By Jinnie Chua, Assistant Editor of In Public Safety
The growing number of firefighter suicides is staggering, especially when you consider that more firefighters are lost to suicide than in the line of duty. Since 1880, the Firefighter Behavioral Health Alliance (FBHA) has recorded 978 firefighter and EMT suicides in the United States, but this figure is much lower than the reality.
Jeff Dill, a retired fire captain and founder of FBHA, predicts that less than half of all firefighter suicides are reported. “It’s hard to tell if suicides are actually going up or if we’re just becoming more aware that they’re happening,” said Dill. “We’re the only ones in the country who are tracking and validating these deaths, and that’s a sad statement.”
What’s clear is that more needs to be done to recognize the issue, educate the firefighter community, and ultimately take measures to prevent firefighters from taking their own lives.
Better Reporting Leads to Better Prevention
A crucial aspect of addressing the mental health and suicide rates of firefighters is having the right data and information to approach the issue. “If we know as much as we can about the problem, we can know how best to attack it,” said Dill.
The FBHA offers a confidential reporting system on their website, where anyone can complete a form to report a firefighter or EMT suicide. Dill has also built an extensive network of contacts across the country and shares his personal cell phone number so fire chiefs or family members of firefighters can contact him directly after losing a loved one. The information collected is used to create better training programs and prevention strategies, which the FBHA offers to fire and EMS organizations in the form of educational workshops.
FBHA currently offers seven different workshops that aim to make behavioral health issues in the fire service more accessible to family members, counselors, Employee Assistant Programs (EAPs) and firefighters themselves. These workshops teach three main actions to take when it becomes apparent that a fellow firefighter is in need of help:
- Be direct – Take a proactive approach when you see a fellow firefighter struggling. Make an effort to engage them and don’t shy away from initiating a difficult conversation.
- Challenge with compassion – Ask them questions like “What do you mean by that?” or “Why are you acting this way?” Listen and if it appears they are in a crisis, do not leave them alone.
- Do an internal size-up – Spare a moment to be honest about your own feelings and struggles. It’s important for firefighters to look out for themselves as much as it is to look out for others.
“I tell firefighters – you’ve changed whether you realize it or not,” said Dill. “And how could you not? We’re expected to act brave and strong, but it’s tough to hold that image.”
The Danger of “Cultural Brainwashing”
FBHA reports that the five main causes for fire and EMS suicides are marital and family relationships, depression, addictions, health and medical issues, and PTSD. Dill believes that each of these causes stem from the greater, over-arching issue of “cultural brainwashing” where firefighters feel pressured to fit a certain image.
“You put this uniform on and you’re supposed to act brave, strong and courageous,” said Dill. For example, many firefighters find themselves battling cancer and end up taking their lives because they don’t want to be a burden to their families. “You’re supposed to give help, not ask for it.”
Although this is a dangerous ideal to live by, Dill maintains that the solution is not necessarily to break down the image that firefighters are brave and strong, but to encourage firefighters to show strength by recognizing when they’re struggling. It’s up to fire chiefs and leaders to lead the way by normalizing conversations about mental health and wellness.
“We have to start in our fire academies,” said Dill. “They teach us how to handle things on the fire ground and things like how to do paperwork around the station, but what about dealing with personal and emotional issues?”
Once fire chiefs have established open communication, it’s important to provide resources to deal with problems when they come up. In addition to Critical Incident and Stress Management (CISM) teams, Dill is a big advocate of creating peer-support teams. This involves specifically training members of your department to become points of contact that firefighters can approach on a day-to-day basis with any troubles. If peer-support members decide something should be escalated, they can then refer their fellow firefighters to a counselor or doctor who oversees the team.
Recognizing Those at Risk
Providing firefighters with support is now more important than ever. Dill recalls how in his early days of being a firefighter in the late 1980s to 1990s, firefighters dealt mostly with structure fires, vehicle accidents and even occasionally delivering a baby. But with recent mass shootings, terrorist attacks and other critical incidents, the trauma can hit firefighters quickly and hit them hard.
“We always said in the fire service, how call-after-call builds up,” said Dill. “That still happens, but nowadays, dealing with these horrific scenes and picking bodies up off the streets… It’s tough and it can hit you instantly.”
There are five warning signs that can indicate a firefighter is battling behavioral health issues and needs further help. It can be useful to remember “RAILS”:
- Recklessness/Impulsiveness – Erratic behavior or suddenly acting out of character.
- Anger – Suppressed or explosive anger over seemingly minor issues, often directed at the individual’s family.
- Isolation – Creating distance from fellow firefighters or losing interest in family activities at home.
- Loss of confidence in skills and abilities – Losing the ability to complete normal tasks due to overwhelming emotional or personal issues (e.g. a seasoned firefighter who can’t remember how put an engine in gear to pump.)
- Sleep Deprivation – Difficulty sleeping can indicate stress, anxiety, PTSD or several other emotional issues.
Although all firefighters could be at risk, some of the most vulnerable individuals to firefighter suicide are retirees. Unless they prepare for the transition, when a firefighter or EMT retires, they can find themselves dealing with loss of identity, belonging, and purpose. “Since 2011, we have validated 170 retirees and 36 of those 170 took their lives within the first week of retirement,” said Dill. “We cannot have that.”
The Importance of Vetting Counselors
One of FBHA’s main efforts is ensuring that every firefighter is referred to a qualified counselor who understands the culture of the job. “Those who are going to work with us need to understand who we are and what we do,” stressed Dill.
From understanding the terminology to realizing that it’s often against a firefighter’s instinct to unload their personal issues, counselors need to be familiar with cultural brainwashing and what firefighters experience on the job. If not, they could end up doing more harm than good. For example, Dill has worked with two firefighters who had their counselors pass out on them when they started sharing their stories. Such experiences can deter firefighters from seeking help again.
Being unfamiliar with the culture is the main reason firefighters tend to avoid Employee Assistant Programs (EAPs). However, Dill believes EAPs have the potential to be a great resource if staffed with individuals who are familiar with the fire service. Dill encourages fire departments to build relationships with EAP staff by inviting them for ride-alongs, allowing them to sit in on training, or simply inviting them over for dinner at the fire house. The same applies for chaplains and counselors in the community.
“You should be going out into your communities to start vetting and building these resources so one day, when a firefighter comes in and says ‘I need to talk about something,’ you’re prepared to help them,” said Dill. If firefighters or EMTs are struggling to find help, FBHA also offers to call counselors in the area and vet them for free.
“You really have to practice self-care when you get involved in these types of issues because you’re giving a part of your heart and soul,” said Dill. “You’re dealing with people’s lives.”