Behavioral health issues often go undetected; subtle clues can be easily missed or overlooked. Suicide is the fourth-leading cause of death among white males ages 35–45; it is the second-leading cause of death among white males ages 20–34. These are also the two demographic groups in which most U.S. firefighters fall. That fact, coupled with the inherent stresses of public safety in general, and fire and rescue service in particular, can create a “perfect storm” for behavioral health issues in the fire service.
During this year’s International Fire/EMS Safety and Health Week (June 16–22), the IAFC and the National Volunteer Fire Council (NVFC) will challenge fire departments around the world to address the issue of behavioral health. This year’s theme, Saving Our Own: An Inside Job, reflects the critical need for the fire service to examine its opinions, culture and policies surrounding behavioral health, as well as related physical safety and wellbeing.
Behavioral health is acknowledged within the framework of the National Fallen Firefighters (NFFF) Life Safety Initiatives. Specifically, Life Safety Initiative #13 states that “Firefighters and their families must have access to counseling and psychological support.” The NFFF has used this initiative to provide resources to assist agencies in addressing firefighter mental and emotional health.
Why is it so important for the fire service to focus on behavioral health? In truth, some of the factors that lead to behavioral health issues in the fire service aren’t specific to firefighters. External pressures may contribute to behavioral health issues in anyone, especially if potential coping mechanisms may be altered or not available. In particular, life crises such as a divorce, loss of a significant other and financial issues can all exert tremendous emotional pressures and challenge an individual’s coping abilities. Today, many of us are experiencing the effects of one of those life crises: the Great Recession. Loss of employment within the family or loss of a home from foreclosure or default is occurring at unprecedented rates.
But firefighters are also at risk for additional, specific contributing factors that can lead to behavioral health issues. Exposure to traumatic events and responses to “bad” calls are not uncommon within the fire service. The nature of the fire and rescue service is to respond to chaos and re-establish order or mitigate the emergency. Exposure to such tragedies, particularly over a long period of time, can extract an emotional toll on responders, which can compound if resources are either unavailable or not utilized to assist in coping with the impact of such events.
Support from Professionals & Peers
Prevention and early intervention related to traumatic stress and other life-altering occurrences that may impact the behavioral health of our first responders are critical health and wellness mandates for the fire service.
Although many fire service organizations have well-developed and established employee assistance programs (EAPs) that are designed to provide evaluations and interventions for such mental health challenges, peer support systems prove to be just as critical. Peer support systems often are the first link to prevention, early detection and intervention when co-workers within the service are experiencing challenges that require professional assistance.
An excellent opportunity is to identify mental wellness professionals available within your community to assist in training your department and personnel not only on how to develop robust coping mechanisms, but also on how to identify and support colleagues who may need intervention during a crisis. Subtle changes in an individual’s behavior such as moodiness, isolation, quiet introspection, loss of interest in activities or bouts of anger can be early warning signs, as can be unexplained tardiness, absenteeism and poor work performance.
Culturally, the fire service has been built on acts of bravery and heroism, which may create stigmas or barriers that prevent individuals from asking for assistance or communicating openly. Another resource that may be of particular importance, because it removes the issue from the chain of command: a fire department chaplain or religious leader who can assist in prevention and identification of individual firefighters struggling with behavioral health issues and provide resources/guidance.
You Can Make a Difference
It’s critically important to provide specific training to all fire department members in early warning signs of behavioral health issues and how best to provide support, assistance and resources. Chiefs and company officers throughout the department must create and maintain a culture of accepting and promoting open lines of communication in a non-threatening manner to facilitate employees’ access to behavioral health services.
To learn more about International Fire/EMS Safety and Health Week and find resources for behavioral health initiatives, visit www.safetyandhealthweek.org.
Sidebar: Helping Firefighters Deal with Psychological Stress from Job's Routine and Extraordinary Events
At an international conference on March 1, the NFFF introduced a new Behavioral Health Model that changes the way the fire service assists firefighters and others on the path to healing. It is based on the concept that no two firefighters will necessarily have the same reaction - not even to the same call.
"Years of accumulating research involving leading experts in the field of recovery from traumatic events, as well as our own work after September 11, helped us develop this new model," said Chief Ronald Siarnicki, executive director of the NFFF. "We realized not all firefighters want or need to sit in a room immediately following a distressing situation and talk about their experience. Instead, they want to know what resources are available to them and their families and how they can access those resources when necessary."
The Behavioral Health Model reframes existing debriefing practices by recognizing how different people react to and cope with traumatic situations. The model emphasizes that people have varying stress thresholds that need to be considered when offering assistance following a traumatic event.
"This new model reminds us that a person's experiences, values and beliefs can impact how they react to any call," explained Siarnicki. "We believe this new model will give the fire service a better path to implementing a more comprehensive approach to helping our nation's firefighters and their families find assistance when and if they need it."
For more information about the new Behavioral Health Model go to www.lifesafetyinitiatives.com.