OCD and the New York City firefighter

As a New York City firefighter, Timmy Reen brought his own sheets and pillowcase for overnights at the firehouse and wiped down everything with bleach wipes – including the inside of the fire engine. He carried his own remote control for the fire station TV to avoid touching the shared one. None of this hurt his work. Since he resigned three years ago, though, his obsessive-compulsive disorder has gotten much worse, as he told the New York Times. 

He’s one of an estimated 2% of American adults who’ve had clinical OCD. For some people, the disorder involves the need to check and recheck certain objects –  and the dread that something terrible will happen if they don’t. Others suffer from intrusive thoughts, typically taboo or violent.  Reen remembers having symptoms going back to the age of 6, when he compulsively counted wheels on highways. He’s tried therapy, multiple medications and long bouts of exposure therapy. Over half of OCD patients show meaningful improvement from a combination of medication and exposure therapy, but for those like Reen who don’t get better, symptoms can worsen with age. 

One of Reen’s first jobs after high school was putting up advertisements on subway platforms and trains. Until then, his obsessions and compulsions had mainly involved counting and repetitive behavior, but now he was surrounded by dirt, metal dust, pipes and standing water. “It was contaminated,” he said. “It was evil, it was demonic.” He quit – and rarely rode the subway after that.

But it rode him. Pocketing change one day, the thought hit him: Those dollar bills, those coins, they have all been on the subway at some point. He began washing his money, and eventually stopped accepting $1 bills as change. Realizing, on the beach, that some swimmers had probably taken the A train, the contamination, in his mind, spread to the Atlantic Ocean.

Reen worked as a firefighter for 20 years, and his colleagues had full faith in him. But when Covid hit, he became obsessed that the required vaccine could put him in a permanent state of contamination. He sought an exemption but it was denied, and he resigned on Sept. 15, 2022, at 53. The vaccine mandate was lifted five months later.

Now, Reen lives on a firefighter’s pension, and goes days without seeing another person. If he goes out, he plans his route in advance, considering wind direction and sewer grates. Now that it’s getting warmer, he’ll play golf with his three grown sons, two of them firefighters, usually at a public course in Brooklyn. He arrives two hours early to wipe down everything he intends to touch and to prepare himself mentally. There are rules: No one can touch his clubs, and no one can pull his ball from the cup. 

‘What this does is reduce the profile and priority of mental health and addictions in America’

Paolo del Vecchio spent 30 years working at the Substance Abuse and Mental Health Services Administration, retiring last month as founding director of the Office of Recovery. But his expertise is more than professional. He has what these days is called “lived experience” – at 23, he’d made plans to end his life by jumping from a Philadelphia subway platform. He credits SAMHSA with his recovery. 

In March, Health and Human Services Secretary Robert F. Kennedy Jr. announced he would eliminate the agency and move its functions elsewhere in a massive restructuring of his agency. Separately, a leaked Trump administration draft budget laid out plans to terminate more than 40 mental health and substance programs.

The elimination of the federal agency explicitly set up to address behavioral health will “reduce the profile and priority of mental health and addictions in America,” writes del Vecchio, in an opinion piece in Stat. Behavioral health issues will “be subsumed and made diminutive” by placing them within a larger structure, he writes, and that will “limit access to necessary resources, increase bureaucratic burden, and obfuscate public accountability.” 

Del Vecchio notes that the agency’s portfolio – mental health and substance issues – touches pretty much every family in the country, including those of Donald Trump (alcohol contributed to his brother’s death) and RFK (in recovery from drug addiction). “They witnessed first-hand how these conditions can be deadly,” del Vecchio writes. “That is why actions to reduce federal leadership on these issues make little sense.” 

Ministers have mental health crises, too

Nearly one out of five senior pastors at Protestant churches say they’ve contemplated self-harm or suicide in the past year, Christianity Today reports. About half report feeling lonely or isolated, almost 60% say they’ve experienced feelings of depression, and almost two-thirds say they’re not talking to a professional about their mental health.

The data is from surveys released in 2023 and 2024 by Barna Group, a consultancy that tracks American faith, culture and related issues. Pastors’ mental health has been getting worse. The pandemic might be part of the problem, and ministers have mentioned political polarization as another. Growing awareness of abuse and increased suspicion of church leaders may also factor in.

Pastoring is difficult, and involves taking on anxieties and emergencies whenever they arise.  Pastors “just give and give and give until there’s nothing left to give,” said Ron Cook, who co-founded Care for Pastors with his wife, Rodetta. It provides counseling, coaching and support for ministers across the U.S., encouraging them to seek counseling for preventive care rather than wait until their mental health suffers. 

Some pastors imagine they should be able to carry on and act as though talking about their mental health concerns is an admission of weakness, says Mary Hulst, chaplain at Calvin University. She’s trying to show them a different path. “It’s an admission of strength to say, ‘I know myself well enough to know I’m not as well as I can be, and I want to get healthy,’” Hulst said. “That’s a beautiful thing to acknowledge.