SACRAMENTO (CBS13) — Twice as many firefighters in the U.S. die by suicide than in the line of duty. Now fire departments are sounding the alarm.

Karen and Lew Lewis still treasure the mementos from their son Billy’s dream job, working as a firefighter-paramedic for the Sacramento Fire Department, at the busiest firehouse in the city. 

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“Twenty bad calls a shift, you know, that involved everything from suicides to gunshot victims to knifings and fights,” Lew Lewis said. “These guys see some things that you can’t un-see.  

The Lewis family said they believe the things Billy saw and experienced changed him. “We knew he was deteriorating and we were helpless,” Karen Lewis said. 

Karen says a brutal domestic violence call was a breaking point. 

“This woman was laying on the ground covered in blood in front of her children. And when they got back to the station he apparently was throwing things and he just lost it,” she said. 

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After more than 20 years as a firefighter, Billy resigned and got help for post-traumatic stress, but his mental struggles continued. Then came Valentine’s Day, 2016, when Lew found his son.

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“He hanged himself,” Lew said. 

Fire departments across the country are grappling with similar stories at an alarming rate. So far this year, reported firefighter suicides are more than double the number who died in the line of duty. 

Jeff Dill founded the Firefighter Behavior Health Alliance, one of the only organizations that track first responder suicides.  

“We are just losing way too many good men and women,” Dill said. “When we put on this uniform we’re expected to act in a certain manner and that is brave, strong, courageous. Give help — don’t ask for help,  because we don’t want to be the weak link.”

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In Sacramento, support has become a priority. Firefighters are now trained as peer counselors so they can spot trouble early. 

“The days of ignoring a problem and just going, ‘Oh, well, they’ll deal with it,’ are gone.” Sacramento Fire Captain Keith Wade said. “If you’re working next to me, I’m with you 48 hours at a time. I’m going to know if you’re not being yourself. It’s my duty to say something at a certain point.”

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It’s estimated that only half of all firefighters’ suicides are actually reported, so the numbers could actually be much higher.