After the Worst Call: Grief, a Child Case or the Loss of One of Your Own

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.

Some calls are different. Ask anyone who has worked in public safety for long and they can name the one that changed something: the child who did not make it, the colleague they stood beside at a funeral, the radio call that ended with a name everyone knew.

Police officers, firefighters, paramedics, corrections officers and dispatchers are trained to function through tragedy, and most do. They finish the shift, write the report, and show up to the next one. But a call involving a child, or the death of someone from your own department, can land in a place training does not reach.

In the weeks and months afterward, grief is normal. So are sleeplessness, anger, guilt and replaying every decision. For some first responders, those reactions settle over time. For others, they deepen into depression, and depression can bring thoughts of not wanting to live. When that happens, it is a signal to get support, not a sign of failure.

Grief, guilt and the questions that do not stop

After a child call, many first responders find themselves thinking about their own kids in new ways, checking on them at night, unable to watch certain shows, feeling a sudden distance from family life. After losing a colleague, the questions can be relentless: why them, why not me, what could I have done.

These questions are a natural part of grief. The concern is when they start to crowd out everything else, or when the guilt hardens into a belief that you do not deserve to be here. A firefighter in his forties might go back to work, perform well, and still feel hollow for months afterward, without telling anyone.

When grief needs more than time

It can be hard to tell normal grief from depression. Some signs that it may be more than grief:

• Weeks go by and the heaviness is not easing, or is getting worse
• Feeling worthless or deeply guilty, beyond sadness about the loss
• Thinking about death, wishing you had died instead, or thinking about suicide
• Withdrawing from the crew, from family, or from everything that once mattered
• Not being able to sleep, or sleeping all day on days off
• Using alcohol to blunt the feelings
• Talking about not being around in the future

Survivors of a line-of-duty loss sometimes feel they owe it to their fallen colleague to keep going without complaint. Taking care of yourself is not disloyal. It is part of honoring the work you shared.

Checking on each other after a loss

In the aftermath of a hard call, crews often rally around the obvious people: the partner, the family of the fallen. It is worth checking in more widely, and for longer. The quiet engineer, the dispatcher who took the call, the officer who was first through the door: each of them may be carrying more than they show.

If you are concerned about someone, ask them directly whether they are having thoughts of suicide. A plain question like "Since the funeral, have you thought about ending your life?" can open a door, and it lets the person know the subject is not off limits with you. If they say yes, stay close and help them reach 988. Call 911 if they are in immediate danger.

Private care, separate from the department

After a critical incident, some departments offer debriefings or support programs. Those can help. There is also another path: a clinician you find on your own, outside any department process. Ask that clinic up front how it handles privacy and records, so you know what to expect.

Grief and depression both respond to care, and recovery is possible. While things are raw, one practical step is to ask someone outside the home to hold any firearms for a while, or to make sure they are stored securely.

Spravato, in brief

When grief has turned into depression with acute suicidal thoughts in an adult, a clinician may discuss one prescription option as part of a wider plan. Spravato (esketamine) is a nasal spray the FDA has approved, taken along with an oral antidepressant, to treat depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behavior. It is also approved for treatment-resistant depression. It is not a crisis treatment: it does not replace emergency care or a hospital stay when one is needed, and it has not been shown to prevent suicide or to reduce suicidal thoughts or behavior. It is given only in a certified clinic under a safety program called the Spravato REMS. The patient takes it there under supervision, stays at least two hours to be monitored, and does not drive until the next day after a full night of sleep. It is never dispensed for home use. Whether it fits is a clinician's decision after an evaluation.

Maybe you keep coming back to that call or that funeral and cannot tell whether it is grief or something more. A free 30-minute consultation, offered by some clinics that provide this treatment, is one gentle way to sort that out: you describe what happened and ask whether an evaluation is the right next step. Your spouse, a friend, or someone who stood beside you that day can join you.

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.