Recent suicides of responders have thrust officials to push the importance of emotional fitness.
Just as being physically fit is vital for fighting fires, providing EMS care and performing rescues, authorities say it's just as important for personnel to have their heads in the game.
Firefighters have the second most stressful job in the nation, according to a study released last month by the University of Wisconsin-Madison.
Soldiers were found to have the most stressful job.
Learning to deal with stress will involve a culture change, says Jeff Dill, a licensed counselor and founder of Firefighter Behavioral Health Alliance.
Dill says his research shows there have been about 170 responder suicides in recent years including a number in fire departments in Phoenix, Chicago and Philadelphia.
"It's really difficult to get a handle on the exact number of suicides," he said. "But, we're losing good people. We really need to do what we can do prevent these deaths."
It's not only active firefighters who are taking their lives. Dill says retirees also are vulnerable and need attention.
"It's culture shock for retirees. That's why it's important for them to be prepared for the lifestyle changes ahead, and to stay connected," he said adding that he counsels and provides information for firefighters who are about to or who have hung up their gear. "It's very important to pre-plan."
Dill says the focus on emotional well-being needs to start in the academy. Promoting fitness above the shoulders is just as important, but doesn't always get the proper attention.
Responders too often keep things bottled up. "Unfortunately, firefighters are entrenched not to show weakness. They will call a Mayday when they are in trouble in a building, but they often suffer in silence. They don't want to appear weak. If we ask for help on the fire ground, we should feel comfortable asking for help at the firehouse."
When Dill, a battalion chief at Palatine Rural Fire Protection District in Illinois, emphasizes that early prevention is vital. Someone who hints about taking their life shouldn't be ignored.
And, he was quick to add that the suicidal person may not have shown any outward warning signs.
Last week, Ralston, Neb. Fire Chief Kyle Ienn participated in the Chief Brunacini Leadership Conference in Arizona. On Tuesday, he was found hanging from a bridge in his hometown.
His death has his colleagues grieving and seeking answers.
Billy Hayes, vice-president of marketing and outreach at Columbia Southern University, a friend who spent time with Ienn at the conference, said it's been a rough week for those who knew him.
He remembered Ienn as someone who went out of his way to console the families and colleagues of fallen heroes. "Kyle's death is a tremendous loss to his family, his community and the entire fire service. He was a good friend."
As a state advocate for the National Fallen Firefighters Foundation's Everyone Goes Home program, Ienn not only taught but promoted the Courage to Be Safe courses.
"This shows no one really knows," he said adding that nothing seemed out of the ordinary last week.
The importance of behavioral fitness was listed as one of the 16 Firefighter Life Safety Initiatives. It states: "Firefighters and their families must have access to counseling and psychological support."
NFFF Executive Director Ron Siarnicki said his team has reached out to fire service personnel during this sad time.
He said Ienn touched many during his years as a volunteer with the Foundation.
"It's important right now that we take care of our own. There are many out there grieving."
Siarnicki said during a teleconference with fire service media on Thursday that the NFFF remains committed to helping responders and their families seek psychological help.
Last summer, the NFFF held a two-day symposium to discuss depression and suicides in the fire service. After hearing from experts in the field, and discussing the issue, a White Paper was developed and recently released.
Among the recommendations are:
*The limited state of current empirical information and understanding regarding suicide in the fire service should be clearly acknowledged in all discussions and presentations on the subject, no regardless of source, audience, or objective
*NFFF and other fire service constituency organizations should advocate for funding and support of empirically sound epidemiologic study of fire service suicide to provide a solid basis for understanding and action.
*Researchers working on military projects should be specifically recruited, encouraged, and supported to translate salient elements of that research to investigate suicide in the civilian fire service.
*NFFF and other fire service constituency organizations should advocate funding and support for similar empirically sound epidemiologic study in fire service populations of conditions known to interact with and/or exacerbate suicide risk (e.g., depression, PTSD, conduct disorders, and substance abuse), where speculation regarding prevalence is widespread but data are presently limited.
*Advocates for action should be admonished to couch presentations regarding perceived incidence, presumed causal factors, potential interventions, and such cautiously and conservatively, sticking closely to established.
