Posted by: Francis Koster Published: December 6, 2020

We Need To Take Care Of Those Who Are Taking Care Of Us

My father was a fireman and ambulance driver in a small town in Ohio. I have clear memories of going to the funeral of a fireman killed in the line of duty in a neighboring town. I was very young and had to hold my dad’s hand when we walked from the church to the cemetery. Flags at half-mast still have a powerful impact on me.

Over Thanksgiving, I had a chat with a friend who is a lifelong member of the law enforcement community. We were discussing the existing and expanding stresses on First Responders as Covid-19 explodes around the coming holidays.

I was explaining how awful the next few months are going to be, given the fact that it took 3 months for the first one million Americans to be infected, and 6 days for the latest one million, and the rate is rising.[1] I said I was worried about the stress on our doctors and nurses. He replied, “Do you know that more law enforcement officers die by suicide than are killed in the line of duty?” I did not.

After we parted, I could not shake the emotions that statement caused in me. Got out my laptop and started researching. He was right.

I verified that before Covid-19 hit, around 50% more First Responders (Police, Fire, Ambulance) died at their own hand than were killed in the line of duty – and that is likely an understatement.[2] One of the challenges in tracking suicide deaths of First Responders is that while there are strong requirements for reporting injury and death while on duty, there are no standardized reporting requirements if a first responder dies at home. For a number of reasons, including fear of embarrassing the family of their friend, experts in the field believe that many suicides are classified by first responders as "accidental deaths" (implying a gun misfired, or the deceased had an accidental overdose), understating the actual toll by about half.[3]

Before Covid-19 hit, not only were self-inflicted deaths higher than those occurring in the line of duty, the suicide rate of all First Responders was around 50% higher than the population in general.[4] Investigations show that the majority of these were the result of cumulative exposure to tragedy – many episodes of Post-Traumatic Stress Syndrome (PTSD). According to one source, during their career, the average first responder experienced 188 episodes that were so emotional that PTSD could result from each.[5]

My thoughts turned to the healthcare workers now trying to cope with the tidal wave of Covid-19 sickness that has hit us over the past months and will continue to increase during 2021. My research found that in “normal” times (before Covid-19) the suicide rate of healthcare workers was equal to that of First Responders![6],[7],[8]

I learned that the biggest psychological scars that are left on the psyche of all of these rescuers are a cumulative sense of failure. When a person dies, it will be a single time of mourning for the family – but for the first responders and the doctors and nurses, it is a time of repeated painful anger at a system that failed to protect the innocent from a person that refused to wear a mask, or did not provide have enough ventilators, or required them to work endless days of very long hours while masked up, with no break because the cries for help just kept coming. Souls get damaged.

Feeling alone is one of the highest risk factors for those at risk for PTSD.[9] One study showed that healthcare workers who had strong social support networks, including adequate access to economic assistance, psychological intervention, and supportive supervisors had a much better chance of psychological recovery than those who do not.[10] Another rigorous study showed that during medical training young doctors participation in four half-hour long web-based therapy to assist their coping with what they were seeing reduced their thought of suicide by about half.[11]

Local First Responder and medical leadership could put such programs in place for the next six months to help their troops get through this.

While they do that, please make human contact with those under stress. Put a homemade pie on the front porch, or take out their trash. Call them, and let them know you are there for them. Listen to them carefully, and lovingly. They are placing themselves at risk out of duty, and caring for you.

As I have said before, if we want to change the future, we have to change our personal behavior. Will you?


Authored by Francis Koster Ed. D.
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[2] I found two sources of numbers for 2019. The first was the FBI which said 89 died in the line of duty. The second was Officer Down, an organization devoted to suicide prevention among Law Enforcement, which said 148 ended their own life. This is 1.66 times larger than the number killed in the line of duty. The National Law Enforcement officers says Memorial fund website offers a similar number at 135, found at Note that this only reports on police deaths. Reports of deaths among firefighters have about the same ratio.

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Francis P. Koster Ed.D.

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