Firefighters struggle with suicide, fatigue, PTSD
Tony Martinez, a 29-year veteran Cal Fire captain in Napa County, said he “bleeds Cal Fire,” but neither of his young adult sons want to follow him into the fire service, and he understands. “I tell my young firefighters: ‘Don’t work here,’ ” he said.
Statistics gauging the extent of the department’s mental health problem are scant: Cal Fire collects no information on PTSD or suicide among its staff so the agency cannot say whether it’s as rampant as firefighters say.
Cal Fire does track the number of times its employees and family members contact a peer-support team for help with an array of issues, primarily physical and mental health. And those numbers have been climbing: from 1,362 contacts in 2011, the first year Cal Fire began compiling the data, to 17,310 last year.
Counselors say a majority of the requests for help are related to stress. So far this year, 24% sought referrals for medical and psychological issues, 12% for grief and loss and about 9% for addiction or substance abuse.
A 2016 report found that nationwide, firefighters are 40% more likely to take their own lives than the general population. In addition, in a 2019 online survey of more than 2,600 wildland firefighters, about a third reported experiencing suicidal thoughts and nearly 40% said they had colleagues who had committed suicide. Many also reported persistent depression and anxiety.
The survey is believed to be the most extensive research into the mental health of wildland firefighters.
Patricia O’brien, a former federal firefighter who coauthored the study, said the increasing frequency and intensity of California wildfires, coupled with the fireservice ethos of stoicism, is a formula for severe and unresolved trauma.
“This is humans battling a force of nature. We don’t get to conquer nature,” she said. “And if we try to do that, there will likely be negative outcomes in the form of trauma exposure, tragedy and loss. There are human burdens that firefighters carry.”
California’s firefighters carry a heavier burden than most. Unlike the majority of the nation’s wildland firefighters, Cal Fire crews are required to be ambidextrous: They staff local fire agencies in 36 of California’s 58 counties, meaning they toggle from responding to wildfires to hazardous material spills, swiftwater rescues, train crashes and medical emergencies.
“We are humans first, not firefighters or dispatchers,” said Ali Wiseman, a Cal Fire dispatcher who reeled off a cascade of colleagues’ deaths while attending the recent trauma camp in the desert. “Even though it’s hard or painful and embarrassing, I have to trust the world and tell my story.”
Now a year-round, neverending battle
All that the fire service once understood about fire size, behavior and severity is no longer valid. “Once-ina-career” fires now come every year. What used to be called a fire season is now a year-round battle in California, with about 8,800 wildfires last year alone. Firefighters are staying on the fires lines much longer as they battle larger, more intense and more persistent fires.
In recent years, fire scientists watched as back-toback fires did the unthinkable, burning across the Sierra Nevada’s granite wall. Lightning sieges sparked fires where flames had seldom been seen, in the North Coast’s “asbestos forests,” dubbed that because they used to be virtually fireproof.
California’s wildland firefighters are now in a defensive crouch, facing an amped-up enemy fueled by climate change’s most destructive weapons: the worst drought to grip the Southwest in 1,200 years, loss of 130 million parched trees from disease and pests, and extreme weather conditions that defy predictability and precedent.
And there is little indication that things will get better as California cycles into an era of what fire crews call drought fires — massive, stubborn and dangerous. Wildland fire commanders caution their charges to “keep their heads on a swivel” — always alert to danger. Mental health experts now add another layer to that vigil: Firefighters must also be on the lookout for stress, fatigue and trauma in themselves and their colleagues. It’s tricky, however, to spot.
For some, PTSD can be caused by a single horrific event. For others, it’s a career’s-worth of awfulness that finally becomes too much.
“It’s all cumulative,” said Jeff Griffith, a Cal Fire captain who retired in December after 30 years on the job. “It’s a bucket, and there’s a drop, drop, drop. Eventually your bucket is going to overflow.”
Griffith said the personality type of firefighters is to “walk it off then get back to work. The sense is that you can’t go to your crew and confess a weakness because you are the officer. We’ve got hotlines where people are talking about substance abuse and marital abuse. People are overdosing on their day off.”
One reason that mental health data is hard to come by for California’s wildland firefighters is they have “a work culture in which people are being paid to be tough and show no weakness,” said Sidra Goldmanmellor, an associate professor of public health at University of California, Merced, whose work as a psychiatric epidemiologist focuses on tracking depression and suicide.
“People are much less likely to volunteer information about their mental health problems,” she said. “It’s very different to how we talk about physical health problems. In large part, it’s the stigma. In many cases, though, people don’t recognize their depression and PTSD as a psychiatric problem.”
Cal Fire’s mental health program, Employee Support Services, functions as triage, working with those who want help, then directing them to therapists or doctors. Mike Ming, a 30-year Cal Fire veteran in charge of behavioral health and wellness, said much of the work is done by peers who are “active listeners.” The counseling and other services are voluntary and confidential.
“We ask the question, ‘Are you going to kill yourself?’,” Ming said, adding that if a firefighter says he or she is considering suicide, the peer counselor immediately contacts authorities. “We are never going to leave them alone in that case. We stay with them.”
Ming said firefighter suicides are a “trend that we’re hearing about more. We’ve had six deaths over the last couple of weeks. There have been overdoses. There’s no getting around that in the first-responder world, there is a problem with suicide. Cal Fire is no different.”
While peer programs can be useful in reaching those reluctant to talk about private matters with strangers, Goldman-mellor said it’s difficult to measure their effectiveness if the fire service doesn’t collect data on suicides and PTSD.
“In general there are very few programs out there that have empirically been shown to reduce suicide rates,” she said. “Even if a program does work, you may not have the numbers. You can’t claim that it’s effective to reduce suicide if you are not tracking that outcome.”
Another problem is lack of expertise in diagnosing unseen wounds — not broken bones but broken minds. “It’s very, very, very difficult to diagnose PTSD,” Goldman-mellor said. “Many physicians are not trained in evaluating mental health problems.”
Mynda Ohs is a trauma counselor based in San Bernardino who specializes in treating first responders — both her husband and son are wildland firefighters. She said it’s common for firefighters to mask their stress or trauma by binge drinking or taking illegal drugs.
“The most prominent thing I see is anxiety,” she said. “First responders can become accidental alcoholics, looking to take that edge off quickly. They are looking for calm. I see a lot of porn addiction — it’s legal and it does serve as an outlet or release. I have five right now that I am trying to help.”
Feeling better, feeling lighter
Back at Nurturing Nest — the rambling spa-retreat in Desert Hot Springs that usually caters to a selfhelp, spiritually inquisitive crowd, mats are rolled out, and firefighters gingerly work through yoga positions in a sunny room.
On weeks when the facility is given over to firefighters, its name is toughened up to Freedom Ranch. Some firefighters, dubious about the need for therapy, call the trauma retreats “Camp Snoopy.”
Cal Fire sends more than a dozen firefighters each month for intensive treatment at these workshops, with sessions involving vision boards, yoga and mindful breathing lessons.
Those who come to the retreat do so of their own volition. No one is ordered to attend. For some it took years to gather the courage to face their demons.
Steve Diaz is quietly observing from a corner. He retired as a battalion chief after 34 years with Cal Fire, the last few years as part of the peer-support program. He knows six colleagues who killed themselves. “I believe it is a crisis,” he said. “One is too many.”
Ramesh Gune runs the facility and is a therapist trained to work with first responders. He’s drained at the end of a week of concentrated counseling, as if he’s taken on the trauma of his charges as they slough off their emotional injuries. He speaks softly, gesticulating with his slender hands.
“Mostly anger, that is what I see a lot,” he said. “‘I am not what I pretend to be,’ that’s the conflict. ‘I feel helpless.’ That sense of helplessness drives them crazy. They cannot save people. ‘I am not enough.’ They harbor that negative feeling constantly. They become paralyzed.”
His work, he said, begins with reminding California’s firefighters that there is a path to feeling better, feeling lighter.
Hiram Vazquez, 38, carries a body full of tattoos as visual prompts lest he forget what’s important to him — portraits of his family on one muscular arm and a pirate theme on the other to remind him of the storms he’s weathered. The Cal Fire captain based in Riverside is trying to focus on the good things, incorporating coping tools he learned at the retreat.
“I came here pretty broken. A broken family, broken life. A lot of grief,” he said. He twice planned his suicide. He bought life insurance and planned to shoot himself, but rethought that when he realized his family wouldn’t be able to collect on the policy until it had been in place for two years. “And I didn’t want my kids to clean up after me,” Vazquez said.
Plan B was to speed along Highway 74, running through a guardrail and staging the scene to make it look like a car accident.
“I had hit rock bottom,” Vazquez said. He finally asked for help, and came to the desert.
“Stuff I didn’t realize I was carrying came up,” he said. “I’ve been on incidents where my friends have got burned over. I’ve been on incidents where people I was working close to have died. I’ve lost good friends. I’ve seen a lot of deaths. I’ve seen a lot of suicide with my peers or people that I know.”
Some of the trauma came from witnessing the trauma of others. Vazquez was in charge of an engine on the 2007 Harris Fire, which killed eight people in San Diego County. Another engine was caught in the fire, trapping firefighters.
“I was listening to the radio traffic, and one firefighter was screaming for help,” he said. “I was listening to air attack talking to the battalion chief who’s trying to find those guys, and he’s guiding them into this site, then telling them to back out because it’s about to get burned as well.”
As he recounts the story in a group session, other firefighters nod in recognition and understanding. No judgment.
“I feel free,” Vazquez said. “I feel like I don’t have to carry that burden anymore. Now I find I can live free.”
The responsibility of leading crews, and keeping them safe, weighs heavily. It’s one of the burdens that brought Orton, 47, the former Marine now stationed at a Los Angeles County inmate fire camp, to a trauma retreat.
“Every action I take (as) captain, every day of my career, I always think, ‘How am I not going to die? How am I not going to kill somebody today?’ You are constantly thinking about that on the job. I compartmentalize things so that I am able to take the stress.”
Compartmentalizing — putting negative thoughts and upsetting experiences in a mental lockbox — is an expedient way of stowing trauma, getting it out of the way so that memories don’t become incapacitating.
But even well-secured boxes can spring open.
That’s what happened to Orton on the last day of a retreat. He abruptly shared a long-buried personal trauma — the emergency stillbirth of his son 18 years earlier. Gune gently guided Orton through an exercise in which Orton could cast away his pain by visualizing the event and speaking to his lost son, saying the goodbye he was unable to express at the time.