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Unresolved Trauma as A Predictor of Death by Suicide:
QPR Theory Part II
- 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 alcohol
Dissimulate their level of despair
Go untreated (and remain at risk for suicide)
-Paul Quinnett, Ph.D.
Founder & CEO, QPR Institute
In the October article, we provided an example of how QPR
theory, as outlined above, applied to an experienced investigator. The man had no idea as to the level of his
despair until he participated in a study of traumatic stress within his
profession. Left undetected, and without intervention, the results might have
been tragic. 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—to provide support and save lives.
This month, other
examples will provide awareness of the importance of paying attention to those
who may be at risk in the workplace. These stories were told in training classes
and shared in the spirit of helping others avoid similar mistakes—and save a friend’s
His friends had no idea how their stories affected him, that he
was battling deep depression and suffering from survivor guilt.
The first story involves a firefighter who was the
lone survivor of a tragedy involving three of his peers. The firefighter who
told the story in class gave the details which follow.
First responders often operate in
that constant adrenaline rush ‘world’, and when they no longer have that
mechanism to keep this rush going, things tend to fall apart. In this case, the
firefighter was trained to a very high level in a Special Operations Company.That group of firefighters is known as The Rescuers of Rescuers.Thus, when firefighters get trapped, these are the ones managing the search and extraction. These firefighters are elevated
to the same level as the Navy Seals, who take pride in such high-level
In this case, the firefighter was
the second to last person to bail out a window, six stories up, leaving behind
the Lieutenant. The highly-trained firefighter would later learn that the
others all died, leaving him to be the only survivor. After the incident, due
to his injuries, he was unable to return to firefighting. Over the next five
years, his friends tried to help him by taking him to social events and
spending time with him. While they had the best intentions, as firefighters do,
they talked in front of him about firefighting and all the new fires and
rescues they were experiencing.
His friends had no idea how their
stories affected him or that he was battling deep depression. After five
years of living with survivor guilt, plus being unable to return to the job
that he once prided himself in holding, he died of an overdose. At the request
of his family, the death was attributed to an accidental overdose. But those
who knew him felt it was suicide. His friends and fellow-firefighters were
devastated when they learned what happened.
The lesson learned is to be aware
that people process events that affect their lives in different ways.Thinking that someone is okay because they
may not be showing signs of depression outwardly, might be a mistake. This man
needed more help than we realized.
Over a period of months, it became accepted that the once friendly
co-worker had changed and no longer desired their friendship and support.
and third stories involve people for whom details of the co-workers’ suffering
were unknown by their friends. No one at work knew the level of their despair
until it was too late. The second example involves a well-respected railway
middle manager. While the details of his personal life were mostly unknown, his
peers knew that something was different when he began to avoid interaction with
them. Because the man had gone through a divorce, his friends assumed that he
was privately coping with the changes in his life and would ‘get through it’
and eventually return to normal.For
months, it became accepted that the once-friendly co-worker had changed and no
longer desired their friendship and support.
Early one morning,
a rumor circulated throughout the offices that the employee was found dead,
with a handgun beside him. The company intranet shortly confirmed the facts.The man had been found over the weekend by
his son; there was no note.Those who were once his closest friends, gathered in a conference room to talk after
learning of his death. As the stories came together, the co-workers were
surprised at the amount of information that had not been shared. The employee who told the story in QPR Gatekeeper Training expressed deep regrets that the team had
not gotten together to discuss their observations before it was too late.
from normal activities with his peers was a common experience, but as additional
information came out, his friends began to see just how much he had changed.
One colleague who lived near him talked about how he had ceased caring for his
once immaculately groomed lawn. “The grass in his yard was knee-high," the
co-worker remarked. Someone else shared that he heard a rumor that the man’s
wife would not allow him to see their children, but he thought it was just gossip
at the time. Now, as the stories came together, they realized that all the
signs of a profoundly depressed person were staring them in the face, but it
was too late to help him now.
I had no idea his life was at risk. I knew he had problems, but never
knew it could lead to suicide.
Friend of a Pilot Who Died by Suicide
The third story involved a pilot who
took time off from flying for ‘health’ reasons. His peers knew he was coping
with alcohol addiction and assumed that he was getting much-needed help, while
off from work.At first, many of his
friends stayed in touch and offered support in his recovery.Then gradually, over time, contact between
the pilot and his co-workers ceased. The pilot in treatment reached out to many
of his flying mates, but no one returned his calls. The friend who talked about this example in class spoke of receiving a phone call from the pilot a few
months after he left work. Due to his schedule, the working pilot, was unable to return the
call. Before he knew it, a few weeks had passed, and he received news that his
friend had taken his life.“I had no
idea his life was at risk. I knew he had problems, but never knew it could lead
The peers assumed that since the pilot off work was being treated for addiction, he was getting help
by a mental health professional. They assumed this was all the help needed.
After his death, the guilt over letting their brother down was clear. Yet, like
the other two stories— the lack of understanding of risk factors and warning
signs allowed the peers and co-workers to make assumptions that led to fatal
Unresolved trauma may indeed lead
to death by suicide. Sometimes the source of trauma may be known and other
times not. But what is clear is that with education and training on what to
look for as potential risk factors and warning signs, we can reduce the number of deaths by
suicide. In all three cases, peers were able to recognize changes in their
co-workers but when they understood the significance of these changes, it was
QPR Gatekeeper Training involves
both online and classroom presentations. The QPR Institute also offers
Train-the-Trainer programs where peers within an organization can train their
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.