It is widely understood that firefighting is a physically rigorous job that requires members to dedicate time and effort toward maintaining optimal physical fitness. But it is becoming increasingly recognized that firefighting can take a toll on “mental fitness” – and that great effort should also be placed in helping those in the fire service to maintain optimal mental health as well.
The Mental Health Risks of Firefighting
The nature of the job means firefighters have significantly higher rates of things like anxiety, depression, and post-traumatic stress disorder (PTSD)1. A Ruderman Family Foundation white paper reveals that first responders are more likely to die by suicide than from a line-of-duty death. Here are some of the recent statistics on mental health risks in firefighting:
- PTSD. In its 2016 report, the International Association of Fire Fighters (IAFF) “estimated that 20% of firefighters and paramedics exhibited symptoms of PTSD as compared to 3.5% for the general population.” (source)
- Depression and anxiety. “1 in 5 firefighters will struggle with behavioral health issues, including depression, at some point in their careers.” (source)
- Substance abuse disorders. “Eighty-five percent of career firefighters reported past-month drinking.” (source)
- Sleep disorders and burnout. “Nearly half of U.S. firefighters are likely experiencing burnout and associated health problems.” (source)
In turn, fire stations may experience higher numbers of absences, decreased morale, increased errors, higher turnover, and other negative effects when mental health issues aren’t addressed.
These findings are becoming increasingly recognized and acknowledged in the fire service as important issues that should no longer be viewed as taboo; they need to be destigmatized and addressed with the prevention, education, and support.
According to an article from the American Psychological Association, behavioral health units used to only be found in departments in big cities like New York and Boston, but now “are becoming more common in small and midsized fire departments. As these units become more common, fire departments are embracing new treatment models to break the stigma.”2 But even with improvements in this area, there’s still room for growth: the most recent Needs Assessment of the U.S. Fire Service by the NFPA found that only 20% of U.S. fire departments report having a behavioral health program. There are many resources that have been created or updated in an effort to improve firefighter health (such as NFPA 1582, NFPA 1583, the IAFC’s Healthcare Provider’s Guide to Firefighter Physicals, and the Fire Service Organizational Culture of Safety (FOCUS)) but many of these resources target physical health and wellbeing rather than mental health initiatives.
Implementing Firefighter Mental Health Initiatives at Your Department
Instituting physical health initiatives is relatively straightforward; common activities include scheduling weekly workouts, offering compliant physicals, sharing healthy eating and nutrition information, etc.
Unfortunately, behavioral or mental health initiatives may be more difficult to implement, because they tend to be less straightforward, and because of the stigma that still remains (in fact, according to an article from the IAFF Center of Excellence for Behavioral Health Treatment and Recovery, “92% of firefighters view seeking treatment as a sign of weakness”3).
If you’d like to implement or improve mental health initiatives in your department, here are some practices to consider:
- Employ a holistic wellness program that encompasses medical wellness, physical fitness, and behavioral health, and that are “educational and rehabilitative” rather than punitive, such as the Fire Service Joint Labor Management Wellness-Fitness Initiative from IAFF and IAFC.
- Educate all team members on the warning signs of mental health issues – either informally or through educational seminars.
- Offer training on stress reduction, coping techniques, and mental health management practices. Require participation in educational health & wellness courses, such as the IAFF’s online Behavioral Health Awareness course.
- Promote good communication (“Departments that promote good communication and positive emotional interactions can enhance daily operations, teamwork and personnel satisfaction”4)
- Offer an Employee Assistance Program (EAP) (or reinvigorate your current EAP)
- Offer enrollment in a program like the IAFF Center of Excellence for Behavioral Health Treatment and Recovery or Firestrong.
- Implement a “behavioral health champion” to lead your efforts. According to the IAFC, “The most successful behavioral health programs are cooperative efforts between labor and management and often have a ‘champion.’ This behavioral health champion collaborates with others to implement the program, assess effectiveness, provide leadership and ensure sustainability.”
- Utilize the services of a behavioral health specialist or a non-denominational chaplain to support firefighters and fire department staff.
Whether your agency already has mental health initiatives in place or you’re just starting to address them, implementing strong mental health education and support program is critical for any fire department, regardless of size. However, it won’t have the desired impact if your station treats mental health issues as taboo. Invest in creating these initiatives, but also ensure that you set the tone of a culture that’s open to discussing mental health issues and that supports those who seek the necessary treatment. In the long run, the benefits of having effective mental health initiatives will be far-reaching for those in the fire service.
Note: We are not mental health professionals and are only offering these tips based on our own research.
1 Occupational Health & Safety, https://ohsonline.com/articles/2020/01/21/mental-health-and-first-responders-how-their-jobs-can-cause-more-than-just-stress.aspx
2 American Psychological Association, https://www.apa.org/members/content/firefighters-mental-health
3 IAFFrecoverycenter.com, https://www.iaffrecoverycenter.com/blog/silent-suffering-firefighting-depression/
4 IAFC, “The Fire Service Joint Labor Management Wellness-Fitness Initiative”, pg. 48, https://www.iafc.org/docs/default-source/1safehealthshs/wfi-manual.pdf?sfvrsn=7931df0d_5