– Executive Summary –
Over the past decade, the fire service has seen an increase in suicides and mental health issues, highlighting the critical need for mental health support among firefighters. Regular exposure to traumatic events, such as emergencies and large-scale disasters, can severely impact their mental well-being, potentially leading to depression, anxiety, PTSD, and, in severe cases, suicidal tendencies. In response to the number of firefighters suffering from mental health issues, the United States Fire Administration and International Association of Firefighters implemented campaigns and programs to help raise awareness and educate firefighters. Although awareness campaigns and educational programs began emerging in the 2010s, there is no set standard, and the suicide rate among firefighters continues to escalate, even exceeding on-duty fatalities.[1]
The complex nature of mental health creates challenges in understanding why firefighters struggle to effectively use available mental health services, and why they often suffer from psychological distress in private. This thesis aims to understand the barriers preventing firefighters from seeking and receiving mental health support and propose recommendations for enhancing mental health initiatives.
For this research, I analyzed published studies and conducted qualitative interviews with fire service leaders and firefighters. These interviews offer a better understanding of the experiences and feelings of fire service personnel. Structured analysis of the interviews identified key themes pertaining to barriers in fire service mental health, such as trauma, self-stigma, organizational leadership, trust, culture, and social support. Interviewing fire service leaders and firefighters provided a view of the institutional and personal factors affecting mental health in the fire service.
This research revealed self-imposed stigma and culture as the main barriers to help-seeking among firefighters. Firefighters listed pride, stubbornness, and skepticism as reasons for not wanting to seek help initially. However, over time, the firefighters who were interviewed sought help, signaling a positive change in the mentality of firefighters concerning mental well-being. The three departments participating in the study demonstrated how leadership involvement and support of behavioral health programs affected firefighters’ engagement and trust in mental health programs. These departments showed that a collaborative approach to mental health can positively influence the overall culture of a department, despite any legacy attitudes toward mental health which remain in the fire service. The research further revealed the role of social support in firefighters seeking help, particularly the role of family members, and pointed to the need for fire service programs to include families in training and education of behavioral health.
The results of this thesis underscore the necessity of creating an environment that encourages help-seeking behavior, and emphasizes the role of trust, social support, and effective communication. Recommendations include targeted trauma training, stigma reduction initiatives, leadership training to foster supportive environments, expanding access to mental health programs, fostering cultural shifts toward openness, enhancing social support systems, diversifying mental health support avenues, continuous program evaluation, and developing effective communication strategies. Creating a standard program from the U.S. Fire Administration that focuses on the above recommendations can guide agencies in implementing and adapting the programs to their specific agency needs. Firefighters dedicate their lives to rescuing others and ensuring their communities are safe, at a cost to their own mental well-being. As a result, firefighters view themselves as the rescuer, and struggle to seek help for themselves. Firefighters’ reluctance to seek help underscores the urgent need for systemic changes to support the mental well-being of firefighters, who play a critical role in our communities, as well as focusing on creating a more open, supportive, and resilient fire service culture. Fire service leaders and firefighters at the local, state, and federal levels must work to identify the needs of their agencies and collaborate to develop a culture that embraces mental health initiatives to improve the overall well-being of firefighters.
[1] “Saving Those Who Save Others,” Firefighter Behavioral Health Alliance, accessed October 16, 2023, https://www.ffbha.org/.
