The Morning Journal (Lorain, OH)
Issues often unreported among firefighters
Stigma attached to mental/behavorial health is a barrier to seeking help
Firefighters who are diagnosed with PTSD are six times more likely to commit suicide, association director says.
With the suicide rate among firefighters becoming more prevalent, along with the number of mental health issues such as posttraumatic stress disorder, anxiety, depression, alcohol and substance abuse, the once taboo subject can no longer be ignored.
Firefighters who are diagnosed with PTSD are six times more likely to commit suicide, according to Jim Brinkley, director of Occupation Health and Safety for the International Association of Firefighters. Addiction adds another layer of risk for suicide.
“I can tell you the real issue is not suicide, the real issue is the underlying mental health conditions that really lead to the outcome of suicide,” Brinkley said. “That is what we really need to focus on. That is what many of our members (firefighters) are suffering from, whether it’s posttraumatic stress, general anxiety or acute anxiety.”
PTSD, according to the National Center for PTSD, “can occur after you have been through a trauma. A trauma is a shocking and dangerous event that you see or that happens to you. During this type of event you think that your life or other’s lives are in danger.”
“We know every firefighter you ask can readily name three instances in their career that are going to stay with them for the rest of their lives,” Brinkley said. “It’s just the way it works. We all have them in our memory banks, but it’s how you process those images and how they impact you in your daily life.”
For years in the fire services industry there has been a stigma associated with mental health issues, according to fire officials. Firefighters who suffer from such issues as PTSD, substance abuse or depression have been reluctant to ask for help or seek out treatment.
One in every five IAFF firefighters is believed to be suffering from PTSD.
Brinkley notes those are just the ones they know about. He believes the issue may be under reported because of the stigma attached to the problem.
“We know that we have many that are suffering in silence,” he said.
According to statistics provided by Doug Stern, director of communications and public affairs for Ohio Association of Professional Fire Fighters, 92 percent of firefighters say the stigma is a barrier to seeking behavioral health treatment, and 28 percent of firefighters believe behavioral health issues will hurt their pride or their reputation, or they worry about confidentiality or are not aware of available services.
“We work in a culture that if you ask for help, it’s a sign of weakness and it has always been that way,” said Matt Askea, a lieutenant in the Akron Fire Department and IAFF peer support leader. “The reason for that, I think, is because our job requires us to be around traumatic situations on almost a daily basis, so if we show any signs that those types of calls or those situations cause us discomfort, then there is a lot of thought that maybe we shouldn’t be in this kind of work.”
He also believes that with the stigma attached to mental/behavioral health issues, those firefighters may worry if they seek help that it could put their job in jeopardy, affect their ability to get promoted or cause them to be seen as a weak link by their co-workers. He also believes they may feel other people will not see them as being dependable in an emergency situation and look at them as being wounded or injured and not the type of person others would want to work with.
“We are the ones you call for help,” Brinkley said. “We
know that 92 percent of firefighters report that stigma is a barrier to seeking help… We are the ones you call for help so I’m not supposed to be asking.”
According to Askea, it’s a very stressful job and its just not normal for people to be exposed to these types of events day after day, week after week, year after year.
“It will affect you,” he said. “We are a resilient group of people and we can take a lot of stress, but you know sometimes even the strongest of folks need to reach out and get some help.”
Although The National Center for PTSD says that it can happen to anyone, the percentages for those who work in the fire service are a lot higher. Approximately seven or eight out of every 100 people will have PTSD at least once in their lives, compared to one in five of firefighters and paramedics, according to the Journal of Occupational Health Psychology.
One statistic that Askea finds alarming is that firefighters are an estimated three times more likely to die by suicide than in the line of duty. He notes they are trying to reduce these numbers so they are looking at why it is happening and looking at the risk factors in general, which include PTSD, clinical depression, chronic pain, alcohol or substance abuse, in addition to the daily risks of the job such as burn out or compassion fatigue.
He also believes that education is the number one factor in reducing the stigma and enabling firefighters to ask for help.
“If we reduce the stigma, and if get administration on board with this and our peers actually encourage post traumatic stress members to take the steps needed, then those numbers will go down significantly,” Askea said.
“We need to change the stigma that we can’t talk about it if we are upset about a call we went on,” said Bill Mastroianni, a lieutenant for Euclid Fire Department and director of operations for the OAPFF. “We are trying to spread the word that behavioral health is a problem in the fire service and that we are trying to address it. We are trying to get more people involved in recognizing behavioral health.”