Page 64 - JSOM Spring 2021

TABLE 5 Resource Profile of EMS Professionals Stratified by The postulate that exposure to suicide will increase suicidality
Prior Military Service Compared to the Overall Sample in others, whether or not the person who died was known
Civilian EMS Military NSS personally, is known as suicide contagion. It may result in
496 (64.4%) 61 (71.8%) 187 (24.3%) point-clustering, which is when it occurs in specific geographic
n (%) n (%) n (%) areas or within particular populations. 38–40 A previous longi-
Employment resources tudinal study by Ursano et al. revealed that US Army soldiers
Incident debriefing 404 (61.4%) 42 (49.4%) 162 (21.8%) were 1.4–2.3 times more likely to have a suicide attempt if they
Departmental 49 (7.5%) 5 (5.9%) 45 (5.9%) had been exposed to a completed suicide in their unit. These
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chaplain odds had a direct linear relationship as the number of unit
CIT 287 (43.6%) 31 (36.5%) 112 (15.1%) suicides increased. Additional studies have shown the con-
41
EAP 304 (46.2%) 42 (49.4%) 122 (16.4%) tagion effect of suicide on various populations, including the
Exercise programs 41 (6.2%) 2 (2.4%) 15 (2.0%) military, particularly when media coverage of the event is pres-
Time off 153 (23.3%) 24 (28.2%) 75 (10.1%) ent and after controlling for various other factors. 37,41,42–45,46–49
Prior history of Compared to EMS providers without any stress syndrome, the
counseling for a 170 (25.8%) 30 (35.3%) 42 (5.6%) proportion of veterans who knew another EMS provider who
stress-related event had committed suicide was 4.2 times higher (36.5% vs 8.6%),
Currently in 30 (4.6%) 4 (4.8%) 2 (0.3%) making EMS personnel in general, and veterans specifically, a
counseling unique group primed for prevention strategies.
Has considered
suicide 140 (28.2%) 26 (31.0%) 19 (2.6%)
Knows an EMS Potentially Traumatic Experiences
professional who The LEC has been used to quantify the rates of PTEs in com-
has considered or 245 (37.2%) 31 (36.5%) 64 (8.6%)
committed suicide bat veterans with a known association between the severity of
NSS = no stress syndrome; CIT = crisis intervention team; EAP = em- PTSD symptomatology and the exposure to trauma, particu-
ployee assistance program. larly as it relates to the frequency of exposure. 27,50 Increases
in exposure to PTEs have also been associated with suicide
attempts and other stress syndromes. 27,51 In this study, veterans
who potentially had any stress syndrome had rates of PTEs
TABLE 6 Partial Regression Coefficients and Squared Semipartial that were 2–4 times higher in nearly every category than in
2
Correlations (sr ) for Each Predictor on Each Block of a Hierarchical
Linear Regression Predicting IESR Total Score (n=770) their civilian EMS counterparts without stress syndromes.
Predictor B Std. Error B β sr 2 p Value
Block 1 The Impact of Prior Military Service
Sex –11.90 9.29 –0.307 0.059 .012 In this report, hierarchical linear regression demonstrated
Minority status –0.018 6.15 –0.008 — .939 that neither the isolated background of military service nor
Age –0.475 4.61 –0.009 — .941 the presence of one or more combat deployments were pre-
Block 2 dictors of VT in this population of EMS personnel. However,
Shift length 0.715 0.33 0.219 0.041 .036 the experience of combat patrols or other dangerous duty per-
Annual income –0.662 1.60 –0.046 — .680 formed by deployed military personnel was both significant
Years of field 0.692 4.81 0.144 — .886 and predictive. This suggests that it is not military service or
experience (>5) combat deployments alone that promote the development of
Block 3 stress syndromes, but the exposure to PTEs during combat
Ever considered 2.22 4.49 0.494 — .623 operations that are uniquely predictive of VT. These results
suicide are consistent with prior studies that have shown that the de-
Knew an EMS velopment of PTSD or other mental health illness are directly
provider who related to the frequency and intensity of duties in the combat
committed 3.99 4.08 0.979 — .331 theater. 35,52–55
suicide
Has CF 12.71 4.27 2.972 0.078 .004
Has BO 8.86 4.16 2.133 0.040 .037 Limitations
Block 4 There are several limitations to this study. Generalizability to
Served in the 9.73 6.49 1.498 — .139 other populations is unknown. North Carolina is particularly
military unique in its military presence, having one of the most exten-
Years of service –1.065 0.41 –0.298 0.061 .061 sive military footprints in the country and, to a varying degree,
Deployed to a representative of all branches of service. 25,26 The military is the
combat theater 5.75 6.44 0.892 0.013 .376 second largest overall employer in the state. Intrinsically, this
26
Performed study may have a higher proportion of prior service EMS per-
combat patrols sonnel when compared to other geographic areas.
or other 19.12 6.98 2.740 0.066 .008
dangerous duty It is possible that data on female prior service alone was not
Engaged (or reliable given the sample size. In addition, given the time that
was engaged –5.15 7.76 –0.663 — .510
by) the enemy these female veterans likely served in the military, it is possible
IESR = Impact of Events Scale-Revised. that they were in noncombat military occupational specialties
(MOS) and were not directly involved in combat operations.

62 | JSOM Volume 21, Edition 1 / Spring 2021