR Theory Part 1
- Carolyn V. Coarsey, Ph.D.
QPR Assumptions for those at Risk to Death by Suicide:
Tend not to self-refer for treatment
Tend to be treatment resistant
Often abuse drugs and/or alcohol
Dissimulate their level of dispair
Go untreated (and remain at risk for suicide)
-Paul Quinnett, Ph.D.
Founder & CEO, QPR Institute
I continue to read in
the press and hear stories about responders who are exposed to trauma as part
of their routine work and later died as a result of suicide. At the Foundation,
we follow the QPR Gatekeeper model because it encourages the education and
empowerment of everyone.The goal is to
become aware of risk factors and warning signs in peers, co-workers, family
members—and all with whom we interact.
Because we support organizations where trauma occursin the workplace, we are aware that many
employees experience situations that are anything but"normal."And worse, if the traumatic experience is not
given attention— then resolution and healing may never occur.
Not surprisingly, fatigue and lack of rest between fatal investigations
were related to symptoms more than exposure to upsetting accident sites.
In the late nineties, I conducted multiple interviews with
investigators of aviation, rail, pipeline, and marine tragedies for the
National Transportation and Safety Board (NTSB). The purpose of the study was
to determine any relationship between clinical depression and post-traumatic
stress disorder following exposure to carnage on-site during their
investigative duties.Not surprisingly,
fatigue and lack of rest between fatal investigations were related to symptoms
more than exposure to upsetting accident sites. In addition to these interesting
results, many individual stories caught my attention. The one that follows is an example of what Dr.
Quinnett discusses in explaining the theory behind QPR.
A very senior aviation accident investigator responded
affirmatively to every question used to diagnose clinical depression and most
of the symptoms of post-traumatic stress disorder. When asked for the onset
date for each symptom, the time given corresponded with the most recent fatal
accident. None of the other investigation dates, despite their similarity in
crash details, were associated with symptoms.
I asked him if anything unusual had happened in his personal life
during the dates of this investigation. He responded, “Not that I can think
of." He quickly followed with, "Except that my sister was murdered,
the same month."
We continued talking about the investigation and peculiar
points about the impact of the aircraft and the destruction associated with it.
He always came back to the same position—while the investigator had seen gruesome
sites like the most recent one before, none were upsetting to him. I asked him if
anything unusual had happened in his personal life during the dates of this investigation.
He responded, “Not that I can think of." He quickly followed with,
"Except that my sister was murdered, the same month."
The accident and the murder had happened over two years
before this interview occurred. I asked if he considered seeing a counselor
over his sister's death. He had not. He said that the investigation had taken
so much of his time during the year his sister died that he had no time for
himself.I explained that I understood
as I appreciated the intensity of that investigation, but now over two years
had gone by, and his symptoms remained active.He told me that until the interview, he had not realized how the dates
of these tragedies corresponded—and how much he was suffering.He agreed to contact the employee assistance
program and go for counseling. I followed up later, and learned that he saw a
professional weekly.He was grateful for
the help he was receiving.
Looking back, I often wondered how things might have gone
had the interview not occurred when it did. Part II of this article will
provide a story where a responder survived a trauma, where his peers did not.
He later died by his own hand.
Watch this touching video called "Love Calls Back" related to supporting the LGBTQ community
QPR stands for Question, Persuade and Refer, and is a research-based intervention that anyone can learn. If you are interested in learning more about how to become a Gatekeeper and becoming part of a more extensive network that is dedicated to suicide prevention, please contact us. The Foundation works with the QPR Institute to customize this successful intervention for cruise lines, aviation companies, human resources professionals, and other workplace groups. To learn more about the training classes offered by the Family Assistance Foundation, and for information about upcoming Gatekeeper classes and how you can become a trainer within your workplace go to fafonline.org. You can also contact Cheri Johnson at email@example.com.
Upcoming Gatekeeper Trainings
London Gatekeeper Training
December 6, 2019
London Train-the-Trainer Training
December 6, 2019
QPR Gatekeeper and Train-the-Trainer Training will be offered at additional locations when additional dates for Foundation Member-Partner Meetings are announced for 2020.