QQQ 37 November 20, 2019: Unresolved Trauma as A Predictor of Death by Suicide: QPR Theory Part II

QPR Quick Quotes: November 20, 2019 Unresolved Trauma as A Predictor of Death by Suicide QPR Theory Part II

November 20, 2019

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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 undetected
     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 life.


His friends had no idea how their stories affected him, that he was battling deep depression and suffering from survivor guilt.

-A Peer-Firefighter


    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 technical work.

    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.


    The second 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. 

    Withdrawal 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.

-A 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 to suicide.”

    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 results.  

    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 too late.

    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 co-workers. 

About QPR

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 cheri.johnson@aviem.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.

© 2019 QPR Institute Inc./Family Assistance Education & Research Foundation

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