Addressing Suicide Among First Responders: How Colleagues, Friends, and Family Can Help
Resource Type: Article
Whether they’re running into burning buildings, engaging an active shooter, or navigating crowded streets at high speeds on the way to a hospital, first responders often put their lives at risk as part of the job. And while they may recognize the inherent danger, firefighters, police officers, and emergency medical services personnel sometimes fail to consider the toll it can take on their mental health.
The rate of suicide was 18 per 100,000 for firefighters and 17 per 100,000 for police officers. Comparatively, the rate of suicide for the total population was 13 per 100,000 people.
Those are “very concerning numbers,” said Dr. Nate Perron, a core faculty member at Counseling@Northwestern, External link:open_in_new, who has expertise in police and first responder wellness. “But it shouldn’t be as surprising as we initially thought.”
Those responsible for helping us at our most vulnerable points are hurting, too. And it’ll take the work of friends, family, and colleagues to help keep them safe.
Why First Responders Are at Risk for Mental Health Conditions and Suicide
Repeated exposure to death and destruction can result in emotional trauma, leading to mental health conditions such as depression, anxiety, PTSD, and, worst cases, suicide.
How First Responders Develop Serious Mental Health Issues
death, grief, injury, pain, and loss
demanding schedules, physically challenging jobs, and a lack of safety and security
Can result in
If left untreated, it can lead to
depression, anxiety, PTSD, suicidal ideation, and suicide
FHBA founder Jeff Dill, a licensed counselor and retired fire captain from the Chicago suburbs stressed that it doesn’t take an enormous tragedy to affect a first responder. Mass shootings or natural disasters, such as Hurricane Katrina, are acute events that can cause PTSD, but a person could be affected by cumulative work exposure to more minor incidents.
The Ruderman report notes that poor mental health can prevent first responders from completing their duties and remaining attentive to the task at hand. For example, PTSD has hindered first responders’ abilities to accurately assess risks, plan responses, and focus on more than one problem at a time, such as multiple victims in an accident. Stress can create physical reactions in the body that cause responders to be less capable of completing the tasks associated with physically demanding jobs.
There is also no defined timetable for when exposure to trauma begins to cause severe mental or emotional harm.
“Even senior officers who have not shown signs [of depression] in the past can certainly have reactions or responses that, to them, seem like very confusing feelings of despair,” Dr. Perron said. “A situation that suddenly reminds them of their grandchild who just passed away or a circumstance that reminds them of some tremendous grief or loss they haven’t dealt with can certainly affect them.”
“These are professionals who explicitly prioritize bravery and toughness, and putting others before themselves, so there’s this perception within these departments that to speak out about your struggles is selfish and is contrary to your job description,” Heyman explained.
She also noted that many have a legitimate fear of being discriminated against if they do speak out.
“Mental health is a prerequisite for becoming a police officer, and folks fear that if they speak openly about anxiety or depression, they might lose their weapon and be told that they have to retire, which is not entirely fictitious. That has happened,” Heyman said.
Barriers to Mental Health Treatment for First Responders
The Ruderman Family Foundation report classifies barriers to addressing mental health into three groups:
Strength, bravery, and resilience are revered.
Silence about mental health issues leaves responders feeling isolated.
Responders perceive their colleagues to be more judgmental than they are.
Responders fear speaking out will limit career advancement.
Lack of Awareness
People lack knowledge about mental health and the conditions that should cause concern.
Shame, fear, and embarrassment contribute to stigma.
The media does not cover first responder suicide or mental health, which creates the perception that there is no problem.
Responders have limited access to services.
Costs for treatment can be high.
Erratic work schedules leave limited time to seek treatment.
How to Help First Responders in Need of Support
Through Nationwide Chaplain Services, Dr. Perron has provided mental and emotional support to police officers in the Chicago area. He participated in ride-along to get to know officers on their turf in a way that made them more comfortable and enabled him to understand their needs better.
“We spend so much money making sure that officers have the correct armor and weapons to keep them and other people safe. How are we arming them emotionally and mentally?” he said. “First responders are people that need to be armed in the same way–holistically.”
Dr. Perron shared his thoughts on how workplaces, colleagues, family, friends, and individuals can prevent mental health conditions from worsening and leading to suicide.
Workplaces and Colleagues
Police departments, fire departments, and emergency medical systems must prioritize preserving mental and emotional health to make it easier for first responders to access available support.
“When the chiefs call me, I tell them they have to work on two things: You have to work on your peer support and your resources,” said FHBA’s Dill, whose organization consults with fire departments nationwide.
Dr. Perron said agencies can support the mental wellness of their employees and volunteers by:
Having the police chief and fire chief talk about mental health and the importance of going to counselors. Having open and honest discussions is critical.
I am placing a mental health advocate or someone in local precincts and firehouses who is made available to talk to comfortably.
We are having management check in regularly with workers.
“Being able to process a traumatic incident is increasingly recognized as a crucial and important element in supporting officers, firefighters, and EMT personnel,” he added.
Family and friends often recognize their loved one showing stress symptoms before the first responder. If a first responder disengages with their community outside of work, that can be an early sign of trouble.
“If there is a display of unsafe behavior or erratic behaviors, loved ones need to be very clear that these are some of the unhealthy things,” Dr. Perron said.
To provide support, he encourages family and friends to:
Be clear about concerns regarding problematic behavior they notice. Clarity in communication is essential.
Encourage an individual to seek help and offer to help them find treatment, such as counseling.
Push back on notions that getting mental health treatment will affect the person’s job.
Everyone must know what they need—physically, mentally, socially, and spiritually.
“Ultimately, all of us need to make sure that we are well-balanced in all these different areas of our lives,” Dr. Perron said. “If even one of those areas is significantly impaired, it can affect all the other areas.”
First responders should ask for help if they begin to experience the following warning signs:
If you or someone you know is in immediate need of help, the following hotlines assist first responders and their families:
Safe Call Now: Call 1-206-459-3020 for a 24/7 hotline staffed by first responders.
Fire/EMS Helpline: Call 1-888-731-3473 to reach this helpline run by the National Volunteer Fire Council.
Frontline Helpline: Call 1-866-676-7500 for a 24/7 line staffed by first responders and run by Frontline Responder Services.
University, N. (2022, November 29). Addressing suicide among first responders: How colleagues, friends, and family can help. NU-MAC. Retrieved February 24, 2023, from https://counseling.northwestern.edu/blog/first-responders-suicide-help/