The mangled grill of the truck with its front chassis seemingly turned inside-out and its metal guts strewn about, portended a grisly scene of what first responders might find on the other side of the doors. Eric Trussell had only been a firefighter about a year when he answered the call to the scene and knew immediately the chances of there being any life inside the vehicle were slim to none.
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The man slumped behind the steering wheel he could tell had been killed instantly. In the passenger’s seat, still buckled in, sat the man’s lifeless 4-year-old son whose face had smashed into the dashboard. The scene would be the first to burn into Trussell’s brain that would catalog 23 years of macabre and heartbreaking images all too familiar to those in his profession.
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Of the man, Trussell recalled that “most of the bones in his body felt like they were broken when we removed him from the truck” and as for the child, “there was a lot of blood, but you could see the trauma to his face and body.” All these years later and experiencing moments even more gut-wrenching has not rendered Trussell any more de-sensitized to such horrors.
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“You can ask a thousand firemen which one bothers them and it’ll be kids dying… every time,” Trussell said. “Pulling dead babies out of house fires – instead of allowing it to affect you negatively, you just kind of use it to make you a better driver.”
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Such are the moments that lead to PTSD and throw a monkey wrench into not only the human psyche, but also the very fabric of deciding between right and wrong. Such memories can lead one to question life itself. Since 2019, four Marion County Fire Rescue firefighters have committed suicide, a tragedy not unique to these parts – the U.S. Fire Administration says the incidence of Post-Traumatic Stress Disorder (PTSD) affects around 20 percent of all firefighters, three times the rate among the general population.
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A shroud of sadness comes across Jamie Banta’s face as he talks about these life-and-death challenges facing him and his agency. As a veteran firefighter and now chief of MCFR Banta has seen more than his share of tragedy and human loss. But now, he and his department are in a struggle for survival within their own ranks.
Against that backdrop, Banta set out to re-examine how his department works and how its firefighters/paramedics deal with the day-in, day-out pressures of their job. Among the boldest steps was reaching out and utilizing the expertise of the Institute of Human and Machine Cognition. IHMC is an internationally recognized research outfit with a facility in Ocala that specializes in finding ways to optimize human behavior. It does significant research on members of the military to enhance their effectiveness and health.
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IHMC brought together a team of nationally known experts on everything from neurology and psychology to crisis intervention and, of course, fire and medical operations.
“What we experienced was a cluster of suicides,” said Banta, who has three decades of firefighting experience, including seven years MCFR chief. “It almost became a contagion.”
The first suicide within the MCFR ranks was in 2019, when Emilio Rivera took his life. Three years later, it was Nick Zancanata. After those two deaths, Banta and his commanders became concerned, but as the chief put it, “there was rationalization.”
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Then came 2023. Grief once again gripped the department when firefighter Tripp Wooten committed suicide. Just a month later, another firefighter, Allen Singleton, took his life. Banta said the deaths of Wooten and Singleton “shocked the department” and made him and his commanders more cognizant of the behaviors of their crews.
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“Tripp and Singleton in the same month was significant,” Banta said. “We’re re-evaluating everything we do.”
Up until that point, MCFR had relied on its Behavioral Health Access Program, or BHAP, an internal initiative that relied heavily on firefighters helping fellow firefighters.
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“Prior to Tripp and Alen, we had always worked on a peer support team system,” the chief said.
He later added, “Firefighters and paramedics see things day in and day out that would affect anyone. They see terrible things happen to good people.”
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‘Why is this happening?’
With around 700 firefighter/paramedics, MCFR is the second-largest fire department in North Florida, only exceeded in size by Jacksonville. It is also located in one of the fastest growing counties in the nation. As the community grows, so do the demands on its fire service.
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First, Banta read the book “When It Is Darkest: Why People Commit Suicide and What We Can Do to Prevent It” by Rory O’Connor. It inspired him to act.
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It also led to him ask himself: “Why is this happening in a profession that is so noble?”
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The most obvious problems MCFR is dealing with are not unique to it. Nationwide, suicide among firefighters is a concern. In addition to that, fire departments, including MCFR, are having trouble filling open positions. The shortage is so severe that, to ensure enough manpower is available for each shift, MCFR has gone to “mandatory overtime,” meaning firefighters who typically work 24 hours on, then have 48 hours off, are having to forego some of their off time. Beyond that, James Lucas, the longtime MCFR public information manager, said the number of calls is steadily increasing due to population growth, meaning firefighters do not have any slow times during which to get adequate sleep.
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Banta said 48 hours is not adequate anymore for the typical firefighter to recover from the rigors of fire and rescue work. Some departments, including Gainesville and Pasco County, have moved to a 24/72 schedule, meaning 24 hours on and 72 hours off. The problem there, however, is that converting to 24/72 would cost the county about $30 million a year in new costs for recruiting, training, outfitting and paying a full additional shift of firefighters. In addition, Lucas questions whether there are enough new firefighters coming into the pipeline to allow MCFR to easily staff a full, new shift of crew members.
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But the pressures facing firefighters go beyond lack of sleep, although that is a major concern. Both Banta and Lucas said along with sleep deprivation, firefighters also face mental health issues, physical health problems, financial woes, relationship conflicts and substance abuse.
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“We know there’s a lot of external factors when it comes to substance abuse,” Banta said.
Joe LaCognata is the head chaplain for MCFR. He said firefighting has changed from what many people traditionally think about it. “Wellness used to be fitness, being in shape,” he said. “Now, it’s so much more.”
“These groups are literally running calls around the clock. It didn’t used to be that way.”
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After reading “When It Is Darkest” and consulting his command staff, Banta began working to change the culture within his department. While switching to 24/72 was on the table, there were other steps that would cost less and could potentially produce results.
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The first step Banta took was to begin communicating what he was thinking, what he was learning and, importantly, that there should be no shame in seeking help, something that big, strong firefighters have often felt.
“The chief is pushing down, saying ‘It’s okay not to be okay. Let’s talk about it,’” Lucas said.
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Trussell says that in his years of service he can think of six that he knew committed suicide – five of them personally, including Rivera. He is well aware that the trauma experienced on the job is a major catalyst to the rash of suicides, but in none of the cases is it the only cause.
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“Of all those, there were other issues,” Trussell said. “Rivera – he was a sergeant in the Marine Corps with several deployments to Afghanistan and he had a lot of underlying issues. Others, there were addiction issues.
“The five that I was real close to were the light in the room, strong, tough dudes you want by your side. When you talk to them, they won’t really admit much.”
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Discipline reviews have also been modified to “be more thoughtful,” Banta said, especially for those employees experiencing substance abuse issues. Historically, substance abuse has been treated as a disciplinary infraction. Now, Banta is promoting a gentler approach.
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“People aren’t going to come forward to get help if they think they’re going to get terminated,” Banta said.
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Now, MCFR is approaching substance abuse as a disease, rather than misconduct, and it is even written into the fire union’s latest agreement. If a firefighter has a substance abuse problem, they are offered treatment. If that fails, then they can face termination.
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Trussell believes there may be issues related to chemical imbalances and that “even something as simple as Vitamin D from the sun could fix some of these people.
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“Most all of the people I’ve known (that committed suicide) were prescribed medication, were taking it or not taking it – that stuff just doesn’t help, it turns them into a different person, but I don’t think it fixes the issues.
Blue Sky Analysis
As he looked for answers, Banta approached the Marion County Hospital District, which funds health initiatives to benefit the community, and asked if it would help MCFR take a deep, expert-driven dive into what’s ailing its firefighters. The district said yes.
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“I think we have been through so many emotions and feelings with these deaths, I think the chief has been open to anything,” LaCognata said.
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Lucas explained the range of emotions that firefighters feel because of their job: “The chief likes to say this is a job where you can be the last person someone sees before they die, and you can be the first person someone sees when you deliver a baby.”
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Banta approached IHMC about conducting what the research institute refers to as a “Blue Sky,” in which it gathers leading experts on a subject and seeks in-depth, even radical approaches to solving a problem.
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IHMC founder and Director Ken Ford said while the institute had conducted numerous Blue Sky gatherings related to military performance, this was the first one focusing on firefighters. He praised Banta and other members of the community for being willing to look beyond traditional approaches to elevate the performance of its firefighters.
“It’s somewhat impressive that the people in Marion County care about this issue so much to take this kind of action,” said Ford, who Florida Trend magazine in 2020 named one of Florida’s “Living Legends” for his success in scientific research.
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Participating in the day-and-a-half Blue Sky were Banta, Hospital District board member Rich Bianculli, Marion County Administrator Mounir Bouyounes and local fire union chief Rolin Boyd. They were joined by 18 experts in everything from fire/rescue management to organizational innovation to neuroscience to psychiatry.
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The Blue Sky is designed to encourage lengthy brainstorming about an issue. Questions are asked. Suggestions are floated. No idea is too outlandish to be considered, hence Blue Sky.
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In the case of MCFR, ideas that gained traction included:
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Consider changing the way fire and rescue calls are dispatched to reduce workload without reducing the quality of service. Do we really need two or three fire vehicles to respond to every call?
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Normalize psychological assessments and counseling to remove any stigma firefighters might sense.
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Conduct strategic mental health assessments during the recruiting process.
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Implement biosensing testing to determine the health of a firefighter, measuring everything from vitamin and testosterone levels to substance abuse and undetected disease.
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CBDs as a means of alleviating anxiety and other symptoms in certain firefighters.
The hiring of a full-time health service officer to oversee physical and mental health assessments of the 700-plus MCFR staff members.
Much of the discussion focused on determining what makes a firefighter “resilient,” which means being strong physically and mentally and knowing how to cope with the horrors of the job. Of course, the nature of the job often makes that difficult.
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“Firefighters develop PTSD at the same rate as military service members, and the U.S. Center for Disease Control notes that law enforcement officers and firefighters are twice as likely to die from suicide than in the line of duty,” said Blue Sky participant Jacob King, chief of the Springfield, Ohio, Fire Rescue Division.
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A second brainstorming session on how to change the MCFR culture and create “organizational resilience” produced these suggestions:
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Switch to a 24/72 schedule, which would not only benefit existing firefighters but help in recruiting and retention.
Do what’s necessary to create a strong esprit de corps, which Ford called “super important.” Ford said esprit de corps is “a hundred little things” that unify an organization and lets its members know “they’re part of something special.”
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Improve public relations efforts so the community has a better idea of what firefighter/paramedics face in their jobs. “In Marion County, we average two building fires per day. We have many vehicle accidents. No one knows this. It is a challenge to get that info to the community,” Banta told the Blue Sky gathering.
In the end, the ideas that drew the biggest endorsements of the Blue Sky involved scheduling, improved training, innovative therapies and recovery procedures.
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Specifically, the group encouraged MCFR to:
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Explore the viability of the 24/72 schedule, recognizing the estimated $30 million-a-year price tag will be a challenge.
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Implement a “biopsychosocial assessment” that will regularly measure the overall health of firefighters. “This baseline would allow biomonitoring and design interventions (nutritional, behavioral, dietary, education, training, etc.) with more personalized regimens than available from primary care providers.”
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Establish “tools of resiliency: There are three levels of these practices – hot/cold therapy, breath control and mindfulness, decompression rooms and exercise challenges. Also in the group, explore a new station alarm system that does not wake the entire station unnecessarily.
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And, of course, elevate esprit de corps and pride within the department. “Lots of little efforts can lead to meaningful improvements in cohesion and sense of purpose, key contributors to resilience,” the Blue Sky report states.
Ford said one of the biggest benefits of implementing a resilience program at MCFR is that it immediately sends a message to firefighters and paramedics that they are important to the organization and the community.
“They’re trying to treat firefighters like they’re important people,” Ford said.
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As for scheduling, Ford said the $30 million price tag for converting to 24/72 is manageable because there are ways to create efficiencies and reduce that overall number. Plus, Lucas said, the department spent $10 million last year on overtime because of the “mandatory overtime” rule.
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Ford and other members of the Blue Sky team agreed that changing the culture at MCFR will bring the advantages of attracting better recruits and keep existing personnel from going elsewhere.
A chaplain’s perspective
LaCognata, the MCFR chaplain, was a high school principal in Chicago before retiring and entering the ministry. Yet, in the 15 years he has been the department’s chaplain, he has seen a side of firefighting the public rarely does.
The suicides, he said, are gut-wrenching, heart-breaking reminders of how difficult a firefighter’s job can be.
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LaCognata, like Ford, recognizes the public’s lack of understanding what firefighters encounter on the job. “They pull kids out of pools, see people in their final moments, have to pull victims from horrible crashes” – what he calls “critical incidents.”
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“They see so much for so long, it becomes a heaviness,” he said.
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That is why the chaplain supports the idea of a 24/72 schedule, especially with the current mandatory overtime policy.
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“I mean, if it takes them a day or two to come down, by the third day they have to get up again,” he said.
LaCognata said he has seen some common characteristics among the firefighter suicides over the years. They typically are middle-age white men. They tend to be despondent over relationship issues or financial woes.
And, when they take their lives, it tends to be reported to the public.
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“It’s always very public,” LaCognata said somberly. “You’re not going to see in the paper that Joe the Plumber died from suicide.”
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He also asks a question, one to which he doesn’t have an answer:
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“Are they dying because they’re firefighters? That’s the question. How much of this do we own?”
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The good news, LaCognata points out, is that firefighting is a good job. It gives purpose and meaning, and there is “the brotherhood.”
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“The fire service is another family,” he said.
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LaCognata said it is encouraging that MCFR is seeking answers to the suicide crisis. Ten years ago, he said, this conversation was not occurring.
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“Now, we’re talking about it,” he said. “Next is how to be resilient, so when stress comes over you, you’ll be in position not to be overwhelmed.”
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Elijah Rushing is a 34-year-old four-year veteran of the Ocala Fire Department. He claims a strong spiritual life has helped him navigate the troubled waters of the job. “Everyone doesn’t have the same method for dealing with stress – I’m more of a Jesus guy, so that’s where I put my stress.
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“There’re people who have come here for work and they have their first experience with a bad call, they can’t do it, so they leave. That’s always an option and I don’t judge people for that.”
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For LaCognata, an important part of resilience is being part of an organization that “doesn’t let you fall down in the first place.”
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Which brings us back to esprit de corps. The goal is to develop a department where the brotherhood means that fellow firefighters are looking out for you and making sure you take steps to be healthier in mind, body and soul – not just as a firefighter but as a person.
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“The whole person comes to work every day,” LaCognata said. “It’s just not a firefighter."
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For the veteran chaplain, the change that is occurring at MCFR is palpable. “I think one of the biggest things is we have a broader definition of wellness,” he said. “People are open to mental health wellness.
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“We’re seeing culture change. To be part of such a change is profound. We’re literally seeing a change in culture.”