A recent panel discussion on suicide awareness in the fire service emphasized the mental health challenges faced by firefighters and emergency medical personnel. Sponsored by the International Association of Fire Fighters (IAFF) and moderated by the IAFF’s Charmaine Nero, the panel included Lauren Kosc, LCPC, NCC; Capt. Brandon Dreiman, CAPRC, of the Indianapolis Fire Department, and Lexipol Strategic Wellness Director Rachelle Zemlok, PsyD.

The discussion highlighted the reality that firefighters are at a significantly higher risk for suicidal thoughts and behaviors due to the intense and often traumatic nature of their work. Exposure to destruction, injury and death on a regular basis can do the following:

• Lead to conditions like PTSD and depression
• Foster feelings of hopelessness
• Disrupt healthy coping mechanisms
• Increase social isolation
• Condition firefighters to become increasingly comfortable with the idea of death

Any or all of these effects can contribute to a heightened risk of suicide. To underscore this point, the panelists shared alarming statistics about recent surveys in which a large percentage of firefighters reported having suicidal thoughts.

Risk Factors for Suicidal Ideation

According to the panel, there are several personal characteristics that make it more likely a member of the fire service might consider or attempt suicide. These include:

• Traumatic exposure: Frequent exposure to traumatic events — such as deaths, injuries and violence — can desensitize individuals to death and increase their risk of suicidal thoughts.
• Mental health conditions: Pre-existing mental health issues, including depression, PTSD, and substance use disorders, are significant risk factors for suicide.
• Major life transitions or losses: Events such as divorce, retirement or the death of a loved one can exacerbate feelings of hopelessness and increase suicide risk.
• Clusters of suicide: People in first responder communities are more likely to consider suicide if someone else in the same area or department has died by suicide.
• Family history: If someone else in the person’s family has attempted suicide or died by suicide, that person may be at an increased risk to do the same.
• Previous attempts: If a person attempted suicide in the past, they’re more likely to try again in the future.

Major Warning Signs for Suicide Risk

According to Capt. Dreiman, risk factors aren’t as significant an indicator as warning signs, which are specific behaviors that might indicate a person is actively considering suicide. While they don’t necessarily predict someone will take action, they are definitely a cause for concern:

• Expressing hopelessness: Statements about feeling trapped, being in unbearable pain, or having no reason to live are serious red flags.
• Behavioral changes: Sudden withdrawal from social activities, giving away possessions, saying goodbye to friends or family members, or drastic changes in mood or behavior can indicate an increased suicide risk.
• Talking about suicide: Direct or indirect references to suicide, such as talking about ways to die or expressing a desire to end one’s life, are critical warning signs.
• Researching ways to die: If you discover someone is looking into ways to die, that’s also a red flag.

“As a spouse, I see myself as the frontline defense for my husband’s mental wellness.”

Other Causes of Concern

Dr. Zemlok, whose husband is in the fire service, emphasizes the importance of the family as a support for a first responder partner. “As a spouse, I see myself as the frontline defense for my husband’s mental wellness, right? Because he can go to work, and he can tell everyone he’s OK. ‘Yeah, I’m good. No problems.’ But if I live under the same roof as him, I see it first.” She points out some additional items of concern, besides the signs and factors above, that families should be vigilant in looking out for:

• Increased irritability and anger: More frequent angry outbursts or irritability could indicate underlying stress or mental health issues.
• Substance abuse: Increased use of alcohol or drugs as a coping mechanism can be a sign someone is struggling with their mental health.
• Poor sleep: Sleep deprivation can lead to increased emotional distress, impaired judgment and increased depression and anxiety, all of which are closely linked to suicidal thoughts. Chronic sleep problems can exacerbate feelings of hopelessness, reduce the ability to cope with stress, and increase impulsivity, making individuals more vulnerable to suicidal ideation.
• Isolation and withdrawal: If a loved one starts to isolate themselves, avoiding social interactions and family activities, this could be an indicator of severe distress.

Watch the full discussion on YouTube:

Finally, the discussion covered the various initiatives and resources available through the IAFF to support mental health and prevent suicide. These include peer support programs, behavioral health screenings and the IAFF Center of Excellence, which offers specialized treatment for firefighters. The IAFF will shine additional light on this issue in September during National Recovery and Suicide Prevention Month, when the organization will host webinars, provide helpful resources and host a Suicide Prevention Safety Stand Down during the week of September 9–13.

The panelists stressed the need for continuous education and proactive mental health management throughout a firefighter’s career, not just at the entry level, to ensure early intervention and sustained support.

Peer support and access to mental health professionals are both vital in ensuring members of your team have the wellness resources they need when they need them. Lexipol provides training and certification for both peer support members and clinicians who support first responders.