The Silent Crisis: Suicide Among First Responders

Suicides among first responders have been highlighted as a significant public health problem. According to studies (Stone et al., 2021), there were 47,500 suicide fatalities in the U.S. and an estimated 1.4 million suicide attempts in 2019. The causes of suicide are complex, with many personal, socio-demographic, medical, and economic factors playing a role.

The High-Risk Occupations

One potential risk factor is occupation and several occupations appear to be at higher risk for suicide, including first responders. First responders, including firefighters, emergency medical services (EMS) clinicians, law enforcement officers, and public safety telecommunicators, are crucial to ensuring public safety and health.

The Stress Factor

First responders may be at elevated risk for suicide because of the environments in which they work, their culture, and stress, both occupational and personal. This stress can be acute (associated with a specific incident) or chronic (an accumulation of day-to-day stress). Occupational stress in first responders is associated with increased risk of mental health issues, including hopelessness, anxiety, depression, post-traumatic stress, as well as suicidal behaviors such as suicidal ideation (thinking about or planning suicide) and attempts.

The Impact of Emergencies

Even during routine shifts, first responders can experience stress due to the uncertainty in each situation. During emergencies, disasters, pandemics, and other crises, stress among first responders can be magnified.

Relationship Problems

Relationship problems have also been linked to a large proportion of suicides among the general population (42%). Because first responders can have challenging work schedules and extreme family-work demands, stress caused by relationship problems may also be magnified in this worker group.

The Alarming Statistics

Law enforcement officers and firefighters are more likely to die by suicide than in the line of duty (Foundation, 2018). Furthermore, EMS providers are 1.39 times more likely to die by suicide than the public (Death by Suicide, 2018). Studies have found that between 17% and 24% of public safety telecommunicators have symptoms of post-traumatic stress disorder (PTSD) and 24% have symptoms of depression (Lily, Pearce, 2013).

The Need for Action

As a first step towards addressing this issue, an inter-agency team of researchers from the National Highway Traffic Safety Administration (NHTSA), and the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control (NCIPC) and the National Institute for Occupational Safety and Health (NIOSH) is analyzing suicides among first responders using the most recent three years of National Violent Death Reporting System (NVDRS) data available.

The silent crisis of suicides among first responders is a call to action. It’s time we address this issue head-on to protect those who protect us every day.

If You’re in Crisis, Help is Available

If you’re in crisis, there are options available to help you cope. You can call or text the 988 Suicide & Crisis Lifeline at any time to connect with a trained crisis counselor. For confidential support available 24/7 for everyone in the U.S., call or text 988 or chat at, or visit



Death by suicide—the Ems profession compared to the general public. (2018, September 14).

Foundation, R. (2018, April 10). Ruderman White paper on mental health and suicide of First Responders. Ruderman Family Foundation.

Lilly, MM & Pierce, H. (2013). PTSD and depressive symptoms in 911 telecommunicators: the role of peritraumatic distress and world assumptions in predicting risk. Psychological Trauma: Theory, Research, Practice, and Policy, 5(2):135-41)

Stone, D. M., Mack, K. A., & Jones, C. M. (2021). Changes in suicide rates - United States, 2018-2019. MMWR. Morbidity and mortality weekly report.