Almost 95 percent of firefighters who responded to an anonymous survey of firefighter mental and behavioral health said they have experienced critical stress on the job. And, more than 76 percent said those experiences have caused lingering or unresolved emotional issues.
The firefighters reported experiences including recurring/unwanted memories, anger or withdrawal, substance abuse, sleep problems, and family issues. Additionally, almost 20 percent said they had experienced thoughts of suicide.
More than 75 percent said they believe these behavioral health issues are a result of post-traumatic stress.
The survey was a collaboration between the International Association of Fire Fighters (IAFF) and WNBC in New York. Almost 7,000 firefighters from throughout the United States and Canada responded.
Jay Colbert, 3rd District Vice-President, IAFF, said the responses were an eye-opener, and demonstrate the cumulative effect of what firefighters see and experience on the job.
Colbert said he thinks discussions on behavioral health like those that come from the survey results can help create a culture shift among firefighters. “This has really brought it out of the shadows,” Colbert said.
More than 86 percent of respondents said they believe there is a stigma that creates a barrier to seeking help for behavioral health or emotional issues.
They cited various concerns related to that stigma, such as putting their job at risk; being seen as weak or unfit for duty; or that a colleague will not trust their judgment under pressure.
Firefighters take the role of public service seriously, and put their own needs secondary, Colbert said.
“Our main priority is protecting the public,” Colbert said. “We took an oath to protect those people in harm’s way.”
Seeing people lose loved ones or lose their homes may make a firefighter feel that his/her health issues are secondary concerns, but, “The protectors need protectors, too,” Colbert said.
Is Training Helpful?
Many departments now include such education as part of a firefighter’s training. In the survey, more than 89 percent said they were aware of behavioral health services offered by their employer, but only about 28 percent reported having used their employer’s Employee Assistance Program (EAP) for emotional or mental health issues related to their job. Only about 36 percent of those said they found it helpful.
Almost 75 percent said they had participated in a Critical Incident Stress Management (CISM) defusing (about 55 percent found it helpful).
Peer supports proved more beneficial in the respondents’ eyes. Just over 42 percent sought help from a peer support service or a fellow firefighter, and almost 77 percent of those who did found it helpful.
Colbert said peer support classes that he runs have been extremely successful. “We can’t run enough peer support classes,” Colbert said.
Patrick Morrison, IAFF assistant to the general president, Division of Occupational Health, Safety, and Medicine, said that IAFF has increased efforts to address the behavioral health of firefighters in the past several years, including a behavioral health peer instructor program that aims to train peers within all of the fire departments where IAFF has members.
The IAFF opened its own treatment facility in March of 2017 in Maryland. The IAFF Center of Excellence for Behavioral Health Treatment and Recovery is a 64-bed inpatient residential facility for IAFF members to treat addiction and other co-occurring disorders such as PTSD.
About 350 firefighters have been treated at the facility, Morrison said. Center clinicians have gone through specialized training to understand the firefighter population.
Morrison cited a number of major events in recent months that affect firefighters, including mass shootings, hurricanes, and wildfires.
“With all of these events, what we have found is that what we are missing are clinicians that really understand the culture in some aspects,” Morrison said. “I talk to many firefighters who said they went to seek help but the individual they were taking to was more interested in what the event was than what they needed for the help. They didn’t understand the firefighter culture.”
The IAFF is looking at ways to reach out to associations for behavioral health clinicians, and promoting increased training for clinicians, such as through online programs or ride-alongs.
“It is very difficult to get clinical people that really understand the PTSD/first-responder issues that we have,” Morrison said. “I think it is a responsibility for employee assistant programs to develop that, build that cadre of clinicians, and then have those outside resources.”