Firefighter suicide: Understanding cultural challenges for mental health professionals.

Abstract

Suicide is a widespread problem that is severely underreported within the fire service. There is a growing body of evidence that suggests firefighters are at increased risk of committing suicide compared with their civilian counterparts due to disturbingly higher rates of posttraumatic stress disorder and substance use disorders, which serve as markers for suicide completion. The main problem for mental health professionals in addressing suicide in this population is the substantial lack of empirical research on mental health of firefighters as well as the compounding cultural stigma that exists in addressing mental and behavioral health issues. Additionally, there remains a discrepancy in reported rates of suicide and a lack of information on attempted suicides-related to low reporting rates by family members, fellow firefighters, and departments, as well as no official national tracking database for suicide in firefightersthat further complicates research in this area. This article (a) discusses current research on suicide within the fire service, (b) explores issues and challenges for psychological assessment and intervention for practitioners working with this population, (c) describes specific approaches toward decreasing suicide in firefighters, and (d) suggests policy considerations for fire departments and mental health professionals.

A longitudinal assessment of the road to mental readiness training among municipal police

“…Concerns about stigma and possible identifiability may also have impacted participant reports (e.g. Halpern, Gurevich, Schwartz, & Brazeau, 2009;Henderson, Van Hasselt, Leduc, & Couwels, 2016;Karaffa & Koch, 2016). Relatedly, in the absence of diagnostic interviews assessments of symptoms and skills, as well as absent assessment of objective behavioral indicators, the current results may not replicate and may not reflect the full impact of the training program.…”

Anxiety sensitivity and suicide risk among firefighters: A test of the depression-distress amplification model

“…Nevertheless, AS social concerns may be particularly important to understanding suicide risk among firefighters and may signal the need for a culture shift within the fire service to normalize emotional expressions [55,57]. There does not appear to be a replicable pattern of relative mean AS subscale scores across samples of undergraduates [26], psychiatric outpatients [24], male substance users [27], and firefighters (this study) testing the depression-distress amplification model.…”

“…The AS social concerns subfactor is characterized by thoughts such as, “I worry that other people will notice my anxiety” and “When I begin to sweat in social situations, I fear people will think negatively of me” [12]. Given that stoicism is valued within the fire service [55], any demonstration of fear or anxiety may contribute to perceptions of social isolation, which, in turn, may exacerbate depression and distress. Shame, too, is relevant to the AS social concerns factor.…”

Provincial Correctional Service Workers: The Prevalence of Mental Disorders

“…Third, responses were based on anonymous online self-reporting of current symptoms, making reliability and validity ambiguous [40]; however, the results are consistent with previous Canadian correctional worker responses and increased reliability and validity would require a substantial investment. Fourth, even when anonymous, people may underreport clinical symptoms [41,42], and PSP, including correctional workers, report substantial concerns regarding stigma and confidentiality [5,6,[43][44][45][46]. Fifth, even well-validated and conservative self-report screening tools are only approximations.…”