I am honored to release this announcement from NFFF and acknowledge my role in contributing to this national inquiry that will seek to find new strategies to reduce firefighter suicide.

ANNOUNCEMENT

Contact:

Dr. Sally Spencer-Thomas Victor Stagnaro, Interim Managing Director

720-244-6535 National Fallen Firefighters Foundation

SallySpencerThomas@gmail.com (410) 721-1279

Washington, D.C. (April 5, 2018). The National Fallen Firefighters Foundation announced today that it will be partnering with Dr. Sally Spencer-Thomas to explore gaps and strengths in firefighter suicide prevention. This comprehensive evaluation will help set the direction for a new national suicide prevention program.

According to the National Fallen Firefighters Foundation, in any given year a fire department is 3 times more likely to experience a suicide than a line-of-duty death. Firefighters are able to engage in the life-saving work they do because of their stoic, self-sacrificial and service oriented personalities. Firefighters are able to engage in the life-saving work they do because of their stoic, self-sacrificial and service oriented personalities. While these strengths help firefighters save the lives of others, these same strengths may hinder their own help-seeking behavior when firefighters become incapacitated by stress. When these personality traits are coupled with their lowered fear of death and the inherent risks and challenges associated with the fire services, the result can be increased suicide risk.

Most firefighters had lived through significant exposure to trauma – both intense single events and the accumulation over their career. Some of this exposure, like suicide deaths and child fatalities, can be particularly disturbing. Post-traumatic reactions are common when combined with other job stressors, firefighters – who pride themselves on psychological hardiness – can sometimes find themselves overwhelmed.

For some, their ability to compartmentalize emotions and memories and to function as decisive problem-solvers starts to become compromised. Some may become prone to self-medication through substance misuse and other reckless behavior as a way to deal with the anxiety, depression, insomnia, and traumatic memories.

In addition to trauma exposure in the field, firefighters find many operational stressors exacerbate stress. Shift work, administrative challenges, sleep deprivation and family strain all come along with the work of being a firefighter, and these factors take their toll on well-being.

The “Us” versus “Them” mentality that is forged within the tight bonds of the fire service not only can isolate firefighters from people who care about them, it also can cultivate a profound mistrust of outsiders. This wariness often prevents them from reaching out to nonspecialized mental health professionals.

This barrier to help-seeking is compounded by the stigma of mental health challenges and suicide. Because firefighters routinely respond to situations involving people living with severe and chronic, poorly controlled mental health conditions, they associate “mental illness” with something from which they try to distance themselves.

Because firefighters work in tightly knit teams that depend on each other’s mental soundness for their personal safety, a strong tendency to hide struggle exists. No firefighter wants to be the weak link of the team. Many have forged most of their identity around being a firefighter; in other words they have a “single-source identity.” The threat of losing this vocation is much more than just losing a job. Opportunities for advancement are highly coveted and not making rank is often taken as a deep personal failure. Together these elements help explain why it is so challenging for firefighters to reach out for fear of repercussions.

Between these high levels of stress, great exposure to suicide and barriers to help-seeking, it is not surprising then to see that firefighters experience elevated rates of suicidality compared to the general population. A recent study of 1027 current and retired U.S. firefighters revealed career prevalence estimates:

Suicidal thoughts: 46.8%
Plans for suicide: 19.2%
Suicide attempts: 15.5%

By comparison, for the general U.S. population, lifetime rates of suicidal thoughts, plans, and attempts are 13.5%, 3.9%, and 4.6% respectively.

The good news is there are many protective factors that can be built upon to help firefighters through these difficult situations. First, the camaraderie within the fire service is powerful. The close bonds that are forged are as close as any family member. The firehouse becomes the second home. Second, the work offers a strong sense of purpose daily. When people have a mission-driven calling for their life, and they are able to connect to something larger than themselves, they have extra motivation to persevere when times get tough.

The purpose of this needs and strengths assessment project is to answer four questions:

How do we prioritize factors contributing to suicide risk and emerging risk?
How do we prioritize protective factors buffering against suicide risk?
What is needed for a strategic plan to prevent, intervene and respond to the crisis of suicide?
What are the key components of effective supports and outreach including family, peer support, Critical Incident Stress Management response, department psychologists, Employee Assistance Programs, Chaplaincy programs, and more?

The data for this gap analysis will be gathered by several methods on a national scope and will engage wildland, volunteer, large municipal departments and smaller departments, as well as family members. Throughout the process, an inquiry into these behavioral health needs will be examined over the course of his or her career from new recruit to advancement to retirement. Both qualitative and quantitative methods will be used including focus groups, in-depth-interviews, surveys, and literature review. The review will also harness the lessons learned from model programs like Broward, Houston, Phoenix, Chicago, and Denver.

The ultimate goal for the needs and strengths assessment is to inform the process of building a new national suicide prevention program.

“I am inspired to see how the National Fallen Firefighters Foundation is tackling the issue of suicide head on,” said Dr. Spencer-Thomas. “This approach of deep listening followed by thoughtful strategy development is key in making successful inroads into suicide prevention.”

References

NFFF (2014). Confronting Suicide in the Fire Service: Strategies for Intervention and Prevention. Retrieved on April 5, 2018 from https://www.everyonegoeshome.com/wp-content/uploads/sites/2/2015/02/Confronting_Suicide_FINAL.pdf

Stanley, I., Hom, M. & Joiner, T. (2016). A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and paramedics. Clinical Psychology Review, 44 (2016) 25–44.

Stanley, I. H., Hom, M. A., Hagan, C. R., & Joiner, T. E. (2015b). Career prevalence and correlates of suicidal thoughts and behaviors among firefighters. Journal of Affective Disorders, 187, 163–171. http://dx.doi.org/10.1016/j.jad.2015.08.007.

Henderson, S., Van Hasselt, V., LeDuc, T.& Couwels, J. (2016). Firefighter suicide: understanding cultural challenges for mental health professionals. Professional Psychology: Research and Practice, Vol. 47, No. 3, 224–230