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First Responder Prevention & Awareness

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We are a community in crisis. First responders are exposed to crisis situations every day. Sometimes these responses become a personal crisis for the first responder. The Texas LODD Task Force recognizes and acknowledges the tremendous sacrifice that first responders and their loved ones make to serve their communities and we realize that sometimes that being willing to sacrifice so much comes at a cost.  This cost is the crisis of a balanced and whole feeling of well-being.  Chronic stress, lack of sleep, continued exposure to trauma, and stigmas can lead to a first responder feeling depressed, fatigued, and sometimes traumatized.  
A first responder’s first contact with trauma, crime, and death can be a defining moment in his or her life. Even with all of the training that law enforcement, firefighters, EMS personnel, and dispatchers go through, sometimes we are inadequately prepared for the natural psychological reactions that are common following repeat exposure to the worst of humanity.


September is Suicide Prevention Awareness Month and this year we are bringing our we are Stand-Down Week information and resources over to our main website so that agencies can access suicide awareness and prevention resources throughout the year.  This information was introduced in 2018 for Fallen First Responder Awareness Month.  We have refreshed the material and am making it available to any department who wants to address this critical issue.  The Texas LODD Task Forces want to help be a part of turning the tide of emotional and psychological crisis by offering resources and information for your agency to use to address this topic.  Please feel free to download these resources and use them to start a discussion within your own agency.


Our suicide prevention resources are dedicated to the memory of Paramedic Ryan Burger who died due to suicide in 2015. Ryan dedicated his life to helping others through his work as a Paramedic for Austin/Travis County EMS.  It is our hope that by sharing his story, creating resources, and opening up channels of dialogue, that we can bring greater awareness to first responders that there is hope, help, and healing.

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Love, Loss, and Legacy: Ryan & Stephanie's Story
By Stephanie Cunningham

Ryan had that kind of smile that instantly put you at ease and a laugh that you couldn't help but enjoy listening too. He had a wicked dark sense of humor and didn't care about saying the "appropriate thing" around friends or even strangers yet had the unique ability to present his point of view in a concise manner and articulate well under pressure. It was likely because he thoroughly enjoyed having the spotlight on him; he joked about returning to his "adoring fans" when interviewed by local stations about some EMS-related issues. He knew his stuff and truly wanted to do right by his patients and provide the most appropriate care, which wasn't always a rush to the hospital - one of the reasons the Community Health Paramedic positions at ATCEMS appealed to him.



It was a complete chance that we met, an algorithm on somehow decided that because we listed ourselves as "active" and "liked dogs" that we would be great together. I don't care how it happened, I'm just glad he was the first person recommended to me one Friday evening when I started perusing an online dating site before it was even commonplace to admit to online dating! The meeting may have been chance, but being together still involved a lot of blood, sweat, and tears. At the time we met, I was considering putting myself through a bridge course to go from I-85 to Paramedic. As a graduate of UT-Austin, I loved the Biology and neuroscience courses and research that I was involved in, but there was an unexplainable draw to EMS. He cautiously discouraged the additional time and money, knowing that Austin-Travis County EMS was about to stop credentialing paramedics. 


I regularly teased him that our brains were making it easy for us; the oxytocin and dopamine were surging early-on and knowing this, I approached the relationship with far more caution than he did. He still wanted me to help shop for a house, his charm won out, and we bought what we dubbed our "White Picket Fence" less than a year later and filled it with 2 dogs. I was the daughter of a career Army pilot and sister to 2 brothers who also served so Ryan's atypical work schedule was not a deterrent and our strong personalities complemented well. That's not to say he wasn't a complete pain in the** at times and I, in turn, knew how to push his buttons. We weren't perfect, but we worked really well together. I found my partner, my best friend, and the man I loved through good and bad and I feel incredibly lucky for that. Ryan wanted to stay at Austin for 20, buy 4, and have a pension in his 40's. Knowing that he wanted children and a family, my plan was to go back to school through a physician's assistant program. 

At the end of 2014, the plan changed. The accumulation of stresses, especially associated with the system, was destroying the man I loved and retirement from Austin was not an option. I forced the issue that before the end of 2015 we would be gone - to another department or for him to go back to school while I worked - whatever he thought was right. There were bad days, and sometimes bad weeks, but the roller coaster always made its way toward an upward climb again. The evidence that we were coming out of the low was Ryan's resolution to focus on diet and exercise with some regularity to feel better physically, to moderate drinking on his off days better, and to really work hard to get a sleep routine that worked for him since he almost always wound up working night shifts downtown. This behavior resolution came again over the Christmas holiday in 2014. Ryan was on an upward climb and I breathed a sigh of relief. We decided to get married in May of 2015, once my work was in a natural down time, and to save money, we planned to just elope and spend 2 weeks in Thailand to rest, recuperate, and enjoy each other.


The second weekend in January, the roller coaster took a nosedive and on January 13, 2015, I missed his call while I was on the phone at work. I looked down to see a text from Ryan that just said "911" which seems obvious: call now. We talked for almost half an hour and had a few laughs actually mixed in with the conversation. He said he felt better and was going to try and sleep. He called again at 11:59 and I never had the chance to hear his voice again after that 9-minute call, which he terminated. I was home within an hour, fully believing as I walked to the door that he was in crisis but alive. He was not and I had missed him. "Survival mode" is the only thing I can describe as my reaction. It made sense to start making a list of what to do and whom to call. Made sense that his mom would need to be picked up from the airport that night. Nothing else made sense. You can know without really knowing. I'm forever grateful to the field personnel, to the individuals, both strangers, and friends, who moved to help when they themselves were hurting. It would be incorrect to say that I was thankful to the department or the city during that time.


In April 2015, Austin-based STAR Flight nurse Kristin McLain died during a rescue. I was up late reading and working. The emotions of the day Ryan died tore through me again as I thought about how her husband was getting the news that would change every day going forward. What happened that night, perhaps looked the same, but what happened later that week was different. Three months before, it felt like we were the dirty little secret, not the provider that dedicated their life to service. The comparison between the two services compounded the loneliness and the stigma that Ryan was not worthy of remembrance. 


I remember talking to another Paramedic's wife and she told me that while the symptoms that I shared about watching Ryan struggle were eerily similar to her husband's, she knew he would be ok because he was excited about the baby they were about to have. I couldn't tell her that Ryan text me 36 hours before ultimately he died to say "I don't know if I tell you this enough, but you're the love of my life. I am lucky enough to have a future wife that challenges me to be a better man." I followed that text by telling him what I thought the name of our daughter should be, to which he replied "it's beautiful." 


We want to shield ourselves from the belief that tragedy could happen to us and so we search for evidence that we are different from the people to whom chaos and pain come. It's protective, and it's understandable. It doesn't, however, do much to forge community and empathy among each other, but it does isolate those who struggle. As I have seen and heard of more spouses losing their first responder to suicide, the initial reaction has been "I hope they don't feel alone". It's what has prompted and driven me to try and make connections with those families in the aftermath. They are no different from the families for whom American flags line the highway and even strangers pack churches and funeral halls to recognize and thank for their service and their life. 


It's odd to describe "shock" and "the fog" from the perspective of living it; the scientist in me wishes someone had been taking fMRI scans regularly during the intensities of grief in the first 2 years especially. I had the energy and resolution to do things like continue to work full time and navigate mortgage closing without any help and take care of some necessary house renovations. Those seemed obvious to have to continue. At the same time, I cried in the grocery store when I saw any young father caring for his children or randomly at a phrase, song, or smell. I ran a marathon 1 year, 1 month, and 1 day after Ryan died, but I also would regularly go 4-6 days without showering during that timeframe. I lost close to 20% of my body weight and drank like a soldier more frequently than is pleasant to admit. I read so many books on grief and shame and autobiographies on those who experienced loss and suffering. I researched PTSD and adrenal fatigue. I filled many journals with thoughts and memories. My addiction changed from alcohol to reading/writing to exercise to travel; throwing myself fully into anything that would change the void that I felt in half of my body and the brokenness that I felt in the rest. I wanted to feel again and was yet terrified of what that would mean. There was definitely a dichotomy to the grief process and not just emotionally but also of having the capacity to do certain things and desperately wishing for help or wondering why other decisions seemed impossible. Those amazing people who came into my life, many times randomly, that I learned the definition of resilience and persistence from, and who shared their vulnerabilities and experiences with me are invaluable friendships to me.


I have a hard time with the phrase that says that "good can come from suffering". There was nothing good about Ryan dying and Life is vicious enough to regularly "teach" us or challenge our resolve w

Other  Resources

SAFE CALL NOW – 1-206-459-3020 OR 1-877-230-6060
Safe Call Now is a resource for public safety employees to speak confidentially with officers, former law enforcement officers, public safety professionals, and/or mental healthcare providers who are familiar with your line of work.


SHARE THE LOAD – 1-888-731-3473 A program run by the National Volunteer Fire Council. They have a helpline, and have also collected a list of many good resources for people looking for help and support.


CopLine – 1 - 800 - COPLINE

COPLINE offers a CONFIDENTIAL 24-hour hotline answered by retired law enforcement officers who have access to continuous critical clinical support in order to help callers through the initial crisis as well as provide ongoing assistance with the successful management of various psychosocial stressors that impact a significant number of law enforcement officers and families throughout the U.S.


LIFELINE CRISIS CHAT - A online help chat that is part of the National Suicide Prevention Lifeline network. Get help via chat instead of a telephone call.

CRISIS TEXT LINE- Crisis Text Line is free, 24/7 support for those in crisis. Text 741741 from anywhere in the US to text with a trained Crisis Counselor. Crisis Text Line trains volunteers to support people in crisis. 


911 WELLNESS FOUNDATION - The foundation's mission is to foster optimal health fueling resilience, peak performance, and a high Quality of Life (at work and at home) for our nation’s 911 Public Safety Telecommunicators (PST).

FIREFIGHTER BEHAVIORAL HEALTH ALLIANCE - The mission of Firefighter Behavioral Health Alliance is to collaborate, develop and implement behavioral health awareness, prevention, intervention, and post-crisis strategies to provide firefighters with an easily accessible and confidential source of information.


1ST ALLIANCE - First Alliance is working to bring together First Responders and a variety of resources that can assist in the time of need. They have 3 primary goals: to provide a central Global support database so First Responders can confidentially find spiritual and emotional help, to form an alliance of First Responders that can change legislation and benefits, and to collect post-traumatic stress injury and suicide data that can be presented to affect change.


THE CODE GREEN CAMPAIGN - The campaign has two main goals. The primary goal is raising awareness of the high rates of mental health issues, substance abuse, and suicide among first responders. The secondary goal is providing education for responders on how to provide care for themselves and recognize issues in their peers.


BLUE HELP- It is the mission of Blue H.E.L.P. to reduce mental health stigma through education, advocate for benefits for those suffering from post-traumatic stress, acknowledge the service and sacrifice of law enforcement officers we lost to suicide, assist officers in their search for healing, and to bring awareness to suicide and mental health issues.

My3App- The MY3 phone app allows offers a way for an individual to be prepared to help themself and reach out to others when they are having thoughts of suicide.

Ryan's Story
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