Depression, Suicide, and Suicide-By-Cop

Depression, Suicide, and Suicide-By-Cop Nicole Duranceaux, Ph.D. Albuquerque Police Department Behavioral Sciences Division Albuquerque, NM 87199 (505) 764-1600 Cell (505) 417-6407

Why Should a Police Officer Know About Depression? • Accounts for most suicidal, passive neglect behavior • Suicidal persons are sometimes homicidal persons • Annually, twice as many police officers kill themselves than are killed by assailants and accidents • Police officers are expected to offer help to the public, victims, friends, co-workers and subordinates.

Depression Key Points • Most common mental-health-related problem • In a lifetime, moderate-severe depression will affect • 5% - 10% of males • 10% -20% of females • Accounts for 75% of all psychiatric hospitalizations • Depression versus ‘Major Depressive Disorder’ or ‘Clinical Depression’

General Characteristics of Depression • Sadness • Usually situational • All of us have been sad, and have learned to deal with it. • Grief • Often the most severe sadness • May have a clear cause • E.g., death, divorce, loss of health

Criteria for Clinical Depression • Five or more of the following for at least 2 wks: • Depressed mood or lack of interest or pleasure • Significant weight change • Sleep disturbance • Psychomotor agitation or retardation • Daily fatigue • Problems thinking, concentrating • Feelings of worthlessness or guilt • Thoughts of death, dying, suicide • Change from previous functioning • Not better accounted for by something else • May come about through biochemical changes in the brain.

General Characteristics of Clinical Depression • If untreated, a major depressive episode can last six months or longer. • The onset is often gradual (i.e. weeks or months) • Can begin suddenly following a trigger • I.e., death of a loved one, divorce, job loss • Person may be unaware of depression, but • May experience it as disappointment, anger, “emptiness,” loneliness, or fatigue. • May be apparent to an episodic observer • “ I just saw Uncle Fred for the first time in months and he looks like shit”

Circumstances of the Law Enforcement Encounter • Barricadel, with or without a hostage(s) • Suicide in progress (or completed suicide) • “Man with a gun” call • Welfare check • Interrupted homicide/suicide. • Bizarre behavior (bridge jumper, running in traffic, setting self on fire)

Suicidal Triad • Alcohol - either chronically or acutely • Isolation - divorced, “ a loner “ , a person who has “burned his bridges “ with family and friends • Hopelessness - both real and perceived

Suicide • Rate for U.S. • About 14.5 per 100,000 • 75-90 suicides per year in Albuquerque metro area • Usually begins with thoughts, fantasies • Means, motive, plan, intent (MMPI) • Emotional reasoning, alcohol impair the thinking process

Suicide • Plans range from vague thoughts to elaborate and detailed instructions, letters, etc. • Suicide gesture • Mimics suicide attempt but… • Intent is to change someone else’s behavior • Suicide attempt - intent to end one’s life

Suicide By Cop • AKA “victim-precipitated homicide.” • Subject may attempt to “lure” authorities into the confrontation • Often starts as a disturbance call • e.g. “man waving a gun around” or “man threatening neighbors with a knife” • Initiating event typically is relationship based

Suicide By Cop • Subject is usually • Male • Young • Intoxicated • Despondent • Angry • Often has history of prior contact with police • Subject resistant to initial attempts at verbal de-escalation • ”You are just going to have to kill me”

Suicide By Cop • Subject may respond to skillful, persistent verbal de-escalation. • Simply repeating commands isnotverbal de-escalation • Outcome will hinge on • Subject’s behavior • Level of intoxication • Responders’ skill • Available resources

Suicide By Cop • The “ideal” response would include a CIT/CNT officer, a less-lethal force option (or two), and lethal force. • IF THE SUBJECT HAS A FIREARM, ALL COMMUNICATION MUST TAKE PLACE FROM A POSITION OF COVER.

Suicide By Cop • Subject’s actions dictates response • Lethal force: used in response to credible threat of the same from subject • If subject de-escalates threat, any movement in that direction should be reinforced • Subject’s actions may be so dangerous that there is no time for negotiation • If subject in custody, should be evaluated at mental health facility

Suicide By Cop • Don’t let a suicide by cop event lead to the injury/death of an officer.

Depression, Suicide, and Suicide-By-Cop