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Mental health challenges we face

Behavioral health issues are as much a threat to a firefighter's overall safety as building construction, reduced staffing and response times


Editor's Note:The National Volunteer Fire Council's National Firefighter Health Week runs August 16-20. It's an annual week-long initiative held each August to educate the fire and emergency services community and the public about a variety of health and wellness issues that affect first responders. Monday's topic of focus is behavioral health. In addition to Chief Kenny's personal perspective below, be sure to check out tips from the NVFC here as well as its special Health Week page.

By Chief Pat Kenny

As we begin the NVFC's National Firefighter Health Week, I think it is important to be aware of the National Fallen Firefighters Foundation's 16 Life Safety Initiatives. The Initiatives, established back in 2004, were intended to directly provide for firefighter safety. Many of the Initiatives deal specifically with health, either directly or indirectly. In my travels across the country there is a common failure in the fire service to be familiar with and embrace these Initiatives.

Monday's focus of Health Week is behavioral health.  It is with that in mind that I would like to center specifically on the 13th Life Safety Initiative, which states, "Firefighters and their families must have access to counseling and psychological support."

This is an area of firefighter health that I am becoming painfully aware is a challenge in many organizations. The reasons for that challenge have nothing to do with apathy on the part of the department or our fellow firefighters. Instead it appears to be a direct result of lack of knowledge on the subject, the culture of the fire service and frankly a lack of training on just knowing what to do.

More challenges
The reality is we are seeing more and more mental health challenges for our fire service brothers and sisters than ever before. We are now beginning to read stories from across the country of firefighter suicides. It does not matter if the organization is career, combination, or volunteer; the fact that this profession brings us face-to-face with many dramatic situations is just a reality.

However, it does not stop there. Not only are we seeing a rise in post traumatic stress syndrome as a result of emergency responses, we are also being faced with many personal challenges that bring upon mental health issues such as depression and anxiety. The economic downturn has forced firefighters to walk away from their homes, firefighters are being laid off, and aging parents need care, all of which can lead in some cases to an atmosphere of despair.

Mental health challenges are just as much of a threat to a firefighter's overall safety as building construction, reduced staffing, response times and physical health. Yet, for some reason, our approach to this issue goes silent.

Personal experience
Believe me, I know of what I speak. I was just as guilty of mishandling the situation of mental health challenges as anybody. In February last year, I had an article published in Fire Chief Magazine entitled, "A Father's Grief." It was probably the most difficult thing I have ever written in my life. The article briefly outlined my struggles as a Fire Chief to deal with the loss of my 20-year-old son Sean, who took his life after 15 years of dealing with deep depression.

Since that article was published and with the encouragement of many wonderful people in the fire service, I have gone out to give talks on how poorly I handled the entire situation and what I have learned.

I had an opportunity to show all in my department that mental illness is no different than a back injury. Both are things no one would choose to be afflicted by and can cause day-to-day hardships over the most simplest of things. Yet how they are viewed in today's society is in direct contradiction. One is very acceptable while the other can cause shame.

I thought if my department knew of Sean's condition, how could they possibly understand the whole mental illness concept and its ramifications when my wife and I were living in that environment every day and we felt lost? I knew my fellow chiefs had their own crosses to bear, so why add to their plate?

That decision, in hindsight, was a huge mistake. The toll it took on me to try and keep up this "super" façade and the pressure it put on my few confidants, no matter how well intentioned, was a huge error in judgment.

Not unique
The unsolicited feedback I continue to receive from my talks is very clear and consistent. Sean's situation is not unique. The mental health challenge may impact a family member in your department, a firefighter or you! Many in the fire service struggle with the contradiction of needing to be superhuman one moment during a crisis situation and then, in the next moment, return to your "Clark Kent" persona as a husband, mother, spouse, etc.

What I am asking you to do during this week and then for the rest of the year is to examine in your department what education you provide on this subject and what support is out there for not only department members but for their families, too.

Do you have access to counselors who are familiar with the fire service culture? If you are fortunate enough to have an employee assistance program, do you know who they are and what exact services they provide?

In my talks I provide an example that I use consistently when I speak on this topic. In any firehouse in these great United States or around the world for that matter: If a firefighter complained of chest pains for a second time, whether that is their next duty day or their next drill night, they would be challenged to seek medical attention. In fact, they would have no choice or a significant other would be notified!

Yet in the same scenario, if a firefighter who normally was very social was now withdrawn, depressed or agitated for a number of days, would most of us have the courage to see if they needed help? That does not mean to ask the question, "Are you okay?" We all know the answer to that one is an automatic "Yes." Yet if you rephrase the question and ask someone, "Is there anything I can do for you?" we become fearful that they may indeed give us an answer!

Mandatory subject
We have to make mental health training a mandatory subject from our entry-level firefighters at the academy all the way up to our chief officers. The only way to change a culture about this particular topic is to have support throughout the organization that this is a critical subject for firefighter health and well-being.

I'm confident we can get there. The National Fallen Firefighters Foundation is currently in the process of putting together a consensus protocol to deal with mental health challenges to address Initiative #13. I believe their research will lead to many answers in this difficult area. Remain on the lookout for that information. Be diligent in looking for guidance on the subject from your local mental health care professionals. The approach must be proactive not reactionary.

Let me conclude by saying that while this is a difficult area to tackle, the danger from ignoring mental health is just as real as the peril of a structural collapse. In both cases, the person becomes buried and in some cases that is fatal. Take a good look at your department as well as yourself and see what you can do to improve the mental health awareness of all.

Both Sean and I thank you.

Patrick J. Kenny is a former Deputy Fire Chief at the Western Springs, Ill., Fire Department and current Assistant to the Executive Director at the Illinois Fire Chiefs Association.

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