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Members of the FDNY watch President George W. Bush as he surveys Ground Zero.

The realities of firefighting and mental health

In June, the London Fire Brigade responded to one of the most tragic incidents the international fire service has witnessed in years. In the middle of the night, some 40 apparatus and hundreds of firefighters descended upon a 24-story apartment block in North Kensington. Upon their approach, London’s bravest came face-to-face with the towering inferno, undoubtedly watching in disbelief as the flames scaled the exterior walls of Grenfell Tower.

In the midnight hours, they encountered a situation that even the most battle-hardened of smoke-eaters hopes to never experience during their time on the job. Every firefighter in the fleet of responding engines must have readily identified that they were reporting to a worst case scenario. Immediately they must have recognized the devastating implications of a fully-involved apartment block during the nighttime hours, the soul-crushing reality that casualties were all but inevitable.

After dismounting from their rigs, every man and woman donning bunker gear must have looked up at the tower and contrasted that chaotic view with that of the sparse huddles of the structure’s evacuees assembled on the streets and sidewalks. After receiving their orders, and structural information indicating that interior operations would be significantly hindered, the realities of the grim task that awaited them must surely have set in.

By the end of such grueling shifts, a crowd of thankful citizens paid tribute to their heroic efforts as the firefighters departed for their quarters, one can see the expressions of exhaustion – both physical and emotional – on their faces. The horrific manifestations of having responded to a call in which some 80 souls were lost.

With tragedy only one alarm away, we’ve thankfully seen a great shift in fire service attitudes toward the examination of the relationship between firefighting and mental health. There can be no doubts that the relative torrent of increased media attention on this critical subject is at least in part due to a spate of shocking firefighter suicides that have garnered public attention. However, suicide is but one aspect of the psychological impact a career in the fire service has on the practitioner. Unfortunately, the magnitude and depth of the problem which devours our membership is much greater, and far more complex.

The London Fire Brigade battles the Grenfell Tower fire in the early morning hours.

The London Fire Brigade battles the Grenfell Tower fire in the early morning hours.

Over the last few years, our noble industry has seen a number of organizations and individuals expend great energy on investigating and propelling new research on the subject. We’ve seen the publication of a number of exceptionally powerful pieces that have brought significant attention to the once taboo subject of firefighter mental health. Trainings which offer courses along the lines of “psychological first aid for responders” have become commonplace. Fire departments have increased their efforts to retain the services of mental health professionals, be it counselors or Critical Incident Stress Debriefing teams. All-in-all, we’ve collectively made significant strides in addressing the realities of firefighter mental health.

However, we owe it to ourselves to be unashamedly honest about this situation. As an industry we’re still leagues behind the rest of society when it comes to acknowledging and effectively combating our invisible enemy. Whether we like it or not, we have an image to uphold, an image we take great pride in. It’s one of unfaltering toughness, one in which we’re inexhaustible. We convey an image to the public that depicts the firefighter as superhuman, the problem is that we’re not.

We are human, flesh and bone with a psyche no different than that of anyone else. We have conditioned ourselves to absorb an inordinate amount of psychological punishment, yet we’re all acutely aware that our armor will inevitably fail. Despite the bitter realities we all face, we’ve constructed an environment within our very own industry that perpetuates an insidious myth that we’re somehow supposed to be invulnerable to trauma.

We’ve stigmatized the impact of our profession on our mental health to such an extent that we won’t even entertain the notion that something as horrific as suicide might be line-of-duty related. To this very day, there are numerous fire departments that won’t even afford the same funerary accommodations to active members who committed suicide as they do to former members. We’ve even maintained pension systems with vesting plateaus that incentivize remaining in a situation detrimental to one’s mental health even after they’ve hit their psychological “breaking point”.

Let’s be brutally honest, many of us have blatantly downplayed the extensiveness of the psychological injury most of us already have, or will incur over the course of our careers. We’re inherently wary of any attempt to “talk about” an incident, be it an intervention through a CISD team, a mental health professional, or a simple and informal tailboard chat with a colleague. We joke about our business becoming “too touchy feely”. However, the reality is that the systemic deterioration of our mental health is something we need to talk about.

A recent study published by the National Fire Protection Association suggested that up to 37 percent of active firefighters may exhibit the clinical symptoms of Post-Traumatic Stress Disorder. Recent surveys and studies conducted by the Centers for Disease Control and others suggest that firefighters drink alcohol twice as frequently and with greater intensity than the rest of the population. We’ve found that firefighter suicides are both horrendously underreported and difficult to quantify, but what we do know is that the annual suicide figures of our brethren may very well rival those of line-of-duty-deaths.

We sign up for the job knowing the risks. We accept the distinct possibility that there may come a day when we don’t make it home. We plan and account for the likelihood of sustaining physical injuries, yet we actively avoid coming face-to-face with the specter of psychological damage. The almost universal truth is that we’re afraid to shatter the image of the unbreakable firefighter. The terrifying reality that runs counter to the image we desperately attempt to maintain, is that we know we’ll never emerge from this business unscathed, that we all leave something behind, or perhaps more accurately, bring something home with us.

We routinely cradle crippled souls, stabilize shattered bodies, peel flesh from our sleeves, and feel the bones below our hands crack as we fight valiantly to save those we instinctively know are already lost. We can no longer continue to overwhelmingly facilitate the survival of an industry-wide culture that reinforces a dangerous perception, one which proffers that we’re largely immune to the carnage we regularly witness. It’s time to shine a light on the shadows that stalk our industry. It’s time to change fire service culture, and that change can only begin with those within the profession itself.

For more information, email jesseheitz@gmail.com

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<p>Jesse A. Heitz formerly served as a firefighter with the Chaska Fire Department, and as the Training Officer for the Carver County Fire Departments’ Hazardous Materials Response Group. He is the author of Fire Resistance in American Heavy Timber Construction: History and Preservation.</p>

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