Fire Service Mental Health: Culture and Resources

PBS recently aired a multi-part documentary on Ernest Hemingway. As many know, Hemingway battled mental health issues most of his life. And you could make a strong argument that his mental health problems were the result of nature and nurture. Hemingway’s father died by suicide after years of depression and anxiety, which greatly affected him. At age 61, Hemingway took his own life.

The documentary draws into focus of how taboo mental health and suicide were in the first half of the 20^th century. The culture of the day was to view both as a personal weaknesses. And for someone like Hemingway whose persona was that of uber-masculinity, the mental health stigma was even greater.

Culture changes at a slow pace; bits of it are passed down from generation to generation. That’s why sixty years after Hemingway’s death, we still haven’t fully come to terms how to view mental health problems. Culture also doesn’t exist in a vacuum; it’s pervasive. The fire service has a strong and unique culture, yet it is part of the overall American culture in the United States. And that’s partly why we still cling to old ideas about mental health in the fire service.

Combine that with the fire service’s Hemingway-like persona of masculinity (characterized by strength and courage), and you can see why suicides and poor mental health still plague us.

To get a handle on this, we sought out one of the fire service’s leading expert on firefighter suicide and mental health. Jeff Dill is a retired fire captain and a licensed mental health counselor. In 2010 Dill launched the nonprofit Firefighter Behavioral Health Alliance, which among other things tracks active and retired firefighter suicides. We put these eight frequently asked questions about firefighter mental health to Dill.

What’s the state of the fire service culture as it relates to behavioral health?

I am a firm believer the state of the fire culture is still in its infancy stage as related to behavioral health. When Firefighter Behavioral Health Alliance (FBHA) first started talking about PTSD and collecting firefighter suicide data in 2010, we were told by many there were no such issues or problems within the fire service. In 11 short years, the fire service has come a long way — but there is still so much more work needed.

One important issue that FBHA has concerns about is those firefighters either approaching retirement or in retirement. Fire departments need to create programs that prepare members for either retirement or those who are leaving the job because they were injured on duty.

How has it changed over the past five or so years?

Over the past five years the change has come in three parts. First was the evolution of peer support teams. With such organizations as the Illinois Firefighter Peer Support, the IAFF Peer Support Training Program, Joanne Rupert’s First Responder Trauma Counselors plus many more, has shown us that talking to our brothers and sisters can create a comfortable atmosphere for firefighters to talk in. Second, the dedication of so many counselors, social workers and chaplains to understand the fire service culture has created a bond of security for firefighters to seek help. Third, it is the courage of firefighters to stand up and talk about their issues to others. This, I believe, has led others to open up and to seek help.

Why has it changed?

There has been plenty of positive changes because organizations are sharing data, workshops, resources and assisting families of firefighter losses. The openness of firefighters and their families has created an educational process that was lacking in behavioral health in the fire culture for many years, in fact the entire history of the fire service. FBHA believes education is a key factor in the growth and understanding of behavioral health.

What role does culture play in firefighter mental health?

Culture plays a major role within the fire service. There tends to be a cultural brainwashing, which is not meant to be a negative term, within our world. When we put our uniforms on we are expected to act in a certain way (brave, courageous, heroic, handle issues on your own, don’t show weakness). Who expects this? Our brothers and sisters we work with. The communities we serve.

The history of the fire service has determined this culture. Yet, when we are challenged either on the job or in our personal lives, trying to go it alone has ended with many wrestling with addictions, relationship issues, depression and unfortunately suicide.

What role do officers play in setting fire department culture?

Officers play an immense role in setting up the fire culture especially in regard to behavioral health. Yet so many have not been trained on how to listen, how to communicate and how to find resources for their organizations.

In our workshops, FBHA always asks, “What do you think we see more of these days — structure fires or our personnel dealing with personal or professional issues? And where do we allocate the majority of our training?” Of course, the answer is most training is aimed at the operational issues. Educating our officers is one of the 12 points FBHA advocates when creating a behavioral health program for a department.

What role does higher education play in shaping a fire officer’s ability to influence fire department culture?

Education can play a major role in people’s lives. In addition to a bachelor’s or master’s degree, it is about attending workshops, talking to people who struggle that will give you the education for understanding behavioral health. Regarding officers, who, again, are key to driving fire department culture, a formal education does pay off. When considering an officer candidate with job experience alone and an officer candidate with both a higher-education degree and job experience, that latter usually will be better rounded, better equipped to lead toward positive changes in the mental health areas.

What needs to happen at the firehouse and department levels to improve firefighter mental wellness?

I am a firm believer every organization should have a behavioral health program. This includes more than just an employee assistances program and a peer support team. We believe it takes 12 points to accomplish this. If anyone wants our recommendations, we will send them the 12 points. It takes time, training and patience. Plus, the chief and senior officers do not have to handle the workload. This takes a joint effort from the rookie firefighters to the chief’s office.

Are the current mental health resources available to the fire service effective?

Because we are so new to behavioral health within the fire service, we do not have a complete handle on this issue. But what we have in place, such as peer support and CISM teams, trained counselors across the U.S. and great support from fire chiefs, I believe we are on the road to ensure our people have a great career and a better retirement.

We’re grateful to Jeff Dill for sharing his insights and expertise on this vitally important issue. For those who need help or believe they work with someone who does, we’ve listed numerous sources in the accompanying call-out box. These are trusted resources operated by groups that understand firefighters and the mental health strain we face.

For those looking to become that more well-rounded fire officer who knows how to recognize and address this mental health crisis, look into Eastern Oregon University’s nationally recognized Fire Service Administration bachelor’s degree program. This 180-credit hour program meets model curriculum for the U.S. Fire Administration’s Fire and Emergency Services Higher Education. You can learn more about firefighter mental health here and the bachelor’s degree program here.

It will take education and courage to break through this wall of stoic, machismo that is harming and killing our firefighting sisters and brothers. Chipping away at it starts with each one of us.