The following article was submitted for the 2025 Fire Service Thought Leadership Essay Contest, focused on understanding the “why” behind mental health challenges in the fire service. This article received the second-place honor in the contest, which is managed by Darley, in partnership with the National Fallen Firefighters Foundation (NFFF).
Read past essays and learn how to submit your own essay.
By Marc Revere
I have long since stopped analyzing the origins of the mysterious prompts, those that shift one’s entire focus from concord to discord, such as the theme of this essay contest. They often trigger a kaleidoscope of memories, those on seldom-charted topics, only stopping when my subconscious surfaces a concise, poignant vignette to ponder, like this vivid remembrance.
It’s evening in 2015. I’m sitting on my usual bench between the 9/11 statue and the National Fallen Firefighters Memorial at the National Fire Academy. The air’s heavy and humid. Lightning flashes over Catoctin Mountain, highlighting the black skies, but too far to hear thunder. Fireflies, much closer, create their own light show as the eternal flame flickers, softly illuminating engraved plaques of the fallen on the stone monument.
Sitting in silence, I reconnected with some of those old friends, a long list of heroes. Getting up, I touched each name, letting them know someone remembers. Someone cares. Earlier that day, I gave the first keynote address at the Inaugural National Professional Development Symposium. It was an incredible honor juxtaposed with an evening of lament.
Having worked for decades in a brutally intoxicating profession, I’d thrived in life-and death arenas, chaotic maelstroms, struggling to make sense of things, restoring order while witnessing pain, unspeakable agony, and emotional suffering. An indelible visual repository of traumas, accidents, killings, suicides, natural and unnatural deaths, child abuse, elder abuse, SIDs, burns, CPRs, hangings, shootings, and LODDs, each conditioning me to lose friends.
And now, a decade later, as I always do, I am left wondering: Do construction workers, mechanics, teachers, lawyers, artists, musicians, janitors, businesswomen, and men have these thoughts? Do they have remarkable, unexpected reflections that come out of nowhere? I share these personal observations to answer one of the essay’s questions, ‘Why?’ At least, ‘the why’ for me, from a firefighter’s perspective. Notwithstanding other factors, some must face issues like sleep deprivation, hostile work environments, not fitting in, poor supervision, dysfunctional organizations, lack of support, marital problems, divorce, alcohol abuse, etc.
“Are Firefighters Really So Unique?” Yes, is the answer to the second question. But I am not referring to their passion, courage, devotion to duty, and commitment to service. When questioning their ‘mental health struggles,’ it’s the numbers that make them ‘unique’. Numbers based on data indicate a unique problem for the fire service. Here’s an example. The suicide rate for firefighters is 18 per 100,000, compared to 13 per 100,000 for the general public. According to the Firefighter Behavioral Health Alliance, there have been 1,750 firefighter suicides since 1880, with 95% of the deaths occurring between 2000 and 2022. It is those numbers and the skyrocketing increase (95%) that make us ‘unique’. Just like there is a rationale for the presumption law in my state covering heart, cancer, back, and lung illnesses, firefighters have a greater propensity to face these illnesses than the general population. Based on the data.
Solutions: Various existing models are available to address the mental health needs of firefighters, starting with “America Burning,” published in 1972. If we simply change the goals from 50 years ago to: 1) Congress will establish an agency to provide a national focus for firefighters’ comprehensive mental health program with adequate funding to reduce PTSD and suicide. 2) Congress will establish a national fire data system to review and analyze mental health issues unique to firefighters. It worked a half-century ago.
Or we can adopt a model currently available through the Law Enforcement Mental Health and Wellness Act of 2017. Their objectives are to 1) create a national crisis line, 2) Create a suicide event reporting surveillance system, 3) embed mental health professionals in law enforcement agencies, and 4) expand peer support programs for access for all officers.
There are two emerging solutions that address unique mental health challenges in other occupations that we could easily adapt for firefighters.
1. LandLogic, designed for farmers and ranchers, is one of the most common and well studied forms of psychotherapy. It’s based on the research by Dr. Michael Rosmann, who helped create a national network to prevent suicide among farmers. Couldn’t we just change the name and incorporate the unique issues of the fire services to better assist our members? We have done it before. Crew Resource Management, introduced to the Fire Service in 2001, is a variation of Cockpit Resource Management, which was introduced to Aviation in 1979.
2. Brain balancing is a treatment with impressive results. A 2021 study shows that brain mapping techniques increase resilience by 11%, including a 13% increase in relationship satisfaction, a 33% decrease in depression, and a 68% decrease in anxiety. Most importantly, there was an 18% decrease in suicidality and a 64% decrease in PTSD.
In one of the ten most influential books in the U.S., “Man’s Search for Meaning,” Viktor Frankl wrote, “You can live with any ‘how’ if you have a “why.” The “why” refers to a sense of purpose in life. The “how” represents the specific challenges individuals face. Frankl, an Austrian neurologist/psychologist, spent three years in concentration camps, including Auschwitz. His observations of fellow prisoners show that our solution is deceptively simple. People with a powerful reason or purpose to live can endure almost any hardship.
Mental health struggles are complex and intricately intertwined with the human experience. The American Fire Service’s (AFS) challenge is not to alleviate the pain of suffering members, but rather to find ways for them to become more comfortable tolerating their pain, while identifying ways to enhance their resilience.
The solutions I’ve addressed do not take into account the cost and resistance of our members. We can overcome those obstacles. We accomplished this with the 16 Firefighter Life Safety Initiatives, NFPA 1710, and other safety programs. Why can’t we start by identifying mental health situations that shout, “Watch Out!”
Many of us have made rapid “ready, fire, aim” size-ups, without having a complete picture, and then adjusted our aim when the unknowns are revealed. We are good at it. What should our size-up be for this crisis? “The AFS is on the scene of a National Mental Health crisis: offense mode: assuming Mental Health Command: Main Street USA.” Or we can approach it methodically using the Center of Public Safety’s strategic plan model. Or in combination with the four methods mentioned earlier. The tools are there! How much more do we need to learn from those in the trenches, experiencing mental health issues, or in their graves, before we act?
My title, “What Doesn’t Kill You Will Haunt You,” is a quote by Gordon King, the fire boss for the Loop Fire in California, where 12 El Cariso Hotshots lost their lives. And what haunts me are dead friends and colleagues, including firefighters who are still among the living, but who are physically and sometimes mentally not the same. Once upon a time, they were bulletproof heroes without weaknesses, the personification of courage and selflessness, and now they are living in a mental health purgatory. And often in the shadow of mental health assistance.
We must take a proactive approach to protect a vast ‘Sea of Blue’ by identifying processes that address their mental health struggles while implementing effective solutions. But if we lack the moral courage to act on behalf of those who daily demonstrate physical courage to serve others, who have seen things no one is supposed to see, and who need our support with resilience, healing, and hope, we must ask ourselves: What will haunt us years from now?
ABOUT THE AUTHOR
Marc Revere served as fire chief for the Novato, Mountain View and Monterey Park fire departments in California.