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Recognizing Suicide Warning Signs in Firefighters and EMTs

Recognizing Suicide Warning Signs in Firefighters and EMTs


Behavioral health is a key component of an overall firefighter health and wellness program. Unfortunately, it is a difficult subject to discuss – many factors affect a firefighter’s ability to understand when a fellow brother or sister is suffering, but that does not make it any less critical an issue.


By far, the number one comment by fire and EMS chiefs associated with departments that have suffered a loss is that they didn’t realize or recognize the warning signs that their member was displaying until after the loss had occurred.


The Firefighter Behavioral Health Alliance (FBHA) tracks and validates FF & EMT suicides in the United States. A key component is validation: Whether we receive a confidential report, text message, or phone call of a tragic event of a suicide, confidentiality is always maintained.

FBHA has traveled across North America presenting behavioral health workshops with an emphasis on suicide awareness. Our workshops focus on warning signs and actions to take when a brother or sister is in need of help, and I’d like to share them with you here:

Top 5 Warning Signs – Think “RAILS”

  1. Recklessness/Impulsiveness: These might be subtle signs such as purchasing guns when a person has always been against them. Riding a motorcycle recklessly or charging into burning buildings against policy or procedure.
  2. Anger: Suppressed anger or explosive anger from seemingly minor issues can be a dangerous sign. Displacement (directing one’s anger at someone else instead of the intended person) is often observed. Displacement is most often directed at a FF or EMT’s family.
  3. Isolation: becoming distant from their career company around the station or volunteer firefighters who don’t participate in drills or calls as much. Members might even display isolation around their family. They lose interest in family activities.
  4. Loss of Confidence in skills and abilities: Several FFs and EMTs have advised FBHA they lost confidence in their ability to get the job done due to concentrating on emotional or personal issues they were battling. A seasoned FF who can’t remember how put an engine in gear to pump is an example.
  5. Sleep Deprivation: Loss of sleep can indicate stress, anxiety, PTS or several other emotional issues a member might be struggling with and not realize.



When you see someone struggling or just off their game, follow these recommendations as a starting point:

  1. Be Proactive; Be Direct: We do this when responding to emergencies. We need to take the same approach when our brothers or sisters appear to be struggling.
  2. Direct Questions: Remember these two questions if a member comes to you with suicidal ideations.
  • Do you feel like killing yourself now?
  • Do you have a plan?

A “yes” to either one of these questions means you need to engage your department procedures or protocols if in the firehouse. If outside of the department then they need help immediately. NEVER leave them alone!

  1. Compassion: The theme in our workshop is: Be Direct and be compassionate. Stay in the moment when talking to them. It is the most difficult type of conversation but always speak from the heart.
  2. Discretionary Time: If a member comes to you to talk about a difficult issue they are struggling with and you have never dealt with this type of issue, then let them know but also use discretionary time. Do not make statements just to fill a void. For example: I never realized you were struggling with this issue and I don’t have a lot of knowledge on this problem, but let me find out a little more about it and we will talk later. (If this is a crisis moment then do not leave member alone)
  3. Walk the Walk: The number of firefighters, officers and EMTs/paramedics who help their brothers or sisters out by taking them to AA classes or counselors cannot be overstated.  They sit outside and wait until the appointment is over. Taking care of our own goes well beyond the station or fire ground.


Posters and tip cards are available for your departments and personnel. Please contact Jeff Dill at for more information.

This article was written by a guest contributor, Jeff Dill. Jeff is the founder of Firefighter Behavioral Health Alliance - NPO (FBHA).  FBHA was established in 2011 to educate firefighters and fire officers on suicide awareness and prevention.  Dill holds a Masters Degree in counseling, is a Licensed Professional Counselor, and recently retired as a Captain from Palatine Rural Fire Protection District in Inverness, Illinois. He is a member of the American Counseling Association, National Board of Certified Counselors, International Association of Fire Chiefs, and a member of the International Association of Fire Fighters.  Jeff also sits on numerous committees including the Florian Program, IAFF, National Volunteer Fire Council, NFPA, as well as a consultant for the Western Massachusetts Fire Chiefs Coalition. 

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