Dena Ali outlined the factors involved in the fire service’s “dark secret”─firefighter suicide─and strategies for detection and prevention. The Raleigh (NC) Fire Department officer presented her classroom session “Fire Service Suicide Prevention Approach” on Thursday, April 27 at FDIC International 2017.
She said suicide can be prevented if the risk factors are recognized. Ali noted that in a given year, generally, the firefighter risk of death by suicide is three times that of death in the line of duty. The fire service must focus the same attention on preventing firefighter suicides as it does on preventing firefighter line of duty deaths.
Ali shared her own struggle and several case studies that pointed to common factors in this issue. Although a firefighter may appear to be happy and contented on the outside, that is often just a mask to conceal that person’s true feelings.
The precise reasons behind a suicide are often a mystery, since the person with all the answers is gone. However, factors common to a suicidal mentality include a feeling of disconnectedness, a thwarted desire to belong, and the feeling of being a burden to family, friends, and colleagues. These are among the strongest predictors for a potential suicide, Ali said.
Firefighters in this situation may avoid sharing their feelings with others because they perceive it as a sign of weakness. Ali said firefighters perceive their role as “pillars of society”; the strong ones who save others.
Post-traumatic stress disorder (PTSD) from continual exposure to the tragic circumstances in emergency response is another factor in suicide, she said. Possible indicators of PTSD include depression, drug/alcohol abuse, and recklessness. Ali said while each factor can be dangerous itself, if two are combined, such as depression and substance abuse, it can have a synergistic effect.
In creating a suicide outreach and prevention program, Ali recommended following National Fire Protection Association 1500, Standard on Fire Department Occupational Safety and Health Program (NFPA 1500, 2013 ed.) This latest edition particularly addresses critical incident stress as a part of overall firefighter health. She also noted there are several suicide prevention education initiatives are available from fire service organizations such as the National Fallen Firefighters Foundation and the National Volunteer Fire Council. Also, the Rosecrance Florian Program offers behavioral health treatment specifically geared to emergency responders.