Suicide scene training linked to better responder preparedness

Attending the scene of a suspected suicide can place first responders at the intersection of emergency response, public health and bereavement support. Police, emergency medical technicians, firefighters and water-safety personnel may be among the first people to arrive, often confronting a person who has died, possible traces of the method used and relatives or neighbours experiencing shock. The study examined how responders in Ireland manage these encounters and whether their previous training prepares them to communicate effectively, support those bereaved by suicide and cope with the emotional consequences of the work. The findings point to a clear but manageable gap: respondents generally held non-stigmatising attitudes, yet their practical knowledge, confidence and perceived organisational support were less developed.

Researchers combined a national survey with qualitative focus groups in a mixed-methods design, allowing them to measure broad patterns while also examining how first responders described individual experiences. The quantitative component assessed suicide literacy, attitudes, postvention knowledge, organisational support and preparedness. The researchers used multivariate analysis of variance to examine the relationship between previous suicide-related training and the measured outcomes, adjusting for sociodemographic factors. Qualitative material was gathered through 10 focus groups and analysed using reflexive thematic analysis, a method designed to identify recurring patterns in participants’ accounts while considering the influence of interpretation and context.

A total of 1,587 first responders completed the survey, providing a substantial national snapshot of experiences across a range of emergency roles. The participants’ responses suggested that attitudes toward suicide prevention and people who experience suicidal thoughts were generally positive and non-stigmatising. That finding is important because evidence of hostility, blame or avoidance could compound the difficulty of an already sensitive response. By contrast, respondents recorded lower scores for suicide literacy, postvention knowledge, support from their organisations and preparedness for attending suspected suicides. The pattern indicates that willingness to approach the issue is not the same as having the knowledge required to provide safe, appropriate and compassionate support.

Suicide literacy in the study encompassed the knowledge needed to recognise and understand suicide-related warning signs, risk factors and protective factors. Postvention knowledge concerned the practical and supportive role that can follow a suicide, particularly when responders interact with people bereaved by the death. These domains are closely related to scene safety. First responders must identify potentially relevant information, avoid assumptions about cause, communicate with distressed relatives and connect family members and others to appropriate support. Weak scores across these areas may therefore help explain why responders experience uncertainty even when their general attitudes toward suicide and suicidal individuals are constructive.

Previous suicide-related training was significantly associated with higher suicide literacy, more positive attitudes and greater postvention knowledge after the researchers adjusted for sociodemographic factors. The associations were consistent with the idea that structured training can move knowledge beyond a general sense of concern and into specific, repeatable practices. Nevertheless, the researchers cautioned that the effect sizes were small. The survey therefore does not establish that training alone produces a large change in performance, nor does the observational design demonstrate that training directly caused the differences. It instead identifies prior training as one factor connected with better knowledge and attitudes, while highlighting the need for comprehensive preparation rather than assuming that a single course is sufficient.

The focus groups added detail to the numerical findings. Across 10 groups, participants described substantial gaps in both training and confidence when responding to suspected suicides. Their accounts indicated that uncertainty was especially difficult when responders had to communicate with bereaved people. At such scenes, practical demands can arrive simultaneously: someone may be in acute shock, relatives may have questions, and responders must determine what help is appropriate without making promises that exceed their role. These tasks require more than general first-aid or emergency protocols. They depend on communication skills, knowledge of suicide postvention and an understanding of how grief and possible trauma can affect a person’s immediate behaviour.

Respondents also described the considerable emotional toll of attending the scene of a suspected suicide. The burden could include exposure to death, distressing evidence, difficult conversations and the distress of relatives, as well as the cumulative strain of encountering such incidents in the course of routine duties. The findings underline that support should not end when a responder leaves the scene. People may need time to process what they have seen and heard, and organisations require an adequate way to provide that support. Without follow-up assistance, initial training can lose much of its value if the emotional demands of the work remain unaddressed.

The results argue for a system in which preparedness covers prevention, response and postvention rather than treating any one of them as a separate task. Comprehensive training should equip first responders with the knowledge and communication skills required to support bereaved relatives, recognise when additional assistance may be needed and refer people to appropriate services. It should also be matched to the reality of their roles, which can differ among emergency personnel. Organisational measures, including adequate support after incidents and access to reflective or psychological assistance, are presented as essential companions to instruction because knowledge and confidence are not developed or maintained in a vacuum.

For public health, the study suggests that a relatively small investment in coordinated training could improve an important point of contact for people affected by suicide. First responders may be the only professionals present immediately after a death, yet they are also the group least likely, in many cases, to have received formal preparation for the bereavement dimension of the job. Closing that gap could reduce uncertainty, make communication more compassionate and help prevent avoidable adverse outcomes for people left behind. The study does not show that all incidents are poorly handled, and it does not imply that individual responders are responsible for the shortcomings identified. Rather, it shows that general willingness to help must be reinforced through evidence-based knowledge, scenario-specific communication practice and dependable organisational backing.

Overall, the mixed-method evidence presents a clear message: Ireland’s first responders approach suicide with broadly positive and non-stigmatising attitudes, but many report that suicide literacy, postvention knowledge, preparedness and organisational support fall short. Training is associated with better literacy, attitudes and postvention knowledge, although the small effect sizes mean that evaluation and continued reinforcement are important. The qualitative findings deepen that conclusion by showing how uncertainty, difficult conversations and emotional strain can shape the experience of responding to a suspected suicide. Strengthening comprehensive training and ensuring adequate support in the aftermath are therefore not peripheral measures. They are practical components of a safer response for first responders and for the bereaved people who encounter them at one of the most difficult moments following a death.

Subject of Research: First responders’ training needs and experiences at suspected suicide scenes in Ireland

Article Title: First responders’ experiences and training needs at the scene of a suspected suicide in Ireland: A mixed methods study

Article References: Goodwin, J., Duggan, S., Drakos, K., Cotter, P., Biskupovic-Goulding, R., Kelleher, S., O’Malley, M., Walshe, N., Noonan, B., Flynn, R., Gleeson, E., Kelly, A., Culloty, L., Fingleton, N., Fitzell, O., Cudmore, J., Hackett, O., Shine, V., Pierce, B., … O’Donovan, A. (2026). First responders’ experiences and training needs at the scene of a suspected suicide in Ireland: A mixed methods study. PLOS One, 21(10), e0360382. https://doi.org/10.1371/journal.pone.0360382

Image Credits: AI Generated

DOI: 10.1371/journal.pone.0360382

Keywords: suicide prevention, suicide postvention, first responders, emergency medicine, suicide literacy, bereavement support, responder training, Ireland, mixed-methods research, First, responders, experiences