The fire service is beginning to pay attention to the emotional and psychological health of its members. In recent years, organizations such as the National Fallen Firefighters Foundation have launched programs on stress management and other emotional and behavioral health issues. And just this summer, the International Association of Fire Chiefs and the IAFC Volunteer and Combination Officers Section released a Yellow Ribbon Report exploring emotional and behavioral health issues in the fire and emergency services.
It’s about time. Firefighters have always been at increased risk of physical and emotional stress, and not just because of the bad calls they sometimes go on. The work schedule, sleep disruptions, tight living quarters, physical demands of the job, time apart from family – all of these factors also contribute to a cascade effect of stress under some circumstances.
The IAFC/VCOS report includes both general insight and specific guidelines for improvement in the area of behavioral and emotional health. It should be read by all firefighters. In particular, it talks about the need to change a culture where asking for help can be seen as a sign of weakness. It underscores the need to make the emotional health discussion as essential as operational training and readiness.
One important point in the report is the concept of cumulative stress overload. Most emergency services agencies are pretty good about providing resources for critical incident debrief – the school shooting, the line of duty death. But those same agencies often overlook gradual changes and cumulative stress reactions. It is in this area that the actions of the company fire officer and first level chief officer are critical.
Check in with firefighters suffering from cumulative stress
These actions are not limited to officers. Peers, friends, family and other co-workers can also take the initiative to check in on others who seem to be suffering from the effects of cumulative stress. But fire officers must be vigilant in this area. It is part of the job of maintaining operational readiness and keeping everyone safe.
The first thing fire officers must do is pay attention. Especially notice changes in behavior. Is a normally outgoing person suddenly withdrawn? Is an easy-going person suddenly prone to fits of anger? Has a physically active person turned into a couch potato? These types of changes don’t necessarily mean that something bad is going on, but they do warrant follow-up.
What is the best way to follow up? Ask the right questions, then listen appropriately. It can be helpful to think through how to frame the inquiry rather than just being spontaneous. Asking someone, “What’s eating you lately?” might result in a good conversation, or it might make the other person withdraw. Asking someone, “Are you OK?” might have positive results, or might simply bring the reply, “I’m fine.”
One way to increase clarity in asking about behavioral changes is to include specific observation. You might say, “I’ve noticed you don’t eat popcorn and watch movies with us anymore in the evenings. We miss having you as part of the group. Is there a reason why you’ve chosen to make this change?”
Such inquiry may or may not bring out useful information. Someone might respond, “Well, I just started back to school for my degree and I need to study at night.” That would certainly be good knowledge for the officer to have.
Or the response might be, “I don’t really like the kind of movies the rest of you want to watch. So I just keep to myself.” Also valuable information.
Or the inquiry might result in stonewalling. “No, I’m fine.” That’s OK. Every inquiry will not immediately (or ever) yield information. The important thing is to keep the lines of communication open. The officer could respond, “OK. But if there’s ever anything you want to talk about, or anything at work that is bothering you, you can always come and talk to me privately and confidentially.”
Listening is a critical skill that few people come by naturally. Becoming a good listener takes skills, practice and patience. Especially when it comes to issues of behavioral health, reaching out to someone apparently in need might not result in a response for days, weeks or even months. The officer must maintain an attitude of readiness and openness at all times.
Being a good and ready listener is one way an officer can be a valued role model. Keeping confidences, avoiding gossip, and treating people equally and inclusively are all ways that officers can set the tone with their own actions.
It is also important for officers to respect differences among their crew members and be inclusive among all personality types. Some people are reticent and private, others are uninhibited. Everyone, regardless of personality type, needs to know that he or she has the support of coworkers and leadership among the crew.
Share fire service behavioral health resources
Finally, from a practical standpoint, first line officers and chiefs must know what resources exist to support those dealing with emotional health issues, and how to access those resources. Most fire departments are connected to a number of resources, including employee assistance programs, department chaplains, peer support networks, community resources, designated medical providers and more.
Officers need to know the advantages and limitations of each resource, as well as how any firefighter might confidentially access that resource.
The IAFC/VCOS report emphasizes the need for training at all levels of the organization to implement the kind of cultural change that is needed when it comes to behavioral and emotional health in the fire service.
This training can begin in recruit school and should continue up through the ranks to the department chief. Only when the commitment is made continuously and department-wide will the culture finally shift to allow those in need to access the help they need. Doing so isn’t just a nice thing to do, it is a matter of life and death.