When Serving Becomes Surviving: PTSD and Suicide in the Fire Service

by Peggy Sweeney
The Sweeney Alliance

Editor’s Note: Tim Casey, referenced in this article, was a dear friend of mine who took his own life in the summer of 2015. 

While watching a news report about a major apartment fire with many casualties including several children, I became aware of a group of professionals who regularly experience grief and traumatic stress; specifically, the men and women who serve their communities as firefighters. In spite of their dedicated service to their communities, few people in the civilian world are aware of, or seem to be concerned about, their physical, mental, and emotional struggles. Soon after that newscast, I outlined the Grieving Behind the Badge program and set my sights on offering help. I had expertise in grief and loss, but that did not prepare me for the obstacles before me.

when serving

The fire service is a culture unto itself. Words such as brotherhood and sisterhood and family are not loosely used in fire stations. If a firefighter is severely injured on the job, the hallways of the hospital are lined with members of their department who stand watch and attend to every need of the family. When a firefighter dies in the line of duty, every firefighter from that department or station stands watch on scene until the body is recovered and carried respectfully to the waiting ambulance.

Because of this closeness to one another, you can surely understand how difficult it is for a civilian, much less a woman, to gain acceptance into their minds and hearts. In other words, I didn’t walk the walk nor talk the talk of a firefighter. Before I could help them, I needed to educate myself. Fortunately, I met several emergency response professionals who willingly shared their personal stories that brought to light many of the demons that haunted their dreams and contributed to the rising statistics of substance abuse, divorce, post-traumatic stress (PTSD), and suicide in the fire service community.

“Who takes care of us? Our families? They try, I know mine did. But the average or normal person cannot share our experience, they can’t imagine what we do or see. … For me personally, I decided to treat my condition, my discomfort with alcohol. The ease and comfort that came from a bottle was a welcome house guest. I could turn off the noise, shut out the visions and thoughts with at first a few beers and in the end gallons. … Only by chance did my wife discover my suicide attempt, without her intervention my effort would have been a success”. (Casey, 2012)

By 2000, I had presented numerous Grieving Behind the Badge programs in North America. With each classroom experience, I began to see a pattern emerge. Some of the participants, when asked if they were disturbed emotionally or mentally by traumatic calls, emphatically stated that they were tough and strong. They had been taught to “suck it up” and not talk about their problems with anyone. In contrast, the majority of the firefighters stated that they were bothered by some of the more traumatic calls. When they sought out their fellow firefighters to talk about these calls and their feelings, they were often shunned or ridiculed for being weak or unable to handle the emotional strain of their job. No one in the fire service wants to be labeled as unfit or suffering from some form of mental illness. The stigma is too much to bear.

“I was a bad ass firefighter, a seasoned veteran, even looked up to. How could I be seen as weak? Simply put, I couldn’t. So I pushed on, I drank more, worked more and everything around me began to crack and fall apart”. (Casey, 2012)

As of 2010, according to the National Fire Protection Association (NFPA, 2011), there are approximately 1,103,300 firefighters in the United States: 30% career (full time, paid) and 70% volunteer. Firefighters (both paid and volunteer) are usually:

“first on the scene of accidents, suicides, and acts of violence (assault and battery, rapes, bombings, school shootings, etc.). They respond to floods, earthquakes, and airline crashes where the death toll and property destruction is overwhelming. They care for victims of domestic violence and child abuse. Firefighters extricate mangled bodies from motorized vehicles following an accident and provide medical assistance to homeless patients on the streets of inner cities. At times, they must physically restrain patients who are combative due to mind-altering drugs. Likewise, they comfort parents and family members when a child or loved one has died. Moreover, all too often, they must cope with grief following the death of a fellow firefighter in the line of duty.” (Sweeney, 2000)

In the last several years, suicides within the fire service have been increasing at an alarming rate. It is hard for anyone to know exactly how many suicides have actually occurred. Gary Ludwig, a well-respected fire service professional, states that “no one truly tracks the number of suicides among paramedics, firefighters, or even police officers. Some say the reason why is because suicide overall — the cause of nearly 11 of every 100,000 U.S. deaths annually — is underreported. … [the] Occupational Safety and Health Administration (OSHA) only tracks on-the-job deaths – not those that occur off the job” (2011).

Some firefighters may receive help shortly after a traumatic call in the way of a critical incident stress debriefing (CISD) or visiting with a department chaplain. A few departments have taken a step further and implemented programs that include information on PTSD and suicide prevention.

Chicago Fire Department, December 22, 2010. Two firefighters, Corey Ankum and Edward Stringer died in the line of duty
Chicago Fire Department, December 22, 2010.
Two firefighters, Corey Ankum and Edward Stringer
died in the line of duty

The Chicago Fire Department suffered the suicide deaths of seven firefighters in an eighteen month period between 2007 and 2008. They embarked on a research project to understand why and discovered that between 1990 and 2010 there were 1,787 deaths of active firefighters. Of these, forty-one had died by suicide.

The study found that while the national suicide rate during the same time period ranged between 10 and 12 suicides per 100,000 people each year, when the Chicago [Employee Assistance Program] EAP stats were converted to match the national numbers, the number was around 25 suicides per 100,000 people. (Peluso, 2012).

Following this investigation, the department launched a program, Family Fun Days, which invites participants to learn more about mental health issues, nutrition, and managing finances in a less stressful environment. A Tip o’ the Helmet to the Chicago firefighters for helping to erase the stigma of mental illness!

With all the good that departments like Chicago have done, it has been my experience that the majority of fire chiefs do nothing to help their firefighters cope with grief and traumatic stress. They continue to lead with the mantra “tough it out and go on”. Many departments do not have a program in place that provides information on PTSD and suicide prevention. Some firefighters have lost their jobs or have been turned away from their department because they suffer from emotional trauma due to many of the calls they have been on.

Even more disturbing is that, in most cases, a firefighter who has died by suicide is not honored by his department for their years of service and dedication to their community as they would have, had they died in the line of duty. In addition, many families of the deceased have not been offered emotional support or assistance because their loved one died by suicide.

“Post-traumatic stress disorder, depression and even suicide are very real and vastly underappreciated threats to the safety and careers of our first responders. And it’s time the rest of us acknowledged it, de-stigmatized those conditions and gave front-line staff better tools with which to cope”. (Cornies, 2012)

To train to become a firefighter is one of the greatest gifts you can give to your community. Few civilians appreciate the many sacrifices they make or the toll it takes on their body, mind, and spirit. Firefighters consistently come in contact with many elements of stress and trauma. They deal with life-threatening situations and witness human tragedy and death regularly. While trying to cope with the carnage, the stress, and the nightmares, they return again and again to fight fires and save lives. They struggle physically, mentally, and emotionally to survive the horrific calls. Then return home to self-medicate to forget. For many of them, this is their normal day.

References Casey, T. O. (2012). The slow death of a firefighter. Retrieved from https://grievingbehindthebadgeblog.net/2014/02/12/slow-death-of-a-firefighter-casey/

Emergency responders put their life on the line. Retrieved from https://grievingbehindthebadgeblog.net/2014/03/18/emergency-personnel-cornies/

Ludwig, G. (2011). Suicides among firefighters and paramedics. Retrieved from http://www.firefighterclosecalls.com/news/fullstory/newsid/130593/

National Fire Protection Association. (2011). U.S. fire department profile through 2010 survey. Quincy, MA: Author.

Peluso, P. (2012). Chicago firefighter suicide report seeks answers. Retrieved from http://www.firefighterclosecalls.com/news/fullstory/news/Chicago

Sweeney, P. (2000). Firefighters at risk. Retrieved from http://sweeneyalliance.org/grievingbehindthebadge/firefighters-at-risk/

About the Author: Peggy Sweeney is a mortician and bereavement educator and the president of The Sweeney Alliance. She has developed and taught countless workshops for coping with grief and trauma including the Grieving Behind the Badge program for emergency response professionals. She has written numerous award-winning articles and is the editor of the Grieving Behind the Badge newsletter. Peggy is a former member of the Comfort (TX) Volunteer Fire Department and a former EMT-B. If you would like additional information, please contact Peggy at peggy@sweeneyalliance.org