Category Archives: Behavioral Health

Talking About Suicide Can Help You Avoid It

Sometimes, the pain can be too much to bear. It feels like you don’t have any way out of the difficulties you’re facing, and it seems will only worsen over time. That’s why you started thinking about suicide.


But suicide isn’t the answer, and there is help. You can call the National Suicide Prevention Hotline at 800-273-TALK (or 800-273-8255), a local emergency room, or even just dial 911. You know that suicide isn’t the right choice, and these resources can help you realize why. Once you’ve made that call, you’re ready to learn about other ways to get help, the facts about suicide, and some long-term strategies to stay alive.
Image Source: Pixabay

You Can Get Help Right Now

Calling the Lifeline will put you in touch with people who can help. It’s completely free, and you can call anytime. You can also visit the National Suicide Prevention Lifeline site, where you will also get specific resources if you are a veteran, LGBTQA, or a teen.


Here are a few additional actions you can take to help yourself right now:

  • Put everything on hold. Promise yourself that you’ll wait two days before doing anything you can’t undo.
  • If your suicidal thoughts are strong, visit your nearest emergency room.
  • Reach out to family or friends that you trust. Tell them why you are feeling suicidal. Sometimes, just talking about your pain can help you manage it better.

Aren’t Suicidal Thoughts OK?

If you have some suicidal thoughts, do you really need to call or visit the ER? Isn’t it normal to have those thoughts?

It depends on what you mean by “normal.” Yes, many people think about suicide from time to time. In fact, studies show that a variety of mental health problems — depression, bipolar disorder, schizophrenia, and anxiety disorders — are all linked to suicide. However, thinking about harming yourself is not normal.


Psychology Today explains that suicidal thoughts are linked to worsening health, self-injury, and even death. In other words, you have to take these thoughts seriously. Even if many people have them, that’s not an excuse to downplay their severity and importance.

Long-Term Suicide Prevention Tips

Because studies link mental health problems to suicide, the Depression and Bipolar Support Alliance has some great advice for long-term prevention. These include:

  • Stay social: Keep in touch with friends and family, and spend some time with both.
  • Avoid drugs and alcohol: Both can lead to uncontrolled impulses and depression.
  • Write down triggers and signs: Create a log of what situations make you feel suicidal and any signs showing that you’re feeling that way. Share this with people you trust.
  • Create a plan for life: Write down contact information for close friends, family, the local emergency room, and the national lifeline. This can be used in an emergency to save your life.
  • Get professional help: Seek out a therapist or counselor to help you navigate through the pain and problems causing the suicidal thoughts.


You also need to be wary of using alcohol and drugs. Even though those can dull the pain temporarily, you can develop a substance abuse problem and become addicted without realizing it. People who suffer from substance abuse addiction are more likely to cause self harm.

You Have The Right To Keep Living

You’ve heard before that suicide is not a solution. That’s completely correct, but knowing it doesn’t help. If you are currently having suicidal thoughts, call 800-273-TALK to get immediate help. Then work on a long-term solution to keep yourself alive, including getting some professional help. You deserve to live.

Jennifer Scott

An Unwelcome Family Reunion

A gathering is occurring; one that many of us have had quite often…
It is one of sadness, yet we sit quietly, silently objecting their intruding presence…
Alone we sit at this table, yet we are not truly alone…
One by one, members of this family begin to return home…
We tearfully object to their presence yet still they come…
One by one, they arrive closing in around this singular family…
None of which are related but all have been brought into our life by tragedy & calamity…

This unwelcome family reunion consists of the following:
An elderly gentleman, who died at a family gathering…
A young girl, who failed to look both ways while crossing the street…
A teenage boy, whose pain in life was too much for him to live…
An infant lying helpless, still & lifeless, cold in a crib…
An old friend, which we failed to recognize the signs of a heartbroken soul…
A heartbroken mother, crying out as her car lost control…

These family members are scars upon our heartbroken soul…
They are the ghosts of those who haunt our mind that we seemingly can no longer control…
They are the ones that have somehow escaped the grip of the grave…
These are the memories of the people, in their last moments that we could not save…
Their last breath, their screams, and their torment are forever etched into our souls…
We have tried to for years to bury this heartache and pain…
Through unhealthy means, through drugs, and alcohol, yet they return again & again…

Until one day we sit alone but not alone with these family members from our moments past…
And we cry out as we are about to end our life and breathe our last…
Then in the stillness, a voice speaks to our hearts…

“These losses, their pain, they were never meant for you to carry from the start…”
“For grief is a process and the pain of a hurting heart isn’t meant to conceal…”
“But to own their tragedies is a burden that no one should ever feel…”
“My child, I have carried your burdens and I will carry all of these…”
“But you must first let go, forgive yourself, and give them to Me…”
“For all who are weary, overburdened, and who carry this post-traumatic stress…”
“Can come to Me, and I will heal the brokenhearted and give them rest…”

It is then, we, the rescuer look upon Him with our tear filled eyes…
To finally then see the presence of our Savior, who has answered our heart’s cry…
One by one, the ghosts of our tragedies past begin to gradually leave…
Although, they often try to break back in, we now know & believe…
Even though that we who have rescued others and saved those who have called…
Jesus is our one true Savior, the greatest Rescuer of all…

God Bless all those who have carried this pain for far too long. May God grant you the peace that your heart has sought for and the peace that comes from God’s Son.

God Bless,

Andy Starnes

Bringing Back Brotherhood Ministries.

Raising Our Children Well

Raising Our Children Well:

The greatest lesson I have received in accountability and responsibility has been through the blessing of parenthood. God has shown me so much and continues to do so even through the eyes of a child. I have received my daily devotion while reading my daughter a children’s bible story. I have felt the weight of my own sin when my daughter has looked upon me when I have done wrong. I have realized that God is close to children in such a way that their faith is often far greater than any of the greatest theologians. I have realized that in order to do the right thing, to follow God, to obey His word is worth it and it comes at a great cost: personally, politically, and professionally.

Yet through all this I have seen the glory of heaven and God’s grace through the eyes of our child. I have realized the error of my own ways and even though there are many who don’t believe the way that I do; I soldier on knowing that God died for me: a lowly sinner. And if He would die for me & change my life then He can do the same in anyone’s life no matter their circumstances.

“The first step to correcting any error is repentance. Unless we are willing to say ‘I was wrong’, we will never know how to follow His right” (Ravi Zacharias).

The greatest privilege God has bestowed upon our marriage is one of parenting. From the moment I began to pray about having a family, to our prayers together, to the moment we found out, and to the moment we held our precious miracle: “Emma Caroline Starnes” has been covered in prayer.

God’s word reminds us that we are to be examples of “The Way” to our children. We must be diligent in continually seeking a closer walk with Jesus “lest you forget the things you have seen.”

“Only take heed to yourself, & diligently keep yourself lest you forget the things your eyes have seen, and lest they depart from your heart all the days of your life. And teach them to your children & grandchildren especially the day you stood before the Lord your God in Horeb…”(Deuteronomy 4:9).

In this particular scripture, Moses is commanding & instructing God’s people on obedience. We should not forget what God has done for us. The Israelite’s were rescued from slavery, led through the Red sea, fed manna from heaven but yet they rebelled. If we look closely at our own lives, we are not any different. God has blessed us in countless ways, saved us from our sin, and yet we often grumble, complain, and walk away from God. And then we try to justify our sin as the Israelite’s did.

In the midst of our journey through our own wilderness, we need to realize the great responsibility placed upon us. We are teaching, influencing, and molding the next generation which are our children. They are watching our every move, our every word, and more importantly they are watching when we fail.

The things we have seen, our experiences, our failures, and how God has brought us through it all are a part of our story. They are all part of our testimony. We should tell our children God’s story, our story, and how God saved us from our sin. They need to know that we are fallen creatures as well and that through God there is hope in Jesus Christ. They need to see, feel, and touch our Christianity. Our love for God cannot be in proclamation only but it must be present in all aspects of our lives.

For “the righteous man walks in his integrity; his children are blessed after him” (Proverbs 20:7). To live a righteous life, is to always remember that we were bought with a price. To remember that “While we were yet sinners, Christ died for us” (Romans 5:8). God has paid the ultimate price for our redemption. It is up to us live a life that is worthy of such a gift.

Our children need to know that sin has lost the battle and this world cannot justify our bad behaviors when we kneel before the Almighty. Only the blood of Jesus Christ saves us, redeems us, and transforms us. May we accept the challenge to be transformed and show the world that Jesus Christ lives and reigns in us.

God Bless,
Andy J. Starnes

The Rosecrance Florian Program

Want to learn more about firefighter behavioral health and what we can do about it? Here’s your opportunity:

If you have been following our posts, you all know that our mission is to encourage, inspire, & provide the critically needed resources for the members of the fire service.

And as a part of this mission, it requires that we learn about valuable programs available to first responders to assist them. This may not seem like much but anyone who has been in need has either had a bad experience or heard of someone who sought help and received poor treatment in the process. This should never happen and thus we strive to vet and verify that the services we recommend are going to treat our first responders with dignity and respect.

We had the honor and privilege of meeting Dan DeGryse at the IAFF Peer Support Certification Program in March of this year. I can honestly say that Dan’s sincerity and passion for this subject was truly genuine. I witnessed him continue his work at FDIC and have followed his work throughout the country.

If you are a firefighter in need: PTSD, substance abuse, and more then please consider The Rosecrance Florian Program as their program is designed and run by first responders. You can learn more here and contact Dan for more information below:

Daniel DeGryse B.A., CADC, CEAP, LAP/C

Director, Rosecrance Florian Program

Rosecrance Harrison Campus

3815 Harrison Ave.| Rockford, Illinois 61108

Direct: 815 387 2461| Fax: 815 391 5040

Cell: 312 833 0196


View the Rosecrance Florian video for Firefighters and Paramedics

Check out the NEW Rosecrance Florian Program for Firefighters and Paramedics

In many cases, we are the first ones that see our brothers and sisters in need. We have seen that the fire service is lacking in training in the areas of addressing firefighter behavioral health. The Rosecrance Florian Symposium is an opportunity to learn more about how we all can help our brothers and sisters in need. Save the date and spread the word!

Register for the Rosecrance Florian Symposium at

Thanks again for supporting the mission of Bringing Back Brotherhood Ministries!

God Bless,
Andy Starnes

Suffering from Firefighter Burn-out?

Suffering from Firefighter Burn-Out? Read this:

What is work to us as firefighters?

Is it burdensome or bothersome?

Or is it the place where our passion is pursued and a part of ourselves receives fulfillment?

Have the days of feeling satisfaction from a job well done long past?

Has the loss of morality and the endorsement of situational ethics caused us to lose hope in our work and our leaders?

Has the world of instant answers caused us to quit at the slightest sign of adversity?

Have we considered our own work ethic?

“And whatever you do, whether in word or deed, do it all in the name of the Lord Jesus, giving thanks to God the Father through him.” Colossians 3:17

Have we forgotten the value of:

Sweat falling from our brow…
Sore muscles from pushing past our limits…
Knowledge gained from a relentless pursuit of learning…
Making a difference and bearing the scars of our work…

We must ask ourselves-does this exist anymore in our eyes but do these aforementioned areas matter to us?

My friends, the loss of work ethic is more tragic than we may realize. If we are unwilling to work hard, to seek out answers, and to push past our limits because its too hard or the world has beat us down; then how quickly will we quit on those we love when life becomes too hard for us then? 

Those who have a shallow work ethic will sacrifice little, slander much, and eat food that they never earned and brag about accomplishments & knowledge they don’t have.

Those who sacrifice much for the benefit of others may have little material gain but will lay their heads down in peace. Their hearts will not be in turmoil nor suffer from moral bankruptcy. 

Those whose work ethic is pure will not conform to the pattern of the world even when it hurts.

“Therefore I urge you, brothers and sisters in view of God’s mercy, to offer your bodies as a living sacrifice, holy and pleasing to God-this is your true and proper worship. Do not conform to the pattern of this world, but be transformed by the renewing of your mind.” (Romans 12:1-2)

So what is a living sacrifice? It is to offer the best of one self to God in spite of opposition. 

It is to offer our heart and soul to God even when the world continues to do evil and prosper. 

It is to be obedient to our belief in Him rather than giving into our selfish desires. 

It is to be broken and contrite but knowing that this is when God takes our empty hearts and fills it with His Spirit. 

It is to take hold of a new strength that is not our own. 

It is to fall upon our knees only to rise being lifted by the strong shoulders of Jesus. 

This is the work ethic that we must return to:

To work with all our might as if Jesus is our boss. For if He is truly our Lord, affirmation from others isn’t necessary nor required. 

If Christ is our focus, the hard work we put forth is not in vain but will be another star in our crown. 

For if we are carving our efforts into others hearts and not into plaques or certificates the dividends that will be paid to us will be in one powerful statement as we enter the gates of heaven:

“His master replied, ‘Well done, good and faithful servant! You have been faithful with a few things; I will put you in charge of many things. Come and share your master’s happiness!’ Matthew 25:21

Let us strive to live a life that is well done by God’s standard. May our work ethic remain steadfast and run the race until He calls us home. For our finish line is not made by human hands. 

Our efforts are not in vain and God is not overlooking our struggles. He is merely waiting upon our requests to be renewed, refilled, and strengthened by His Spirit. 

When we have reached the place where we realize we cannot do it by our own work ethic we have begun the journey to a significant existence rather than a successful one.

God Bless,
Andy J. Starnes

Bringing Back Brotherhood Ministries

We the Post Traumatic Souls

We the Post Traumatic Souls:

In most cases, the world looks upon its public servants with high regard. There are a few that abuse the position, tarnish its reputation, and damage the public’s trust. As a whole, less than ½ of 1% of public servants abuse their place of public trust. This is percentage better than doctors, lawyers, and even our clergy.

Yet, in the midst of such great trust and such great responsibility there is something that the public doesn’t see. They don’t see what we truly see. They don’t know the burden of the ghosts that haunt our spirits and how we are statistically dealing with these scars in self-destructive ways.

Firefighters, police, and first responders are suffering from PTSD, anxiety & depression, and the number of suicides is on the rise. Why is this so? Is it the one bad call that sets off a chain reaction of a personal firestorm? Or is it the cumulative stress of the things we see daily and then add our struggles that we face in our own lives?

The young woman whose life was taken too soon by a careless drunk driver…

The lifeless infant thrown to you as you arrive with passionate screams from the mother to save her child…

The constant exposure to death, tragedy, difficult personnel problems with no consistent sleep…

And when we do sleep is often interrupted by flashbacks, shaking, or jolted awake by the tones for another call for help…

The constant exposure of everyone else’s tragic circumstances does not leave the servant unscathed…

In fact, we often carry these personal moments with death us. Without our knowledge, their moments become part of us, begin to affect our daily actions and relationships, and soon our lives begin to unravel from the sheer stress and weariness of carrying the weight of too many losses.

This is where we begin…

Where we realize that their deaths and pain were not ours to own…

We need to understand our role was to help even if there was seemingly nothing we could do…

Our very presence brought assurance, comfort, and in some ways closure for others…

But when those who have lost loved ones, we do them a great disservice by our refusal to let them go…

For many who have lost those dear to them, they will always have a scar on their heart but yet they will move on…

For us to hold on to their pain, to relive it, to feel regret is to prevent the living from healing…

We don’t realize it, our subconscious repeats the incident, and hypervigilance seems to steal our peace…

But we must understand, when a funeral happens it is not for the dead but for the living…

So they may grieve, so they may heal, so they may say goodbye…
We the post traumatic souls refuse to let them go, the dead are restless as they constantly re-live their last moments in our minds…

We blame ourselves, we pour our pain away through prescriptions, alcohol, trying to cover the pain with poison…

When what we really need more than anything is peace…
Yet tragically, so many seek this peace by ending their own lives…

The desperation of the moment, the lack of sleep, and the stress of it all diminishes their focus and they believe the lie of the enemy that suicide is their solution…

And then they die not realizing that by their actions they have laid another restless soul upon another’s heart…

Their death and loss becomes another’s burden and we repeat this cycle…

So what do we do? How do we let go of all this pain and begin to heal?

Post-Traumatic Stress is a normal reaction to an abnormal event. Our bodies reacting with all of the symptoms are the effects of the collateral damage of catastrophes crashing through our attempts at resiliency. We need to realize that we are HUMAN! We need each other and we need help bearing these burdens. We need the peace of God in our hearts that comes not from this world but from a settled assurance that the overwhelming circumstances of our lives are reconciled. In Philippians, Paul reminds us to:

“Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace that passes all understanding, will guard your hearts and your minds in Christ Jesus” (Philippians 4:6-7).

Did you hear that? “The peace that passes all understanding will guard your hearts and your minds in Christ Jesus.” This peace comes from knowing that we have been reconciled to God not because we are worthy, not because of anything we have done, but because we the broken and contrite have come to the foot of the cross and realized that the scar in our souls can only be healed by the one who loved us so much that He died for us.

Paul understood the burdens of a weary soul. He lived a life in which he persecuted, arrested, and had Christians murdered. He must have awoke many nights reliving those moments and feeling great sorrow for his past. Yet, He was able, by the grace of God, not only to move forward but to minister, to plant churches, and write most of the New Testament (to name a few of the mighty works God did through an imperfect and sinful man).

We need to realize, that no matter our past our pain and tragic moments are not meant to be our permanent address. Grief and sorrow have their purpose and we are meant to feel these emotions but we are not meant to dwell there forever. To do so is to reject the gift of God and create a prison of hell and torment while we are on earth and this is what the Devil would have us do.

“For no one is cast off by the Lord forever. Though He brings grief, he will show compassion, so great is His unfailing love. For He does not willingly bring affliction or grief to anyone” (Lamentations 3:31-33).

The challenge we face as servants to our fellow man in their last moments is not to take ownership of them nor to let those moments own us. They do not define us but yet refine us. If we don’t seek help, these moments can collectively destroy us. We who have been greatly tested can either courageously share our testimony or we can become bitter and alone. We can take post-traumatic stress and as we heal in time can show post traumatic growth by ministering to others who suffer as we did. We can remember what we have been through but not relive it. We can look in the eyes of the hurting servant first responder and truthfully say “Many will tell you that they know how you feel but they don’t. However, I do know how you feel and I don’t have all the answers but I will listen, I will be here, and I will walk with you as you heal.”

May we all come to know the peace that passes understanding…

May we all have the courage to seek help in our broken moments…
May we all turn our tragic moments of pain into testimonies that we share to help those experiencing the same…

God Bless,

Andy J. Starnes

Bringing Back Brotherhood Ministries

Please see our resources that are available on the Firefighter May-Day Page for more information on how to receive help or how to help others:

Firefighter May-Day

Suicide on the Installment Plan

Suicide on the Installment Plan:

“Without realizing it, we often carry something around with us everywhere we go. We bring it out in our conversations and it shows up in our attitudes. It never really existed, yet it’s power lives among us and keeps us from moving forward.” Author unknown.

Many times, we overlook the distant look in a fellow firefighter’s eyes. Slowly, with the constant assault on our heart we begin to die on the inside. 

It begins with a look, an act of omission, choosing to remove oneself, and the very lines on our face can tell more than many of us would like to admit about the condition of our heart. 

We blindly and foolishly believe that we can move through our days and function without others realizing that we are silently suffering on the inside. 

Our behaviors give us away and cry out to others what our prideful selves refuse to do. We are showing signs of a tremendous fire inside our hearts, slowly burning, choked down but not out. 

In these moments, if not careful we can hurt others in so many ways. We push others away and build walls around our hearts. 

We seal off our emotions as if they were a hazardous material that no one should touch. 

Yet in reality, we have been hurt so deeply that we would rather suffer in solitude than allow anyone else into our world that may hurt us again.

But do we realize that our defensive efforts are actually destructive ones to others and ourselves?

Do we really want to spend our lives pushing others away? 

Do we realize what we are doing to others by ‘protecting’ ourselves?

If we are not careful, we are leading others down the same dark path as we assume our defensive posture. 

What can we do?

We cannot continue nor allow others to suffer alone. We must not let these brothers or sisters think that no one cares for them. They are carrying a sign around their neck that is printed in bold letters:

“HELP ME!”  

Those who suffer in this way is a slow and gradual death. It is suicide on the installment plan. Day by day a piece of them dies right in front of the world yet no one says or does anything about it.

Will we as leaders, friends, and believers take the time to speak words of comfort?

Will we take the time to listen to them?

Will we take the time to care?

Will we be so focused on saving lives that we fail to save the lives that are dying right in front of us?

Will we shine His light into their darkness?

Jesus said, “I am the light of the world. Whoever follows me will never walk in darkness, but will have the light of life.” (John 8:12)

For if we don’t take the time we may live the regret of the results of their collateral damage, their or our wasted life, or the memories of what we should have done to try to help. 

Let us ask ourselves:

Would we want to be treated as they are being treated? 

Don’t we realize that their behaviors are a cry for help? 

Who will help them? 

We save others but yet we are failing to save ourselves…

As leaders we cannot ignore their silent cries that says more than words can ever say. We cannot ignore them no more than a person hanging from a fiery window screaming for help. 

Those that we know who carry these burdens are trapped at a fiery window and only those in their fellowship, those closest to them, will be able to make the rescue if they act in time.

Take the time to share Jesus with them. Be the brother or sister that they need when the call comes in. Don’t wait, respond and make the greatest rescue: The rescue of a broken life. Give them the greatest gift that you can give: The gift or your compassionate presence. You will never regret it.

God Bless,

Andy J. Starnes

Bringing Back Brotherhood Ministries

Rescuing Our Own

Rescuing our own- “Why don’t those who save others call for help?”

The United States is seeing increasing numbers of first responders suffering from behavioral health despite the increasing of availability of behavioral health resources. Statistical data has shown an increase in first responders suffering from these behavioral health issues such as: anxiety and depression, PTSD, alcohol & substance abuse, and increased risk of suicide. First Responders are exposed to occupational stress at a higher level than many other occupations and we respond differently to potentially traumatic events. Could our responder mind-set and our culture be contributing to the increase in the behavioral health issues?

Consider this: “The American fire service has been rocked in recent years of apparent suicide clusters in large, metro fire departments” (Gist, Taylor, Raak. p.2). “One study that examined North Carolina firefighters found the following: “Compared with professional firefighter line-of-duty deaths (LODDs), suicides occurred more than three times as often” (Salva p.1).

What do we really know about first responders and occupational stress exposure?

As part of the Tampa summit in 2004, the National Fallen Firefighters Foundation (NFFF) identified 16 life safety initiatives in order to improve firefighter health and safety. Fire Life Safety Initiative 13 was born out of the collective research that identified the increasing number of behavioral health issues in the fire service.  The Suicide and Depression Summit held in 2011, which was sponsored by the NFFF, expounded upon FLSI #13 and identified further areas of needed study pertaining to suicide and depression in the ranks of first responders.

To further emphasize the importance of this problem consider the following examples:

Consider the case of Kyle Lenn, a 23 year member of the fire service, and considered one of the most progressive fire chiefs of his time. He was actively involved in the Everyone Goes Home program, active in the Nebraska Fire Chief’s Association, and more. On the morning of January 31rst 2012 his body was found hanging from a bridge from an apparent suicide. His death shocked the fire service community and numerous other deaths like Lenn’s have brought attention to behavioral health problems in the fire service (Wilmoth,).

Or this quote from Clifford F. Carlisle, Mountain Brooke Fire Department-

“Over the years, one of our firefighters, killed his wife and then himself. Another firefighter transferred from a larger department, worked several years, resigned and committed suicide. Others have been involved in a variety of altercations, domestic problems, and stress related episodes and illnesses. One employee who appears to have become a recluse, retired and left the country. His problems followed him overseas” (Shantz, p.1).

In my personal experience, I have lost several friends to suicide and two of those were firefighters. We as first responders experience tragedy, loss, pain, and are with the trauma level hospice worker who compassionately cares for others in their last moments. These experiences are often embedded in our memories and many suffer post-traumatic stress disorder due to this.


Consider the statistical data below concerning first responders/firefighters by an organization who counsels and treats first responders:

  • As much as 37% of the fire service suffers from PTSD.
  • “As a result, some estimates put alcohol abuse in fire departments at upwards of 25 – 30%, approaching two or three times the incidence of alcohol abuse in the general population (7 – 9%).”
  • As much as 30% of firefighters suffer from depression.




Yet, in the face of these overwhelming circumstances there is help for those who save others. The question remains, with behavioral health resources becoming increasingly available, why are first responders not reaching out for help?  In regards to firefighter behavioral health, Fire Life Safety Initiative 13 was developed to provide psychological support and counseling to all firefighters. Due to the suicide clusters, as mentioned in the introduction, this lead to the Suicide and Depression Summit. In Baltimore Maryland 2008, the first FLSI 13 Consensus meeting was held which focused on potentially traumatic events. This consisted of six different research organizations and six different fire service organizations that focused on identifying the resources needed to create behavioral health assistance that would effectively serve firefighters and their families (Gist, Taylor, Raak. P 5.).

The researchers at the Suicide and Depression Summit were the top individuals in the fields of PTSD, Suicide, and Employee Assistance Programs, and Firefighter Health Research. These different organizations were formed into consensus groups that would identify “behavioral health resources, improve upon member assistance programs, and address self-help and peer support” (Gist, Taylor, Raak. p.5). These groups focused on providing programs and support to firefighters/first responders that have been previously been identified into two areas of need:

  • The High Risk Responder: The high risk responder is a first responder who has serves in a disaster role for long durations. As studies have shown that these individuals are at a greater risk (as high as 34%) for developing Post Traumatic Stress Disorders (PTSD). Studies also have shown that there is a “relationship between the duration of traumatic exposure and the development of posttraumatic stress” (Castellano, Plionis p.328). Consider the another perspective of the High Risk Responder: A first responder, firefighter or police officer who serves in very active areas for long shifts, works overtime, and works a second job at another busy job. As public servants, can we see a correlation between serving on the busiest unit, company, or force and the development of post-traumatic stress?
  • Rescuer-Victim Group: The Rescuer-Victim group was identified through studies after Hurricane Katrina. Many of the first responders became victims to the incident themselves. They suffered from three critical incident stress incidents simultaneously: the actual disaster itself, the failure or breakdown of the emergency response organizations, and the personal and ethical crisis that the responders faced during the disaster. These first responders had to choose between obeying their sworn duty and protecting/saving their family. In my experience, this group still exists today without the presence of a disaster event. I believe that the Rescuer-Victim Group occurs when a first responder must choose between dealing with their own personal problem, the failure of support from their organization, and the collateral damage that is thereby caused within their families. This is one reason why many first responders are not seeking help. As they are paralyzed by their problem, know they must do something, but often fail due to the possibility of losing their job, not being aware of the resources available, and the failure of their organizations to adequately train their employees to assist those in crisis.

The Suicide and Depression Summit’s efforts developed the following programs to assist firefighters: After Action Review, Psychological First Aid, Screening and Assessment Materials, Behavioral Health Assistance Program standards, Web training in evidence supported intervention for clinicians treating fire service members, and Support for effective peer assistance efforts (Gist, Taylor, Raak. p.8). Many of these programs already existed but were not developed with the fire service specifically in mind due to the complexities of our culture and the need for peer support. Since then the following areas have been developed and are available through the National Fallen Firefighters website under the Everyone Goes Home section. If you are not currently aware of these resources, I strongly suggest after reading this article that you visit their website and begin the journey to learning how to rescue our fellow brothers and sisters.

After Action Review:

After Action Review (AAR) has been practiced by the military for years. Under the Everyone Goes Home program the After Action Review is a training section that evaluates what the first responders just did after every call, every training, or every significant incident. The goal is to take the ‘who’ out of it and to learn why what happened. This is an immediate debriefing involving only the members involved. This can be implemented with ease in any organization regardless of size, staffing, or resources. The leadership can begin discussing calls each day and monitoring their co-workers behavioral health in order to prevent or reduce the increasing rate of behavioral health issues in emergency services today. (


Psychological First Aid (PFA)

PFA is a form of emotional first aid. It has been studied and implemented since 9/11 and Hurricane Katrina. The field application of this model was implemented on 9/11 to the members of the New Jersey Task Force One (NJTF-1). PFA consists of five phases or steps: assessment, stabilization, triage, communication, and follow-up connection. The implementation of PFA was found to be more successful through the use of peer counselors as they “fit the culture of law enforcement emergency personnel and lent credibility and familiarity to the counseling effort” (Castellano, Plionis, p.329).  PFA connects the first responder with “mutual support following high impact calls while enhancing daily performance and citizen satisfaction” (Gist, Taylor, Raak. p.7). It is designed for immediately after the incident which uses evidence based support designed by the US Department of Veterans to prevent the development of post-traumatic stress disorder or PTSD (Brymer M, Jacobs A, Layne C, Pynoos R, Ruzek J, Steinberg A, Vernberg E,Watson P. p.5). As firefighters, the doorway to assist them after an incident is through the assistance of peer counselors. If your organization currently offers training in critical incident stress management (individual and group counseling) I highly recommend that you attend this training in order to better care for those in your fellowship. After all, who sees the first sign of a ‘working fire’ inside of our lives if not our fellow firefighters that work with us 1/3rd of our lives?

A Multi-component CISM model augmented with peer-to-peer counseling:

Many departments employ the use of Critical Incident Stress Management to assist in managing first responder stress to Potentially Traumatic Events otherwise known as PTE’s. This Critical Incident Stress model consists of six components which are acute crisis counseling by peer counselors, an executive leadership program, a multi-disciplinary team, an acute traumatic stress group training, a 24-7 Hot-line for first responders, and a reentry program. Currently there are resources available through the NFFF for CISM training and many departments across the country have certified CISM teams. Does your organization have a CISM team? This is our 911 for our personal May-Day’s.  Does your organization have a Hot-line for those who need to counseling? If this isn’t the case consider the following numbers that can are available for first responders in crisis:

  • The Share the Load Program by The National Volunteer Firefighters Counsel: org/help1-888-731-FIRE FREE (3473)
    This free, confidential help line available 24 hours a day, seven days a week to members of the fire, EMS, and rescue services and their families. Please see their video on the Warning Signs of Firefighter Behavioral Health:
  • Firefighter May-Day: Please visit and click on the Firefighter May-Day page for a list of resources of trained professionals who can assist our fellow brothers and sisters.

The complexities of behavioral health equals further research is needed:

In regards to firefighter behavioral health. First, there is a limited amount of verifiable data available regarding firefighter suicides thus funding should be allocated to provide a better understanding.  Second, as the Suicide and Depression Summit recruited the top experts in the field the fire service should recruit the experts in the military who are already performing similar studies and programs pertaining to suicide. Those who encourage action in this field should be instructed to present their findings based on observable and verifiable data; not based on assumptions and personal experience.

The contributing factors for suicide in the fire service should be researched further focusing on elements of thwarted belongingness and personal contribution as they may contribute to higher risk of suicides (Gist, Taylor, & Raak p.22). Screening and intervention approaches should be created and designed specifically for the fire service. Such programs have been developed such as the TSQ-Trauma Screening Questionnaire as part of the FLSI #13 initiative. This is a tool that allows the supervisor to quickly determine whether or not an employee needs further care or assistance. It is valuable due to its simplicity and its similarity in how firefighters ‘size-up’ problems.

These programs should be preventative and intervention based while grounded in empirical data. Cognitive Behavioral Therapy, suicide ideation program training, and behavioral health care training should be readily available and inexpensive to the fire service, its leaders, and the necessary heath care providers. Sadly, most firefighters aren’t aware of these programs and neither are their leaders. Peer support programs should consist in training members in addressing suicide. Each organization should follow a strategic plan of action similar to the National Strategy for Suicide Prevention which explains a more comprehensive approach to suicide prevention through education, screening and better medical care, and more available resources for the individual after they have been discharged to help re-acclimate them back into their daily life.  The materials for these trainings should be easily accessible along with a suicide hotline listed. The materials should be developed in cooperation with IAFF, IAFC, NVFC, and USFA. These organizations all are have significant influence on the fire service and through this partnership it would ensure a more successful implementation. All of these recommendations will be made possible only by allocating funds for their research and implementation.

Many firefighters and first responders do not readily seek help for their behavioral health problems due to a lack of knowledge of the resources currently available. As mentioned above, there are currently numerous resources available to first responders and firefighters such as the FLSI #13 resources which are based on the following programs: After Action Review, Psychological First Aid, Screening and Assessment Materials, Behavioral Health Assistance Program standards, and free web based training. Many departments currently employ the multi-disciplinary CISM approach which offers employees defusing’s, debriefings, and follow-up if needed after potentially traumatic events. The belief that firefighters don’t readily seek help isn’t based upon opinion; it is based on the numerous interviews with first responders, counselors, fire chiefs, and personal observations and interviews with those in my sphere of influence. The continual trend of not being aware of these resources lead to the writing of this article.


 We have identified the problem, now what?

We are constantly training to stay ready for the next challenge we may face. Let us ask ourselves, how well are we trained in saving our brothers and sisters from their own personal may-day? As a member of the emergency service world, let us ask us ourselves the following questions:

  • Does your organization currently offer any services for its members for behavioral health concerns such as: alcohol, substance abuse, depression, PTSD, counseling, and stress management?
  • What services do they currently offer?
  • Are you familiar with Fire Life Safety Initiative #13
  • Are you familiar with CISM-Critical Incident Stress Management
  • If you or someone you knew needed help in any of these areas would you know how to receive assistance?

How well were you able to answer the questions above? On average, most first responders are not aware of the resources their organization provides and are not aware of how to help someone or themselves in the event of a personal crisis. This identifies the need for training. As leaders, we should be just as well-trained in taking care of our people as we are proficient at providing services for our customers. There are internal customers and external customers. We need to take care of our own so they may thrive and provide even better service to our citizens. The incentive to the organizations for offering this training is reduced employee behavioral health issues which results in reduced medical expenses, longer careers due to better management of these behavioral health issues, and reduced cost to the employer by maintaining their workforce rather than firing/losing employees due to these issues. If we are to truly be accountable for the profession that we serve we should be well-trained at rescuing our own. The greatest save we may ever make could be the person next to us. Let us take up the challenge and not let our brothers and sisters lives burn down around them. Begin the rescue of our brothers and sisters today by beginning a personal commitment to learn more, become trained in these areas, and teach others to do the same.

May their cries for help go unanswered no more….

Andy J. Starnes

Bringing Back Brotherhood Ministries



Works Cited:

Antonellis Jr. Paul J., Thompson. Denise A. A Firefighter’s Silent Killer: Suicide. Fire Engineering University. Penn well Publishing. (Pg.1)

Brymer M, Jacobs A, Layne C, Pynoos R, Ruzek J, Steinberg A, Vernberg E, & Watson P. Psychological First Aid. Field Operations Guide Second Edition. National Child Traumatic Stress Network. (p.5). retrieved from:

Castellano, Cherie. Plionis, Elizabeth. (2006) Comparative Analysis of Three Crisis Intervention Models Applied to Law Enforcement First Responders During 9/11 and Hurricane Katrina. Oxford Journals. Retrieved from:

Ford, Travis. (2006). Building Support for Firefighter Life Safety Initiatives in Higher Education. Executive Leadership. Retrieved from:

Gagliano, Anne. (2009). What Every Firefighter’s Spouse Should Know. Fire Engineering. Retrieved from:

Gist, Taylor, & Raak, (2011).Suicide Surveillance, Prevention, and Intervention Measures for the US Fire Service. Findings and Recommendations for the Suicide and Depression Summit. Retrieved from:

Manning, William A. (2007). Fire Life Safety Initiatives. Everyone Goes Home Summit White Paper. Retrieved from:

Nock, Matthew K. Joiner, Thomas. Berman, Alan L. (2011) Issues of Depression and Suicide in the Fire Service. Retrieved from:

Salvia, JS. (2008). “Suicide among North Carolina professional firefighters: 1984-1999.” Dissertation Abstracts International, 69.

Shantz, Mark. (2002) Effects of Work Related Stress on the Firefighter/Paramedic. EASTERN MICHIGAN UNIVERSITY SCHOOL OF FIRE STAFF AND COMMAND. Retrieved from:,%20Fitness,%20Wellness/Effect%20of%20Work%20Related%20Stress%20on%20the%20Firefighter%20Paramedic.pdf

Wilmoth, Janet. Trouble in Mind. NFPA Journal. May 2014. Retrieved from:


Alcohol and The Fire Service: A Long Tradition

Drinking alcohol and being a firefighter seem to go hand and hand. When I grew up at the firehouse it was an every weekend occurrence. Even before I was a member, I would hang out there on the weekends with my dad. Every Friday night after a few hours of bingo it was time for the “boys” to crack open the beers and get the hall set up. All the members would huddle around the bar in the back of the hall and tell all the stories of the big fires throughout their careers. 

Attending the conferences it seems the tradition lives on. You can almost bet there will be a major alcohol sponsor and a block party waiting. All the parades and the major events seem to hold the same precedence, Alcohol and lots of it. Does the Fire service have higher rates of alcoholism than the general population? Is it time for the leaders of the major events to take a look and see if there is need of change?

A recent Study by JSciMedCentral says it does. They questioned 112 firefighters from the northeast and they said that 58% of the firefighters reported binge-drinking behavior in the last 30 days. The study questioned both volunteer and paid firefighters and the numbers were staggering across the board. They ask the firefighters why they believe the alcohol use was so high and they said “tradition” as one of the factors among other things.

I personally work on helping firefighters who are struggling with alcoholism and drug abuse. I talk to guys every week whose lives have been destroyed by alcohol. The very traditions that firefighters follow are causing some to lose everything and hit rock bottom. Thus the results of this study aren’t surprising to me at all.

The JSciMedCentral study clearly shows that cultural issues are contributing to the fact that drinking, and overdrinking, are more prevalent in the profession. First of all, when questioned the firefighters didn’t believe their profession was any worse than any other profession. So we’re looking at a culture that has normalized behavior that is actually excessive.

Many departments expressed having zero tolerance policies about drinking on the job. These policies are acceptable because they are consistent with the culture. The overarching trope is that firefighting is a serious, tough, demanding business after which one has to unwind. The JSciMedCentral study quotes responses that use the word “unwinding” as a common view the respondents had about after-hour drinking activities. So much so that the study showed hangovers – that is, having been drunk the night before reporting for duty with perhaps too few hours to sleep it – were tolerated to a greater extent than drinking on the job. This is in keeping with the culture – the idea of toughing it out and getting one’s act together for the serious work at hand.

I have been saying over the last few years that something needs to change. Promotion of alcohol at fire service events should be cut back. Drinking alcohol and stepping foot into a volunteer fire department should be an absolute no. I can’t believe that in 2015 we still allow individuals who are under the influence inside of a fire department. The amount of cameras on you today will destroy an individual for one simple mistake. It will disgrace a firefighter and the department.

Perhaps it would only take a slight change in culture to pave the way for policies reflecting less tolerance of after-hours drinking. Reporting how firefighters viewed their colleagues’ drinking habits, the study writers put the word “unwinding” in quotes. It’s a significant notation singling out of a pivotal word that holds the drinking culture together. The concept of “unwinding” fits with the idea that alcohol consumption is earned, by a hard, stressful job completed. This wording positions alcohol as a tool, if not an ally, against stress, exhaustion, risk, and sacrifice. In the most extreme mythos, it is conferred on someone who has measured up to manhood (roughly 80 – 90% of respondents were male) – which could seem like a lot of psycho-babble, except that issues with alcoholism, according to the study, seem to decrease with age.

The good news cited by the study is that 50% of responders reported that after the Oklahoma City bombing they sought out friends as their “coping strategy,” while only 19% reported turning to alcohol. This suggests that community, friendship, and responder-brotherhood can be leveraged in the struggle against alcoholism. Connecting socially in non-alcoholic events might help reduce the firefighter perception that alcohol is a tool for handling stress. Efforts going on across the country have hit on this idea and are beginning to leverage the sense of community in creative ways as they develop systems to keep firefighters safe and mentally healthy. A successful change in culture will take time, dedication, ever more awareness and eventually wider standardization.

References: JSCI MedCentral Study


Mark Lamplugh Jr. is a fourth generation firefighter and former captain with the Lower Chichester (PA) Fire Company. He is now the Chief Executive Officer of 360 Wellness. . 360 Wellness has access to the best treatment centers and clinicians across the country. Let our experienced wellness specialists match you
with a treatment center or clinician that meets your needs and gets you on the road to full recovery as soon as possible. We make sure to get you the best possible help available. Call our wellness hotline and speak with a wellness specialist to help you find the best help possible: (800)901-1640

Mark W Lamplugh Jr
Chief Executive Officer
Cell: 561-762-9729


Conducting a Firefighter Size-Up

As one soldiers on in sharing the love of Christ with others in the fire service there is a consistent theme that we encounter. It is the encounter of the wounded and broken soul who has built walls around their heart in defense of the hurt in this world. Their eyes seem to cry out the Psalmist words “My God, I cry out by day, but you do not answer, but I find no rest.” Psalm 22:2 their mannerisms and behaviors bear the scars of worry and anxiety. Anxiety has damaged their health, disrupted their productivity, causing them to negatively treat others, and has ultimately reduced their ability to trust in God. This is the place where we meet others on the broken road to Christ.

Consider this:
How many of us have worked with or currently work with someone who is cynical, bitter, and unforgiving?
Have we ever worked with someone who seems to know it all but yet continually betrays other’s trust?
How many people have we met that seem cold and will not open up to anyone?

If you have answered yes to any of the following questions you have a great opportunity in front of you in the fire service. Unfortunately, many do more harm to them than good.
Many people, including myself have offered short quick fix answers to someone’s life long problems of pain and struggle. Many say they are willing to help but walk away when it becomes too personal. Many of us become defensive when another is bitter or seems to attack everyone in their path.
“Anxiety weighs down the heart, but a kind word cheers it up.” Proverbs 12: 25

The Fire service is in desperate need of encouragement. Disciples of Christ are needed to rise up and “answer us when we call.” (Psalm 20: 9) Men and women are broken, hurting, suffering, and in our traditionalist mentality we think that pride means we should ask for help. This couldn’t be further from the truth. In the fire service, we do nothing alone. Every aspect of our lives is based upon team concepts whether it be stretching a hose line, performing CPR, to taking care of our daily duties; we do these things together! Why should one who saves others who now finds themselves in desperate need of help suffer in silence? Have you been in such a place? Are you there now? Would you like to do something about it? Whether we realize it or not our painful experiences do not invalidate us they have actually prepared us to help others.

As a firefighter, you are given another unique opportunity: To save other firefighters! No one else is more qualified than you right now! No one else will be welcomed into their inner circle of trust. And no one else can understand the things that we see like another firefighter can. As a firefighter, you can break down the walls of bronze that our built around another’s heart through God’s love and mercy. He has divinely prepared us for this position and has been training us all along the roads of our lives. “For He breaks down gates of bronze and cuts through bars of iron” (Psalm 107: 15-16). If you are ready to answer the call of Christ and reach out to your brothers and sisters in need there are many ways to do so.

Have you considered how much training that we as firefighters go through to be prepared to answer the call? How much training have we received to answer the call of the hurting, the broken, and the desperate needs of our brothers and sisters within our own fire houses? The good news is there are many opportunities available to be better equipped to help our brothers and sisters in the fire house. In your spare moments today consider the following training opportunities and learn more about them:

• Critical Incident Stress Management: After completing my CISM training last year, I realized how valuable this training is. It is an honor to serve those in crisis but I consider this training a must for all first responders due to the personal crisis we all face every day. Take the time to learn more about this valuable training and consider serving on a CISM team. “CISM is a method of helping first responders and others who have been involved with events that leave them emotionally and/or physically affected by those incidents. CISM is a process that enables peers to help their peers understand problems that might occur after an event. This process also helps people prepare to continue to perform their services or in some cases return to a normal lifestyle.” LEARN MORE AT

• Fire Life Safety Initiative 13: We should be as passionate about saving our own so we can save others. There are many more out there who offer free training in this subject and you can visit the NFFF’s website and receive free training on peer support as well. (

• Firefighter Behavioral Health Alliance: Jeff Dill offers several programs that provide invaluable training in saving our own. This training is to directly educate firefighters/ Emergency Medical Services (EMS) personnel and their families about behavioral health issues such as depression, Post Traumatic Stress Disorder (PTSD), anxiety and addictions, as well as firefighter suicides. Please check out his website and the current workshops available:

• Discipleship: “When I was a company officer, one of the joys was to see one of the firefighters on our truck get promoted to captain. This was especially true when I was able to witness the change that began when a rookie firefighter was assigned to our truck. I felt that it was my responsibility to ensure that they were well prepared for their current position and future new positions.” Keith Helms

Discipleship SOG

FCFInternational has developed a Standard Operating Guideline (SOG), Essentials of Biblical Discipleship, to assist members in discipling other first responders. Please read over this document in order to better understand the direction that FCFInternational would like to take with the Discipleship Ministry.

Marriage Ministry:
Firefighters and first responders today suffer one of the highest divorce rates in the country. Perhaps your marriage is in trouble or you work with someone who is struggling. Would you like to be able to help yourself or others? Consider learning more about the following resources:

Fire Family Life: Firefighting is a noble profession. And also one that takes an emotional toll sometimes at the expense of marriages and family life. Our Mission is to honor, strengthen, support and encourage fire service marriages and families. With professionalism, integrity, top quality programs and a positive environment, we offer:

• Free Online resources about marriage and fire family life
• The Fire Wife Sisterhood – A private wives support community
• Rescue My Marriage program (currently only for wives)
• Events – live and virtual including our exclusive couples weekend, Flame Fest
Learn more at

Fellowship of Christian Firefighters International Marriage Retreat:

How much is your marriage worth to you? The fire service can be a difficult place to serve and could cost you your marriage. FCFInternational will once again be holding a marriage retreat to help you thrive in your marriage. Friday September 18- Sunday September 20 we will be learning how to treat our spouses like a CHIEF. Reserve your room today for only $98.99 at the Magnuson Hotel in Clarksville, Virginia. Call 434-374-5023 and tell them you are with the Fellowship of Christian Firefighters International to get your discounted rate. The rest is on us. Learn more at

The Weekend to Remember Get-Away

Life has daily challenges such as jobs, kids, activities, errands, and life have a way of overwhelming a marriage. Before you know it, other things are taking more priority above what’s most important: your spouse and family. FamilyLife’s Weekend to Remember® marriage getaway is your chance to make a change. Learn more at:

Bringing Back Brotherhood Ministries:

In 2010, God placed a burden upon my heart. I learned through this experience that the fire service isn’t a spiritual detriment but a spiritual opportunity. Through many years of talking with firefighters, counseling, encouraging, and simply being there for one another I learned that there is a common theme that unites us all: brokenness. We as first responders, are not superhuman but we perform the extraordinary. Yet when the fires of life touch our own lives we often don’t apply our training to these situations. The statistics are overwhelming. Firefighters suffer some of the highest rates of suicide, divorce, substance abuse and alcoholism, and suffer from PTSD, and anxiety and depression. We the rescuer are in need of rescuing but many of us refuse to ask for help. The purpose of Bringing Back Brotherhood Ministries is to restore the hearts of firefighters/first responders with the hope of Jesus Christ. Our mission is to provide the critically needed resources that many of us either refuse to seek or don’t know how to ask for help. This mission is teach, empower, and equip our fellow firefighters and first responders with the skills, the discernment, and show them that the greatest save they could ever make may be right beside them within their own fire house or their own home. We offer daily encouragement through our website, Facebook, twitter, and an email subscription. We offer a Firefighter MAY-DAY page that lists resources such as the ones mentioned above specifically for those in emergency services. Our goal is to encourage firefighters that may be in a dark place. We want them to know that they are not alone and we refuse to ignore the increasing trend of rising behavioral health incidents. Please visit our website at for more information or contact myself personally as there is so much more we can do together.

Keep the Faith and remember the greatest save you may every make may be your own life or your fellow firefighters in the fire house. Begin practicing the skills of a firefighter size-up today. Watch for the cues and clues of a ‘working fire’ within your fellow firefighter’s lives. Don’t crawl past a fire! Let’s extinguish the flames of these issues together.

God bless,
Andy J. Starnes
Bringing Back Brotherhood Ministries