by Peggy Sweeney
Author’s Note: I address firefighters in this article, but the information provided applies to any and all emergency response and public safety professionals.
Suicide is a very serious topic that we rarely discuss. Each year, thousands of adults and children either attempt or complete suicide to resolve problems or put an end to emotional pain. As a result of their deaths, surviving family members and friends not only grieve, but must cope with feelings of guilt, anger, and the archaic stigma associated with suicide.
Suicide is a major, preventable public health problem. According to the Centers for Disease Control, in 2010 it was the tenth leading cause of death in the U.S., accounting for 38,364 deaths.
Based on data about suicides in 16 National Violent Death Reporting System states in 2009, 33.3% of suicide descendents tested positive for alcohol, 23% for antidepressants, and 20.8% for opiates, including heroin and prescription pain killers.
Men completed suicide four times more often than women at a rate of 79% of U.S. suicides. Suicide is the seventh leading cause of death for males and the fifteenth leading cause for females. Suicide is the second leading cause of death among 25- to 34- year olds, the third leading cause of death among 15- to 24-year olds, and the eighth among 55 – 64 persons . One of the major risk factors for suicide is depression and other mental disorders, or a substance-abuse disorder (often in combination with other mental disorders). More than 90 percent of people who die by suicide have these risk factors(1). For every suicide death, it is estimated that an average of six family members and friends will experience the pain of grief; a figure I believe is extremely low. You may read the full report HERE.
“Suicide is the complication of the disease of depression. It is a complication because not all with depression complete suicide, but all who complete suicide suffer from some type of depression”. Sue Endsley; her son, Ryan, died by suicide at the age of 19.
How does depression feel?
To help you understand the severity of emotional trauma, I would like to paint a mental picture of what my severe depression felt like in 1985. I have labeled it the “well of depression”. It is a very deep, very dark place, cold and lonely. The walls of this well are slimy and moss-covered. It smells rancid and the floor is broken into huge junks, you are not able to maintain a stable footing. As you look up from the depths of the well, you can only see a faint glimmer of light. No matter how hard you try, you cannot pull yourself up and out. The safety rope that dangles in the center of the well is just out of your reach. Your silent screams for help appear to fall on deaf ears. Your once secure and normal life continues to slowly plummet into the depths of deep despair. You feel as though you have lost control of everything. You doubt your self-worth. Everything appears hopeless.
Wes describes his depression as if he were standing on the shore on a very cold, cloudy, windy day. The ocean waves came roaring to shore. He knew he could be consumed by the waves and taken out to sea. He needed to seek shelter from the storm, but he could not move away from the shoreline. He feared for his life. No one was there to rescue him. He felt very alone. And then the waves finally rolled over him and he was taken by them. They are the waves of depression. This depression can last a few hours, or days, or weeks, or months…. or a lifetime.
During my brief time in this well of depression, I saw no ready answers for the problems I was facing. Many people would probably view my struggles as minor dilemmas, simple and easy to solve. Yet, as the days and weeks elapsed, I sank deeper and deeper into depression. I could not think. I could not rationalize the apparently easy solutions to my problems. On one hand, I felt as if no one cared about me, on the other, I did not want to trouble them with my fears. I questioned my self-worth and the value of my existence. My thoughts of death had a calming effect. I cared very much for my family, yet their love could not dispel the need I had to end the emotional pain.
When someone is in a severe depression they often disguise their true feelings. They may appear normal, their usual self. Some of their behaviors may be out of character, but nothing so unusual that you would question his or her behavior. Slowly over time, you may begin to notice a deviation in their personality. A once happy and outgoing person, they now appear withdrawn and troubled. In spite of this change in personality you assume that they are going through some rough times and will be back to normal in a few days. I was one of the lucky ones. I had a friend that hung in there with me until I got over the rough spots. Because of her, I chose life. For many, this is not the case. Many choose suicide.
Why is there suicide in the fire service?
Professions, such as firefighting, contribute many elements of stress and trauma that greatly exaggerate depression. These men and women are placed in life-threatening situations and witness human injury and death regularly. After one of these traumatic calls, they realize that the other firefighters in their department appear to be coping with the severity of the call with no apparent trouble. No one talks about the nightmares or the recurring thoughts of the horrific incidents that haunt them daily. He or she assumes that everyone else is dealing with the stress; therefore, something must be wrong with them.
Being injured or disabled as the result of their hazardous job may also cause depression. Because they can no longer function as a firefighter, they believe that they are of no value to their department or have a purpose in life. They may be dealing with seemingly insurmountable personal problems such as a divorce, chronic illness of a family member, financial worries, or substance abuse, to name a few. Rather than asking for help (they may be perceived as weak), they will turn these feelings and thoughts inward. As each new traumatic incident and/or personal struggle occurs, they slip deeper and deeper into depression. It is no wonder that the fire service has one of the highest suicide rates in America. Sadly, the numbers are escalating at a rapid pace.
Among members of the emergency response professions, it has been my experience that one specific issue or event does not trigger genuine thoughts of suicide, but rather a culmination of traumatic events over years. Left unresolved, without the benefit of trained, professional help, many firefighters become increasingly depressed and overwhelmed by these events. Many develop post traumatic stress disorder (PTSD); an anxiety disorder often associated with combat veterans or frontline emergency workers like police officers and firefighters(2). Thoughts of suicide become more focused and appear to be a ready answer for ending the deep emotional pain that has been their constant companion over the years.
As we all know, human beings require certain basic needs, such as food and water, for survival. It is also very important for our survival to feel needed and appreciated, loved and cared about. When our perceptions of life and living become skewed and there is no one to help us cope with depression, we fall deeper and deeper into the well or the waves come closer and closer to consuming us. It is during this difficult time that many people will resort to the use of mind-altering drugs and/or alcohol (or other potentially addicting solutions such as chronic gambling or compulsive spending) as a means of coping with their emotional problems. These temporary remedies merely assist in numbing the pain they are feeling, but do nothing to resolve the reasons for the deep-seated problem of depression.
Help for firefighters
Too many firefighters are dying by suicide! Many organizations within the fire service continue to receive federal dollars for studies on firefighter suicides. We have enough information on this topic. As early as 1991, these same fire service organizations studied this important topic. I do not need another study! I do not need to know how many firefighters have died by suicide, how it was accomplished, or the events that led up to their suicide. The death of one firefighter by suicide is enough for me to know that help is needed NOW.
Where can firefighters/EMS, police and correctional officers, and 911 dispatchers go for help if it is not offered through their fire department or agency?
- Warrior’s Heart – PTSD, Addiction and Chemical Dependency Treatment Center for Veterans and First Responders in San Antonio, TX
- West Coast Trauma Retreat, Joel Fay
- Picking Up the “Peaces” (Australia), Kate and David Tonacia
- Badge of Life, Andy O’Hara
- Code 9 Project, Deborah Ortiz
- Federation of Fire Chaplains, Ed Stauffer
- Low Country Firefighter Support Team, Gerald Mishoe
- Emergency Chaplain Group, Skip Straus
We do not need money spent on another study. The money would be better spent on funding to establish chaplaincy programs, counselors experienced in addiction and ptsd therapies to help firefighters and their families, educational programs related to traumatic stress and suicide prevention as well as bereavement programs for fire departments and families touched by suicide. Some of these worthwhile programs have been in existence for a long time, but lack the financial help to reach those in need.
“While large city departments might have funding for Chaplaincy, small urban and rural departments do not. Our ministry operates primarily on individual and corporate donations. The difficulty we run into is that the agencies really know and receive the benefits of the Chaplaincy. They should, at the minimum, be instrumental in helping the Chaplaincy raise funding”. ~ Chaplain Skip Strauss, Emergencies Chaplain Group
It is an established fact that stress and traumatic events influence a person’s susceptibility to heart attacks, strokes, and other medical problems. I strongly believe that fire departments must recognize the importance of programs that focus on depression, post traumatic stress, addiction, suicide prevention, and coping with loss and grief.
Training them to deal with trauma, stress, and grief is no less important than training them to be safe on the fire ground. Peggy Sweeney
No longer can job-related stress in the fire service be ignored. It is the duty and responsibility of every fire service officer to provide for and enhance the emotional wellness of his or her department as well as themselves if needed. Without the support and dedication of everyone traumatic stress and grief will continue to take a toll on firefighters and their families.
Copyright Peggy Sweeney. All rights reserved.
1. Moscicki EK. Epidemiology of completed and attempted suicide: toward a framework for prevention. Clinical Neuroscience Research, 2001; 1: 310-23.
2. Crosby, D.: crisis calls take personal toll on 911 dispatchers.
The Courier-News: http://couriernews.suntimes.com/news/crosby/11582574-418/denise-crosby-crisis-calls-take-personal-toll-on-911-dispatchers.html