When Serving Becomes Surviving: PTSD and Suicide in the Fire Service

by Peggy Sweeney

Author’s Note: This article was previously published on the Grieving Behind the Badge website which has since been closed. Some information has been updated, but the overall article is noteworthy.

While watching a news report about a major apartment fire with many casualties including several children, I became aware of a group of professionals who regularly experience grief and traumatic stress; specifically, the men and women who serve their communities as firefighters. In spite of their dedicated service to their communities, few people in the civilian world are aware of, or seem to be concerned about, their physical, mental, and emotional struggles. Soon after that newscast, I outlined the Grieving Behind the Badge program and set my sights on offering help. I had expertise in grief and loss, but that did not prepare me for the obstacles before me.

The fire service is a culture unto itself. Words such as brotherhood and sisterhood and family are not loosely used in fire stations. If a firefighter is severely injured on the job, the hallways of the hospital are lined with members of their department who stand watch and attend to every need of the family. When a firefighter dies in the line of duty, every firefighter from that department stands watch on scene until the body is recovered and carried respectfully to the waiting ambulance.Because of this closeness to one another, you can surely understand how difficult it is for a civilian, much less a woman, to gain acceptance into their minds and hearts. In other words, I didn’t walk the walk nor talk the talk of a firefighter.

Before I could help them, I needed to educate myself. Fortunately, I met several emergency response professionals who willingly shared their personal stories that brought to light many of the demons that haunted their dreams and contributed to the rising statistics of substance abuse, divorce, post-traumatic stress (PTS), and suicide in the fire service community.

Who takes care of us? Our families? They try, I know mine did. But the average or normal person cannot share our experience, they can’t imagine what we do or see. … For me personally, I decided to treat my condition, my discomfort with alcohol. The ease and comfort that came from a bottle was a welcome house guest. I could turn off the noise, shut out the visions and thoughts with at first a few beers and in the end gallons. … Only by chance did my wife discover my suicide attempt, without her intervention my effort would have been a success. (Tim Casey, 2012)

By 2000, I had presented numerous Grieving Behind the Badge programs in North America. With each classroom experience, I began to see a pattern emerge. Some of the participants, when asked if they were disturbed emotionally or mentally by traumatic calls, emphatically stated that they were tough and strong. They had been taught to “suck it up” and not talk about their problems with anyone.

In contrast, the majority of the firefighters stated that they were bothered by some of the more traumatic calls. When they sought out their fellow firefighters to talk about these calls and their haunting reactions to what they experienced they were often shunned or ridiculed for being weak or unable to handle the emotional strain of their job. No one in the fire service wants to be labeled as unfit or suffering from some form of mental illness. The stigma is too much to bear.

“I was a badass firefighter, a seasoned veteran, even looked up to. How could I be seen as weak? Simply put I couldn’t. So I pushed on, I drank more, worked more and everything around me began to crack and fall apart”. (Tim Casey, 2012)

As of 2017, according to the National Fire Protection Association (NFPA, 2011), there are approximately 1,056,200 local firefighters in the United States: 35% are career (full time, paid) and 65% are volunteer.

Firefighters (both paid and volunteer) are usually first on the scene of accidents, suicides, and acts of violence (assault and battery, rapes, bombings, school shootings, etc.). They respond to floods, earthquakes, and airline crashes where the death toll and property destruction is overwhelming. They care for victims of domestic violence and child abuse. Firefighters extricate mangled bodies from motorized vehicles following an accident and provide medical assistance to homeless patients on the streets of inner cities. At times, they must physically restrain patients who are combative due to mind-altering drugs. Likewise, they comfort parents and family members when a child or loved one has died. Moreover, all too often, they must cope with grief following the death of a fellow firefighter in the line of duty.

In the last several years, suicides within the fire service have been increasing at an alarming rate. It is hard for anyone to know exactly how many suicides have actually occurred. Gary Ludwig, a well-respected fire service professional, states that “no one truly tracks the number of suicides among paramedics, firefighters, or even police officers. Some say the reason why is because suicide overall — the cause of nearly 11 of every 100,000 U.S. deaths annually — is underreported. … [the] Occupational Safety and Health Administration (OSHA) only tracks on-the-job deaths – not those that occur off the job” (2011).

Some firefighters may receive help shortly after a traumatic call in the way of a critical incident stress debriefing (CISD) or visiting with a department chaplain. A few departments have taken a step further and implemented programs that include information on PTSD and suicide prevention.


Chicago Fire Department, December 22, 2010.
Two firefighters, Corey Ankum and Edward Stringer
died in the line of duty

The Chicago Fire Department suffered the suicide deaths of seven firefighters in an eighteen month period between 2007 and 2008. They embarked on a research project to understand why and discovered that between 1990 and 2010 there were 1,787 deaths of active firefighters. Of these, forty-one had died by suicide.

The study found that while the national suicide rate during the same time period ranged between 10 and 12 suicides per 100,000 people each year, when the Chicago [Employee Assistance Program] EAP stats were converted to match the national numbers, the number was around 25 suicides per 100,000 people. (Peluso, 2012).
Following this investigation, the department launched a program, Family Fun Days, which invites participants to learn more about mental health issues, nutrition, and managing finances in a less stressful environment. Kudos to the Chicago firefighters for helping to erase the stigma of mental illness!

With all the good that departments like Chicago have done, it has been my experience that the majority of fire chiefs do nothing to help their firefighters cope with grief and traumatic stress. They continue to lead with the mantra “tough it out and go on”. Many do not have a program in place that provides information on PTSD and suicide prevention. Some firefighters have lost their jobs or have been turned away from their department (volunteers) because they suffer from emotional trauma due to many of the calls they have been on.

Even more disturbing is that, in most cases, a firefighter who has died by suicide is not honored by his department for their years of service and dedication to their community as they would have been had they died in the line of duty or a non-duty related death. In addition, many families of the deceased have not been offered emotional support or assistance because their loved one died by suicide.


Ludwig, G. (2011). Suicides among firefighters and paramedics. Retrieved from https://www.firehouse.com/safety-health/article/10464585/suicides-among-firefighters-and-paramedics

National Fire Protection Association. (2011). U.S. fire department profile through 2019 survey. Quincy, MA: Authors Evarts, B. and  Stein, G.

Peluso, P. (2012). Chicago firefighter suicide report seeks answers. Retrieved from http://www.firefighterclosecalls.com/news/fullstory/news/Chicago


Website of Interest: The Final Call: Why Firefighters Commit Suicide
Fault Lines explores the hidden epidemic of suicide among US firefighters and asks why more isn’t being done to help.


Although Tim Casey and I had never met in person, we had a long-standing friendship through emails and phone calls. Several years ago, I received his first email. He had attached an article he wrote about his struggles as a firefighter; the nightmares, his addiction to alcohol, and his suicide attempt. He wanted to share his story in an effort to touch one firefighter, officer or other first responder who was struggling with these same demons. He felt it was his duty as someone in recovery to tell them “help is available”.

Thank you, Tim, for your friendship and your efforts to help your brothers and sisters. May you find peace, at last, on that mountain.

About the Author: Peggy Sweeney is a retired mortician and bereavement educator. She has developed  and taught countless workshops for coping with grief and trauma including the Grieving Behind  the Badge program for emergency response professionals. Peggy has hosted support groups including Halo of Love for bereaved parents and Comfort and Conversation for grieving adults and teens. She has written award-national articles for national organizations and local newspapers. Peggy also served her various hometowns as a firefighter and EMT-B. Peggy has devoted her time and efforts to making a positive change in the lives of others and reducing the number of suicides which are becoming all too common. She was humbled to receive the Firefighter of the Year award from her Texas fire department. You may contact her by email peggy@sweeneyalliance.org

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.