Firefighting is no easy task. The mental struggles that come with the job run as deep as the physical ones. Firefighters experience traumatic stress at high rates, which can weigh on someone day after day in this vital yet demanding job.

Those in the fire service experience much higher rates of mental health challenges than the general population, particularly in the areas of sleep disorders, depression, substance abuse, post-traumatic stress disorder, and what we’re bringing more awareness to today, suicidal ideation and action.

The International Association of Fire Fighters (IAFF) estimates that approximately half of all firefighters think about ending their life. In Minnesota, four to six active firefighters die from suicide each year.

In honor of World Suicide Prevention Day Sept. 10, we want to provide reminders about the heightened risks for firefighters, warning signs and how to help yourself or someone you know who may be at risk.

Individual experiences vary, but people who are considering suicide usually report feeling hopeless, worthless, agitated and/or overwhelmed, among other strong emotions. While the feelings the person is going through are intense, they usually are temporary – and treatable with professional help.

Who’s at risk for suicide?

Suicide is a global phenomenon that affects people in all regions of the world. In fact, it is one of the leading causes of death worldwide, according to the World Health Organization. Each year, more than 700,000 people die by suicide – that’s about one in every 100 deaths. And, for each suicide, there are more than 20 suicide attempts.

Situational or chronic mental health disorders are often linked to a person’s suicidal thoughts or attempts. Globally, WHO estimates more than 264 million people of all ages have depression, which also is the leading cause of disability worldwide and a disorder that can lead to suicide. However, not all people with mental illness contemplate suicide. People who do not have a history of mental illness also might consider and attempt suicide.

Risk factors and warning signs

Factors that could put a person at risk for suicide include:

• Previous suicide attempt(s)
• Mental illness, particularly depression
• Alcohol or substance use disorder
• Stress and crises, such as financial or legal problems
• Chronic pain or physical illness
• Severe emotional distress, such as from war, conflict, disaster, physical or sexual violence, abuse, loss of a loved one
• Social isolation
• Discrimination, bullying, especially due to gender identity or sexual orientation
• Family history

Most people who die by suicide exhibit verbal and behavioral warning signs before doing so. These may include: talking about wanting to die or threatening to kill oneself, feeling trapped or hopeless or having no reason to live; looking for ways to kill oneself; increasing use of alcohol or drugs; showing rage or talking about seeking revenge; giving away valued possessions, or writing a will; withdrawing from loved ones; sleeping too much or too little; and experiencing extreme mood swings.

Helping someone who’s at risk

Important: If you fear a person is in immediate danger of harming themselves, do not leave them alone. Reach out for professional help – contact emergency services, a crisis line, or a health care provider.

If you are concerned a loved one is considering suicide, discreetly let them know of your concern and start a conversation to encourage them to seek professional help from a clinician or a local prevention resource or support group. Listen to what they say, and offer to help them find a resource and/or to go with them as support. From there, keep in touch with them and ask how they’re doing. If need be, reiterate your concern and again encourage them to seek professional help.

Helping yourself cope

Losing someone you care about to suicide can be – in a word – devastating. It’s common to feel overwhelmed, shocked and grief-stricken. It’s also common to feel a host of other emotions, including anger, confusion, guilt, shame and relief. The reality is, there is no right or wrong way to feel because everyone – whoever or wherever they are – experiences loss differently. As hard as it is, in time and with support, you can begin to heal and feel better.

Try to remember you are not alone, and you do not have to go through this alone. Ask for support and accept help from trusted friends and family. Peer supporters who have experienced similar tragedy and stress are also available to listen and provide confidential support.

Especially if you have been unable to complete day-to-day activities, are struggling with difficult emotions, or have felt emotionally numb for several weeks, seek professional help.

We’re here for you.

Confidential help is available over the phone or online, anytime for any firefighter and/or their family through the free and confidential MnFIRE Assistance Program (MAP). No call or inquiry is too small. If something happened on the job or in your life, or if you’re just feeling stressed, we’re here to help.

For more details or for help, call 888-784-6634 or visit https://mnfireinitiative.com/hhap/.

Repurposed from MnFIRE Assistance Program partner, Optum

Since it was passed in July 2021, the Hometown Heroes Assistance Program (HHAP) has supported hundreds of peer support calls and visits with mental health providers, trained the majority of the state’s firefighters on their occupational health risks, and has paid out nearly $800,000 in critical illness claims – all at no cost to firefighters, their departments or their communities.

The HHAP dedicates $4 million per year to ensure that every Minnesota firefighter has access to the education, prevention and care needed to handle a cardiac, emotional trauma or cancer diagnosis. It combines three vital elements: an assistance program with expanded emotional trauma resources, an up-to-$20,000 critical illness policy, and ongoing health and wellness training.

In the 12 months since the legislation went into effect, the program has changed – and saved – lives by providing:

• 721 firefighter-focused mental health providers across the state to offer up to five no-cost counseling sessions to firefighters and their families. To date the MnFIRE Assistance Program has facilitated 272 provider visits.
• An expanded network of trained MnFIRE Peer Supporters, which has responded to 430 calls.
• 52 paid Critical Illness claims, totaling $773,000. Illnesses have included full-benefit cancer, COVID-19, post-traumatic stress disorder, skin cancer, other cancer, ALS, heart attack, sudden cardiac arrest, heart disease, kidney failure, coronary artery disease needing surgery and other mental disorders.
• 512 MnFIRE trainings to 13,929 firefighters.

William Ewald of the St. Bonifacius Fire Department shared how the MnFIRE Assistance Program and Peer Support network have helped him immensely.

“Going into the fire service, every candidate expects to fight fires, but the fact of the matter is we’re 80% medical response and that has a highly emotional response. The emotional aspect was heavy for me,” says William. “I’ve learned how to better manage my stress and get through it so it’s not so impactful on me or my family.”

Christian Worby, a Coon Rapids firefighter battling multiple myeloma, accessed the critical illness benefit this past year.

“This program has allowed me and my family to focus on my treatment rather than worry about our finances due to the cancer diagnosis,” says Christian. “It’s great having the extra financial support. It’s an extra safety net. It’s an expensive deal having a major illness.”

These are just a few of the success stories that have come out of this monumental legislation. So far, we have provided support to firefighters in 85 of Minnesota’s 87 counties.

All active Minnesota firefighters – volunteer, paid-on-call, part-time and full-time – can access the MnFIRE Assistance Program, are automatically enrolled in the Critical Illness insurance policy and can receive training – all at no cost to them.

Receive help for a crisis, find out more information or file a claim by calling 888-784-6634 or visiting our HHAP page.

Since Day 1, William Ewald has fully supported MnFIRE and its mission, especially the Hometown Heroes Assistance Program (HHAP).

“But I was the absolute last one who thought I would need it because I felt so good,” said William, who is a captain for the St. Bonifacius Fire Department.

When William faced health challenges, the 59-year-old reached out to MnFIRE for help through the HHAP not once, but twice.

“I was a bit in denial at first that I needed this resource … because pride can get in the way,” he said.

But he is glad he moved his pride to the side to accept the resources from the HHAP, the most comprehensive firefighter well-being legislation that passed through the legislature in 2021. William used two of three components of the HHAP for his health challenges: the MnFIRE Assistance Program (MAP), which targets emotional health and stress unique to the fire service; and the Critical Illness Program, an insurance policy which covers diagnoses of cancer, cardiac or other critical illnesses, and provides a lump-sum cash payment up to $20,000 to assist with expenses.

“It’s resources available for us in our time of need after we have helped others in their time of need,” William said. “Because sometimes we need the help.”

William has also participated in the third component of the HHAP: training, which provides free education to fire service members across the state about health risks facing firefighters.

All HHAP resources are free to all active Minnesota firefighters – volunteer, paid-on-call, part-time and full-time.

Using MAP: A Call for Help

William first reached out for help after a tough medical call involving a 5-year-old girl, who William said reminded him of his granddaughter.

“Going into the fire service, every candidate expects to fight fires, but the fact of the matter is we’re 80% medical response and that has a highly emotional response,” William said. “The emotional aspect was heavy for me.”

So he called the MnFIRE hotline number.

“All of us at St. Boni have the number programed into our phone,” William said. “But as the phone rang, I hung up because I was too scared to talk. (The MnFIRE Peer Support program director) called me back in minutes.”

William and the peer support director talked through the scenario William had just experienced. After the call, the director texted to reassure William that she and others through MnFIRE, will always answer the call and be there for help.

“That was a meaningful day,” William said. “We continue to encounter those tough scenarios, but through MnFIRE I learned how to better manage my stress so it’s not so impactful on me and my family. (The MnFIRE Peer Support program director) coached me through how to cope and get through the process.”

Using the Critical Illness Program: A Cancer Diagnosis

As a firefighter, William knew his chance of receiving a cancer diagnosis was higher than most people. But it still was a shock to learn in June he has prostate cancer.

“What followed was my strongest support system of the people I met through MnFIRE,” William said. “Emails they sent me were overwhelmingly supportive, encouraging and optimistic. They were engaged in the process, to help with resources and guide how MNFIRE could help with a cancer diagnosis.”

MnFIRE helped William walk through the process of applying for the Critical Illness program.

“I opened the MnFIRE website and pushed the ‘Apply Now’ button,” William said. “I thought, ‘It cannot be this easy.’”

Within five minutes, William had the online paperwork filled out and other paperwork ready for his oncologist to fill out. The process from applying to having the money in his bank account took 10 days.

“It’s that simple,” William said. “I thought it would take months. This is really good legislation.”

The money went to use right away in a variety of ways, including paying the family’s maximum out-of-pocket insurance expenses.

“A PET scan alone is $28,000, and I will need three of those,” William said. “This (Critical Illness program) gives you the comfort knowing you’re already managing cancer. You don’t need to focus on resources, and this allows you to focus on recovering without worrying about your copay. It brought unexpected relief we hadn’t counted on.”

William had surgery the week of Aug. 8 and is working on the recovery process before easing back into work on light duty. He is optimistic for the future, in part due to MnFIRE and the HHAP. For other firefighters hesitant to reach out for help, William shares encouragement.

“Make the call and have that initial courageous conversation,” he said. “The support, resources, encouragement and how much they care and stay engaged will be uplifting even in your darkest hours. It’s a tremendous and valuable resource we all need to use.”

To learn more about accessing these life-changing resources for yourself or a loved one, visit our Hometown Heroes Assistance Program page or call 888-784-6634.