Understanding the Risks and Taking Action
By Kellie O’Dare, PhD, Kathryn O’Dell, Victoria Steigerwald, Daniel Horning, Deborah Beidel, PhD
Suicide remains a leading cause of death in the United States, deeply impacting communities. In some cases, multiple suicides occur close in time or location, forming a phenomenon known as a suicide cluster. Suicide clusters are often linked to contagion, where exposure to a suicide increases the risk for others. While exposure alone does not guarantee risk, certain factors – especially those inherent to the fire service – can heighten susceptibility.
The fire service, with its demanding environment, close interpersonal bonds, exposure to trauma, and long-standing organizational and cultural issues surrounding mental health, creates conditions where the ripple effects of suicide are profoundly felt. The complexity of contagion makes identifying and measuring risk factors and incidence challenging. However, recent suspected suicide clusters within the fire service have highlighted the need for broader exploration and open discussions on this critical issue.
Why Suicide Contagion Might Happen: Risk Factors
Suicide contagion is rarely caused by a single reason. Instead, the intersection of various factors creates an environment where contagion is more likely. Using the Center for Disease Control and Prevention’s (CDC) socio-ecological model for suicide risk and protective factors, we can discuss factors across multiple levels: individual, relationship, community, societal, and policy.
Individual level. Pre-existing vulnerabilities such as emotional distress, mental health issues, substance misuse, or past suicide attempts may increase the risk of suicide contagion. These challenges can diminish resilience and intensify feelings of hopelessness when coping with the loss of a peer. Risk may be amplified when the person who dies by suicide is of higher rank or very well known, potentially leading others to question, “If they couldn’t cope, how can I?”
Research suggests repeated exposure to trauma may numb first responders to death and methods of self-harm, heightening their capability for suicidal behaviors. Easy access to firearms – a common method in firefighter suicides – further elevates risk.
Relationship level. The close bonds within the fire service amplify the emotional impact of suicide. Strong connections mean a loss affects not only close colleagues but also the broader network. Strained relationships with supervisors, peers, or family members, coupled with workplace incivility, may further isolate individuals, increasing feelings of distress and hopelessness. Conflict within intimate relationships and a lack of a strong home support system can heighten feelings of despair, especially during personal struggles.
Community level. The culture of firefighting often discourages seeking help for emotional challenges. A lack of psychological safety – where individuals fear judgment or repercussions for sharing struggles or mistakes – further compounds the issue. Poor leadership that deprioritizes or perpetuates negative perceptions of mental health exacerbates these challenges, weakening trust and support within teams.
Societal level. Poorly framed media coverage and informal discussions, such as social media posts, can unintentionally glorify or normalize suicide. These narratives may reinforce the perception that suicide is a solution to distress, particularly for those already struggling.
Conversely, avoiding acknowledgment of the death or concealing it was a suicide can result in feelings of invalidation and isolation. The use of language such as “committed” or “completed” suicide is common but problematic, as it can imply judgment, blame, and misunderstandings.
Society also perpetuates a “hero persona” for first responders, creating unrealistic expectations that discourage acknowledgment of struggles. Limited access to mental health resources and inadequate postvention efforts leave many firefighters without the tools needed to process traumatic losses.
Policy level. The absence of standardized mental health protocols and sustainable funding undermines suicide prevention efforts. Many departments lack clear guidelines for postvention strategies, leaving personnel without structured support following a suicide. Insufficient funding prevents the implementation of proactive mental health programs, regular screenings, and access to competent clinicians, further increasing systemic gaps in care.
Immediate Actions and Long-Term Measures to Address Suicide Contagion
Addressing suicide contagion in the fire service requires immediate interventions paired with long-term strategies to tackle risk factors comprehensively.
At the Individual Level
Providing crisis support in the immediate aftermath of a suicide through trained peer specialists and psychological first aid is essential to help process grief and trauma.
Long-term strategies should focus on integrating resilience training and stress management programs into every stage of a firefighter’s career, from academy training to retirement.
Widespread use of pre-planning tools, such as crisis cards, can further enhance preparedness by outlining personalized coping strategies and support contacts. Lethal means safety training can raise awareness about the risks of firearm access for individuals struggling with suicidal thoughts and offer strategies for prevention and protection.
At the Relationship Level
Immediate interventions should prioritize activating peer support networks and ensuring clear, empathetic communication grounded in best practices. Open discussions guided by established messaging protocols can reduce misinformation, foster a supportive team environment, and promote a culture where firefighters genuinely care for their peers’ well-being, embracing the mantra, “I am my brother’s keeper.”
Long-term measures should offer relationship-focused mental health resources, education, and outreach to help firefighters and their families navigate unique challenges. Strengthening family and peer connections through training and outreach can enhance social support systems and reduce isolation, a critical factor in preventing emotional distress.
At the Community Level
Postvention protocols can provide unified and supportive responses to suicide, ensuring the organization addresses grief collectively. Agency-wide psychological debriefings can normalize conversations about loss and healing.
For longer-term change, Behavioral Health Access Programs (BHAP) can embed critical mental health resources within fire departments. Leadership training programs focused on mental health advocacy can foster cultural change, promote psychological safety, and transform the organizational approach to mental wellness.
At the Societal Level
Interventions include developing best-practice guidelines for suicide-related messaging to prevent glorification or normalization. Mass public health campaigns focused on first responder suicide prevention can emphasize appropriate help seeking behaviors and connections to vetted resources.
Over the long term, expanding access to culturally competent care and prioritizing first responders in broader mental health initiatives are key. Addressing societal pressures, such as the “hero persona,” through educational outreach, can also humanize first responders and encourage proactive mental health support. We can improve messaging around discussing suicide by adopting language that is compassionate, non-judgmental, and free from connotations of blame or finality.
At the Policy Level
Enforcing standardized mental health protocols for postvention and proactive care is vital. Allocating sustainable funding ensures access to essential resources like BHAPs, peer support, and competent clinicians.
Long-term strategies should include the adoption of evidence-based frameworks such as the Zero Suicide Prevention Framework. By addressing systemic barriers through thoughtful policies, departments can create environments where proactive mental health care becomes the norm. For instance, departments should consider removing copays for mental health services, especially following a suicide death. Consistent evaluation and data collection should guide best practice development and future policy enhancements.
Call to Action
Preventing suicide contagion in the fire service requires a comprehensive, multi-level approach. Immediate postvention efforts must be paired with long-term strategies that address individual, relationship, community, societal, and policy-level factors. With actionable steps, the fire service can move toward resilience, support, and systemic change. The time to act is now.
