As described in Ep. 007 “How to Find a Therapist for Thoughts of Suicide,” working with a mental health professional who understands your culture is critical. Without understanding a client’s culture, counselors can unintentionally be insensitive towards their client’s values. (*Understanding someone’s culture doesn’t necessarily mean you have to be from that culture.) When we think of “culture”, images of people in traditional clothing and notions about racial groups may come to mind. Culture, though, encompasses much more than that. Culture has to do with the development of a learned group identity. When defined in this way, it is easy to see that First Responders have a culture all their own:
- Language with unique expressions and vocabulary (What’s your 20? Box Alarm, 2300, pipeman)
- Customs (the use of bells and sirens, unit insignia, the chain of command, special flags)
- Dress (uniforms, boots, special hats, symbols of rank, and experience)
- Traditions (strict dress codes, the importance of taking care of your own, funerals with pageantry, self-reliance)
- Expected behaviors (deference to authority, being punctual, prioritizing mission over personal safety)
- A sense of uniqueness (Firefighters vs. Police, civilians vs. First Responders)
- Feeling misunderstood (distrust of outsiders, friendships mostly with other First Responders, a sense that others cannot understand their experience)
And within the broad First Responder Culture there are many subcultures as well, each with their own special customs, language, and traditions:
- Police
- Fire
- Military
- Veteran
- EMS
- Paramedics
- Grunts
- Special Operators
- Pilots
Many Americans are aware that our veterans are at very high risk of taking their lives. What is less well-known is that our First Responders also have high levels of suicide. The rate of suicide among police is about 50% higher than that of the general public, and the suicide rate of firefighters is even greater.
Why do First Responders have increased risk of suicide?
Largely, it has to do with their exposure to trauma. First Responders, like combat veterans, frequently witness tragedies, death, and destruction. As First Responders often say, “The worst day of your life is my average day.” This exposure to death and injury increases their risk of considering suicide when in moments of extreme stress.
Secondly, First Responders have higher rates of PTSD, (Post Traumatic Stress Disorder.) PTSD is often thought of as a combat-related problem; however, PTSD can occur whenever there is a traumatic event. A car accident or a fire, for example, can lead to PTSD. We know from research that PTSD is a frequent precursor to suicide.
Additionally, to cope with trauma, First Responders often turn to alcohol, sometimes excessively, as a way of trying to not think about what they have experienced. Often, disturbed sleep patterns are experienced among First Responders. Lack of sleep can make them less able to rebound from their physically and psychologically exhausting duties. First Responders typically are in possession of firearms, a method of suicide frequently used impulsively when under stress. Furthermore, the First Responder tradition of being self-reliant makes them resistant to seeking mental health care even when they are contemplating ending their lives.
In Closing…
First Responders form a unique cultural group identifiable by their dress, customs, and behaviors, and there are numerous sub-cultures. Sadly, the duties, experiences, and traditions within First Responder culture make its members vulnerable to thoughts of suicide. We can’t remove the danger and risk to serving as a First Responder. What we can do, though, is to address some of the cultural traditions that increase the risk of suicide among First Responders. We must encourage First Responders to develop ways of coping with stress other than alcohol, to seek help when they themselves are hurting, and to develop suicide prevention programs in their organizations.