A firefighter who is normally skilled and confident has been making mistakes and becoming confused during routine tasks. An engineer has become withdrawn and is isolating herself in the station when on shift.
A company officer who is usually easy going has become short tempered with his crew. A chief is suspected of drinking heavily on his days off.
All of these behaviors are signs of stress. Being an emergency responder is stressful, and it's not just about the calls. But those calls can take their toll. Studies show that overall, about 15 percent of all firefighters will develop symptoms associated with post traumatic stress disorder during their careers.
There are many factors that contribute to firefighter stress. The nature of the job itself is one source: seeing events on a regular basis that other people may not see in a lifetime can change your perspective on the world.
Firefighters are notoriously sleep deprived, and the hours worked do not always contribute to stable family life. The divorce rate among firefighters is higher than that of the general public.
According to data cited by the National Fallen Firefighters Foundation, virtually all firefighters will experience significant stress during their careers. In most cases, firefighters get through these difficult times without permanent harm done.
How they get through these events is something individuals and departments can contribute to in a positive way.
The first step to having firefighters deal effectively with stress is to make it safe to do so. Company officers can play an important role here — learning how to be good listeners, and encouraging crews to talk about tough calls among themselves.
Company officers are in a position to see behavioral changes in the first stages among their coworkers. They can check up on individuals, and potentially address problems before they become more serious.
For this to happen, an atmosphere of trust is essential. If firefighters think that their officers are going to spread gossip about them if they divulge any problem or weakness, they simply won't do it.
Company officers must make it clear that any confidences shared by their crew members will be kept confidential. The ability to share resources for further help is an invaluable job skill for all officers.
Many departments have peer support teams who can act as first responders when it comes to stress and other behavioral health issues. Members of these teams are trained to listen effectively, to conduct post-incident defusings and debriefings, and to make referrals to other available resources.
Peer support team members are not psychologists and they don't do formal counseling. But they can provide a supportive, trusted and confidential environment for people to vent or discuss issues that are bothering them.
Most importantly, peer support team members are fully aware of the resources available for support with behavioral health and are knowledgeable about how to access those resources. These resources might include an in-house psychologist for large departments, or access to Employee Assistance Programs, support groups, or medical care.
The National Fallen Firefighters Foundation has recognized that attention to firefighter behavioral health is an important part of their mission, and integral to achieving one of the 16 Life Safety Initiatives: "Firefighters and their families must have access to counseling and psychological support."
Toward this goal, NFFF has developed a number of programs, including the new Stress First Aid program for emergency responders. This course is based on a military stress model, and provides a seven-step process for recognizing and addressing job related stress.
The key for any stress management program to work is acknowledging that there are likely to be times when every firefighter will need help and support. Firefighters define themselves as those who provide help, not those who ask for it, so asking for help may involve a real shift in organizational culture.
Help can come in many forms, and may be as simple as a company officer allowing crew members to vent after a tough call, or being a trusted listener if an individual needs to talk. Beyond this first level of support, all fire departments should develop a clear list of available resources for members and make sure every member knows how to access these resources. Peer support teams are a great way to create that link.
Ultimately, paying attention to behavioral health is a matter of leadership. As one firefighter said, "It can be hard to ask for help, but it's a matter of safety. Years ago, we used to go into fires wearing day boots and with no mask. But we learned, and now we do things differently to keep ourselves safe."
Peer support and what it represents is part of that continuous learning process.