The demanding nature of their jobs exposes firefighters, first responders, and law enforcement to deeply traumatic events. This exposure can lead to severe mental health challenges and their daily lives. In fact, a 2023 study from the National Highway Traffic Safety Administration reported that first responders and law enforcement personnel are more likely to die by suicide than in the line of duty.
Dr. Daniel Amen, a psychiatrist and author, uses a unique approach to help these individuals at his mental healthcare clinics, using a technology is called a SPECT scan. A SPECT scan produces three-dimensional images of a patient’s brain, assessing blood flow and activity. These scans then inform the development of a personalized treatment plan.
Matt Fiorenza, a retired firefighter-paramedic, spent 22 years with the Anaheim Fire Department. During his career, he witnessed life’s most tragic events while constantly working on the frontlines. “I remember doing a stress debriefing after a woman’s boyfriend had run over their 2-year-old child,” Fiorenza said, recalling one particularly difficult memory. “I remember looking down at this child and seeing the diapers.”
That incident, sadly, was only one of numerous traumatic events that Fiorenza said pushed him into a downward spiral during his career. As the tragedies mounted, he struggled to cope, and turned to alcohol and drug abuse. “I got diagnosed in 2015 with what we know now is PTSD (Post-Traumatic Stress Disorder),” Fiorenza said. “And back then, in the first responder community, they really didn’t know what to do with me.”
After a long, difficult period and hitting rock bottom, Fiorenza attempted suicide three times. “I racked [a gun] and put it in my mouth and my wife heard it and came in and wrestled the gun away,” Fiorenza recalled. He sought professional treatment, but the process was never enough. He isolated himself in his apartment for four months before realizing he needed additional help. It was during this time that he met Dr. Daniel Amen and received a SPECT scan of his brain. He operates mental health clinics across Southern California and the U.S.
Amen explained that the SPECT scan is a powerful tool that takes 3-D images of the brain to examine blood flow and activity. “When we look at his active brain, his emotional brain, that’s the red and white [colors], it’s working way too hard, which is why it just feels awful inside,” Amen explained of the SPECT images of Fiorenze’s brain. Amen believes the images are effective because they display underlying brain problems in visual form. In Fiorenza’s case, the scans helped identify signs of PTSD and traumatic brain injury. “Looking at a picture of my brain, it just took the stigma out of it,” Fiorenza said. “It’s like, okay, I’m not crazy.”
Following a SPECT scan, patients receive a custom treatment plan. Fiorenza’s plan included EMDR (Eye movement desensitization and reprocessing) therapy, supplements, and hyperbaric oxygen therapy. He credits these tools with dramatically changing his life.
After two years of treatment, Amen performed a new SPECT scan of Fiorenza’s brain to monitor his progress. “His cerebellum is healthier and his emotional brain calmed down,” Amen said about the new images.
“I think that for firefighters, seeing is believing,” said Dr. Gina Gallivan, a police and public safety psychologist. Though she does not incorporate SPECT scans into her treatment protocols, Gallivan maintains that those visual results can motivate firefighters to seek help. “The first responders I have spoken to who have had brain scans, they see the visible damage to their brain and it was very impactful for them,” she said.
“What you see among untreated firefighters is a higher incidence of divorce, a higher incidence of bankruptcy, a higher incidence of depression and a significantly higher incidence of suicidal behavior,” Amen said.
Amen, who has used SPECT scans for 34 years, acknowledges some skepticism about the practice. “It’s incredibly frustrating that psychiatrists remain the only medical doctors who virtually never look at the organ they treat,” he said.
Currently, insurance does not cover SPECT scans, but the “Change Your Brain Foundation” at Amen Clinics raises money for education, research, and services. The foundation covered the full cost of Fiorenza’s scan and treatment. Recently, they received enough donations to fund 100 SPECT scans for first responders and firefighters impacted by the recent wildfires in Southern California.
Fiorenza hopes that by sharing his story, he can help remove the stigma associated with seeking mental healthcare and therefore help his peers who are struggling with similar issues.
