by Jeffrey Stouffer editor
July 19, 2010
A continually evolving and expanding segment of the remediation industry, bio-recovery – better known as “crime scene cleanup” or “trauma cleaning” – has made great strides since it first came into being as an organized segment of the business almost two decades ago. Recently, R&R spoke with Kent Berg, director of the National Institute of Decontamination Specialists and founder of the American Bio-Recovery Association, to get his take on where the industry stands today and where it’s headed in the future.
Restoration & Remediation: Briefly, what falls under the scope of work when people talk about “bio-recovery”?
Kent Berg: Bio-recovery is actually a term that was derived from the words BioHazard Cleanup and Scene Recovery. We chose that term because our industry’s scope of work is actually much broader than cleaning crime scenes. We are often thought of as the guys that will clean up anything that is nasty, repulsive, or gross, so people naturally call us to clean up human feces, animal feces, dead animals – usually rotten ones – and gross filth, as in rotting food, poor hygiene, and piles and piles of garbage. Then there’s the decomposed human body scenes, meth labs, the occasional disease outbreak, and anything else that would cause a normal person to stay a hundred feet away to keep from puking.
R&R: You’ve been part of the bio-recovery profession pretty much since before it became a profession. Since that time, what are some of the biggest changes you’ve seen, both positive and negative?
KB: When I first started, very few people in this business knew anything about cleaning and disinfecting. They just wanted to make the visible contamination go away. No one in the insurance industry had ever heard of a crime scene cleanup company, and many adjusters argued that our services were not covered. Today, the biggest changes have been in our profile. What I mean by that is the public, who had never heard of our services, now see us in TV shows, documentaries, movies, magazines, and newspaper articles. We have recognition now, and families are more aware that these services exist.
Another change has been in the performance of the cleanup itself. We as an industry are much more aware of the antimicrobials we are using, the techniques and knowledge related to home construction, vehicle dismantling, and being able to actually render a property safe on a microscopic level.
R&R: From a purely objective point of view, bio-recovery would seem to be about as “recession-proof” as any remediation specialty out there. There will always be accidents, suicides and other traumas that require a professional remediator. What are some of the pros and cons that come along with that?
KB: We know that our services will always be needed, but with a higher profile, we are seeing more and more companies starting up, and more and more fire/water restoration companies adding this service to their menus. Although the demand for our services is increasing, the individual companies’ call volumes aren’t growing as fast because there is more competition for that finite number of incidents.
The pros are that the public will have resources to respond if they need them, and that companies will have to step up their game in service quality and marketing. The cons are that the majority of these new companies are not attending training, not getting any type of certification beyond a half-day OSHA bloodborne pathogen course. It’s these companies that are dragging the good companies down when the public hears about a company throwing a bloody mattress in a dumpster, etc.
R&R: Since hindsight is 20/20, if there was one thing you would go back and change, as far as how you operated your business, what is it, and what would you do differently?
KB: I would have marketed harder. I assumed that people would need my service and seek me out. That was true for a while, but when competitors popped up with their marketing programs, the public chose who was freshest in their minds. It’s a hard lesson to learn, but one I will never forget.
R&R: Technologically speaking, what areas have seen the greatest advances? Chemicals? PPE? Containment?
KB: One of the advancements has been our recognition as a legitimate industry. Today, vendors of specialty restoration products are targeting our industry. Kimberly-Clark markets their suits with the “Recommended by the American Bio-Recovery Association” seal on them. Other products used in our industry have similar tie-ins with our trade association or at the very least mention in their advertising that their product is great for cleaning crime and trauma scenes. Even the insurance industry no longer recognizes us under their “janitorial service” heading, opting now for a “crime scene cleanup” designation for insurance coverage.
We are also seeing new technology in the form of new disinfectants, odor-remediation technology, and devices to actually measure how clean a surface really is. The National Organization for Victim Assistance is putting on a training program this fall for teaching all interested bio-recovery technicians how to better interact with victims and their families. Meanwhile, the National Institute of Occupational Safety and Health has sought out input so they may better understand our industry.
However, I believe the most important advancement for the industry has been the formation of training centers. Legitimate training programs help make sure that any technician who wants to be the best at their profession can attend a school that specializes in that field. By establishing a standard training and certification program, students graduate far ahead of their competitors and benefit from years of experience from seasoned industry professionals, scientists, chemists, and pathologists that helped to design the curriculum.
Jeffrey Stouffer editor
stoufferj@bnpmedia.com
Jeffrey Stouffer is editor of Restoration & Remediation magazine
Wednesday, July 28, 2010
Thursday, June 3, 2010
6 reasons why people commit suicide
by Alex Lickerman, MD
Though I’ve never lost a friend or family member to suicide, I have lost a patient.
I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret makes for a bitter drink, the taste of which I’ve seen take many months or even years to wash out of some mouths.
The one question everyone has asked without exception, that they ache to have answered more than any other, is simply, why?
Why did their friend, child, parent, spouse, or sibling take their own life? Even when a note explaining the reasons is found, lingering questions usually remain: yes, they felt enough despair to want to die, but why did they feel that? A person’s suicide often takes the people it leaves behind by surprise (only accentuating survivor’s guilt for failing to see it coming).
People who’ve survived suicide attempts have reported wanting not so much to die as to stop living, a strange dichotomy but a valid one nevertheless. If some in-between state existed, some other alternative to death, I suspect many suicidal people would take it. For the sake of all those reading this who might have been left behind by someone’s suicide, I wanted to describe how I was trained to think about the reasons people kill themselves. They’re not as intuitive as most think.
In general, people try to kill themselves for six reasons:
1. They’re depressed. This is without question the most common reason people commit suicide. Severe depression is always accompanied by a pervasive sense of suffering as well as the belief that escape from it is hopeless. The pain of existence often becomes too much for severely depressed people to bear. The state of depression warps their thinking, allowing ideas like “Everyone would all be better off without me” to make rational sense. They shouldn’t be blamed for falling prey to such distorted thoughts any more than a heart patient should be blamed for experiencing chest pain: it’s simply the nature of their disease.
Because depression, as we all know, is almost always treatable, we should all seek to recognize its presence in our close friends and loved ones. Often people suffer with it silently, planning suicide without anyone ever knowing. Despite making both parties uncomfortable, inquiring directly about suicidal thoughts in my experience almost always yields an honest response. If you suspect someone might be depressed, don’t allow your tendency to deny the possibility of suicidal ideation prevent you from asking about it.
2. They’re psychotic. Malevolent inner voices often command self-destruction for unintelligible reasons. Psychosis is much harder to mask than depression — and arguably even more tragic. The worldwide incidence of schizophrenia is 1% and often strikes otherwise healthy, high-performing individuals, whose lives, though manageable with medication, never fulfill their original promise.
Schizophrenics are just as likely to talk freely about the voices commanding them to kill themselves as not, and also, in my experience, give honest answers about thoughts of suicide when asked directly. Psychosis, too, is treatable, and usually must be for a schizophrenic to be able to function at all. Untreated or poorly treated psychosis almost always requires hospital admission to a locked ward until the voices lose their commanding power.
3. They’re impulsive. Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed. The remorse is usually genuine, and whether or not they’ll ever attempt suicide again is unpredictable. They may try it again the very next time they become drunk or high, or never again in their lifetime. Hospital admission is therefore not usually indicated. Substance abuse and the underlying reasons for it are generally a greater concern in these people and should be addressed as aggressively as possible.
4. They’re crying out for help, and don’t know how else to get it. These people don’t usually want to die but do want to alert those around them that something is seriously wrong. They often don’t believe they will die, frequently choosing methods they don’t think can kill them in order to strike out at someone who’s hurt them—but are sometimes tragically misinformed. The prototypical example of this is a young teenage girl suffering genuine angst because of a relationship, either with a friend, boyfriend, or parent who swallows a bottle of Tylenol—not realizing that in high enough doses Tylenol causes irreversible liver damage.
I’ve watched more than one teenager die a horrible death in an ICU days after such an ingestion when remorse has already cured them of their desire to die and their true goal of alerting those close to them of their distress has been achieved.
5. They have a philosophical desire to die. The decision to commit suicide for some is based on a reasoned decision often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren’t depressed, psychotic, maudlin, or crying out for help. They’re trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death. They often look at their choice to commit suicide as a way to shorten a dying that will happen regardless. In my personal view, if such people are evaluated by a qualified professional who can reliably exclude the other possibilities for why suicide is desired, these people should be allowed to die at their own hands.
6. They’ve made a mistake. This is a recent, tragic phenomenon in which typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems to me, is education.
The wounds suicide leaves in the lives of those left behind by it are often deep and long lasting. The apparent senselessness of suicide often fuels the most significant pain survivors feel. Thinking we all deal better with tragedy when we understand its underpinnings, I’ve offered the preceding paragraphs in hopes that anyone reading this who’s been left behind by a suicide might be able to more easily find a way to move on, to relinquish their guilt and anger, and find closure. Despite the abrupt way you may have been left, those don’t have to be the only two emotions you’re doomed to feel about the one who left you.
Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World.
Though I’ve never lost a friend or family member to suicide, I have lost a patient.
I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret makes for a bitter drink, the taste of which I’ve seen take many months or even years to wash out of some mouths.
The one question everyone has asked without exception, that they ache to have answered more than any other, is simply, why?
Why did their friend, child, parent, spouse, or sibling take their own life? Even when a note explaining the reasons is found, lingering questions usually remain: yes, they felt enough despair to want to die, but why did they feel that? A person’s suicide often takes the people it leaves behind by surprise (only accentuating survivor’s guilt for failing to see it coming).
People who’ve survived suicide attempts have reported wanting not so much to die as to stop living, a strange dichotomy but a valid one nevertheless. If some in-between state existed, some other alternative to death, I suspect many suicidal people would take it. For the sake of all those reading this who might have been left behind by someone’s suicide, I wanted to describe how I was trained to think about the reasons people kill themselves. They’re not as intuitive as most think.
In general, people try to kill themselves for six reasons:
1. They’re depressed. This is without question the most common reason people commit suicide. Severe depression is always accompanied by a pervasive sense of suffering as well as the belief that escape from it is hopeless. The pain of existence often becomes too much for severely depressed people to bear. The state of depression warps their thinking, allowing ideas like “Everyone would all be better off without me” to make rational sense. They shouldn’t be blamed for falling prey to such distorted thoughts any more than a heart patient should be blamed for experiencing chest pain: it’s simply the nature of their disease.
Because depression, as we all know, is almost always treatable, we should all seek to recognize its presence in our close friends and loved ones. Often people suffer with it silently, planning suicide without anyone ever knowing. Despite making both parties uncomfortable, inquiring directly about suicidal thoughts in my experience almost always yields an honest response. If you suspect someone might be depressed, don’t allow your tendency to deny the possibility of suicidal ideation prevent you from asking about it.
2. They’re psychotic. Malevolent inner voices often command self-destruction for unintelligible reasons. Psychosis is much harder to mask than depression — and arguably even more tragic. The worldwide incidence of schizophrenia is 1% and often strikes otherwise healthy, high-performing individuals, whose lives, though manageable with medication, never fulfill their original promise.
Schizophrenics are just as likely to talk freely about the voices commanding them to kill themselves as not, and also, in my experience, give honest answers about thoughts of suicide when asked directly. Psychosis, too, is treatable, and usually must be for a schizophrenic to be able to function at all. Untreated or poorly treated psychosis almost always requires hospital admission to a locked ward until the voices lose their commanding power.
3. They’re impulsive. Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed. The remorse is usually genuine, and whether or not they’ll ever attempt suicide again is unpredictable. They may try it again the very next time they become drunk or high, or never again in their lifetime. Hospital admission is therefore not usually indicated. Substance abuse and the underlying reasons for it are generally a greater concern in these people and should be addressed as aggressively as possible.
4. They’re crying out for help, and don’t know how else to get it. These people don’t usually want to die but do want to alert those around them that something is seriously wrong. They often don’t believe they will die, frequently choosing methods they don’t think can kill them in order to strike out at someone who’s hurt them—but are sometimes tragically misinformed. The prototypical example of this is a young teenage girl suffering genuine angst because of a relationship, either with a friend, boyfriend, or parent who swallows a bottle of Tylenol—not realizing that in high enough doses Tylenol causes irreversible liver damage.
I’ve watched more than one teenager die a horrible death in an ICU days after such an ingestion when remorse has already cured them of their desire to die and their true goal of alerting those close to them of their distress has been achieved.
5. They have a philosophical desire to die. The decision to commit suicide for some is based on a reasoned decision often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren’t depressed, psychotic, maudlin, or crying out for help. They’re trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death. They often look at their choice to commit suicide as a way to shorten a dying that will happen regardless. In my personal view, if such people are evaluated by a qualified professional who can reliably exclude the other possibilities for why suicide is desired, these people should be allowed to die at their own hands.
6. They’ve made a mistake. This is a recent, tragic phenomenon in which typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems to me, is education.
The wounds suicide leaves in the lives of those left behind by it are often deep and long lasting. The apparent senselessness of suicide often fuels the most significant pain survivors feel. Thinking we all deal better with tragedy when we understand its underpinnings, I’ve offered the preceding paragraphs in hopes that anyone reading this who’s been left behind by a suicide might be able to more easily find a way to move on, to relinquish their guilt and anger, and find closure. Despite the abrupt way you may have been left, those don’t have to be the only two emotions you’re doomed to feel about the one who left you.
Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World.
Tuesday, January 12, 2010
Teen Suicide Risk Factors: Parents Are Too Often Clueless
By Nancy Shute
Suicide is the third leading cause of death among teenagers, and it's a tragedy that can be prevented. Given that almost 15 percent of high school students say they've seriously considered suicide in the past year, parents and friends need to know how to recognize when a teenager is in trouble and how to help.
Parents can be clueless when it comes to recognizing suicide risk factors, or at least more clueless than teens. In a new survey of teenagers and parents in Chicago and in the Kansas City, Kan., area, which appears online in Pediatrics, both parents and teenagers said that teen suicide was a problem, but not in their community. Alas, teen suicide is a universal problem; no area is immune.
The teenagers correctly said that drug and alcohol use was a big risk factor for suicide, with some even noting that drinking and drug use could be a form of self-medication or self-harm. By contrast, many of the parents shrugged off substance abuse as acceptable adolescent behavior. As one parent told the researchers: "Some parents smoke pot with their kids or allow their kids to drink."
Both teenagers and parents said that guns should be kept away from a suicidal teen. But since parents said they didn't think they could determine when a teenager was suicidal, parents should routinely lock up firearms, the researchers suggest. That makes sense. Firearms are used in 43.1 percent of teen suicides, according to 2006 data, while suffocation or hanging accounts for 44.9 percent.
The good news: Both parents and teenagers in this small survey (66 teenagers and 30 parents) said they'd like more help learning how to know when someone is at risk of committing suicide and what to do. Schools and pediatricians should be able to help, but we can all become better educated through reliable resources on the Web. These authoritative sites list typical signs of suicide risk, and they also provide questions a parent or a friend can ask a teenager to find out if he is considering killing himself. Here are good places to start:
The American Academy of Child and Adolescent Psychiatry lists signs and symptoms of suicidal thinking, such as saying things like "I won't be a problem for you much longer."
The American Academy of Pediatrics urges parents to ask the child directly about suicide. "Getting the word out in the open may help your teenager think someone has heard his cries for help."
The National Suicide Prevention Lifeline provides free advice to someone considering suicide, as well as to friends and relatives, at 800-273-TALK.
The National Alliance on Mental Illness's teenage suicide page makes the point that talking with someone about suicide will not "give them the idea." "Bringing up the question of suicide and discussing it without showing shock or disapproval is one of the most helpful things you can do," the NAMI site says. "This openness shows that you are taking the individual seriously and responding to the severity of his or her distress."
Suicide is the third leading cause of death among teenagers, and it's a tragedy that can be prevented. Given that almost 15 percent of high school students say they've seriously considered suicide in the past year, parents and friends need to know how to recognize when a teenager is in trouble and how to help.
Parents can be clueless when it comes to recognizing suicide risk factors, or at least more clueless than teens. In a new survey of teenagers and parents in Chicago and in the Kansas City, Kan., area, which appears online in Pediatrics, both parents and teenagers said that teen suicide was a problem, but not in their community. Alas, teen suicide is a universal problem; no area is immune.
The teenagers correctly said that drug and alcohol use was a big risk factor for suicide, with some even noting that drinking and drug use could be a form of self-medication or self-harm. By contrast, many of the parents shrugged off substance abuse as acceptable adolescent behavior. As one parent told the researchers: "Some parents smoke pot with their kids or allow their kids to drink."
Both teenagers and parents said that guns should be kept away from a suicidal teen. But since parents said they didn't think they could determine when a teenager was suicidal, parents should routinely lock up firearms, the researchers suggest. That makes sense. Firearms are used in 43.1 percent of teen suicides, according to 2006 data, while suffocation or hanging accounts for 44.9 percent.
The good news: Both parents and teenagers in this small survey (66 teenagers and 30 parents) said they'd like more help learning how to know when someone is at risk of committing suicide and what to do. Schools and pediatricians should be able to help, but we can all become better educated through reliable resources on the Web. These authoritative sites list typical signs of suicide risk, and they also provide questions a parent or a friend can ask a teenager to find out if he is considering killing himself. Here are good places to start:
The American Academy of Child and Adolescent Psychiatry lists signs and symptoms of suicidal thinking, such as saying things like "I won't be a problem for you much longer."
The American Academy of Pediatrics urges parents to ask the child directly about suicide. "Getting the word out in the open may help your teenager think someone has heard his cries for help."
The National Suicide Prevention Lifeline provides free advice to someone considering suicide, as well as to friends and relatives, at 800-273-TALK.
The National Alliance on Mental Illness's teenage suicide page makes the point that talking with someone about suicide will not "give them the idea." "Bringing up the question of suicide and discussing it without showing shock or disapproval is one of the most helpful things you can do," the NAMI site says. "This openness shows that you are taking the individual seriously and responding to the severity of his or her distress."
Friday, January 1, 2010
Teen depression and suicide risk linked to late bedtimes and chronic sleep deprivation
A report from the Jan. 1, 2010 issue of the journal Sleep found a surprising link between the typically late bedtimes of teenagers and teen depression and suicide.
Parent-set bedtimes affect teen's mental state
Adolescents with parent-set bedtimes after midnight had a 24% increased incidence of depression and a 20% increase in suicidal thoughts compared to teens with a bedtime before 10 pm.
Most of the teens in the study reported adhering to the bedtimes their parents set for them, showing that it's up to parents to give appropriate guidelines for avoiding sleep deprivation.
Length of Sleep Matters for Adolescents
The length of sleep matters, too, according to the researchers. Teenagers who reported getting less than five hours of sleep a night had a 71% higher risk of depression and a 48% higher risk of suicidal thoughts than adolescents who got 8 hours or more of sleep.
The AASM (The American Academy of Sleep Medicine) recommends nine or more hours of sleep a night for adolescents.
The study was conducted by James E. Gangwisch, PhD, assistant professor at Columbia University Medical Center in New York, N.Y and colleagues and looked at over 15,000 teenagers' sleep habits and mental states. The teens in the study ranged from 12-17 years old.
Other studies indicate more benefits from increased teen sleep.
In previous studies, shorter sleep durations in children and teens have been linked to higher rates of obesity, school performance and general social well-being. And adolescents who don't get enough sleep due to insomnia are far more likely to develop mental health problems, including substance abuse.
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