Mental health service use among firefighters with suicidal thoughts and behaviors
Open accessAbstract
OBJECTIVE: This study aimed to characterize rates and correlates of mental health service use, as well as barriers to care, among a sample of firefighters reporting a history of suicide ideation, plans, or attempts during their firefighting careers. METHODS: Participants (N=483) completed a Web-based survey assessing history of suicidal thoughts and behaviors, prior mental health service utilization, and barriers to treatment. RESULTS: Overall, 77% of participants reported receipt of mental health services during their firefighting careers (attempt history, 93%; plan but no attempt, 77%; and ideation only 68%). Firefighters with fewer years of service were less likely than those with more years to have accessed treatment. Service nonusers were more likely than service users to report concerns regarding reputation and embarrassment as barriers to care. CONCLUSIONS: Findings from this preliminary investigation suggest that the majority of firefighters with a history of elevated suicide risk have received mental health services.
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Approximately one-third of emergency responders meet criteria for other common mental health disorders such as depression, anxiety, and sleep disorders.
“approximately one-third of emergency responders meet criteria for other common mental health disorders such as depression, anxiety, and sleep disorders (1, 5, 15–18).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [16]
The introduction (p. 688) says firefighters appear to be at increased risk of psychiatric disorders, which supports the general mental-health concern. It does not say that approximately one-third of emergency responders meet diagnostic criteria, or give that prevalence for depression, anxiety, and sleep disorders. The study instead examines mental health service use among firefighters with a history of suicidal thoughts or behaviors. (LLM, conf=0.85)
Experimental — accuracy not yet measuredEmergency responders report stigma and privacy concerns regarding seeking care for mental health symptoms related, at least in part, to occupational stress.
“Emergency responders report stigma and privacy concerns regarding seeking care for mental health symptoms related, at least in part, to occupational stress (16, 71–74).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [16]
The Results (pp. 688–691) report stigma-related barriers to seeking care among firefighters, including concerns about embarrassment and reputation. The paper does not report privacy concerns as a barrier, and its study is limited to firefighters with a history of suicidal thoughts or behaviors rather than emergency responders generally. The introduction suggests job-related stressors may increase suicide risk, but does not establish that the symptoms for which respondents considered care were caused by occupational stress. (LLM, conf=0.84)
Experimental — accuracy not yet measuredEmergency responders' work schedules often present a challenge related to accessing mental health care.
“Emergency responders' work schedules often present a challenge related to accessing mental health care (16).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [16]
The Results report that firefighters cited getting time off (20%) and scheduling difficulties (16%) as barriers to mental health care. This supports a schedule-related access challenge, but the study surveyed firefighters with a history of suicidal thoughts or behaviors, not emergency responders generally. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn subsequent studies with fire fighters, difficulties in emotion regulation accounted for the link between depression and insomnia and were linked with PTSD symptom severity, sleep difficulties, and alcohol use.
“In subsequent studies with fire fighters, difficulties in emotion regulation accounted for the link between depression and insomnia and were linked with PTSD symptom severity, sleep difficulties, and alcohol use (16, 17, 57–59).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [16]
The Results (pp. 689–690) address mental health service use and barriers to care among firefighters with suicidal thoughts or behaviors. Searches for emotion regulation, the depression–insomnia link, and associations with PTSD symptoms, sleep difficulties, or alcohol use found no passage in our copy addressing the attributed claim. (LLM, conf=0.76)
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Cites
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Soldier Suicide Rates Continue to Rise
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Self-citationWomen Firefighters and Workplace Harassment: Associated Suicidality and Mental Health Sequelae
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- Authors
- Hom, M. A., Stanley, I. H., Ringer, F. B., & Joiner, T. E.
- Affiliations
- Florida State University (US)
- Venue
- Psychiatric Services
- Published
- 2016-06-01
- Volume
- 67
- Issue
- 6
- Pages
- 688-691
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2316803024
- Cited by
- 52
- References
- 13
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 8 · 2019: 4 · 2018: 6 · 2017: 2 · 2016: 3 · 2015: 1
- FWCI
- 6.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- firefighters, suicidal ideation, suicide attempts, mental health service utilization, barriers to care, occupational stress, length of service, help-seeking
- MeSH terms
- Adult, Female, Humans, Male, Mental Health Services, Middle Aged, Risk Factors, Suicide, Attempted, United States, Logistic Models, Young Adult, Self Report, Suicidal Ideation, Firefighters
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