From the Summer 2022 issue of Fire Fighter Quarterly
Not only is firefighting one of the most physically hazardous professions, but being “communicative” can also take a huge toll on mental health, leaving firefighters feeling overwhelmed, unappreciated, and often alienating from their families.
This mental condition, often called “burnout,” can ruin a firefighter’s career, affect fire companies, and threaten family life.
IAFF has made firefighters’ behavioral health a top priority, opening the first of its kind IAFF Center of Excellence for Behavioral Health Therapy and Recovery and launching peer support training to help members identify and address behavioral health issues.
“The resolute firefighters and paramedics who make up this great union dutifully confront danger and trauma on every shift while protecting their communities, and we now know that it takes an emotional toll. We cannot ignore the huge challenge of behavioral health in our ranks. Chief General Edward Kelly says:” We owe it to our membership and we owe it to their families.”
These efforts are accelerating, with the expected opening of a second IAFF Center of Excellence on the West Coast in the first quarter of 2023 to help manage growing demand within the Fire Service for behavioral health therapy. The original Center of Excellence in Upper Marlboro, Maryland, just outside Washington, D.C., is booked to near capacity after having treated and released more than 2,200 members over the past five years.
In Canada, the IAFF entered into In association with Edgewood Health Network (EHN), Canada’s leading provider of behavioral health therapy services, to help treat IAFF members.
“We have seven facilities across Canada that offer inpatient treatment, outpatient treatment and several specialty programs,” said Darren Taylor, National Director of Business Development for Edgewood Health Network (EHN) Canada during a roundtable discussion on behavioral health at the 2022 IAFF conference. Ottawa, Canada. “Having several facilities at our disposal helps prevent queues. If a firefighter is in crisis but the nearest center is full, the EHN will escort that firefighter to a facility that has a hatch.”
Taylor also discussed another important benefit offered by EHN, which is post-treatment care. “If we do not continue to monitor our patients, we are not providing adequate care and the patient may regress,” he said.
Despite the clear need for more behavioral health services and resources, many IAFF members and affiliate leaders have faced challenges convincing employers to help fund treatment. The IAFF hopes that a new body of scientific data will help associates successfully negotiate access to behavioral health services in their contracts.
The IAFF conducted a member-wide study, the “IAFF Burnout Study,” to determine the extent to which firefighters and paramedics experience behavioral health symptoms, including burnout. The results of this survey will provide detailed evidence of the scope of this behavioral health challenge, and real data affiliates can show employers negotiating working conditions.
Kevin McCann, Head of Coventry, RI Local 3372, says his ministry has been running a 56-hour work week since the COVID-19 pandemic began, and that has clearly affected members.
“We’re having a problem with retention here in Coventry because we’re the only city in Rhode Island that has this brutal schedule,” says McCann, who is often expected to work overtime for 72 and sometimes 96 hours a week. “When I come home on Saturdays, I have to catch up on sleep, so I miss some family things.”
McCann adds that a member of Local 3372 was experiencing post-traumatic stress disorder (PTSD) after a difficult CPR-related emergency call. Note that the call incident was a burden to the member who asked the employer for help. McCann says Coventry Fire Department refused the member’s request for leave and treatment.
McCann encouraged Coventry firefighters to conduct the Combust Study. “We have a contract soon where the shift schedule will come out and we need to be able to articulate what that schedule does for us, and this city needs to understand that we need mental health services.”
Do we have a burnout problem? We hear sparse stories, and this survey will help us speak with more confidence,” says Dr. Susie Gulliver, IAFF behavioral health consultant and director of the Warrior Research Institute at S&W Healthcare System. “Whatever survey shows us, it will tell us where the hot spots are and give us targets for change.”
The IAFF Combust Study seeks to dig deeper into firefighter behavioral health issues, after a 2018 survey by the IAFF and NBC found that firefighters throughout the fire service struggled with mental health issues, with most noting that their fire departments were not. . adequately address the problem.
IAFF initially sent out the Combust Study to members this summer and by August 5, more than 5,000 members had completed it. The 12-minute online questionnaire looked at the effects that issues such as the COVID-19 pandemic, 72-hour shifts, and mandatory overtime have on firefighter morale and mental health.
Gulliver notes that the IAFF is expanding its efforts to treat members with behavioral health issues through Project Access, a telehealth service that was tested with 84 patients. The idea of telehealth arose from the COVID-19 pandemic as medical service providers and users quickly and widely accepted the use of telemedicine. Gulliver expects to add more telehealth professionals to Project Access as needed.
Meanwhile, the IAFF is expanding its behavioral health training curriculum to help members continue successful treatment after recovery and to help outside behavioral health professionals better understand the unique challenges and pressures that firefighters and paramedics face on the job.
Helping Members Recover is a two-hour self-paced course for fire service personnel who want to support a member who is currently engaged in or has recently completed treatment for a mental health or substance use disorder. The course covers common behavioral health issues in the fire service, behavioral health treatment levels, and strategies for individuals and associate leaders to support members in recovery.
Scott Robinson, IAFF Behavioral Health Specialist, says the idea for the course came about when more IAFF members completed therapy at the Center of Excellence and then returned to work. “Affiliate leaders really wanted to make sure that members returned after treatment to a work environment that was helpful and supportive for them,” he says. “We want to be able to tell other firefighters how they can support a colleague in recovery.”
Treating Fire Service Members in Behavioral Health Settings will be a two-day in-person training course for Licensed Mental Health Professionals who treat firefighters and paramedics. The first day will involve learning to work within the classroom around the emergency response function and the unique culture found in firehouses. The second day of the course will be FIRE OPS 101 where mental health professionals don protective gear and perform several emergency response simulations.
“We have found from speaking to many members seeking mental health treatment that far too many mental health professionals are simply not prepared to deal with firefighter issues and unable to successfully assist them,” says the IAFF’s Behavioral Health Program Clinical Coordinator, Lauren Kosk, who, with Robinson, will conduct the first rendition of this course this fall.