Thank you to individuals, families, and departments for sharing their stories about firefighter suicide. Sharing allows us to honor those who lost their lives and have an honest conversation about suicide. There’s a lot of discussion about why it is happening and what we need to do to address it. Recent media coverage points to post traumatic stress disorder (PTSD) as a leading cause.
Research indicates firefighter PTSD rates range from 3.5 to 37.5 percent. Many data come in the wake of large-scale events like the Oklahoma City bombing, 9/11 attacks, other mass casualty incidents, and international events related to weather and war catastrophes. We should expect big reactions with big events; however, we’re caught off guard when there are no major events or other tell-tale signs of suicidal thinking.
Earlier this year, the Centers for Disease Control and Prevention released new suicide statistics showing a 24-percent increase over the past 30 years, to more than 41,149 annually. According to the Firefighter Behavioral Health Alliance (FBHA), there were 132 reported firefighter and emergency medical services (EMS) suicides in 2015, with an estimated 40-percent reporting rate. If we add the 60 percent that are unreported, an estimated 211 commit suicide every year. This equals 1.6 percent of all suicides. So how does the firefighter and EMS suicide rate compare to that of the United States as a whole?
According to the U.S. Census Bureau, there were more than 324 million Americans in 2015. Roughly 1.28 percent of the total population dies by suicide each year. Now consider the 1,341,400 total population of fire and EMS. Roughly 1 to 1.6 percent of this population dies by suicide each year. It seems fire and EMS reflects similar suicide trends as the larger U.S. population.
Even though firefighter suicide is similar by numbers to the suicide rate of the general population, it is even more significant if you consider age. According to the U.S. Bureau of Labor, 91 percent of firefighters are between the ages of 20 and 59. This age range is by far the highest risk for suicide, accounting for more than 71 percent. So how can fire and EMS be chock full of the riskiest age group, with 3.5 to 37.5 percent having PTSD, and have virtually the same suicide trends as the general population? The answers are found within the remainder – the 62.5 to 96.5 percent of the population that don’t develop PTSD and the 1,341,189 that don’t commit suicide.
If you are on the job, you need to ask yourself the following: What keeps you going? What prevents you from committing suicide? How are you able to sleep at night? Why don’t you have PTSD? What keeps you from depression? What is it about fire and EMS that sets us apart from the general population? What are our strengths? Answering these questions will move us far ahead in the battle to save our own.
Suicide is a complex problem that will need a complex solution. There is no silver bullet that will fix this problem. It will take a collective mindset and cultural shift. We must think in layers and systems of overlapping support, education, and intervention. We need to adopt approaches like that of the Denver (CO) Fire Department that addresses “Total Wellness,” incorporating mental and physical health into every facet of the job. We need to recognize resilience when we see it. Resilience can be found within every rank, every station, and every department. We need to gang up on the problems, pool resources, collaborate, and face all the threats simultaneously head on.
There’s power within to save our own. The following three steps will help us to further define this power:
- Identify what type of adversities we’ve faced. In my experience, problems compound quickly! We’re rarely threatened in singular fashion. Examples of adversities include the following:
- Physical (illness, fatigue, injury, disease).
- Intellectual (thinking errors: all or nothing; filtering out positive; catastrophic, emotional reasoning; should have, would have, could have).
- Emotional (depression, fear, disgust, mistrust, inability to share emotions, unknown origin of emotions, feeling numb).
- Social (isolation, humiliation, loss of humor, pride injury).
- Spiritual (persecution, exclusion, anger toward God).
- Environmental (natural disaster, no safe/calm place, hazards).
- Occupational (role ambiguity, dissention among rank, leadership, merger, financial).
- Identify what was helpful for you or your department in overcoming the adversity. What kept you going, moved you through it? What did you do to address the issues? Did you have layers and systems of overlapping support? If so, what were they? How did you sleep at night? What held you together?
- Share what you know. Talk about what keeps you going. Talk about what prevents you from committing suicide. Talk about how you are able to sleep at night and why you don’t have PTSD. Share with your crew what keeps you from depression. Let’s figure out what it is about fire and EMS that sets us apart from the general population. Let’s identify our strengths and move forward in the battle to save our own.
Matthew Carlson, LPC, LAC, PhD Candidate
Professor of Counseling and Psychology
Cornerstone University (online)
Fraser, Colorado
Editor’s note: The writer was a driver-operator for Oshtemo Fire, Michigan, where he was decorated for valor and life saves. He has a master’s degree in counseling, is a licensed professional counselor and a licensed addiction counselor, and is the founder of Resilience Consulting.
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