Shining a Light on Suicide Risk for Wildland Firefighters

2024-11-22 07:33:02 source: category:Finance

As climate change fuels more severe wildfires that burn through larger swaths of forestland and homes each year, firefighters are facing increasingly unpredictable, catastrophic blazes, leading many to speak out about suicide among their ranks, an occupational hazard they once kept to themselves. But a dearth of studies investigating the psychological costs of battling these blazes is hindering efforts to provide firefighters with help.

Wildland firefighters routinely endure treacherous, emotionally taxing conditions. But those conditions have become increasingly untenable as fires grow bigger and fiercer, and keep men and women battling erratic blazes with no relief for weeks on end. 

“The current federal wildland fire workforce is understaffed and overworked,” Riva Duncan, a retired U.S. Forest Service fire staff officer and executive secretary of the nonprofit Grassroots Wildland Firefighters, testified before the House Natural Resource Committee last April. 

People are “at their breaking point,” Duncan said, “leaving a wake of mental health issues, suicides, high divorce rates and very concerning numbers surrounding high incidences of cancer and cardiovascular disease, all from a career of undocumented exposure to smoke, particulate matter and other effects from hazardous conditions we face every operational shift.”

Wildfires across the West Coast reached historic proportions during the 2020 fire season, burning an unprecedented 4 million acres in California and leaving a dozen Oregon counties battling “conflagrations” during a single day. That year, Duncan testified, “I had more firefighters reach out for help with thoughts of suicide, depression and traumatic events than at any other time in my career.”

Yet, despite anecdotal reports of a rising mental health crisis among wildland firefighters, surprisingly few studies have investigated suicide risk among the men and women who put their lives on the line to fight increasingly devastating infernos. In a small survey of wildland firefighters in British Columbia, published in the journal BMJ Open in February, 78 percent of respondents identified mental health risks associated with their job as one of the most important research priorities.

“We don’t have hard numbers on completed suicides among wildland firefighters,” said Patricia O’Brien, an Oregon psychologist who worked as a wildland firefighter for 15 years, including a decade with the specially trained Lolo “hotshots” in Missoula, Montana.

Studying a Quiet Epidemic

Part of the reason it’s hard to get accurate numbers, said Marilyn Wooley, a California psychologist who specializes in treating first responders, is because there’s still a “huge stigma” around suicide. 

Stigma persists partly because of enduring misperceptions surrounding suicide, including the notion that it’s a weak or selfish act, when in fact people who take their own life often believe the world would be better off without them. These myths make people reluctant to seek help and prevent some families from reporting a loved one’s suicide. “There may be a lot of suicides that nobody knows about,” Wooley said.

A large body of research on other first responders, including police officers, urban firefighters and emergency medical technicians, reveals an elevated risk for suicide. More than half of the firefighters who responded in a 2018 study said they’d considered suicide, but only 20 wildland firefighters participated.

The nature of wildland firefighting makes it difficult to study the people who risk their lives to keep communities safe. Wildland firefighters are employed by numerous federal, state, local and tribal agencies whose crews expand and contract in response to need over the fire season. Many are seasonal workers or volunteers. As a result, no one knows exactly how many people fight wildfires in a given year, though estimates range from 35,000 to 50,000. 

“It’s a population that’s really hard to track, to describe, even just to get some numbers on,” said O’Brien. 

The number of men and women killed in the line of duty fighting fires in forests and grasslands averaged around 13 per year between 2010 and 2019, according to the U.S. Fire Administration. At some point, suicides seemed to surpass that, said Charles Palmer, a University of Montana professor who worked nearly two decades as a wildland firefighter. If the number of people who died doing the job is now lower than the number of individuals who take their own life, Palmer said, “that should be extremely well publicized, well researched and validated.”

But Palmer hasn’t seen the type of investments needed to determine whether the data support what has become conventional wisdom. If it was any other problem related to wildland firefighting, he said, it would be well funded and researched.

Palmer attributes the dearth of data partly to the way suicide is treated in general. “It’s just this elephant in the room that nobody seems to want to talk about,” he said. “It touches everyone in some way, yet we seem reluctant to sit down and figure out a plan to address it, to find out more about it.”

Even if researchers never get accurate numbers on how many wildland firefighters are taking their own lives, O’Brien said, it’s clear that they’re exposed to trauma and other factors that increase risk. 

And it’s safe to assume that as climate change drives higher intensity fires, more frequent fires and longer fire seasons, firefighters will experience changes in their working conditions that affect how much time they can spend with family and doing things that are important to them “outside of fire,” she said. “And it’s those kinds of family connections and community involvement that buffer people from negative mental health experiences.”

Understanding Risks

People are attracted to wildland firefighting for “a multitude of different reasons,” Palmer said, but the quick bonds people forge working in high-risk, remote environments is part of the allure. 

“It’s a brotherhood and a sisterhood,” said Palmer, who spent several years parachuting from planes into fire zones as part of a rarified cadre of highly trained “smokejumpers.” 

Palmer loved going to work “every single day,” even when he got banged up. He recalled one jump when he steered his parachute into a fire north of Yellowstone National Park. “I made some mistakes on my flight,” he said. His right side crashed into a log, followed by his ribs and leg. “The log didn’t give,” Palmer said. “My body did.” 

At first Palmer didn’t let on that he was hurt. “I limped myself up the hill with my gear, then realized I had done more damage than I thought.”

Palmer alerted one of his “brothers” who had trained as an emergency medical technician, that he needed help. The EMT did what he could and radioed for an emergency evacuation, but they were in such a remote area that the medivac didn’t reach Palmer until the middle of the night.

Like most wildland firefighters, Palmer relied on an iron will and steely resolve to get through his ordeal.

“It’s a job skill to be able to manage personal discomfort, physical discomfort, emotional discomfort and stress while working in high-demand, high-consequence occupations,” O’Brien said. “But it can be really difficult to shift gears and switch that off.”

The same ability to bury distress that helps firefighters manage emergency situations can prove counterproductive in the long run, especially when traumatic events, persistent injuries and chronic illnesses from the job begin to take a psychological toll.  

In what may be the largest study of its kind, O’Brien surveyed more than 2,600 wildland firefighters about factors related to physical and mental health. Although O’Brien’s research, completed in 2019 as part of her doctoral program, has not yet been published in a peer-reviewed journal, it remains the most extensive investigation of wildland firefighters’ health and psychological challenges.

Wildland firefighters are at increased risk of heart disease, so a primary aim of O’Brien’s work was to identify risk factors for those illnesses. But she also wanted to gauge the prevalence of mental health problems and unhealthy behaviors that could increase cardiovascular risk, including depression, poor diet and substance abuse.

She found that binge drinking rates for wildland firefighters were twice as high as those reported in the general population, while smokeless tobacco use was ten times higher. Depression, anxiety and PTSD, all risk factors for suicide, were common among her survey respondents. 

Close to 1 in 5 people had “probable” depression, that is, they had not been diagnosed but reported feeling down and having trouble sleeping and concentrating, among other symptoms. That’s about twice the rate observed in the general population, O’Brien said. 

The fact that there’s so much undiagnosed depression is concerning because it’s treatable, she said. And wildland firefighters, at least those working in federal agencies, can access treatment through programs like the Employee Assistance Program.

Nearly a third of O’Brien’s respondents had considered killing themselves since starting to work as a wildland firefighter. Close to 40 percent reported knowing someone well in the wildland fire service who died by suicide.

A Call for Support

Palmer lost a fellow smokejumper to suicide in 2017. Ian Pohowsky was 42 years old when he took his life. He was the fifth smokejumper to die by suicide in the seven years prior. Only two smokejumpers died on the job over the same period.

“Ian was unbelievably talented,” Palmer said. “He was extremely interested in giving back and helping young firefighters develop. He was a beautiful person, as are too many of the people that end up taking their own lives.”

In the tight-knit world of wildland firefighters, when someone dies or gets injured, Palmer said, “it strikes the community hard.”

First responders are naturally resilient, said Wooley, the California psychologist. “But with these epic fires they’re out for weeks, they don’t see their families and they’re just exhausted.”

Some firefighters who feel suicidal told her they’ve lost hope. They feel like they’ve “been in hell forever,” said Wooley, who survived the Carr Fire “tornado” that incinerated two California towns in 2018. Then they go home, and it’s hard to adjust to the mundane rhythms of daily life.

When it gets to the point where they’re feeling isolated and exhausted, and engaging in behaviors that alienate people, that’s when they can feel suicidal, Wooley said. “And they stop seeing other options.”

It’s time for suicide to move from being “the elephant in the room” to something that’s recognized as a risk to the workforce and finally gets the attention and resources it deserves, Palmer said. 

There should be a slot on crews for people trained to provide psychological support just like there is for EMTs, he said. “We’ve been trying hard to get an athletic trainer for every crew,” he said, referring to someone who’s trained to prevent injuries. “But even that hasn’t happened.” 

O’Brien said that even though she’s seen a shift in willingness in talk about suicide, “I don’t really know of any formalized interventions that have been done with wildland firefighters.”

She would like to see programs that focus on depression, anxiety, PTSD and substance abuse treated as if they’re no different than firefighters’  physical drills. And firefighting crew members need to be trained to spot warning signs, such as colleagues’ increasing use of alcohol or drugs, sleeping issues or talking about being a burden to others.

The psychological demands of the job will only grow as warmer, drier conditions fuel more severe, unpredictable fires, experts say. And the boom in destructive wildfires is increasing the demand for wildland firefighters, even as agencies scramble to fill vacancies, placing an even greater burden on crews. 

Yet researchers are just starting to understand wildland firefighters’ unique mental health challenges, O’Brien said. Because people volunteered in her study and self-reported their symptoms, the results could be skewed based on who responded. “But it’s the best data that we have at this point,” she said. 

And it’s worrying that 20 percent of those who responded reported having thoughts of suicide in the past year. “That alone, whether it’s worse or lower than anyone else,” she said, “is worthy of attention.”

If you or someone you love is having thoughts of suicide, please call the National Suicide Prevention Lifeline at 800-273-TALK (8255) or text the 741741 to connect with a trained crisis counselor.

link:http://actualitesfrance.com/html/368c1499617.html Forward