We are all familiar with the organizations that have been founded and established with missions to increase safety in the fire service and to reduce firefighter injury and death. We know these organizations by name and their acronyms. Established in 1992, the National Fallen Firefighters Foundation works towards reducing preventable firefighter death and injury. The National Fire Protection Association, founded in 1896, promotes uniformity in fire protection standards, and the National Institute for Occupational Safety and Health (NIOSH), established in 1970, studies worker safety and health. Others, such as the International Association of Firefighters, the National Volunteer Fire Council, and the First Responders Center for Excellence, have similar history. In addition, these organizations have been increasingly visible in relation to addressing mental wellness for firefighters and their families.
In the past decade, the latter organizations along with Fire Engineering have become strong advocates and leaders, offering platforms in focusing efforts on mental health education through articles, presentations, and training that center on fostering understanding of the cumulative effects of our careers on us physically, emotionally, and mentally. One example illustrating such effects of such efforts, spanning 35 years, can be seen from when I became a firefighter for the Chicago Fire Department back in 1989. At that time, a firefighter’s life expectancy was only four years following retirement, and we had approximately 2,200 retirees. Fast forward to 2024 and our life expectancy after retirement has more than tripled, and we have over 3,800 retirees, thanks to the previously mentioned organizations and the efforts of our Union, Local 2, and administration to prioritize our safety and physical well-being.
- Reactive vs. Proactive Mental Wellness in the Fire Service
- Trauma-Informed Peer Support: The Missing Connection
- What Does It Mean to Be Resilient?
Embracing the Topic of Mental Health
In our firefighting careers, we go from call to call with the same goal: to safely and successfully mitigate the emergency. As we move forward and advance our skills as firefighters, we have learned that change and adapting to new procedures takes time. Much like the adoption of rapid intervention teams (RIT) and rehab guidelines at emergency scenes, it’s taken time for some to give attention to mental health in the fire service. Recently, there’s heightened attention being paid to our well-being. which is terrific; however, the focal point has been on the potential costs of being a firefighter rather than how our strengths help us persevere. There are many articles and presentations highlighting the price some have paid, in a manner that suggests we should “sound the alarm” regarding the cumulative physical and mental effects of firefighting careers. The subject matter covers those who have developed physical ailments, those whose personal relationships have suffered, those who have lost their jobs due to unacceptable behavior, and, the worst yet, those who have lost their lives while serving the public or those who have taken their own lives. It’s unrealistic to expect firefighters to maintain perfect equilibrium when it comes to mental health matters, especially given that we are exposed to significantly more trauma than the general public. We must shift our expectations when it comes to firefighters’ reactions to traumatic exposure—both for ourselves and all personnel—and develop ways to mitigate the impact of our experiences.”
Firefighters experience all of life just like everyone else. We are part of the statistics through the National Institute of Mental Health (NIMH), which state that nearly 20% of the population has a diagnosable mental condition and many more people have symptoms that haven’t reached the diagnosable level yet. These statistics alone are concerning without considering experiencing out-of-the-ordinary events.
Americans were reminded that we are not immune to catastrophes like the pandemic we experienced with COVID, which impacted myriad aspects of our lives. We have experienced wildfires, hurricanes, floods, a rise in crime, and mass shootings, among other tragic events. The American Psychological Association (APA) recently reported that in 2023, rates of mental illnesses hit 50% for adults ages 18-34, and that chronic illness was up to 58% in 2023 for ages 35-44. The Centers for Disease Control (CDC) reported a suicide rate in 2022 that has increased by 36% since 2000. During this time, firefighters persevered and remained diligent throughout the epidemic and continue to do so.
Firefighters strive for success on the job, and our approach is straightforward. We learn new, improved firefighting tactics, techniques, and skills, and repeatedly practice them to improve performance. Those are the clear-cut actions we take. The overt reactions from the situations we implement them in are observable, measurable techniques. The invisible reactions are those that have a mental impact on us, whether short lived or lasting. Behind the daily work tasks are feeling, vulnerable people. Approaching the topic of mental health is not as easy or straightforward as our fire tactics, and several barriers in attempting to do so come to mind. Stigma, beliefs, fire department culture, and deeply engrained habits in our firehouse functioning impede efforts to normalize discussions and action regarding our mental health.
Obstacles Remain
Many adverse connotations regarding mental health still circulate through society today, which stymies efforts to openly discuss it. Fire service beliefs and expectations compound these views. We expect personnel to be at 100%, 100% of the time. We embrace the firefighter ethos of being strong, physically and mentally. The characteristics that lead individuals into the profession also contribute. Firefighters embrace the persona of strength, risk taking, and being a person who can take on and handle difficult, challenging situations. Our culture has been forged over many years. Its evolution has been slow compared to our changing world. We adopted this culture when we voluntarily entered the profession, where we are exposed to scenarios most people hope to never encounter even once in their lives. Firefighters do so repeatedly with very little organized mental processing other than our gallows humor with the crew. Our repeated exposure to traumatic scenes includes the sounds, smells, and visual images of death, which we disregard until we can’t any longer.
The Mental Health 5
Reports from NIOSH and other national organizations focusing on line-of-duty deaths (LODDs) have provided contributing factors and guidelines to reduce them. In a similar manner, the mental health field has been doing the same to increase awareness, educate, and provide means to improve mental health concerns on a national level. Interestingly, if you review the NIOSH 5, the identified principles lacking and needing improvement to aid in lessening LODDs can be utilized to improve our engagement of mental health practices within the fire service.
- Risk assessment: Observe and evaluate your peers daily to gauge how each member is doing physically and mentally.
- Incident command: Officers and management must directly engage personnel to promote change from the top down.
- Accountability: Be accountable to yourself and regularly assess how you are doing, and, once again, officers must be accountable for your crews’ mental stability.
- Communication: Engage, process, review, initiate, and always be approachable and available.
- Standard operating procedures: Take steps and follow through with having protocols regarding our mental health as well as our physical health.
Please pause and take an inventory of yourself. Consider your thoughts, words, and actions, and where they fall on the spectrum of those you want to avoid and those you aspire to demonstrate. Do they perpetuate the barriers we face in bringing mental health to the foreground, alongside our performance? Further, reflect on the organization you work for and its leadership. Where they are on the continuum of supporting your personnel in job performance and physical and mental well-being? Just as the military implements a “hot wash” or “after-action review” for each mission, we could incorporate similar processing regarding each incident, evaluating not only our task performance, but also providing an open forum for discussion and processing of thoughts, feelings, and reactions to help us individually and as a team. Additionally, psychology has shown when a person knows the mission, potential outcomes and develops skills to complete it he or she has a better chance of success; this is referred to as informed decision making. Imagine if you had that; along with a bond of supportive coworkers, it could bolster everyone.
We have the resources, we have the ability, and we have the people. We have paths to embody the ideas of empowering each other through peer support, mental health task forces, professional support, and creating SOPs to support them. Embrace the potential future we can create for firefighters to come, and don’t forget your personnel after they have retired!
“Let’s lead with intentional efforts to be better than the day before, even if it is just a little better…and you decide what that looks like as a leader and mentor.”
Dan Degryse is a retired battalion chief from the Chicago Fire Department who has spent nearly four decades in the behavioral health arena. With 30 years in the fire service, his goal is to have 30+ years in retirement, and he knows that won’t happen by accident. He is always available for anyone who would like to have a discussion about topics he presents on paper or in person.
