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March 25, 2013

Chicago Fire Department ~ Suicide Study

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by Daniel DeGryse, Coordinator
Chicago Fire Fighters Union Local No. 2
Emergency Assistance Program

Seven suicides within an eighteen month period by active or retired members of the Chicago Fire Department (CFD), a very distressing and alarming statistic! In the Chicago Firefighters Union (CFFU) Local 2 Employee Assistance Program (EAP), we were quite taken back by the increase in suicides among our members and wanted to take action.  Suicide, a national crisis, was hitting close to home in a dramatic way.  The cause of the sudden increase in suicides within our department we do not know; however, working in the EAP we have the opportunity to get a more in depth picture of what our members are dealing with on the job, at home, and how it affects them.  We asked ourselves, how might what our members on the fire department deal with impact their potential risk for suicide?

We wanted to take a proactive approach to the matter.  So, we increased our efforts to educate our membership on this topic as well as other trying circumstances.  We have been offering our members resources available both internal and external to our fire department to assist them through difficult times.  This is a work in progress which began with visiting every firehouse, creating posters full of resources, writing informational articles on various topics, and collaborating with CFD officials to implement an annual, day long educational event we call “Family Focus Day”.

Since our efforts specific to the topic of suicide began, I have been reading material pertaining to suicide with intent on finding “the answer”.  The answer that is black and white, telling us what we, as a society can and should do to prevent suicides.  Unfortunately, I have yet to find that clear cut answer.  Literature addressing suicide offers some theories, a host of symptoms, “red flag” behaviors, and demographics of those who have committed suicide based on data gathered.  Despite increased attention to the topic across our nation, if you look at the data, the actual number of suicides in the United States has steadily risen since they began recording such statistics.

Opening a Door

My intent in writing this article is to open a door.  Open a door to a topic that socially is not talked about much and offers basically no research or information on suicides among fire department personnel.  Open a door to other departments by offering statistics specific to the men and women of the CFD in hopes that they will follow in kind and compile statistics within their own departments so that we as a fire service, nationwide, can begin to better understand any possible links between our profession and the likelihood of choosing to die by suicide.  The more data fire departments offer the more professionals have to work with.  In addition, as suicide is taking a more forefront position in the media because of its increase in our nation, our military, and certain age groups, I want our membership to become aware of how serious an issue it has become.  With that said, I offer you a brief history of society’s perceptions of suicide and how it has shifted over time, some current professionals’ views, and data specific to our fire department.  I conclude by summarizing the data I offer and some thoughts on where we as a fire service can go from here. 

Historical Perspectives

Suicide has been recorded for centuries.  In the beginning writings about it, suicide was viewed as an acceptable way to end one’s life when dealing with unbearable circumstances whether physical and/or mental.  In some societies, suicide was actually encouraged.  It was encouraged for servants once their master died so they could take care of them in the after life.  It was encouraged for the elderly or sickly so as not to be a burden on family.  It was encouraged as an alternative to religious or civil persecution.  It was encouraged when one’s life no longer provided happiness.  In ancient Roman societies, trained technicians would assist individuals with suicide.  Regardless of the reason, it appeared no stigma was attached to death by suicide.

The first person believed to have challenged the acceptance of suicide was the Greek philosopher, Socrates, in 400 BC.  He viewed people as “property of the gods” and believed we did not have the right to take away from the Gods and suicide would do just that.  Ironically, his own life ended when he was forced to commit suicide by drinking Hemlock as a death sentence for various charges.  Following in this shift of thinking, as societies began developing into more religious based communities, their perceptions of suicide were primarily shaped by their religious leaders and a stigma was born.

During this time, two prevailing scenarios emerged and as a result suicides rose quickly and to large numbers.  One circumstance pertained to individuals who were uncertain about their religion and found suicide the easier route in life rather than being looked down upon for their beliefs by these leaders.  A second predominant thought was in early Christian beliefs which presented suicide as something that true believers should strive for.  In response, religious leaders believed it necessary to change the perceptions of suicide away from acceptable in an attempt to end the rising accounts of suicide.

Jewish leaders attempted to dissuade suicide by forbidding public eulogies and mourning for those who had taken their own life.  Here, possibly, began the stigmatization of suicide within that culture that has spread and continued for centuries.  For Christians, the church began to condemn suicide once the Jewish leaders refused individuals who died by suicide to be buried on hallowed ground.  The church adopted the view that suicide was wrong and mimicked Judas’s hanging himself and as he was a betrayer of Jesus, those who committed suicide were acting in his likeness.  The stigma of suicide continued to expand as expressed in written views, laws created against it, and situations surrounding it.  At one point, to deter suicide, some societies dragged the bodies of those who committed suicide through town, while others hung the heads outside the parameters of towns to make clear to those entering it was unacceptable.  Family “survivors” were also punished.  All their belongings and properties were taken away.  Here, the beginnings of punishment for survivors and the stigma of being associated with a victim of suicide may have taken root.  A clear, dominant theme throughout history is the fundamental role societal beliefs and attitudes have in our reasons for, perceptions of, and our level of acceptance regarding suicide.

In Renaissance times, generally speaking the 14th to 17th centuries, conflicting views regarding suicide stemmed from beliefs that it resulted out of despair versus it being a stoic gesture.  This conflict seemed to somewhat soften the harsher, preceding views.  The 18th century, overall, showed little interest in taking on matters regarding suicide and the accepted stance that it should be looked down upon and was punishable remained intact.  In the late 19th century, 1897, a book Emile Durkheim published, “Le Suicide”, argued that suicide was not an individual choice but a result of pressures society forced on people.  This book received a great deal of attention.  It challenged the notion that suicide was an internal, personal choice and shifted responsibility to society.

In more recent times, 1983, the Roman Catholic Church reversed the Canon Law that prohibited proper funeral rites and burial in church cemeteries for those who had died by their own hand, we again saw a societal shift in the perceived stigma of suicide.  Following that, in 1999 the Surgeon General of the United States released a “Call to Action” to prevent Suicide, declaring it a national public health issue which led the Department of Health & Human Services to publish the “National Strategy for Suicide Prevention: Goals and Objectives for Action” in 2001.

 Present Day Professionals Renowned in Suicidology

Today, many states and organizations are working together to address suicide.  Recently, at a conference in Baltimore, Maryland, the National Fallen Firefighters Foundation brought together three leaders from around the country that have done years of research in the area of suicide.  The doctors who spoke included, Matthew K. Nock, Ph.D. a Professor of Psychology at Harvard University who studies the incidence and epidemiology of suicide; Thomas Joiner, Ph.D. Professor of Psychology at Florida State University who has researched and studied the etiology of suicide, and Alan (Lanny) Berman, Ph.D., who is the Executive Director of the American Association of Suicidology (AAS).

Dr. Joiner identified three behavioral characteristics that may lead a person to die by suicide; these include the person feeling isolated, feeling s/he lacks purpose and is a burden on the world, and has a high tolerance for pain.  Dr. Joiner is also open about the fact that his own father died by suicide.  Dr. Berman, through collaboration with professionals and volunteers across the world, dedicates his energies to the prevention of suicide.  It was a pleasure listening to these professionals who have dedicated their time and energies to an area of the mental health field that so few either commit to or are willing to stay in.  In his presentation, Dr. Nock stated, “Not many doctors continue to research this area because of the lack of data available”.  It’s with this statement by Dr. Nock and our desire to create a starting point in fire department data to work from in gaining understanding for a relatively misunderstood act that we, the EAP at the Chicago Firefighters Union Local 2, offer the following information.

Local 2 EAP Suicide Data 

The suicide data in this article is of fire department personnel, active and retired, specific to the members of the Chicago Fire Department.  We gathered demographic data on deceased members spanning from 1990 through 2010 obtained through records at Local 2.  We also utilized membership information obtained from the Fireman’s Annuity & Benefit Fund of Chicago Annual Reports.

We compared our data to suicide data of the general population for the same time period with the following question in mind, “Are suicide rates specific to our fire department personnel higher than those of the general population, and if so, can we correlate working on the fire department and a person’s susceptibility to circumstances that contribute to thoughts and/or acts of suicide?”

We researched 1787 deaths of active and retired members who worked on the CFD and were members of the Chicago Firefighters Union Local 2.  We identified 41 suicides. All of the suicides were committed by males.  While the ages ranged from 27 to 86, the average age of CFD members who died by suicide is 55.  The mode, or most frequently occurring age of suicide, in our statistics are ages 30 and 57 with three recorded suicides at each age.  If we average the 41 suicides over this period it gives us an annual suicide incidence of two.  The following graph (A) represents the number of suicides per year during this time.

GRAPH A

GRAPH A

National Suicide Statistics 1990 thru 2009

Nationally, the recorded numbers of suicides have varied from approximately 29,000 in 1990 to over 36,000 in 2009 which is presently the latest year of published national statistics on suicide (Refer to Graph B).

GRAPH B

GRAPH B

Comparison of CFFU L2 Data to National Data

U.S. incidence rates for this period ranged between 10 and 12 suicides per 100,000 people each year. In order to compare these findings with the suicide numbers in the CFD for the same time period, CFFU L2 statistics were converted to a figure per 100,000 people. To do this, we used a formula Dr. Aamodt utilized in an article from 2006 to compare police suicides to the general population (mentioned below). For each year we took the total number of suicides and divided it by the total number of members on the CFD. The figure was then multiplied by 100,000 to create a rate per 100,000.

Findings show our rate data ranged from zero to as high as 63.25 with five documented suicides seen in 2008. (Refer to Graph C and Chart 1). Graph C diagrams the numbers of recorded suicides on a national level per 100,000 (blue) and the number of recorded suicides on the CFD per 100,000 (red) for the same time period.

GRAPH C

GRAPH C

Despite our many searches for related data nationally, we did not find any data specific to the fire service. Therefore, we were unable to compare our data to other fire departments. We did however, as stated above, find one study done in 2006 by Professors Michael G. Aamodt and Nicole A. Stainaker from Radford University on police officers entitled, “Police Officer Suicide: Frequency and Officer Profiles” (see bibliography #5). Their results negated a previous study that suggested suicide rates for police officers are higher than the general populations.

Professor Aarmodt’s report suggested various factors that should have been considered in comparing statistics were not, specifically race. I mention this article as it was the only article I could locate specific to a public safety occupation.

What does our data tell us? Keep in mind, we did not separate our data based on demographics such as age, sex, or race. The calculated average suicide rate, over a twenty year period, for the members of the CFFU L2 of 24.98 per 100,000 is over twice as high as the national average of 10.9 for the time period we examined. However, if we use the higher national rate Professor Aamodt would suggest, specific to race (Caucasian) because of a primarily white department, which for 2008 was 21.2, our average of 24.98 is closer to the national rate, yet still higher.

If we break down specific years, the CFD experienced twelve years with significantly higher rates than the general populations. Of these twelve years, four of them 1992, 1997, 2008, and 2010 appear notably higher. Conversely, in nine of the studied years the CFD experienced none or one suicide; whereas the national rate remained relatively constant.

CHART 1

CHART 1

 

In Summary

We set out to gather data on suicides within the Chicago Fire Department after the department experienced seven suicides in eighteen months. Our fire department has experienced 41 suicides in a twenty year period. Whether our rate is higher, lower, or in line with the general population, I will leave that for you to contemplate as we did not set a level of statistical significance for our figures. In my opinion, one suicide is too many. So, until other fire departments gather data specific to suicide, and we compile it, we can only speculate at how our rate of suicides throughout the fire service compares to that of the general population.

Regarding suicide and related mental conditions, in my years in the counseling field, I have learned suicide is one outcome of serious, internal struggles for an individual that may manifest for some time before he/she reaches the decision to die by suicide.

In the fire service we are exposed to many tragic, horrific scenarios that require immediate responses and actions. The impact on how our exposure to these situations affects us as individuals and/or our relations with our families is not necessarily recognized or understood. Does our job experience affect us enough to raise our susceptibility to mental challenges that may lead to suicidal thoughts aside from other conditions?

If we are to answer this or any other questions about suicide in the fire service, we must break the silence. The data I have offered is basic, but enough to start forming hypotheses about suicide and the fire service. This is a beginning. Collecting data is a starting point and should be the first step at making a difference. The following is a statement by former California State Fire Marshall Philip C. Favro in the first edition of “Fire in the United States”:

”Data can save lives”….Unfortunately, the opposite is also true—data can kill. Critical decisions affecting fire and life safety are being made every day. These decisions are being based on what are believed to be “the facts” ….and those “facts” are the results of conclusions drawn from your data you are – or are not – reporting….accurately. Think about it.”

This was a statement encouraging all fire departments across the nation to adopt and adhere to the guidelines of NFIRS. In my opinion, we need to take this advice and apply it here regarding mental health data collection among our members. The more data we have the better we can map more accurate intervention strategies for our brothers and sisters in the fire service. In turn, we can better serve and protect our communities!

In Recognition

I would like to take this opportunity to say thank you to my staff at the Chicago Firefighters Union Local 2 EAP which includes Alfred “Al” Allen, Joan “Bunny” Butler, Frank Crossin, and Larry Murray for their months of research for this report.

Daniel DeGryse BA, CEAP, CADC
Coordinator, Local 2’s Employee Assistance Program

Dan’s article originally appeared in the August 2012 issue of the Fire Chief magazine

Bibliography

1) http://www.suicide.org/suicide-statistics.html, Suicide Prevention, awareness and support.

2) www.suicidology.org/c/document_library/get_File?folderld, U.S.A. Suicide: 2008 Official Final Data, September 13, 2011.

3) www.injacobsmemory.org/history-of-suicide.html, The History of Suicide / Jacob Crouch Foundation, 2011.

4) http://plato.stanford.edu/entries/suicide, Suicide (Stanford Encyclopedia Of Philosophy), July 29, 2008.

5) http://www.policeone.com/health-fitness/articles/137133, – Police Officer Suicide: Frequency and officer profiles, June 20, 2006.

6) http://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate, List of countries by suicide rate, February 4, 2012.

7) http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6013a1.htm?s_cid=ss6013a1_w, SAMHSA 2008-09 study, (2011).

8) http://www.cdc.gov/nchs/data_access/Vitralstatsonline.htm, Deaths: Final Data for 2009. National Vital Statistics Reports, 60(3), January 5, 2012.

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