Manny Almaguer
Posted June 5, 2025
The month of May is noted for raising awareness of the significance of mental health, the impact it has on American lives, and to celebrate those in recovery from mental illness.
Mental Health Awareness Month was established in 1949 under the Presidency of Harry S. Truman. President Truman signed the National Mental Health Act in 1946. This signing marked the establishment of the National Institute of Mental Health (NIMH). It is here where policy changes begin to shift in advocacy for the wellness of the American people. Although the term mental illness was stigmatized and taboo in the community and households, United States policies and programs began to be centered on mental illness, substance use, and crisis intervention.
During the Truman administration, the challenges faced included the transition to peace following World War II, the Cold War rivalry with the Soviet Union, and addressing the post-war economy and civil rights litigation. It’s the late 1940s, and had politics impacted the mental wellness and well-being of Americans? Perhaps these global issues served as a catalyst for mental health awareness in 1946. Nearly 80 years later, the state of American politics and the divisiveness it has created nationally, locally, and even at the doorstep of many households have created fear, strain, and anxiety for many. Mental Health awareness has transitioned from being a popular catch phrase in both federal and state government, where funding is predicated on programs aimed to assist those experiencing mental health symptoms or a mental health crisis, to now, where the evidence and data support that many Americans, like in 2023, where 57 million Americans experienced mental illness. Many people don’t realize they have a mental illness until they are in a crisis. Logic suggests offering both proactive programs and resources to help individuals manage their disease, build resilience, develop positive coping mechanisms, and establish a support network. The shift in the stigma surrounding mental health and illness has occurred, although slowly, the discussions have been taking place in the household and the workplace, and reality is politics has bled over into the second home, many people’s secondary place of refuge, the workplace.
Workplaces and governing bodies couldn’t ignore the fact that more first responders were dying by their own hands than in duty deaths.
There have been successful progressive and upstream mental health programs to assist those experiencing trauma in the workplace. Upstream approaches to mental health refer to programs and training that provide employees with support and resources before a crisis occurs. Employers, where leadership has prioritized the mental well-being of their most valuable asset, have implemented wellness programs that saturate the workplace. The message to employees that their emotional well-being matters is embedded in the workplace culture. Leadership, from a top-down approach, is genuinely committed to one loss of life by suicide is way too many.
When I entered the fire service in 2000, Y2K had city agencies preparing for a significant disruption to the nation’s and cities’ technological infrastructure. The day came and went, and the American citizen hit the emotional reset button. Then came the day that changed our country forever, the attacks of September 11, 2001. The government came face to face with fear and with anxiety-riddled emotions; the country united, and we belonged to each other. The resilience of the human spirit prevailed. The impact on first responders continues to this day. It caused the women and men of public safety to look inward at their mortality, and many had no training, formal or informal, to cope with the emotional turbulence that ensued.
It wasn’t until ten years after September 11th that data was tracked on first responder suicide. Workplaces and governing bodies couldn’t ignore the fact that more first responders were dying by their own hands than in duty deaths. This trend continues today. Blue H.E.L.P., a charity that supports the families of law enforcement officers who died by suicide, reports nationally that 1,405 first responders were reported to have committed suicide since 2018, 75% of whom were male police officers over the age of 40. Firefighter suicides range from 100 to 200 annually, steadily since the mid-2000s. Factors that contribute to first responder suicides are exposure to traumatic events, stress, fatigue or burnout, and lack of support. These risk factors are typically assumed to be present in the workplace. Still, we are now open to recognizing and acknowledging that risk factors also encompass home life, financial factors, health issues, injuries, and societal concerns.
Since 2020, when the pandemic impacted workplace policies and vaccination mandates, it marked the beginning of public safety becoming a welcome mat for state and federal mandates in the workplace. Public safety, up to this point, was siloed from other city agencies. This shift in policy inclusion jostled many civil servants, and some did the unthinkable: they left public safety work. Has their trauma of leaving their livelihood been resolved? Anxiety, fear, and a feeling of abandonment by leadership left many with their breath knocked out of them. Then came an uppercut, the social justice movement following the death of George Floyd. The women and men of public safety were now in the middle of riots and protests. They weren’t being paid to wrestle with their value system. How it was being throttled by societal issues, such as responding to calls where their life safety actions alone could not mitigate the incident, emergency calls involving those experiencing homelessness, and the fear of deportation, became a revolving door. You hauled your emotional state like a caboose, and your well-being was tethered to an anchor. If you publicly embraced those on the margins of society, it came with a cost to your livelihood, so it was often done in secret or silence. Emergency calls have reached record numbers, and the calls for service have become increasingly complex. Once again, like in 2001, the first responders became ME-centric and began to advocate for their well-being. Their roles as mothers, fathers, sons, daughters, and community members defined them once the badge was taken off at shift change.
The lived experiences of first responders began to be told in stories. The burden of unresolved trauma weighed heavily on their shoulders. Courageous, these women and men of public safety called on city leaders to hear their voices. They welcomed leadership to view what was behind the black curtain, where tales of brokenness and healing occurred. The days of being labeled negatively for seeking therapy are fading away, and open discussions on emotional wellness, self-regulation, and alternative coping methods and mechanisms have become normalized in the workplace. First responders continue to seek a voice in leadership.
The city’s response is to cut mental health services due to budgetary constraints. Mental health services, which were unlimited for first responders, are now cut to twelve hours per year. We have come a long way in recognizing the importance of mental health and raising awareness since 1946, or have we?
Assistant Chief Manny Almageur is a Denver Firefighter and dedicated advocate of mental health services.
