Firefighters and other first responders face high rates of post-traumatic stress, depression and suicide. For decades, shame and stigma have kept these issues in the dark. But in Virginia, a number of departments are working to change these trends. In the first of a two-part series, WCVE’s Catherine Komp has more for Virginia Currents.
Learn More: Follow the work of the Northern Virginia Federal Fire Peer Support Team, find information and resouces about firefighters and behaviorial health with the Firefighter Behaviorial Health Alliance, the International Association of Firefighters Center for Excellence which operates a treatment and recovery center, First Responders Addiction Treatment Program, the Rosecrance Florian Program for uniformed service personnel, and the Badges United Foundation which provides mindfulness activities for first responders.
The National Suicide Prevention Hotline provides 24/7, confidential support at 1-800-273-8255 or via chat on their website.
About five years ago, a firefighter at Fort Belvoir took his own life.
Jonathan Lang: That person slipped through the cracks.
Jonathan Lang saw himself slipping too - into addiction.
Lang: Guys knew that I had an issue, but it was all swept under the rug.
Lang: When in actuality they were enabling me to continue on with the same behavior. Nobody called me out on it.
Lang didn’t want anyone else to slip through the cracks, whether facing substance abuse, depression, post traumatic stress or all of those things at once.
Lang: We’re supposed to be the good guys, we’re supposed to be the heroes, the ones that come to help other people. We spend so much time worrying about other people, we don't take any time for ourselves. I mean dedicated firefighters, that are dedicated to the job, they don't know that it starts to take a toll on them.
Lang sought treatment for addiction. After rehab, he volunteered with the peer recovery organization SAARA of Virginia and he saw firsthand the benefits of peers helping each other. He went to his chief, shared his story and asked about developing a peer support team at Northern Virginia’s Fort Belvoir.
Lang: That was the first step was getting management’s buy in to the program, because without that it wouldn’t work.
A year and a half later, Lang’s built a peer support team of 16 people, including firefighters from nearby Fort Myer, a doctor from Belvoir’s Employee Assistance Program and two fire chaplains. It’s the first peer support program for first responders at a US Army installation.
Members go through intensive trainings on stigma, suicide intervention and mitigating stress. Today’s training is by Virginia First Responder Support Services. Harrisonburg firefighter Gene Thompson co-teaches the class with his wife Sarah, a counselor whose PHD work focuses on firefighters and mental health.
Signs and symptoms are different for everyone, say the Thompsons; what’s key is having a team prepared to look for them.
Sarah Thompson: It can really be anything, it can be sleeping problems drinking problems, you know anything.
Gene Thompson: Being depressed, being sad, anxious, being jumpy, night terrors.
The class discusses the subtle but intentional ways peers can be accessible and build trust, even with the guy that might be gruff on the outside.
Gene Thompson: You still say good morning to him, he still says “What’s so good about it?” And we all laugh about it. That was him joking. We never even tried. If they become grumpy over 20 years, do you think you’ll fix them in a day? No.
Firefighters can internalize a lot of stress. Shifts are long; here at Fort Belvoir they’re 48 hours, sometimes with mandatory overtime. You’re away from your kids and spouse, missing everyday things like dinner and homework, and milestones like birthdays and graduations.
Class is briefly interrupted when a call comes in for a fire at a townhouse. But firefighters respond to so much more, including traumatic events like pediatric deaths, overdoses and suicides.
Gene Thompson: All that compounds and it’s always building on your shoulders and you never forget it, you never do. Having peers that can share that burden and that know what I went through and I can offload some of that stress onto and they help me share the burden of knowing it, it really feels good to just offload and tell somebody.
Sometimes trauma is provoked by the sight of a victim. Sometimes it’s the look on a family member’s face, says Fort Belvoir Lieutenant Cory McGhee. A month earlier he responded to a suicide.
Cory McGhee: The husband was home or was home at least when we arrived and to see the impact on him and the family, to find out later that they had kids and everything else. You sit back and you think about that, that is a very sad situation. And for what we've seen as providers to go in, in what was a pretty nasty incident to be on and to kind of walk away from that, to be humans as we walk away and then provide care to the husband after that, and then on top of that, come back home, back here at the station, make dinner, go about our evening, like nothing ever happened. It's a different kind of day for most people.
A study released by the Ruderman Family Foundation in 2018 found that “police officers and firefighters are more likely to die by suicide than in the line of duty.” There were 103 documented suicide deaths by firefighters and/or EMS, and 93 deaths in the line of duty in 2017.
Lang: Which is scary and we're noticing it and we're noticing that there can be an intervention before something terrible happens like that.
According to state data obtained by WCVE, in Virginia at least 71 first responders died by suicide between 2007 and 2016; that number includes 45 law enforcement, 14 firefighters, 7 paramedics and 5 dispatchers. These and national numbers might be low. The Firefighter Behavioral Health Alliance estimates that less than half of all firefighter suicides are reported.
Gene Thompson: We need to break the stigma because that stigma is what's actually killing these first responders. It's not the depression, the PTSD, the anxiety and all that -- yeah they play a part in it, but we're the ones that are stopping them from actually reaching out and helping. So we're a part of the problem, not the solution. We need to be part of the solution and we need to break that stigma in the first responder world.
Peer support training for first responders covers all kinds of kinds of scenarios, like getting outside help for a colleague in crisis and checking in after bad calls. Peer specialists learn to look for problems at home, with relationships or finances. But getting people to open up without shame is a challenge.
Lang: It’s hard. There’s a lot of comments, I hear weak-minded a lot, just suck it up. We have to get out of that mentality.
Lang is making good progress. Before this weekend, Captain Samantha Green and Lieutenant Cory McGhee didn’t see themselves playing a role in peer support.
Samantha Green: As I said in the beginning of this class, I was like this is a complete BS class. It's touchy feely, it's not my style.
Cory McGhee: So before I was definitely the poster child of you know, you come back to the station and you use dark humor. That's how we got over things.
By end of the first day of class, both were changed. They have a better understanding of the mental health crisis facing emergency services. And they now see themselves as part of solution.
McGhee: I'm going to take a different standpoint on how I look at incidents and people. I could have always been that person that kind of gets wrapped up in the mix of not treating a situation as serious, not treating depression or the incidents that we run as serious. Where it's more serious now to pay attention to who the people are, how they act, how they react and what they do.
Green: Dealing with your people is the most important thing we do every day, whether it's informal or formal leader, taking care of your guys period. So the stigma, it's got to be cut, it's gotta be, somehow. But it starts with us. It starts with me, and it starts with everybody else.
Shane Crutcher: The thing that we have to remember every day as a fire chief is where we came from period.
Crutcher sees his role as backing the peer support team, rather than being on it. And being a resource for other chiefs who are having conversations about mental health.
Crutcher: How do we approach folks that have challenges and that are struggling and do it in a manner which doesn't feel like you're out to get them. And not only that but understanding that people have challenges, they have struggles and that's not a weakness. We just need to kind of be much more engaged with them and help them through it.
That’s the message that resonated with Belvoir Fire Marshall Julien Crolet; that it’s a strength to recognize problems and ask for help.
Crolet: Even if you don’t have an established team, it’s always good to rely on each other. The fire department is a family and use it as such when you need help, don't be afraid to speak out.
There is a lot of work to do to change the culture in fire departments. Mike Jackson is President of Fort Meyer Local F-253. He says they’re playing catching up, taking small but significant steps.
Mike Jackson: It's important, but it's going to be a hard road because you know, you've got these guys that, “I have to be tough. I don't want to talk to you about my problems” kind of mentality happening. So we've got to break that down and start over.
The challenges are immediate and the need is urgent. Another Virginia firefighter recently died by suicide. Jonathan Lang said their peer support team was able to deploy to that department to offer assistance, resources and a listening ear.
Lang: I just want people to know about our program and be able to reach out to us from all over the country, that's my goal. Especially the federal side, federal firefighters don't really have an outlet for that. So my goal is to be able to help whoever comes in the door and be ready for any situation that possibly we might see.
Lang sees a future where at least one peer team member is scheduled on every shift; where all new recruits receive peer support and mental health training at fire academies; a future where empathy is a core part of the fire service, and a future where no more first responders slip through the cracks. For Virginia Currents, I’m Catherine Komp, WCVE News.