PTSD, ARE WE SELLING A LIE?
Post-traumatic stress disorder has jettisoned its way to the forefront of firefighter health and wellness in recent years. It is a problem that hits home for a substantial populous of the United States Fire Service, and for good reason. According to the Firefighter Behavioral Health Alliance (2016), PTSD and its underlying consequences have taken the lives of at least 131 firefighters and EMS workers in 2016 alone (Dill, 2016), and that’s only in the United States. This figure sadly includes my senior man and partner of the last 5 years.
The fire service as a whole has done an exceptional job of identifying and educating its membership of the problem, but the time has come to look inward. We must ask ourselves an even more taxing question. Are we responsible for creating and perpetuating the growing epidemic of PTSD and suicide in the fire service?
This question takes its’ roots in the ever developing process of fire service recruitment. Nationwide we dangle before aspiring professionals the bounty of solid pay, great benefits, and an overall culture of camaraderie and family. We sell the position of firefighter from the same platform as white collar business and industry, and we veil our sales pitch behind the shroud of our pop culture image, one that perpetually emphasizes the miracle save and the happy ending, the affluent and beautiful world of the Hollywood fire service where everyone goes home safe and suffering only last for 30-90 minutes (with commercials). Are we selling our future recruits a lie?
The truth is the members of the fire service live in a dark and complex world, one tucked away beneath the surface, where the majority of society will never venture to look. It’s not just the gore and the death; but the abuse, the poverty, and the barrage of sickness, pain, and suffering that will span nearly a lifetime; or at the very least a 20-30 year career.
We Are The Sin Eaters
We as firefighters are the ‘Sin-Eaters,’ tasked with stepping beyond the light of the world into the dark corners where few people choose (or even know) to look. We do this by choice, each and every one of us, and we bear the responsibility of what we see, hear, and smell. We do this, willingly, because as firefighters the public has entrusted us to be strong, calculated, and decisive where others can not because in doing so we ever so often have the opportunity to do something truly remarkable…save a life.
The most important takeaway of this concept is that we do this by choice. We expose ourselves by choice. However, in failing to paint an adequate picture of what we do for our future recruits, we have taken away from them the opportunity to look inward, and to truly ask themselves if they are prepared for what we are tasked with doing. How can we expect to mitigate the problem of PTSD and suicide in the fire service if we first fail to prepare those we recruit for the realities of what we do in the first place?
The first step in combating PTSD in the fire service is to ensure we take on the responsibility of recruiting those who are mentally prepared and discouraging those who are not. If we continue to fail in this respect, the responsibility of their disease or their death rests squarely at our feet, because we are the ones who brought them in under false pretense. The dark side of the fire service should be no less transparent in fire department recruitment, than the fact that we run into burning buildings.
After The Pitch
It is critical that the recruitment process be retooled in order for PTSD in the fire service to truly be mitigated, but it must also extend beyond recruiting, and into employment. The fire service as a whole is exemplar in educating its membership as to the existence of, and subsequent consequences of PTSD and psychological disorders. However, dissemination without resolution can manifest into a dangerous and detrimental environment.
In the age of digital information and social media, it is nearly impossible as a firefighter to log onto a
computer or smartphone without finding an email, memo, or social media post highlighting the prevalence of psychological distress within the fire service. Often these posts showcase a growing list of our brothers and sisters who have committed suicide or fallen victim to the grips of depression, anxiety, and substance abuse.
True to our nature as servicemen, we are quick to spread the word of this growing epidemic in our field. We are even quicker to honor those who have fallen. However, we are failing as an organization to reach beyond education, awareness, and mitigation to the real solution, prevention. Quite the opposite, we are (in fact) promoting the growth of the very problem we are trying so desperately to prevent.
We hire new members to carry on our profession and craft, and we have a responsibility to correct the massive misconceptions we have allowed to infiltrate the hiring and training process. Members are recruited under a false pretense of the mental stamina required of our position and subsequently saturated with education and information pertaining to PTSD, substance abuse, and suicide. Consequently, future generations of firefighters are taught to believe that the behaviors exhibited by those suffering from mental distress are the expected behaviors of persons in their position. This may very well be contributing to the 63% increase in reported firefighter suicides in the United States since 2012.
By over saturating our membership with information pertaining to this grave problem we are forcing them to ask the question “Is this how I’m supposed to feel?” Inevitably a portion of our members will manifest the ‘expected’ response. They will begin to believe that they are expected to be haunted by the things we do, see, hear, and experience because we as an organization have conditioned them to believe this response is ‘the norm”.
One of the greatest points of pride for firemen is the ability to handle an infinite number of situations that the general public could never even begin to imagine. We take great pride in the responsibility of being asked to mitigate any situation that our crews are tasked with resolving, and doing so in a manner that is calm, calculated, and professional. This is one of the greatest traditions carried on the backs of firefighters for centuries, the ability to show up and help where no one else can. It is the very essence of why firefighters have been held in such high regard since the inception of the fire service. However, we have an obligation to maintain this image in the public eye, and we have an obligation to staff our departments and apparatus with members who are prepared to be mentally strong when others can not. We as firefighters hold greater respect and dignity in the public eye than nearly any profession on earth, and the reason is simple, we are there when you need us. It is time for the fire service to move beyond education of PTSD and psychological wellness in the fire service, and to shift its focus towards preventative measures that begin at the recruitment process and build from a foundation of personnel who are prepared for the task that lies before them, who are prepared to show up and perform, fully aware that no one else is coming if we fail.
In 2014 while speaking to the concept of post-traumatic stress growth General James Norman Mattis stated that “while victimhood in America is exalted, I do not think that our veterans should join those ranks” (Mattis, 2014). I think the same should be true of nations firefighters. If we continue to tell our members that they are somehow damaged by what we do, it is only a matter of time before they come to believe this is true. However if we empower them with a sense of pride to be strong and courageous when others cannot, we will bread future generations of firefighters whom will rise to the call to serve their fellow man selflessly and without question, who will wear their battle scars with pride, as they tell a story of a life dedicated to the service of others.
This is our call to action for the fire service. We are not damaged, but rather forged in the fires of our craft to be stronger and more resilient than ever before, because we as firemen are called upon to exhibit this strength unwaveringly.
Mattis, James N. General “General Mattis on PTG.” YouTube. YouTube, 06 Jan. 2017. Web. 06 Feb. 2017.
Dill, Jeff, Captain. “What Are These Numbers? « Firefighter Behavioral Health Alliance.” What Are These
February 4, 2017
Numbers? « Firefighter Behavioral Health Alliance. Firefighter Behavioral Health Alliance, 01 Jan. 2017. Web.
06 Feb. 2017.
I agree with getting away from the “we’re the victims” attitude. Recruit from the folks that want to be firefighters, that have the spark of adventure, not from a pool of folks that need a job and this was available.
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I think we as a nation are seeing a rise in PTS across the board because as CHAOS said there is a rise in exaltation of victim hood along with the majority of Americans are mentally weaker while being more educated than our forebears. I’m not sure there is anything we can do about the latter but the former is simply a matter of instilling pride in oneself. if you have pride, a sense of self worth, you will be less likely to view yourself as a victim.
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It’s not PTSD. PTSD refers to P post meaning after. Soldiers returning from active duty when thier service is done is Post. We as firefighters are always on always on duty even when We are not. There is no post time to develop Tramatic Stress Disorder. It’s more like Cumulative Stress Disorder. The Stress builds and builds and we carry it , some of us unknowingly some with serious signs and symptoms. Saying we have PTSD is incorrect ,that implies that our
stress stops and then it affects us. As firefighters our stress never stops until we quit, retire or die. Individuals need to combat this stress by finding activities that help reduce stress and by talking to counsellors. But thats just my observations and I am just a fireman what do I know.
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Great point. I am retired now but I participated in a class a few years back that has about 100 FF’s from all over the country, when the class was asked how many were on meds I was shocked that over 60% raised hands. Those are the ones admitting to it. We were told 10-20 years earlier it was less then 5%. Scary……be safe brother.
Excellent article, I have often thought that we are the sin eaters of modern times. Luckily I have been unaffected by ptsd and sometimes wondered if I was unfeeling to not be effected. You are right on the money, even though I have a recognized cancer I feel lucky to have had a 33 year career on the job.
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Well put James, and thank you for your comment.
So, we continue to stigmatize PTSD by extremely vetting those that have it and telling them there is no room for them in the fire service? Is that what I’m reading? Nevermind the fact that some of the most legendary and well respected firefighters struggled with PTSD and other issues, and proved to everyone that those issues did not define them, giving those with similar issues the hope and drive to overcome their own demons.
And what about those recruits who would benefit from the fire service as it would provide therapy and relief from those symptoms? The combat veteran struggling without a sense of purpose, lacking the brotherhood he once thrived in. What about him? Sorry, “brother”, you’re not mentally strong enough for this gig, we need guys that won’t respond the way you did to your brothers getting shot and killed when you were 19. Good luck in life. Maybe you’ll find purpose in roofing or selling insurance.
How about we stop stigmatizing the issue of PTSD by perpetuating the belief that owning it and talking about it is a sure way to lose your job, or the trust and confidence of your fellow “brothers”. Instead, let’s acknowledge that it’s real, that it sucks, but that it can be overcome with post traumatic growth. Let’s learn how to convert it into growth. We’re in the business of helping and serving others, so let’s help and serve others. We pride ourselves in being comfortable with being uncomfortable alongside our brother inside a burning building, but yet when that brother wants to have a conversation at the kitchen table, or on the tailboard about his personal battles, it’s crickets. That sort of discomfort isn’t sexy, guess.
And when that brother goes home and offs himself, we wonder why. It’s not because we perpetuate the symptoms by identifying and talking about them. It’s because when someone displays and wants help addressing these symptoms we’re nowhere to be found, except maybe around the corner casting judgement from a safe distance.
There’s a gentleman at the local crossfit gym that has no legs, and he kicks ass. I believe his success stems not only from addressing his handicap, but by diminishing it to its actual size, and treating him like he’s bigger than the two nubs below his waist. His obstacle is treated like a cold- it’s limiting but not debilitating. In New York a Marine veteran with no legs was sworn in as a member of the police department. Ten years ago, he would have been turned away when he went to pick up an application. Now, he’s a cop that shows up to work everyday, with a cold.
Let’s treat PTSD like we’re starting to treat missing limbs; not as problems, but as opportunities to become stronger.
Well written, I couldn’t agree with you more.
Above comment was for ranlikegel.
Thank you !
Again our beloved profession can’t seem to let go of the notion we’re just people . We have a culture of indifference when it comes to these issues and hide behind wonderful terms of dedication, commitment and service
RanLikeGel, Thank you for taking the time to write out this detailed response. I really appreciate everything that you had to say, and believe it or not I completely agree with what you are saying. With that being said there are a few things about my article I would like to clarify for you that perhaps I didn’t articulate well enough. First of all, I would never suggest that a veteran with a PPMHx of PTSD be denied employment in the fire service because of their diagnosis. In fact you are 100% correct, for our nations combat veterans (including those with PTSD) the fire service is an arena where they thrive after their discharge, and it many ways it can be therapeutic (as you put it). We should welcome our veterans with open arms and embrace the culture and attitude they bring to the fire service. These are not the persons I am addressing in this article, and in fact research suggests (despite it being in its infancy) that veterans account for some of the lowest occurrences of suicide in the fire service…in other words, they aren’t the majority who are struggling with PTSD as a result of the fire service. I also couldn’t agree more that our culture needs to embrace the conversation further, we need to be willing to have a conversation with our brothers when they are struggling. This is an area where the fire service could stand to make great improvements. Most importantly I am not suggesting we “vet” those who have PTSD in the hiring process, I am suggesting that we take a closer look at those who have a very limited or misinformed perspective of what we do and ensure they are prepared for the mental toll it can take of the course of a career. Thank you again for the response, that is the best consequence of this article is it gives us all the opportunity to generate a discussion and explore the issue from both a proactive and reactive perspective.
Mr. Toomey, If your response to these criticisms is what you meant to say in the first article, you missed it totally the first time. Everyone KNOWS what firefighters face when they sign-up. It’s true we CHOOSE to be firefighters, but that does not mitigate emotional and psychological hazards we will face and endure. Knowing we will face them does not shield our human minds and hearts from wounds. Some deal with those wounds better than others, but all ARE wounded, if they are “human.” The original article clearly “implied” that we should weed-out the weak-minded, uninformed, unprepared about the– dark, gross, gut-wretching realities of life– individuals before hiring them. Then, the good, solid hires should be internally strong enough, resilient enough and willful enough to endure anything because they KNEW what they were getting into and they can naturally shake off what regular folks can’t endure. Really. Though the article is very INSPIRING about how to MAN-UP and BE PROUD, it does more old-fashioned harm, than good. What research do you have to back up that spreading the word about PTSD and cautioning new generations makes them succumb to the “suggestion” and weakens them?… What specialized education do you have concerning PTSD and mental health matters to write your conclusions? Or is it just your “personal belief” that the “strong will survive?” Do you suggest that informing the workforce about suicide risks and resources makes them more susceptible to offing themselves? All search contradicts this notion old notion. Informing Brothers (just as LEO’s and EMT’s) that the rough realities of the job WILL change us, will affect all of us in SOME way, to some degree (it’s called PTSD) and to be aware that there are ways to mitigate it before it gets deeply ingrained and debilitating … and that there is help available what ever level we are at… this does not fuel weakness… it PROTECTS and BUILDS UP against job burnout, broken families, despair and life burnout. Your article (reduced down) commands… “hire better, inform less (about PTSD), uphold a tradition of strength, PRIDE and GUTS will overcome anything…” Think about that a moment….. Yes, prospective recruits and new hires need to be BETTER informed about the dark side, and better equipped about HOW to protect themselves against job stressors, and prode is necessary to do the job well. However, it’s proper PPE, not ignoring the hazards, that prepares us, and enables us, to stay in the fight. Pride in our life work does not sufficiently “armor us” against what will face in the battle– knowing that there is real support from the Brotherhood– does.
Respectfully, Wendell Bradley, Emergency Services Chaplain
There seems to be a misunderstanding as to why myself and others do push PTSD. We want to make it clear that NOT everyone will get PTSD in their career but what we need to see is awareness to recognize the signs in our brothers and sisters on the job. I agree that the issue should be addressed with recruits but the misconception is that firefighters can block it out and move on because that’s what they do. You can be physically and mentally strong but unless you are indeed “Super Man”, we all have a breaking point. I was diagnosed with PTSD in 2002 after my 11 year old son died from heart defects and 11 months later my wife died from complications from diabetes. I had been a firefighter/EMT trained to be the first in and last out and to save lives, my breaking point? I could not save my family. For years I became sheltered and withdrawn. Dreams, nightmares, sweats, and reliving those days over and over again even to this day. The only reason I am able to return to the fireservice and help others is to talk about it, self therapy if you will. Talking about it does not make you weak and having PTSD does NOT make you a substandard firefighter.
Thank you for sharing such a deeply personal aspect of your own personal story. It means a lot to hear from people on the job who have personal experience with this, and the ways they have managed to cope, process, and maintain good mental health. I agree this is a topic that we should be pushing and discussing with great regularity. It is without a doubt something that has a tremendous negative impact on our membership. I hope you understand in reading this article that I fully accept the prevalence and severity of PTSD in the fire service, I simply want to see a multi faceted approach that begins at the start of the process and runs through the duration of a career. Not any single one of us in this profession can simply ‘block out’ everything (that would be inhuman) however there is something to be said about starting off with a strong understanding of the exposures that we will face from day one in the hiring process. We are all susceptible, but there are certainly people out there who aren’t prepared or equipped for the mental toll of the job from day one, and it would be a disservice to them to push them through the process without fair warning or preparation. All new recruits and candidates deserve and honest look and the negative side of this great profession before they commit.
This article makes a bold statement with out much to back it up besides opinion, but it does open a great discussion. A question for other firefighters does your department participate in After Action Reviews/ debriefs after difficult call? Anyone complete regular mental health check ups? Would these be helpful to our profession?
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Dave this is a blog not a research paper so it goes without saying that it’s an opinion piece. The focus of the article is not PIAs or AARs. It’s specifically addressing the prev hire process
Dave, you are absolutely right, there is a great deal of my own personal opinion and perspective in this article (although it is rooted in research). It is definitely more of an opinion piece than a research paper. However, you hit the nail on the head. Rather than slam everyone with a lot of facts, figures, and statistics, I thought a stronger approach for this topic would be to generate discussion so that all of us our exploring the idea of how we might better combat the problem of PTSD in the fire service. To answer your question, my department definitely takes part in AAR’s and debriefs. However I think the problem here is that those types of organized and facilitated discussions focus much more on tactics, strategy, and execution, and they do not tend to lend themselves to emotional support. I think a lot more is accomplished (for me personally) in an informal setting. For example, it has become something of a tradition for my senior man and I to smoke a cigar after night watch in the firehouse. I have had far more open and meaningful discussions over a cigar and a cup of coffee with my partner than I have ever had during an organized or official debrief. A lot of this comes down to your own particular relationship with your crew, and your level of comfort with the other guys on your rig.
After 33 yrs with the a professional fire service I learned a few things , One was that people act differently to a same situation . Their is no litmus test to see how your crew were doing after a incident . As an officer one of my duties was your crews well being , keep an eye out to see if someone was struggling . PTSD seems to be the root cause to many problems, It may be used a bit too much , you hear this enough you will believe it . i.e. I remember we had a rash of heart issues with our membership . All of a sudden, many people were thinking they were having a heart attack . Don’t get me wrong these are serious issues ,if you hear it enough you can talk yourself into anything .
My Dad who served in WW 2 once told me I served for four years , but that was the end of it , you serve for 33 yrs “, which he thought was harder.
When I applied to go through the firefighter recruitment testing , I asked myself , can I do this job,? am I willing to go the extra mile for complete strangers.? I might see some things that will be disturbing and how will I respond? To me this was not a regular run of the mill shift job . this is some serious stuff , that can and will catch you off guard. 99% of complete boredom highlighted with 1% of heart pounding terror.
We don’t have a human scanner that will show a person’s motivation to become a firefighter , Maybe just asking the question to yourself will show the answer.
I recall , In our group of recruits was one fellow who struggled with most of the training , he was held back and put on longer probation period, but he eventually made into the stations . He lasted years, but it was a terrible time for him . He ended up quitting and is still unemployed to this day. The training staff at the time thought they were doing him a favour keeping him on, would have been best to let him go . Looking back he had all the signs of PTSD. It might have been a bitter pill to swallow , he would be better off today he was let go right at the beginning . So he could have pursued something else.
I think the root of this problem can be solved through the watchful eye training staff ,awareness from Officers on the floor , and have some toughness , it going to hurt sometimes ,. It’s knowing when to seek help . , It can be a very nasty place . That is why we get paid well for what we do.
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I disagree that the gentlemen you are speaking of “would have been better off”. There is no way to know that. As far as I can come to meet you is “he MIGHT have been better off if he was let go, and able to pursue something else he was passionate about.” In the same token he MIGHT have been better off if there was a better support system in place, with members that have a knowledge of PTSD, and the tools of how to cope with it in such a way that he could have lived a happier and less troubled life. I would venture to bet that if this man would have reached out, he would not have been met with understanding, much less the resources to be able to overcome his obstacles. I know because I’ve experience it. I’ve walked into an office full of recruit academy instructor cadre, told them I was struggling, and gotten nothing but blank stares. They WANTED to help me, but had no idea how.
For my part, I’ve made it my goal to learn how to help myself in that situation, should it raise again. But I want to know how to help a fellow brother, so that down the road, when someone else is struggling, I can be there for him and give him the tools to succeed.
I’ve spent over thirty five years running lights and sirens and have now placed two sons in the field every one of us who takes on this responsibility suffers emotionally. What helps us cope is the deep rooted believe we have, that taking on this job and risking all to help another is what we’ve chosen to do. When the man beside us does not take this job on for that reason, but because the dept. convinced him we have better vacation than ibm or more time off than Nordstrom or better retirement than State Farm we have done him and all of us a diservice. And taken what is a real problem in the fire service and increased it significantly.
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While there are many things in your piece that need to be addressed, your claim that firefighter suicide has increased by 63% is the most pressing. There has not been a 63% increase since 2012. While the number of suicides reported to the Firefighter Behavioral Health Alliance has increased, we attribute this to improved reporting and NOT an increase in the suicide rate. It is estimated that we are only collecting about 35-40% of the true total of suicides. Because we do not have 100% reporting we can not say whether the suicide rate has been increasing or decreasing from year to year.
I would strongly recommend you remove that false claim from your article and reach out to Jeff and speak with him directly so you can better understand the numbers he publishes.
I do apologize for how that statement reads. Perhaps a better way to state that figure would be to say that there has been an 63% increase in reported firefighter suicides. Although I have addressed that data collection for this problem is in it’s infancy at best. I would still argue however that it does not constitute a false claim. There has been a significant increase in reported firefighter suicides, and simply the fact that we now see ourselves compelled to document and track this information outlines that there is in fact a growing problem in our field. As far as Jeff Dill is concerned, the only data I used and cited directly from him was the claim that (at the time this was written) 131 firefighters and EMS workers had been documented to have committed suicide in 2016. I would hate to misrepresent the findings of the Firefighter Behavioral Health Alliance, but in this case I believe that figure is pretty cut and dry. More than an article backed by hard data (as almost non exists) this is a piece intended to continue the discussion of prevention of firefighter PTSD and suicide both proactively and reactively. You did say there is much more to discuss in regards to my article, and I encourage you to lay out that discussion here, I am very open to hearing your opinions and furthering this discussion as it definitely effects all of us. I will review the article today and determine if there are areas of misleading information that I feel would be unethical to leave in place. Thank you so much for your feedback, I look forward to hearing more from you.
Yes, that would be a better way to state it since that is exactly what those numbers are. It is absolutely a false claim since we don’t know what the overall firefighter suicide rate is per year. We have no way of calculating if it is going up or down. The only thing we can say with accuracy is “x number of suicides have been validated by the FBHA”. You are misrepresenting his numbers with your statement that there has been a 63% increase in firefighter suicides. The correct way to fame that is “there has been a 63% increase in suicides validated by FBHA since 2012”.
It is one thing to write an opinion piece that is not backed by data, it is another entirely to make false claims which is exactly what you are doing.
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Hey Sean, I have some other issues with your article that I don’t want to post here publicly, will you email me if interested? email@example.com
Dena, I did email you and would welcome your concerns. I do encourage you however to post your comments or concerns publically, it is of course the best way to create conversation and learn. I write specifically for this purpose and I will not shy away from exposure, criticism, or anything else. Thank you for your interest.
I guess thinking about it I must have it after 21 years I have seen the inside of skulls with brains all inside a mangled car, burned children after a mom tried to kill lice with gasoline, fire so hot I suffered burns through my gear having to decide do I push forward or not and I do and end up in the emergency room for second degree burns, having the second story of a structure give way underneath me during a fire and I survived, giving cpr while looking into her eyes I can see life fade away….I can go on and on and on…but you know what? I don’t have PTSD. I have bad memories. I was told when I started this career that these things would come my way the longer I stayed. Every time I have had a new recruit I give them the same speach that was given to me and I have seen recruits come and go after experiencing what what is the reality of the job is. Cutting crushed human bodies out of a car is not firefighting one guy told me when he quit. I had a recruit under me that was a great in great physical shape and did great with fires, but he went with me on two calls that included a mangled teen in a wreck and another of a guy who lost a foot in the rail yard and shortly after that he quit. I really don’t know what to think about all this. I was never in the military but I have family that was and they have issues, but not me. I work a t two full time departments working 48 hr on combined then home one day. I do it because I love what I do and I’m good at it. I started when I was 21.
And I hope you never get it. It could be that it all races back to you after you retire. Be prepared. Have a support system in place. Line up activities for yourself. Take up yoga. Whatever. Just don’t think that because you’ve made it this far, it won’t touch you. It might not, and if that’s the case, great. But if it does, at least you’ll be informed and ready.
Not that my career length adds anything to this conversation but, in my 18 year Career I too have seen some pretty messed up things. We all have full-timers, part-timers, volunteers we know who have dealt with tough situations. I am third generation and #4 FF in my family and my mother was an ER Nurse. Growing up it was common to hear my parents, uncles and grandfather talk about fires, victims, wrecks, etc. I have literally been “forged” my entire life. In my time on the job I have a few calls/victims that will never be erased from my memory. If I think of it long enough I can remember who I was with, where it was, and even what the kids were wearing when…… I guess I have come to accept those as battle scars. I’m not happy they are there but there none the less. But just because I haven’t had any of those calls affect me to the level of the poor souls who felt they had nowhere to turn, no reason to live, doesn’t mean it couldn’t happen. I truly believe that the cumulative effects of a lifetime seeing and doing the things we do will probably have a negative impact on all of us. In my case my wife says I have a black heart. Not that I can’t love or be loved but things in life that should affect me (birth of my children, death of a family member, etc.) don’t give me the same thrills, tears, happiness, anger, sadness that most other “normal” people feel. That is my burden I suppose. Does that mean I have PTSD? Probably. Does that mean I’m gonna hurt myself? Absolutely not. Does it mean that I can understand why others feel they have to? I guess.
The point of everything that I am saying is that it can, does and will affect everyone of us in some way. Some worse than others. I am glad to know that there are so many brave souls out there that are so mentally tough that they can take every ounce of stress and then judge those who cannot. At the end of all this blathering I think those of us who have been bleesed enough to do this job for a long time and haven’t had a call or series of calls that make something snap in us and lead us down the road of severe depression or worse should count our blessings. I truly believe that we should respect that it is happening, recognize it when it does and help our “brothers and sisters” overcome the terrible pain they are feeling. You can’t warn people off. You can’t ignore it. You can’t be too tough to recognize it is happening to you. Regardless of Mr. Mattis’ statements I know first hand of a childhood friend who was thrown across rooms or beaten by his father who was a Vietnam Vet that suffered from flashbacks even 20-25 years later. Flashbacks are , were and always will be a form of PTSD. But then again what do I know I’m just a dumb fireman.
If this was written with supportive data from Psychologists I’d agree with it. That fact is like all Mental Health issues in our society we’re affronted or misinformed about what they are and how they manifest. The profession is in denial of it’s issues until catastrophe happens then seeks minimalist cures to correct it or overkill!! We like think we’re that special because of the demands of the job and folks who have “issues ” probably shouldn’t have chosen this work if they can’t hack it. Use all the cute narratives you like but the FACTS and DATA show otherwise regarding people exposed to prolonged stress and trauma. Get off your Fire Service Ego Throne and recognize our people deserve support from us when their at their best and exspecially when at their worst.
Tye, thank you for your feedback on this article. I wish I had more data to back up this opinion piece, unfortunately data collection for mental health and suicide in the fire service is in it’s infancy at best. In fact Captain Dena Ali just pointed out to me that only 30-45% of FES suicides are estimated to be collected and reported right now. Basically the science and data has not yet caught up with the identification of the problem, and therefore we need to give the people who have already started this difficult and important task the time to collect accurate and influential data. It’s an uphill battle right now. I completely agree with you that everyone in our profession is at a much greater risk to experience mental health issues simply as a result of the constant exposure to trauma over the course of a career. I would never just say “suck it up” as you put it. There are countless strong men and women in the fire service who have battled with mental illness, PTSD, and suicidal ideologies. This is an unavoidable reality of the profession we have chosen, and we have an organizational and operational responsibility to build support systems and resources for those members. The men and women of the fire service who have sacrificed their mental health for the greater purpose of the public good deserve unwavering support and assistance. However this is not the point, nor the focus of my article. My article is asking us as an organization to look at the hiring and recruitment process, and to ask ourselves if we are doing everything we can during the hiring process to ensure we are bringing on members who are prepared for this reality. If we are not transparent as to the risks of our profession, then we in turn run the risk of hiring people who are even more susceptible to mental health struggles throughout their career. I apologize that you feel I have perched myself on a “fire service ego throne”, but I personally would feel responsible if I hired a candidate who was not accurately educated on the dark sides of our profession and later fell victim to mental health problems or even suicide. The fire service is a difficult and mentally/physically taxing profession, and not everyone is equipped with the mental and physical strength to thrive in the world where we operate. We owe it to those people to educate them so that they may make a realistic an informed decision as to whether or not this is the profession for them.
Having been very involved with CISD/Peer Support for decades, and still very active in fire and ems, here is my opinion. Right now, “PTSD” is very “en vogue”, fashionable, cool.. So if you want to be considered really “salty”, you probably have PTSD. This article is interesting, but falls into the same sort of trap, that at the moment; wow it’s part of this salty job, and we don’t know how to avoid this.. “don’t open the door to the fire service, it’s really dark in here”.. It’s the whole “allure” we’re trying to market here. Here is my view of this ‘reality’ – first of all, the mental health profession, and with their help now emergency services have this PTSD thing very, very wrong. IF you break your leg while fighting a fire, are you ‘diagnosed’ with “ITWD” (Inability To Walk DISORDER) ?? No, you are diagnosed with a broken leg, they set your broken bone, send you to physical therapy, and you generally get better. If it rains, sometimes your leg gets sore, or maybe you cant leg press 800 pounds anymore, it reminds you once in a while you hurt it ONCE, but you move on. Apply that to a critical incident. WHAM, it’s a huge shock to your system, and you MAY actually be ‘INJURED”, but there is NO WAY you should diagnosed, described, or believe that you have a “DISORDER”. So the correct terminology should be “PTSI” Post Traumatic Stress INJURY. We then should treat it as such, find a “first response stress debriefer”, a debriefer, peer,, someone on the ball, talk your way out of the crisis phase, and then seek professional help from a trauma expert who can guide you through some of the various treatment modalities for your injury. If a year down the road, you still have serious issues, then maybe you have the ‘DISORDER’, but give yourself, and our co-workers the chance for some recovery before you label them.. Bernie
To those who think that cumulative stress or PTSD is confined to the field side of the radio I am here to tell you that BOTH sides are affected by it. I started as a Volunteer in 1973 right out of high school. By 1981 I was a medevac dispatcher at the globally renowned Maryland Shock Trauma Center. By 1982 I had “graduated” to the 911 communications world with a local county. My very first multiple alarm became a world known event. A furniture store fire with 3 LODDs. A few years later I was on the airwaves dealing with another well known train wreck with a then record of 16 deaths. After 12 years i left to go onto the field side as a Paramedic/Firefighter for the remaining 11.5 years of my career. For this entire time I had the BEST stress relief job in the broadcasting industry as a local deejay. My next years took me back to wearing the headset again as a dispatcher for one of the largest metropolitan depts on the east coast. During the spring of 2015, just 6 months after I mutuly left my latest radio job, our jurisdiction was hit by one of the worst examples of civil unrest. The first hours found me as the fireground operator for the first few hours until 5 more could be brought in on OT. I had a pair of 3 alarm fires as well as several other box assignments and tons of vehicle fires, for which for the first time ever I was forced to tell companies in “The Zone” to drive right past. My night surrealy for the first time allowed me to watch the progress of the fires that I had working on the big screen TVs in our center. That night i heard friends advise that “we are under attack rocks and bottles” a mayday in the height of a 3 alarmer advised that we have “suddenly lost all supply water to the interior crews” when the feeder line was diliberatly sliced at the hydrant. Later the evening was filled with more good friends advising of bricks through the front windows, and side windows on singularly manned vehicles such as Battalion Chiefs. By the time that our 12 hour shift ended we had processed over 1000 fire calls, and I had 2 brief 30 second or less “pee breaks”. Being our last night of the trick everything had gone back to the somewhat normal load of 700-800 Fire/EMS calls that we handle every day. A year went by and the local newscasts we filled with audio and images of that night. Within the next 2 months I began waking up screaming after reliving our night from HELL. I was placed off duty on June 28th to battle my demons “on my own” as the department still does not have a stress program in place, esp for the guys and girls on duty in that room at the top of the Municipal Building. Eventually my nightmares and memories spread beyond that night, as far back to 1973 when I first started. My dreams were not all gorey bloody messes either. I could plainly see myself picking Granny up from the floor as a citizen patient assist call. I also relived the furniture store, the rail event, the tornado and many other major events of my career. I took out own my own striking out with the first 2 therapists, one of whom told me “its your job, suck it up buttercup”. The 3rd therapist, who did not use his DSM5 like a bible, believed in this recently discovered monster known as call taker and Dispatcher stress/PTSD. He used the most up to date therapies, including an eye motion exercise known as EMD. It worked wonders and made me realize that the events of that night were not my fault, and that I had little to zero control over ongoing events from the safety of my console position. On Feburary 24th I was able to return to full duty after an 8 month period of therapy twice per week. Now I have coping mechanisms to employ when major events happen once again in “JOBTOWN”. Throughout my long Dispatch career I have been involved with other aspects of the job, and did not ever merely just unplug my headset and go home at the end of my shifts. I was imvolved in SOPs, procedures, problem, and CAD and Radio Projects. I always hear praise that I am the best dispatcher wherever I work. I appreciate the comments, but as I say, Im merely doing the job to the ultimate of my ability. Ladies and Gentleman. Think of that person on the other end of the radio, sitting in that barely lit cave on “their asses, out of the weather and bad conditions”. That person could be instructing a parent how to do CPR on their barely breathing infant, or telling a mother how to give Narcan in the nose of their middle school son, or may have just gotten their ass reamed from above for wearing that old jobshirt which had just recently been made Verbotten by the newly appointed Fire Chief. In a split second that known voice and mannerisms may turn into YOUR Guardian Angel who picked up you staticy MAYDAY from the drone of everyday fireground ops which the IC might not have even heard. Once you are safe send a few extra clicks on your mike. We LOVE that type of Thank You !!!! Dispatcher stress/PTSD is REAL. I am one of its best known recent poster children.
Unfortunately the research on PTSD has not found any tell tale attributes for people who are likely to have a severe response to a Post Traumatic Stress Injury. As you said on other subjects the research is in its infancy. The military has not be able to identify those personnel likely to experience PTSD so they start resilience training with all personnel. One study of paramedic students performed in Briton in which they were screened for PTSD symptoms prior to training and then followed up three years later. 20% of the persons in the follow up showed that 20% of the respondents had PTSD symtptoms. I am working with some people on developing an evidence based resilience training program. Send me an email if your interested in hearing about it. firstname.lastname@example.org.
I think this is spot on. It starts with recruitment. When I started there was a psych portion, now there isn’t where I’m at. I’m not anti education but it seems we’re more concerned with hiring educated people who can be bosses someday than focusing on strong body and mind.
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Another bad read, right up there with the guy who said cleaning your helmet – was not cool.
No credability author-boy!
This garbage gets brothers and sisters dead.
You are without a clue and this is not good!
“Firemen?” I think you are part of the problem, writing this crap? Not impressed, even a little
This comment came from a place that seems to harbor a lot of anger or emotion about me. I appreciate the fact that you disagree with me, but it would be important and helpful if you could articulate what it is about my opinions that you find so angering and wrong. If you can have a discourse with me about specifics I will always welcome new ideas and beliefs, but in order to grow and lear as firefighters we have to be able to articulae more clearly. Respectfully, you might take the time to learn a little about who am I and what I stand for in the fire service before you write me off completely. Please fee free to comment back or to PM me @ email@example.com. I would sincerely welcome hearing and addressing you concerns about this opinion. PTSD in the fire service is something that has hit very close to home for me personally (more than once) and I am always open to being part of the discussion and not the problem.
It’s concerning how you were so quick to vilify and name call (bully mentality) but given the opportunity for an open discourse and you have been silent. As a Fire Chief I would have expected you to show more professionalism and willingness to communicate.
A good number of comments here seem to be vilifying the author’s opinion on PTSD in the fire service. I happen to agree with what he has written here. I have been in the fire service as a career for 26 years and am also a paramedic. I’ve certainly had calls that I responded to over the years which affected me but even that chronic exposure to death and despair over the years have not resulted in me having “PTSD.” Yes, I am aware that it is a real thing that affects many responders but the author’s point was (IMHO) that we need to stop trying to make people feel guilty if they aren’t experiencing PTSD. Not everyone experiences cumulative symptoms of depression or anxiety after either chronic or acute exposure to highly stressful situations. The majority of firefighters and EMS workers will NOT get PTSD. Certainly we may be effected psychologically in one way or another but that makes us human. It doesn’t mean everyone in fire and EMS is supposed to have PTSD. Additionally, I think it is inappropriate and inaccurate to assume that firefighters who have committed suicide have done so as a result of PTSD. Suicide rates among fire service personnel are comparable to suicide rates among the general population. ALL suicides are in the incline not just firefighter suicides. Suicide has many causes and knows no boundaries. Not every firefighter who commits suicide does so because of PTSD or job related psychological stress.
When you and the author have a PhD and 30 plus years in psychological trauma then we’ll have this discussion. Typical B.S. coming from the non – expert’s.
Educate yourself on a serious subject before chiming in, your out of your league on this one.
Tye, I understand that you have passion for this subject, and for that I thank you. I think if you would take the time to re-read the article as well as my comments, it would be clear that I am in no way saying that PTSD does not exist. In fact quite the opposite, my wife and I (a subject matter expert) even run an organization that is dedicated to help curb the issue of PTSD and suicide in the fire service. I have dedicated myself personally and professionally to this cause after experiencing loss first hand too many times in my own department. It doesn’t take a PhD to be an expert on this subject. While they may spend a lifetime studying it, I live it, alongside my brothers each and every day. I am the expert, we all are, the academic community is only now trying to catch up and find ways to help mitigate the problem. It does a great disservice to all first responders to minimize our ability to discuss this subject without a degree on the wall.