Life and Death for Firefighters - Part 1: Suicide

Posted On May 15, 2023 |

Trigger Warning: In this post, we will discuss firefighters and suicide.

More first responders, both police and fire, die each year from suicide than from an incident on the job, according to the Centers for Disease Control and Prevention. Let's pause and read that again...More first responders, both police and fire, die each year from suicide than from an incident on the job.

When Dr. Ratliff and I began our doctoral journey, we had no idea we would be drawn into the "first responder" world. Looking back, our interest and research with first responders made perfect sense as Dr. Ratliff worked in the emergency department of a major Colorado hospital, and I with the military. Throughout our careers, we both had vast experience working with EMS, medical professionals, military, police, and firefighters - all "first responders."

However, we were shocked to learn that while the suicidal ideation rate for the general population is between 6-14%, the average suicidal ideation rate of first responders is 47%, with almost two times the number of completed suicides compared with the general population.

Specific first responder risk factors related to suicide include repeated exposure to emergency and traumatic incidents, responding to calls for suicide attempts and deaths, extended shift work, disrupted sleep, paid vs. volunteer status, urban vs. rural, and knowledge and access to lethal means (Jones et al., 2018). Additionally, firefighting's demanding and often dangerous nature can lead to physical injuries, further impacting mental health. Not surprisingly, Stanley et al. (2016) found that the risk of a suicide attempt increased by a factor of six for EMS personnel with dual medical and firefighting duties.

The video below highlights the story of a former firefighter-paramedic who posted videos online about his traumatic memories and his struggle with trauma and depression. He died by suicide three weeks before he was to be interviewed. (Trigger Warning)

In our health and wellness educational training program, Sounding the Alarm: A Matter of Life and Death for Firefighters, Suicide Module, we reviewed risk factors and statistics for first responders related to suicide. Primary risk factors for firefighters nationally were discussed and compared to risks in the rest of the population. Additive factors contributing to increased suicide risk were presented, as well as specific indicators or warning signs of being aware of in self and others. Helpful conversation prompts and entry points for having a courageous conversation with someone who might be suicidal were discussed. Finally, strategies for increasing protective factors and seeking help were presented.

Recognizing the importance of addressing mental health concerns among firefighters, many fire departments and organizations aim to reduce mental health stigma, improve access to mental health services, and enhance overall well-being within the firefighting profession. Please contact us if you or your organization are interested in the Sounding the Alarm course.

Dr. Scott~

If you or someone you know is thinking of suicide, please reach out to the following resources:

  • National Suicide Prevention Lifeline: 1-800-273-8255 (call) or text “HELLO” to 741741 or text 838255 for the Veterans Crisis Line
  • T-Mobile and Verizon customers can dial 988 to reach the National Suicide Prevention Lifeline
  • Talk to your family doctor
  • Talk to a mental health professional, such as a therapist
  • Talk to your local VA facility or Vet Center, if you are a Veteran
  • Talk to a close friend or family member who can support you while finding help
  • Talk to someone you trust (Peer Support Program, Clergy, Company Officer) who can support you while finding help


Al Jazeera English. (2016, February 24). The final call: Why firefighters commit suicide {Video].

Jones, S., Nagel, C., McSweeney, J., & Curran, G. (2018). Prevalence and correlates of psychiatric symptoms among first responders in a Southern State. Archives of psychiatric nursing, 32(6), 828–835.

Stanley, I. H., Hom, M. A., & Joiner, T. E. (2016). A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and paramedics. Clinical Psychology Review, 44, 25–44.

Categories: : firefighters, firstresponders, mental health, suicide