Firefighter Mental Health

Advocacy and Action After Disaster

by Mike Kull

If you've been in the Fire Service for long enough, your Fire Brigade has experienced an incident that overwhelmed your capabilities. It's happened to all of us. Despite our best efforts, we couldn’t perform at the level we wanted, or the level we were expected to perform at. It may have been a technical rescue that you didn't have the proper equipment to make the rescue, or it may have been a large fire that you couldn’t stop because you didn’t have enough fire engines, enough manpower, or enough water. The result after the incident may be the loss of life or a large value of property damage. So, what do we do now?

Fire Brigades everywhere are facing challenges with funding, equipment and manpower. Some places are much better off than others but there are very few places in the world where firefighters will tell you they have everything they need. A Fire Brigade must be prepared for every possible disaster or emergency that you could ever imagine. Accidents, vehicle crashes, fires, electrical emergencies, agricultural emergencies, industrial accidents, weather related emergencies, victims trapped or lost, water rescue -- the list goes on and on. It is almost impossible to have specialized equipment and training for absolutely every type of incident you may be called to. Again, we must ask ourselves, what do we do now?

One of the first things that we need to do is to take care of ourselves. The job of a firefighter is stressful and can be very detrimental to our mental health. We need to look after each other, we need to talk to someone if we are feeling depressed and we need to support each other in both our professional and personal lives. Make sure everyone is alright and staying healthy, both physically and mentally. Once we are sure everyone is alright, we need to make ourselves better.

Learning is a lifelong process. There will always be new skills and new knowledge to learn. Technology is always changing, and the world is always changing so there will always be something new that will help us to be better firefighters. There is a vast number of resources available to firefighters that have access to the internet. Simple internet searches will turn up large volumes of information on every topic imaginable. Read and learn as much as you can about the types of threats you will face. After an incident where you’ve faced something new or something you’ve never seen before, you need to research it. Learn as much as you can about it so that you are better prepared to handle it in the future. This makes for some great Company Level Drills during which you can share this knowledge with everyone in your Fire Brigade.

Finally, what can fire service leaders do after an incident that overwhelms your Fire Brigade. The first step is to ensure that you utilized all the resources that you had available. Ensure that you have mutual aid agreements with other resources in your area that may have equipment or resources that you may need. This could include other Fire Brigades, police agencies, military units or civilian resources with access to heavy machinery, water bowsers or other resources. Arrangements should be made to outline how to activate or call upon these resources and other details such as how billing or payments will be managed if necessary.

Once you have ensured that all local resources available have been accounted for, advocacy must begin. Many times, these types of incidents will be reported in the media and on social media. The Fire Brigade may be blamed for the outcome of the incident even if they have done everything to the best of their ability. It is critical to accurately document every shortcoming experienced. Did you have enough manpower? How many more were needed? Did you have enough of the proper equipment? What equipment do you need to change the outcome? Did you have enough resources such as water? What would have helped with a lack of water?  Everything must be documented, and that list of needs must be provided to the local authority having jurisdiction over the Fire Brigade. To supply you with the equipment you need, the local government must know exactly what your needs are, as well as having justification for the expense. Try to find reports or news stories about other similar events that had a better outcome due to the Fire Brigade having the resources it needs. Use these as an example of how your incident could have had a better outcome with the appropriate resources. Advocate for whatever your needs may be, whether it is more manpower, more fire engines, more fire hose, breathing apparatus, rescue tools or an adequate water supply. Make your list and prioritize it, starting with the needs that will have the biggest impact. Provide information about locally available resources that can be quickly acquired.  Give them as much information as possible so that they can make informed decisions and stress the need for a plan to reach full operational readiness.

Fire Brigades may face incidents that overwhelm their resources, leading to significant loss of life or property due to insufficient funding, equipment, or personnel. To mitigate these issues, it is essential for firefighters to prioritize their mental and physical health, pursue continuous training, and document deficiencies encountered during emergencies. Fire service leaders are encouraged to optimize local resource use and advocate for improvements by clearly communicating their needs to local authorities. By highlighting documented gaps and comparing them with better-resourced responses, they can underscore the necessity for adequate support to improve operational readiness for future incidents.


Mike Kull is a retired Fire Chief from Central Pennsylvania. Mike has over 25 years of experience in the fire service and teaches firefighting in both the US and Africa. Mike now serves as Programs Director for Africa Fire Mission and as a firefighter at his local volunteer fire company.

Suicide Warning Signs

by: Jeff Dill

Recognizing Suicide Warning Signs in Firefighters and EMTs 

Behavioral health is a key component of an overall firefighter health and wellness program. Unfortunately, it is a difficult subject to discuss – many factors affect a firefighter’s ability to understand when a fellow brother or sister is suffering, but that does not make it any less critical an issue.

By far, the number one comment by fire and EMS chiefs associated with departments that have suffered a loss is that they didn’t realize or recognize the warning signs that their member was displaying until after the loss had occurred.

The Firefighter Behavioral Health Alliance (FBHA) tracks and validates FF & EMT suicides in the United States. A key component is validation: Whether we receive a confidential report, text message, or phone call of a tragic event of a suicide, confidentiality is always maintained.

FBHA has traveled across North America presenting behavioral health workshops with an emphasis on suicide awareness. Our workshops focus on warning signs and actions to take when a brother or sister is in need of help, and I’d like to share them with you here:

 Top 5 Warning Signs – Think “RAILS”

 1.     Recklessness/Impulsiveness: These might be subtle signs such as purchasing guns when a person has always been against them. Riding a motorcycle recklessly or charging into burning buildings against policy or procedure.

 2.     Anger: Suppressed anger or explosive anger from seemingly minor issues can be a dangerous sign. Displacement (directing one’s anger at someone else instead of the intended person) is often observed. Displacement is most often directed at a FF or EMT’s family.

 3.     Isolation: becoming distant from their career company around the station or volunteer firefighters who don’t participate in drills or calls as much. Members might even display isolation around their family. They lose interest in family activities.

 4.     Loss of Confidence in skills and abilities: Several FFs and EMTs have advised FBHA they lost confidence in their ability to get the job done due to concentrating on emotional or personal issues they were battling. A seasoned FF who can’t remember how put an engine in gear to pump is an example.

 5.     Sleep Deprivation: Loss of sleep can indicate stress, anxiety, PTS or several other emotional issues a member might be struggling with and not realize.

Recommendations:

 When you see someone struggling or just off their game, follow these recommendations as a starting point:

 1.     Be Proactive; Be Direct: We do this when responding to emergencies. We need to take the same approach when our brothers or sisters appear to be struggling.

 2.     Direct Questions: Remember these two questions if a member comes to you with suicidal ideations.

 a.     Do you feel like killing yourself now?

b.     Do you have a plan? 

 A “yes” to either one of these questions means you need to engage your department procedures or protocols if in the firehouse. If outside of the department then they need help immediately. NEVER leave them alone!

3.     Compassion: The theme in our workshop is: Be Direct and be compassionate. Stay in the moment when talking to them. It is the most difficult type of conversation but always speak from the heart.

 4.     Discretionary Time: If a member comes to you to talk about a difficult issue they are struggling with and you have never dealt with this type of issue, then let them know but also use discretionary time. Do not make statements just to fill a void. For example: I never realized you were struggling with this issue and I don’t have a lot of knowledge on this problem, but let me find out a little more about it and we will talk later. (If this is a crisis moment then do not leave member alone)

 5.     Walk the Walk: The number of firefighters, officers and EMTs/paramedics who help their brothers or sisters out by taking them to AA classes or counselors cannot be overstated.  They sit outside and wait until the appointment is over. Taking care of our own goes well beyond the station or fire ground.

 Posters and tip cards are available for your departments and personnel. Please contact Jeff Dill at jdill@ffbha.org for more information or visit our web page at www.ffbha.org.

Find out more about Suicide Questions and PTSD Question

Firefighter Mental Health - you can help your peers, friends, family

Peers, families and friends can support firefighters following a critical incident

by Nancy L. Moore, LISW-S, LCSW, CPCC, Director of Program AFM

Firefighters are exposed to sights, smells and experiences that others can hardly imagine. AFM is developing a firefighter mental health system of care that can be used to support firefighters around the world. Here is some information about critical incidents and ways that firefighters and their family/friends can help.

What Is A Critical Incident?    

A critical incident is often referred to as a crisis event.  Any event which has a stressful impact which overwhelms the normal coping skills of either an individual or a group of individuals may be considered a critical incident.  Critical incidents are typically sudden, powerful events which are outside the normal range of ordinary human experiences.  Unusual events can cause a strong emotional effect even on well-trained professionals and may impact the ability to function. 

Reactions to a stressful event may last a few days, weeks or months and occasionally longer depending on the severity of the traumatic event. With understanding and the support of loved ones, the stress reactions usually pass more quickly.  

Informational Facts: 

  • Critical incident stress affects nearly all helping professionals. 

  • A stress response is normal.

  • No one is immune from the impact of critical incident stress regardless of past experiences or years of service.  Critical incident stress may occur at any time during their career. 

  • Your loved one may experience a variety of thoughts and reactions OR they may experience numbness or absence of any response. 

  • You may not understand what your loved one is going through, but offer your love, support and acceptance. 

  • Don’t be afraid to ask what you can do that they would consider helpful. 

  • Accept the fact that life will go on; theirs, yours, your children, and others around you. 

  • Attempt to return to a normal routine as soon as possible. 

  • Avoid entering into major decisions following a critical incident.  Your loved one’s ability to process information, problem-solve, and make decisions may be hampered at this time. 

What is Helpful.:

  • Talking is GOOD medicine.  LISTENING is key.

  • Encourage regular meals and plenty of rest. 

  • Allow private time. 

  • Exercise or take a walk together.

  • Don’t take their anger and frustration personally. 

  • Encourage, but do not pressure your loved one to talk about their experience. 

  • Offer expressions of support and that you are sorry such an event occurred and you want to understand. 

  • Reassure them they are safe. 

  • Help with everyday tasks (cleaning, cooking, household)

Avoid:

  • Critiquing, probing or attempting to fix the problem 

  • Statements such as:

    • “It could have been worse.” 

    • “It’s fate.” 

    • “They asked for it.” 

    • “It’s God’s will.” 

    • “Quit if it bothers you that much!” 

Common Reactions and Symptoms of Concern 

Critical incidents trigger stress symptoms.  Stress symptoms usually occur in five different categories. There is greater potential for lasting harm the longer these symptoms persist.   Some examples include:

Cognitive/ Thinking

Poor Concentration

Difficulties with Calculations

Poor Attention Span    

Difficulty Making Decisions

Slowed Problem Solving   

Memory Problems

Emotional/ Feeling

Guilt  

Feeling Lost / Overwhelmed

Anger

Depression / Grief

Loss of Emotional Control

Physical/Body

Muscle Tremors

Chest Pains

Gastrointestinal Distress

Difficulty Breathing

Headaches

Elevated Blood Pressure 

Behavioral/Actions

Excessive Silence     

Sleep Disturbances

Extreme Behavioral Change   

Withdrawal from Contact 

Change In Work Habits

Changes in Eating Habits

Spiritual/ Relationship with God

Changes in Religious Involvement

Sense Of Isolation From God

Questioning Basic Beliefs

Loss Of Meaning Or Purpose  

Faith Practices Seem Empty

Withdrawal From Place Of Worship  

Anger At God 

Anger at Clergy

Spiritual Care

1 Peter 5:7

Cast all your anxiety on Him because He cares for you.

Psalm 18:6-35

6In my distress I called to the Lord; I cried to my God for help. From His temple He heard my voice; my cry came before Him, into His ears... 16He reached down from on high and took hold of me; He drew me out of deep waters... 32It is God who arms me with strength and keeps my way secure... 35You make Your saving help my shield, and Your right hand sustains me; Your help has made me great.

2 Thessalonians 3:3 

But the Lord is faithful, and He will strengthen you and protect you from the evil one.

Colossians 4:6 

Let your conversation be always full of grace, seasoned with salt, so that you may know how to answer everyone.

Remember: 

  • Suffering from the effects of critical incident stress is individual and completely normal. 

  • Your loved one is probably not the only one that is experiencing critical incident related stress.  They are probably sharing some of their thoughts and reactions. 

  • The thoughts and reactions will normally subside and disappear in time.  

  • All phases of our lives overlap and influence each other: personal, professional, family, financial, spiritual, etc. 

  • The impact of critical incident stress can be intensified by our own personal perspective and the status of family,  profession, financial, etc. 

  • If the signs of stress that your loved one is experiencing do not begin to subside within a few weeks OR if they intensify, consider seeking further assistance through a counselor, chaplain or pastor