Suicidality in Firefighters: Exploring Occupational, Psychological, and Cultural Determinants

Background: Suicidality is more prevalent among firefighters in comparison to the general population. Research suggests that trauma exposure while on duty may be associated with the increased prevalence of suicidality in firefighters. Duty-related trauma exposure has been previously associated with depression in firefighters and the well-established link between depression and suicidality suggests that depression may explain the relationship between duty-related trauma exposure and suicidality for this population. Additionally, expectations of masculine norm adherence are inherent to fire culture and may negatively impact the relationship between depression and suicidality. However, these relationships haven’t been comprehensively explored. Purpose: The present study aimed to examine the mediating role of depression in the relationship between duty-related trauma exposure and suicidality in a large firefighter sample. Furthermore, this study aimed to examine the moderating role of gender role conflict in the relationship between depression and suicidality in the context of the proposed mediation model. It was hypothesized that 1) duty-related trauma exposure, depression, gender role conflict and suicidality would all share positive associations; 2) duty-related trauma exposure would have an indirect effect (i.e. mediation) on suicidality through depression and; 3) the relationship between depression and suicidality within the proposed mediation model would be conditioned upon levels of GRC (i.e. moderated mediation), with the effect being stronger for men high in GRC in comparison to men low in GRC. Methods: The current study was conducted through the analysis of data collected by an urban fire department in 2015. Participants were 984 male firefighters (Mage = 39.63; SD = 16.26), employed full-time performing EMS or suppression duties, who also completed the target measures assessing duty-related trauma exposure, depression, gender role conflict, suicidality and the theoretically relevant covariates. Results: Correlational analyses were conducted to examine the bivariate correlations between all variables included in the study The proposed hypothesis was supported such that significant positive relationships were found between all relevant constructs including DRTE and suicidality (r = .12, p < .001), DRTE and depression (r = .21, p < .001), depression and suicidality (r = .42, p < .001), GRC and depression (r = .27, p < .001), GRC and DRTE (r = .16, p < .001), and GRC and suicidality (r = .15, p < .001). Next, a series of regression analyses were conducted to determine if there was a significant indirect effect of DRTE on suicidality through depression and a significant conditional indirect effect of GRC at path b1 Hypothesis two was supported such that depression fully mediated the relationship between DRTE and suicidality (ab = .13, SE = .04, 95% CI [.0674, .2057]) with depression accounting for 76% of the total effect. Additionally, hypothesis three was supported such that the relationship between depression and suicidality in the context of the full mediation model was significantly stronger for participants high in GRC (b = .24, SE = .06, 95%CI [.1271, .3582]) as opposed to those low in GRC (b = .05, SE = .05, 95%CI [-.0549, .1494]). Conclusion: Limitations, future directions and clinical implications are discussed.