Firefighter Behavioral Health Alliance
Your Subtitle text

FF Suicide Report

Confidential Firefighter Suicide Report

 

In order for FBHA to be able to serve the needs of the fire service family, the more information we can gather on the firefighter suicide mechanism for pro-active training, the better.  By gathering as much information as we can, we can provide a profile that helps identify at-risk firefighters before this tragedy strikes. This information has proven to be an invaluable tool for the police service.

 

We request that anyone having information on a firefighter suicide please contact FBHA using the form below.  Because we are mindful that some agencies prohibit the release of information by their Departments, and that some family members may not be aware that there is a way to make notifications, we have developed a "blind form" that assists in providing anonymity for the submitting party. This form has been graciously given to FBHA to use from Robert E. Douglas, Jr. of the National P.O.L.I.C.E. Suicide Foundation.  Once you submit this confidential form, it is transmitted to Firefighter Behavioral Health Alliance's email, with the sender information removed. Since we have no means to contact the submitter back because that information is blocked, we appreciate as much information as you can provide.  FBHA then uses this information to keep its training pro-active and post-event, current.

 

At a minimum, we require the agency's name, state, firefighter's sex, rank, years of service, date of death, how death occurred, and any stressors identified or suspected as being a catalyst.  We would appreciate any additional information or details that can be provided.


It is FBHA's policy not to release firefighter or department specific information. We respect the privacy of the families and agencies involved. It is not our intention to cause any undue pain to families or agencies. Additionally, we do not release this specific case information to the media.

 
 

Sincerely,

 

Jeff Dill

Founder 
Firefighter Behavioral Health Alliance

Firefighter Suicide Form

*denotes required field. Please answer to the best of your knowledge. Thank you.

Fire Department Name: 
Gender: *
Age: *
Rank: *
Years of Service: *
Date of Death: *
How suicide Occurred: *  
State: *
Country:
International: City, Province, etc.:
Phone, only if desired to be contacted:
Additional Details: (Catalyst: Stressors, Work, Relationships, Behavioral Health Issues): *
Comments: