The public safety sector – including fire service, law enforcement, EMS and corrections – has made significant gains in raising awareness around suicide among first responders. But did you know that sometimes the very messages used to promote awareness can cause harm and undermine suicide prevention efforts?
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Suicide in the fire service is receiving an increasing amount of attention. A recent survey conducted by the IAFF of its members found that of the 7,000 firefighters who responded, 27% reported that they have struggled with substance abuse, and 65% were haunted by memories of bad calls. More than half reported that they have experienced family and relationship problems, and 19% have had thoughts of suicide.
After a suicide, there is a tendency to conduct a psychological post-mortem. What signs were there that could have been seen? What were the problems the firefighter was facing? Was it related to their job as a firefighter or was it due to family stress?
I have heard more than once about a suicide of a firefighter where the assumption was that the cause wasn’t the fire service, but rather family or marital issues and stressors.
The reality is that in most cases, we will never know what drove the firefighter to such extreme measures; however, the data also supports that firefighting (and any emergency response job) tends to have a significant impact on the members and how they relate to their world.
Firefighters comment on their behavioral health challenges
Fire and EMS personnel are called to respond to everyone’s worst day. Constantly being exposed to these traumas inevitably has an impact on the way people think and see the world.
As part of Center for Fire, Rescue and EMS Health Research study in the journal Work, we conducted focus groups and interviews with firefighters and fire service leaders, and asked about their perceptions of behavioral health challenges in the fire service.
Firefighters reported that they take the stress from being repeatedly exposed to trauma with them. For instance, one firefighter stated: “We had an accident on one of our main highways where we were working to try to get this car open, and the lady died before we could open it. It goes home with you. I mean, you don’t stop thinking about it ever. I mean, there’s not a day that goes by in my life where I don’t close my eyes and think about every person we’ve lost.”
But beyond just carrying the worst calls with them, firefighters reported that being exposed to trauma on such a regular basis also changes the way they respond and see the world.
Some discussed becoming desensitized to trauma and traumatic experiences. One person reported: “After you see enough people die and enough carnage, you go, ‘Oh well.’ And then, you don’t really reflect on it much, you know? You don’t really say, ‘Oh, that’s terrible.’ Like my wife will say, ‘Oh, that’s horrible,’ you know?’ And I’m like, going … How do I respond to that, you know? Well, I mean, you start getting … cold.”
Others described flashbacks and memories that bubbled up about past calls: “I can say that I think one part for me, because I’m a medic, and a lot of times I go on a call … from store to store. I’ve visualized a person that was laying there dead. That’s a problem for me a lot of times. I remember how this man was laid out and he was out. And so every time I go to the bank, I visualize him dead. Or, I go to a store when I drive past the store, I’m like, ‘Oh, that’s where that person got shot in the leg’ or ‘That’s where that baby got hit’ or ‘That’s where ….’ I tend to associate people with buildings.”
Becoming more cynical with time also was discussed as a common theme: “I think dealing with, like, rough and tough city people, it just makes you way more cynical in your personal life. I’m far more aggressive with people than I was five years ago. I was happy-go-lucky. I don’t care what they’re doing. Now, it’s like somebody can really just set me off.”
One recurrent theme that came up was the impact that being exposed to the stress of the job, and the changes it makes in a person, can play a role in family and personal relationships, as on individual described: “So, when something happens outside this job, your reaction is a stark contrast to what your spouse or family would think a normal person’s reaction would be; therein lies some conflict sometimes. You know, like, you don’t think this is a big deal because to you, it’s not. It’s not an emergency to you, but, you know, everyone’s perception of what an emergency is different for them. So, I’ve gotten into some issues over my reaction or lack thereof of a reaction to something when it should have been much bigger. I should be really upset, and I’m not.”
In many ways, being in the fire service and responding to the calls changes the meter of what registers as important for first responders, which can be a challenge. After a bad call, or a series of bad calls, day-to-day stressors and life challenges don’t always register on the “things I should care about” scale, which can lead to frustrations and interfere in relationships.
Firefighters discussed that sometimes the least stressful place they could be was at work, because at least they were around other people who understood.
Impact of the fire service lifestyle
Additionally, the lifestyle that the fire service requires place stress on families and firefighters. While missing a birthday or holiday from time to time can seem like no big deal, when it becomes missing one-third of birthdays or holidays based on shift schedules, it can begin to interfere.
For volunteer firefighters, never being off duty can also take a toll on the family, especially when the calls that come in never seem to come at the most convenient time.
Despite all this, research has found that male firefighters actually divorce at a rate lower than the general population. There seems to be something protective about the fire service for spouses of male firefighters, quite possibly the bonding of the fire service family and camaraderie that comes with being a “firefighter’s wife,” as all the products sold with that mantra can attest.
The same does not seem to hold true for spouses of female firefighters who have one of the highest rates of divorce of any occupation. While there isn’t research to tell us the reason for that yet, it’s likely related to the fact that women face different challenges with the fire service. In research on discrimination and harassment among women in the fire service, we found that women who experienced a moderate to severe amount of discrimination or harassment found the job impacted their home life negatively, had poorer health, and were more likely to be in the range of concern for depression and anxiety.
Consider the reality of the job
The job is not going to change, and there will inevitably be an impact – and changes in world views – for those who respond. It is not always a bad thing, but more a reality that needs to be considered when trying to understand relationships and what impacts them.
Editor’s Note: If you are feeling suicidal, please call the National Suicide Prevention Hotline immediately at 1-800-273-8255 or visit www.suicidepreventionlifeline.org to talk to someone who can help.
