Firefighter Mental Health: The Job Is Killing Us

By Jeremy Hurd

An individual who wants to excel in his career will pursue training that is on the “cutting edge” of his industry. Retaining all of our members has always been the purpose of fire service training. We dedicate blood, sweat, time, and finances to reach that goal, and we strive to make that difference in stopping the needless deaths within our own firefighting community. When around 100 of our members perish each year, we say, “Not again this year!”

So, it’s time to address that other killer in the room that is affecting that many and more: our mental and behavioral health. Until recently, there were no attempts to track the number of firefighter suicides, but thanks to the Firefighter Behavioral Health Alliance and founder Captain Jeff Dill, we now have an idea of the real numbers. What they point out should alarm us all. Dill’s Web site (www.ffbha.org) starts with the statement, “The Firefighter Behavioral Health Alliance was founded to always remember our brothers and sisters in the fire and EMS service who took their lives.” Thanks to Dill and his team’s work of tracking suicides and talking about them, we now have a place to start this conversation.

Many fire service members are suffering from these issues in private because they don’t know what is going on, who they can turn to, or what kind of help they even need. As you read this article, you may even think of a firefighter in your department who committed suicide. Some of you may even think of someone with whom you work or a member of your family who has shown signs and symptoms of a real struggle and could make the decision to end it all. This article is for all of us because we either already know someone who is struggling or we will come across someone who needs our help.

A Trip to FDIC International

I had become discouraged at just how far behind we actually are in the arena of behavioral health, but then I attended the Fire Department Instructors Conference International (FDIC) in Indianapolis in April 2015. There I had several discussions with leaders in the field who made me hopeful. Years ago, there were no behavioral health classes at any fire-related conferences or training and, in the opinion of these experts, if these types of classes had existed, nobody would have attended. FDIC, by my count, featured 10 such behavioral health-focused classes, and there were even more that touched on these topics. I attended as many as I could, I learned some new lessons, and I had a few lessons reinforced.

I heard from Chicago (IL) Fire Department (CFD) Battalion Chief Dan DeGryse as he talked about his experience with the CFD’s Employee Assistance Program (EAP) and his current leadership and involvement with the Florian Program at the Rosecrance Institute. The Florian Program focuses on first responders dealing with co-occurring behavioral issues. Amazingly, there are firefighters out there who are against programs like this, claiming that such programs are money-making schemes. I have visited the Florian Program, and I have seen firsthand the preparation and resulting success. We don’t need firefighters speaking out against these types of programs; we need to encourage firefighters to attend these programs to get the help they can only find there. This is just one program that is proactively focusing on firefighters in need.

I also attended the class of psychologist and retired Bellevue (WA) Fire Department Firefighter Dr. Beth Murphy, who shared the story of a brave firefighter named Kevin who wanted to pass along his experience of leaving the job after almost 30 years, his accompanying desire to commit suicide, and how he overcame that desire with treatment and support. I was reminded that there are firefighters with whom we are serving who are hurting in ways we don’t see and can’t comprehend. However, when there is a need, we have to be ready to respond. During the class, Murphy opened the discussion up for comments, and a few brave souls (including my friend) shared how the audio recording of Kevin was a carbon copy of their lives. Post-traumatic stress disorder (PTSD) is real, and there were people in the audience suffering the effects; many of us had no idea these members existed before they spoke in that class.

Another class featured Coppell (TX) Fire Department Chaplain Steve Calvert, who explained how he integrated a pre-stress program within his department, how it spread to other departments, and why it has become a staple of training programs for officers and new recruits alike. His goal is to create a level of help for our personnel that falls “somewhere between the daily kitchen table counseling/debriefing and the professional clinical counseling that is offered through an EAP.” The focus here was to create peer counseling teams like the one that is successfully helping firefighters in the state of Illinois.

By the end of the week on Friday morning, I struggled to decide whether or not I would go to another behavioral health class or take a mental and emotional break and sleep in. Fortunately, I made the correct choice-I went to another class. Led by Western Springs (IL) Fire Department Chief Pat Kenny, this class informed students of the importance of behavioral health issues. As part of the class, Kenny shared a heart-wrenching story of how his son fought depression as a child and continued to fight hard until he finally ended his life as a young adult. Kenny explained how his experience with his son changed his view on depression and suicide. He also talked about his family’s fear as they walked through the “dark valley” together with no road map on how to handle the situation. He talked about how he decided to keep the problem a secret from the rest of his department and how it was the worst choice he could have made. Kenny said that he justified not sharing the information because he wanted his son to feel normal and be welcomed into the station at all times, also saying that he finally realized that the real reason for the secrecy was that he didn’t want his personnel to worry that they couldn’t follow their chief because he was having problems taking care of his son’s needs.

He also showed the class a video that he made where he discussed this part of the story. Kenny pointed out that everyone needs to talk about their struggles whether they are significant or minor because it can help us work through them; this may also help someone else work through issues he assumed he was battling alone. Being genuine with open honesty will also help our personnel see us as real people with real issues; this goes for every firefighter regardless of position or rank. Kenny summed up the session with this powerful statement: “We don’t need to be Superman wearing a cape trying to save the world; all the while, the cape is choking the life out of us.”

After Kenny’s class, I decided I had shed enough tears and taken in enough depressing information, and I needed a break. I walked through the exhibits and talked to some friends; after a while, an overwhelming thought came to me: “We can’t just talk about it. We have to do something. I have to do something.”

We have to start training our personnel on the specifics of how to prepare themselves for the job so they don’t end up a statistic. We can’t inoculate our personnel from all trauma and traumatic stress because anyone who does the job for any length of time is going to see and experience traumatic scenes that he will never be able to “unsee” or “unexperience.” However, we can prepare him so he knows how to recognize the signs of these stressors and do something about them immediately. We simply cannot and must not turn a blind eye to those who are suffering. For too long, we have covered for our members when they have a need, and we have not intervened enough to get them actual help.

I had this burden in mind when I met with more than 30 people from the Palm Beach County, Florida, area for Thursday night dinner that week. My friend, Palm Beach County (FL) Fire Rescue Captain Larry Doelling, who had been in many of the same classes with me, said to me, “We have to change the way we are educating our people.” He grabbed me by the shoulder and said, “I’m with you. I have some ideas that I want to implement.”

We proceeded to talk about adding more hours of training that centered around behavioral health and prevention. We will now incorporate this training into our new recruit and officer training that occurs before officer promotions. We want our personnel to start thinking about themselves and the stress they have faced and will face, but we also want them to start watching out for their fellow members.

Kenny used the following analogy to describe how this works: If a probationary firefighter observed a captain or a chief on the fireground walking into an area where a wall was about to collapse, he would be expected to scream out a warning and even push him out of harm’s way, if necessary. Why would we expect any less from our firefighters who see a wall of stress about to collapse onto one of our own?

At the conclusion of the conference, I had dinner with DeGryse, Calvert, and Father Jimmy Swarthout. We compared notes, talked about plans, discussed failures and successes we have seen, and talked of our hopes for the future of behavioral health. We were glad that the conference offered multiple classes on the issue and that many people had attended them. Then, DeGryse asked us, “Are we really making a difference? These classes were offered this one time; a few hundred people attended in total, and I feel like we went from trying to empty the ocean with a thimble to using a large spoon instead. That’s still not going to make enough of a difference.”

It made me upset because it was a brilliant question, and I hadn’t thought of it. I responded by telling him about the passionate drive and plans that Doelling and I were going to implement on our return. DeGryse was still a little discouraged; he explained that it was just one department. I further explained that we would make a difference because a few hundred people are going back to their departments with a new understanding of this behavioral health issue, with new tools to prevent long-term effects, with new studies to share with their leaders, and with a passion to do something about the problem. If these people take “spoonfuls” back and begin changing the environment and discussion surrounding this important issue, then next year a new group will go to FDIC International ready to learn about it. Then, as more classes are offered and more people take them, more “spoonfuls” go out to more departments. Eventually, the majority of firefighters will be talking about the importance of preventing and treating behavioral health issues.

Taking the Necessary Steps

Whether you were at FDIC International or working so your fellow members could attend, I hope this article can help start to change how your department helps its firefighters avoid triggers that bring on PTSD symptoms and treat those suffering from the associated effects. All departments can take the following steps to help prevent PTSD and other related mental illnesses:

  1. Talk about the stress that all firefighters will face in the course of doing their job when recruits first enter the fire academy as well as when they are first hired. Also talk about it in regular training. Talk about it when a bad call happens. Talk about it when you see symptoms in one of your firefighters. Talk about it before it’s too late.
  2. Listen when the firefighters in your department talk. Don’t turn a blind eye to those who come to you or others with concerns about their mental health. For too long we have assumed that all firefighters either can “handle” the job or are too “weak” to deal with the calls. We need to consider the fact that some of our people need help but can still perform the job once they have been helped mentally and emotionally. You also need to actively listen and have some tough conversations.
  3. Be proactive, and have a counseling plan in place before problems arise; this begins with a robust EAP that has counselors with a working knowledge of the fire department who can answer phones 24 hours a day, seven days a week. There will be a need for counselors who will listen to the problems, not explore the logistics of being a firefighter. They will need to be prepared mentally to handle what a firefighter might tell them. It also requires each of us to do the appropriate research to find out which EAP partners are most suited to counsel our personnel. Have a list of recommended professionals for our personnel. This will take work, but if we care about our people, we will do what’s required to make sure we are ready when they need us.

Multiple South Florida departments as well as departments from around the country have implemented each of these steps, and there is a groundswell within the fire service to help our own before it’s too late. Unfortunately, before the publication of this article, Indian River (FL) Fire Rescue Department Battalion Chief David Dangerfield took his own life after a long battle with PTSD. I talked with his best friend and other coworkers while we planned Dangerfield’s funeral, and it was clear that many were trying to help him. However, his death is a reminder that there is still a long way to go. His last social media post was a final farewell and plea for us to continue the fight to help others.

Dangerfield wrote, “PTSD for firefighters is real. If your loved one is experiencing signs, get them help quickly. 27 years of deaths and babies dying in your hands is a memory that you will never get rid of. It haunted me daily until now. My love to my crews. Be safe. Take care. I love you all.”

Putting these steps in place will not keep all behavioral problems at bay, but they will begin to form some type of program that will be essential for all fire departments. We must change the way we view stress and emotional trauma, the effects of that stress, and the way we treat those who are suffering from those effects. Our first steps may be the equivalent of a thimble or a spoonful, but if we keep moving forward with the necessary passion and dedication, there will be enough people carrying those thimbles and spoonfuls so that we will empty oceans together.

JEREMY HURD is an emergency medical services captain with Palm Beach County (FL) Fire Rescue (PBCFR) and runs the department’s professional development program. He is also the PBCFR’s chaplain and has helped develop a comprehensive behavioral health program for the department. Hurd is also enrolled in the National Fire Academy’s Executive Fire Officer Program and is pursuing a master’s degree in executive leadership disaster preparedness. Hurd teaches at FDIC International and hosts “Chaplain’s Corner” on Fire Engineering’s BlogTalkRadio.

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