Protecting Your Department’s Mental Health

Posted on December 14, 2023

Just as important as EMS clinicians’ and firefighters’ physical health, is the protection of their mental health. According to the Ruderman White Paper on Firefighter mental health and wellness, the suicide rate for firefighters is 18 out of 100,000 (compared to 13 out of 100,000 for the general population). Additionally, studies by IAFF have found that 5% of all firefighters have attempted suicide and approximately 22% are expected to experience PTSD at some point in their career. Many of those who have experienced PTSD have received assistance and support, which allowed them to successfully return to work. On the EMS front, there were 5,045 critical incidents reported by clinicians at 297 different agencies last year. There is a direct link to the exposure of critical incidents and PTSD and suicide. There isn’t any specific list of criteria that determines if an event is critical, but more so how the individual responds. That being said, there are certain circumstances that are more likely than others to stimulate this response and they’re considered psychologically traumatizing events (PTE).  

Here are 9 of the most common incidents that turn into potentials PTEs: 

  • Serious injury or line of duty death 
  • Suicide of a co-worker 
  • Death or serious injury to a child 
  • Prolonged failed rescue 
  • Multi-casualty incident disaster 
  • Victim is known to the responder 
  • Any incident where personal safety of the responder is jeopardized 
  • Incidents with excessive media interest 
  • Any incident with an unusually strong emotional component.  


Putting mental health front and center 

Work to proactively provide training for EMS clinicians based on the latest evidence for PTEs. You should also educate on the importance of mental health and train on the signs of PTSD, stress disorders, and addiction to empower your clinicians to recognize and reach out to those in distress around them. Ensure to create clear policies regarding no tolerance for bullying and harassment to create an atmosphere that promotes respect and fairness.  

Recognize the importance of peer-to-peer relationships and build a supportive atmosphere that includes trained supervisors, managers, and administration, as well as the availability of trained mental health professionals. Share importance resources such as the National Suicide Prevention Lifeline (1-800-273-TALK [8255]) and www.pocketpeer.org. For EMS services, consult the 2022 Public Safety Officer Support Act, which provides line of duty benefits for EMS clinicians who experience PTSD as a result of exposure to critical incidents. 

Documentation is key  

Since you can’t predict what will turn into PTEs, and each person reacts differently to the same critical events, it is important to document each and every one. Then follow up with those who made reports. Considering 75% of fire records didn’t include any documentation of critical incidents whatsoever, there’s a major opportunity here for improvement. 

For more insights and best practices for keeping your firefighters and clinicians safe, download the ESO Fire and EMS Indexes today.