The Battle Beyond the Flames: A Firefighter's Perspective on Mental Health

There's an old adage in the firehouse that goes, "What happens on the here, stays here." It's a way we try to leave the chaos at the scene and carry on with our day. But what if chaos never leaves you? What if the flashbacks of victims' faces, the screams of people trapped, and the haunting silence of a once-bustling home now reduced to ashes follow you home, into your dreams, and into every quiet moment?

It is reality for many firefighters—mine included. I've suited up, faced walls of fire, pulled people from wreckage, and pulled colleagues from danger. But I guess the biggest battles that I have had are not those involved with fire but those spiritual ones that happen in my mind.

PTSD within the Fire Service

About 20% of all firefighters will develop post-traumatic stress disorder at some point during their careers. That compared to a rate of 6.8% for the general public, and the numbers in and of themselves highlight our profession is not just dangerous to our bodies but to our minds as well. We go towards the potentially traumatic situations that others flee from and frequently see and experience things that scar us far deeper than any burn or cut.

Every call is different; yet, amongst all the variation, one thing isn't: the unpredictability. One moment, we race towards a blazing structure; the next, we are running CPR on a toddler. Such a switch from high-intensity action—adrenaline pumping—can be jarring. It's a weight that builds from one experience to the next, layer after layer, until it's almost too much to bear.

The Dark Shadow of Suicidal Ideation

Probably one of the darkest truths about our job is that, quite frankly, we're more likely than not to have thoughts of suicide, plans of suicide, and attempts of suicide. As a matter of fact, in 2022, it was reported that 37.9% of IAFF members—the backbone of our profession—reported a history of having suicidal ideation or intent. I've lost more friends and colleagues to suicide than I have to the flames. Let that sink in.

Why do so many of us reach that point of desperation? It's not just the trauma; it's the silence that follows it. We don't talk about it—not with our families, not with our brothers and sisters in the department. There's a stigma that says showing pain or vulnerability makes us weak. But we are not weak; we are human. And the silence is killing us.

Depression and a Rising Suicide Rate

Depression makes no discriminant declarations. 11% of career firefighters report symptoms of depression—a number that only scratches the surface, as many hide their pain for fear of being seen as unfit for duty. I have watched former dynamic, unstoppable firefighters in their prime be defeated by what they have seen and felt.

Our suicide rate stands at 18 per 100,000—much higher than the 13 per 100,000 seen in the general population. These are not just numbers but people I represent who give their life to save others while not being able to save themselves.

The Hidden Dangers of Contaminants

Each time I enter a fire, I am conscious of the poisonous substances I am taking in. The thing is, most people are not really cognizant that these contaminants are not only dangerous to our physical health but to our mental health, too. Exposure to these harmful chemicals has been linked to various conditions, including anxiety, depression, and PTSD. It is another risk we take each time we get dressed in our PPE, yet it is rarely discussed.

Why We Don't Seek Help: The Role of Stigma and Psychosocial Stressors

It's hard to admit we need help when the expectation is that we're the ones who always provide it. There is one widespread stigma of mental health in the fire service that stands in the way for many of us from seeking support. We're taught to be tough, to power through. The thing with mental health is that challenges aren't something a person can actually "power through."

Our job comes with unique psychosocial stressors, things like moral injury, which occurs when we are put in a situation where we must make tough choices that go against our values. Imagine you having to decide whom to save first, or seeing firsthand the aftermath of tragedy to which you couldn't stop. Those are not crosses anybody should have to bear alone.

Building a Culture of Self-Care and Support

So, what's the solution? How do we stop more of our brothers and sisters from falling through the cracks? It starts with changing the culture. We need to:

Promote a Culture of Self-Care:

The fire service needs to encourage open conversations about mental health and self-care. It's not weak to reach out and ask for help; it's required for survival.

Provide Access to Mental Health Services:

Mental health services should be provided easily in departments, and their utilizati

on should be free of disgrace.

Train on Suicide Prevention:

Education in recognizing signs of suicidal ideation and response could save lives.

Effective Debriefing After Traumatic Events:

After a tough call, structured debriefings after traumatic events could help in processing what we have gone through and decrease the chances of PTSD and depression setting in.

Final Thoughts: Rewriting the Script

To an outsider, we may look like superhumans. But deep inside, many of us are trying—trying desperately to make sense of the chaos we've witnessed. It's time we rewrite the script.

This is a story not of "toughing it out," but of standing together, loudly speaking out loud, and putting the same emphasis on our mental health as we do on physical safety.

We cannot always walk away from chaos, but with support and understanding, we can learn to coexist with it—one day at a time.