Suicide rates among Emergency Medical Technicians (EMTs) and paramedics are more than twice that of the general population, and over half of firefighter deaths are due to suicide, though according to recent studies only about 40% are ever officially reported.
Captain Diego Luna, currently a Clark County Firefighter who used to work in Reno, describes how first responders often need immediate specialized mental health support, and emphasized that waiting even a couple of days can prevent a suicide or other tragic outcomes. Luna feels that forming networks of certified peer support providers is saving the lives of first responders.
A prior REMSA first responder, who wished to remain unnamed for this report, had a glowing review of how peer support creates opportunities for innovative healing strategies. She described how bringing her German Shepherd to work was one small way she could bring a smile to her team and help boost morale in between intense 911 calls. Peer support seems to be part of a recent uptrend in addressing local needs, and it may be a great fit, but is it a replacement for traditional mental health resources like licensed therapists?
” There are a number of reasons peer support is such an effective response model,” Luna explained.
“For one, it usually takes too long to see a therapist, and you know, with insurance and making sure it’s in-network… By the time you see someone, you’ve probably already had to figure things out on your own. Timely access is a problem. But another big thing is that peer support is based on the needs of the first responder. If you just got off a really tough call and you want to debrief with a peer support member who is from your team and familiar with the incident, you can do that. But maybe you want to talk to someone outside of your chain of command. We have a network for that at the county, state, and national level.”
Luna went on to explain how the compatibility of mental health resources is an important piece, too. “There’s a cultural aspect to being a first responder, and sometimes it’s hard to find that cultural awareness with a therapist - but first and foremost, it’s about timely access to resources and creating that awareness to talk about how you’re doing.”
Luna says it can be a serious compatibility issue when recommendations don't align with the strain that first responders are subject to constantly.
“We’ve actually had mental health providers that offered to go for a ride-along,” Luna explained, and that sort of extra effort to gain insight into the experiences first responders are facing can go a long way.
Captain Luna recounted how one of his team members continued working and saving lives despite the recent murder of his daughter, for which no arrests had been made.
Luna avoided bringing it up at first, not wanting to intrude, but eventually asked, “How are you holding up with all of this, man?”
The firefighter then opened up for over an hour about the overwhelming emotional burden on his marriage and mental health. Luna could tell he had been suffering silently and masking his turmoil due to a sense that others were relying on him.
Later, during a peer support debrief, Luna realized that while many had been concerned for him, no one had checked in.
This underscored the importance of growing peer support networks—recognizing when someone is struggling and stepping in before it’s too late. “It’s about creating awareness—knowing help exists, and making sure it’s actually offered when it’s needed,” Luna said.
At REMSA, according to one of their previous EMTs' experiences, peer support meant a lot of things, but primarily a roster of EMTs on shift who could be there for their peers in whatever way needed.
The EMT we interviewed explained in more detail how bringing her German Shepherd on site with her jubilant attitude would help shore up morale. “Everyone loved playing with her, and her positive energy helped them rehabilitate,” she said.
In between calls, spending a few moments decompressing with Bella was a massive relief to REMSA employees and became a popular and unique source of healing.
In the case of local chapters of the firefighting union, it is common practice for there to be a Peer Response Committee that is funded.
Captain Luna stated that departments themselves can cover the cost of the additional peer support training as budgets fluctuate. However, sometimes getting a member trained and certified while on shift, or paid to attend the training, isn't an option.
In those cases, the union's Committee on Peer Support can be billed by the peer support provider. The reality is that often when these services are provided billing doesn’t take place because of the culture.
“No first responder wants to feel they are making money off of caring for their own. What happens a lot of the time is you end up working extra hours on your off days,” Luna said. He expressed optimism that peer support’s effectiveness was leading to more first responders getting certified though and growing their network pf mutual aid. “Ideally, no one will be working outside their scheduled shifts, because that time off is so crucial to a healthy work-life balance,” Luna concluded.
In the wake of peer support’s wide success, there’s been some movement on getting more funding and policy established for this at the city and state levels. That is a breath of fresh air for EMTs and firefighters who are already working overtime to help their overworked peers.
Our Town Reno contribution by Ryan Longfellow in collaboration with a COM 210 UNR class with Amy Pason