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Firefighters; they are the men and women who save property and lives. But what happens when their lives need saving? That’s the dilemma for hundreds of first-responders each year. The demands of the job and the repeated trauma they see can leave many in crisis.

Firefighters face the risk of many behavioral health concerns such as anxiety, depression, burnout and PTSD, etc. But the problem is that first responders don’t talk about behavioral health when it comes to each other. The often mentioned mantra in Fire/EMS/Law Enforcement is “We help others but never ourselves.” There is a stigma to admitting that the stress and the often disturbing scenes they respond to might be getting to them.

What makes suicide so difficult to prevent is that it is not a condition or disorder, but rather an outcome that may result from the presence (or accumulation) of many risk factors. What makes a suicide in first responders even more difficult to prevent is that they are the helpers. Who are they supposed to call for help when they are the ones who need it? Why is it so difficult for someone in Fire/EMS/Law Enforcement to ask for help? The risk of losing their peer’s respect, fear of being viewed as weak and unable to perform their jobs, fear of confidentiality, fear of losing their career? It’s no wonder, so many of the helpers suffer in silence. Many say seeking help can leave them on the fringe, considered damaged goods by their crew.

And that’s a problem; firefighter ranked number one in CareerCast’s annual survey of the most stressful jobs in 2015, just ahead of soldiers. CareerCast described the profession as, “dangerous in ever-changing conditions, with work not limited to battling blazes; firefighters also assist with medical emergencies and natural disasters.” Firefighters across the nation echo the idea of going to work each day not knowing if they will come back alive.

And that daily stress, combined with limited opportunities to talk about it, is taking a toll – as evidenced by the number 285. That’s the number of active and retired firefighters in the U.S. who are known to have taken their lives since 2012. It’s what many in the profession call “the hidden dirty little secret.” With 46 firefighters in 2015 already lost to suicide, something has to change.

It was a little- discussed topic by fire departments until Captain Jeff Dill created the Firefighter Behavioral Health Alliance (FBHA). Dill started the nonprofit after hearing about the emotional impact the World Trade Towers disaster had on firefighters in 2001, and talking with first responders about lack of mental health resources for those returning from the devastation of Hurricane Katrina in New Orleans. Captain Dill says the number of firefighter suicides that get reported is only the tip of the iceberg.

In 2004, the National Fallen Firefighters Foundation (NFFF) invited fire organization leaders to a summit on preventing line-of-duty deaths. A document titled “16 Firefighter Life Safe Initiatives” was drawn up to promote health, safety and cultural changes in the firefighting community. Number 13 calls for better access to psychological support and counseling for firefighters and their families addressing the occupational stress they face, and to counter the growing incidence of Post-Traumatic Stress Disorder cases.

Despite the effort, the problem continues. A January 2015 article in USA Today cited National Fallen Firefighters Foundation statistics that a fire department is three times more likely to experience a suicide in a given year than a line-of-duty death. They added that PTSD, depression, substance abuse and suicide were still all too common.

Slowly, more and more resources are being created to help firefighters deal with the stress of the job. The Firefighter Behavioral Health Alliance is a great first-step, with information and links to support agencies. The National Volunteer Fire Council and the National Fire Protection Association also dedicate numerous resources to linking firefighters in crisis with agencies that can help.

Some of those are:
Emergency Ministries – providing chaplains for first-responder counseling and support,
Rosecrance Florian Program – offering substance abuse treatment and PTSD support for firefighters and paramedics,
• NVFC Fire/EMS Helpline, 1-888-731-FIRE
North American Firefighters Veteran Network – 24 crisis line for addiction, anxiety, stress and more,
The Sweeney Alliance – The focus of their program First Step Hope: Not All Wounds Are Visible addresses the difficult topics that few in the first responder professions discuss or have resources for PTSD, Suicide intervention and prevention, loss and grief.
Station House – Treatment facility exclusively for first responders, established by first responders.
American Academy of Experts in Trauma Stress – collaborating with organizations to meet the needs of victims and survivors

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