KNOXVILLE, Tenn. — Conversations about mental health are at the forefront of many industries.
The state of Tennessee ranks 11th in the nation in fire mortality according to Tennessee Department of Commerce and Insurance.
The risk for firefighters isn't just running into fires but also the lasting impact the job has on their mental health.
A study from Florida State University polled firefighters and revealed 47 percent considered suicide, 19 percent made plans for an attempt and 16 percent went through with the attempt.
Firefighters respond to every alarm and every call for help not knowing what to expect or how the call could impact their lives.
Knoxville Fire Department's health and safety officer Tim Woods said he knows the struggle firsthand.
"It's not just one traumatic event, which it can be, but it could be many small events that you don't even realize is going on until, you know, years later," Woods said.
Ben Harrington, CEO of the Mental Health Association of East Tennessee, said mental scars from tough calls can be as real as physical ones
"You know, it's a repetitive type of injury if you will. It's much like you keep doing things that hurt your back, well, you eventually learn to do something differently," Harrington said.
KFD Chaplain Paul Trumpore knows exactly how bad days at work can take their toll on his crew members
"Some days, it's not the amazing, some days it's the two fatalities today. Some days it's the somebody's had a stillborn death, okay. Some days, it's the car crash. And you heard a little kid in the backseat, saying 'mama el muerte, mama el muerte,' that means Mom has died, and that's a heavy hit. You know, I don't want my kids saying that," Trumpore said.
Trumpore said firefighters are there on some people's worst days.
"Some of the things that our responders, all kinds of responders that go on is stuff that's supposed to bother you If you're not bothered, I'm more concerned," Trumpore said.
Many firefighters have avoided asking for help because of the negative stigma around mental health, but Woods said more and more firefighters are opening up.
"If you may have some kind of issue going on... it comes across as weak, but we're trying to get rid of that stigma and I feel like we've made strides in the past, and hopefully in the future, we'll continue to make strides," Woods said.
Woods said younger firefighters have helped change the conversation. The department has also added 'critical incident stress management'. It means as a team, a crew decompresses, vents and acknowledges the traumatic events they experienced.
"It's okay to not be okay. And secondly, you're not going to be the first one at your fire department or your volunteer fire department or whatever, that's needed to reach out to get out help. And it is the strongest thing anyone can ever do," Harrington said.
Tennessee recently passed the James Samples Act, which gives greater access to treatment for post-traumatic stress disorder.
If you or a loved one are suffering from mental health struggles, you can find resources available here.