Fighting PTSD in the Firehouse

They’re heroic and brave and can handle any situation. They run towards danger while others are running away. They enter a fire and emerge with rescued people, animals, property. They seem invincible.

It’s a well-deserved characterization that the public places on firefighters, based on their willingness to sacrifice for others and do what most people can’t or won’t. But sadly, with this strong appreciation and sense of duty comes the heavy weight of what firefighters have seen, experienced, and also missed in their own lives.

While their work shift calls them away from family birthdays and holidays, they instead face a wide range of every person’s worst nightmares: mass casualties, deaths of whole families, horrific car accidents, drowning of children. The adrenaline and training kicks in and they do what they have to do. But then they return to the firehouse and, later, their homes, with few tools for discussing or decompressing after the repeated stress of their work.

PTSD in the Firehouse

Post Traumatic Stress Disorder (PTSD) has gained wide notoriety in the past decade, primarily relating to the struggles faced by a large number of veterans returning from combat service. With symptoms like anxiety, depression, isolation, hyper-vigilance, and flashbacks, PTSD can cause serious, life-disrupting issues, leading to divorce, binge drinking, and even suicide.

Only recently has the connection between firefighting and PTSD become more apparent, as the suicide rates for firefighters is growing at alarming rates, with more than 115 firefighters and emergency medical service workers in the U.S. dying by suicide in 2017. This number, according to data compiled by the Firefighter Behavioral Health Alliance, eclipsed the number of LOD deaths for the same timeframe. Sadly, the statistics also reveal that only 40 percent of firefighter suicides are actually reported, suggesting that the epidemic is far more serious and far reaching.

The Causes and Efforts to Help

Researchers point to causes like longer fire seasons, more events with mass casualties, and increased stress for emergency personnel as primary causes of these concerning statistics. Additionally, disrupted sleep patterns, separation from family, anxiety, fire service culture and a lack of coping strategies add to the numerous stressors that can make a firefighter feel alone in his or her struggles.

In response, some stations are hiring counselors or identifying in-house chaplains to formally open conversations with firefighters, or at least be available as needed. However, just like in the military, there is often a perceived stigma related to reaching out for help, and it can be difficult for a firefighter to even know where to start when discussing what has been seen or experienced. According to a recent article in the LA Times on firefighter suicides, counselors working with firefighters are unaware of the level of trauma firefighters experience in the field and often become emotional when listening to their stories. It is critical for firefighters to speak with counselors who truly understand what they face each day in their job.

Using Data to Identify Risks

So what if there was a more scientific way that fire stations could proactively identify team members more at risk for PTSD, based on concrete data like number of exposures to traumatic events? Studies have shown that firefighters’ PTSD and depression can actually be systematically managed with the increased availability of coping therapies, counseling sessions, and other clinical tools.

Product developers at ESO are working to create new features in the ESO Fire software that will allow a station to easily identify a critical incident to track the number of critical incidents each firefighter responds to, allowing officers to track whenever the number of repeated events within a set time frame surpasses a set threshold. Along with other personnel management statistics, like vaccinations and ongoing training, this information can give the station a better overall view of the health – both mental and physical – of their teams, and help identify needed actions and areas for improvement.

Additionally, an alert of a surpassed traumatic event exposure rate could trigger a new set of protocol actions, such as an informal one-on-one or debrief session, or something more formal with a counselor or chaplain. This proactive approach takes the pressure off the individual firefighter, who most likely is already working to manage a heightened level of stress, to open communication channels and ensure that he or she has the coping tools needed.

Turning the Tide

Through efforts like these and an increased awareness of the long-lasting effects of traumatic event exposure, those in the firefighting industry are hopeful that they can begin to gain ground against this little-discussed but devastating danger faced by firefighters. Showing firefighters that they are not alone, that there are tools that can help them process and handle their stress, and that there is hope for relief, can make a difference in living a happier and better-adjusted life outside of the firehouse.

If you are a firefighter who is struggling with possible signs of PTSD, you can take this self-assessment created by the FBHA.