By Sheena Glover
For many in the fire service, it is hard to refute the rich traditions driving the culture of many crews. These traditions often emphasize toughness while stigmatizing those who struggle, especially mentally.
Firefighters are expected to embody strength and bravery in the face of danger or tragedy, suppressing any signs of weakness or need for help. Tradition has led many to believe that asking for help weakens some innate superpower of the firefighter, deterring individuals from seeking the help that is needed. What’s more, these traditions can have negative consequences, especially when it comes to their effects on the mental health and wellbeing of firefighters, resulting in destructive behaviors such as alcohol abuse, even suicide. But there are ways to help.
‘EMT wellbeing’ – a blip in a book
Growing up, I never imagined myself as a firefighter. I grew up around individuals who battled mental illness and other health problems. All I knew was that I wanted to help people feel better, which led me to aspire to become a doctor.
Throughout my childhood and teenage years, I diligently worked toward that goal, becoming the first person in my family to graduate from high school. I even received a full scholarship to college, where I packed my schedule with pre-med courses. However, during the second semester of my sophomore year, everything changed when my advisor introduced me to EMS through a basic EMT course. It was then that my focus shifted. I can vividly recall studying “EMT wellbeing,” which was only a few paragraphs in a massive textbook.
Fast-forward to 2018 when I took on the role of Community Risk Reduction (CRR) Specialist for my organization. In that role, it was my job to assess the risks that were occurring within my community from an all-hazards approach. I looked at high-hazard occupancies and studied the data on high-volume call types within the city. But my most critical assessment focused on the risks faced by first responders as part of the community. I believed that just as you should secure your own oxygen mask before assisting others on an airplane, a first responder couldn’t effectively serve the citizens if they neglected their own mental wellbeing.
My experiences on the front lines revealed firsthand how emotional problems could adversely affect work performance and family life. I quickly realized that what I was given through the brief read on EMT wellbeing was just scratching the surface, as untreated issues often posed significant dangers, not only to the affected individuals but also their colleagues, families, and the community as a whole.
Despite my organization implementing policies and procedures that addressed mental health, employee assistance programs (EAPs) and peer support teams, over the years, I witnessed an alarming increase in the number of firefighters requiring mental health assistance. Some exhibited unusual behavior on calls, others resorted to heavy drinking, and many faced significant challenges at home, including separation and divorce, and tragically, some attempted suicide.
In May 2014 and again in the summer of 2019, I mourned the loss of two close firefighter friends who died by suicide.
Personal risk assessment
As a firefighter, I was trained to assess and manage risk, but I was rarely taught how to evaluate and address the cumulative impact of each call on my mental health and wellbeing. Nobody taught me how to recognize the weight of those impacts on myself, my family, or my fellow firefighters. One critical question I now ask my firefighters: Is your family excited to see you come home after shift? Many first responders have never fully considered the impact of their experiences on their own wellbeing, let alone on their families.
It is well known that throughout a career, a first responder will encounter numerous incidents that leave a lasting mark on their psyche. Certain calls will be etched in their memory, and each call will bring about distinct changes in how they perceive death and respond to trauma. The biggest misconception about mental health is that when one is in crisis, they will possess the cognitive ability and self-awareness to identify the crisis and employ appropriate coping mechanisms or ask for help. That is far from the truth.
First responders are often natural problem-solvers, both in their work and personal lives. For many, when it comes to assessing their own emotional state, it is no longer about whether the glass is half full or half empty, but rather how many drops will it take before the cup overflows, and whether they feel safe enough to confide in someone about their feelings. If you have always been the one offering help, how do you let your guard down and become vulnerable enough to seek assistance? And how do you do so in an organization that has long stigmatized discussions about mental health?
The Small Bites approach
The Small Bites Program is a tactical and strategic approach to having difficult conversations. It is based on applications of CRR to identify and prioritize the firefighter as the foundation of the community.
Endorsed by IAFF Local 385 in Omaha, Nebraska, the Small Bites program aims to tackle challenging topics such as mental health/suicide, diversity and inclusion, and racial inequities by dissecting and breaking down information into small, palatable pieces that are easy to figurately digest. The Small Bites methodology is based on the question: How do you eat an elephant? The answer is one bite at a time – in SMALL BITES.
To continue to metaphor, many problems go unresolved because individuals refuse to face or acknowledge the elephant in the room. The “elephant” represents an issue or problem that people avoid discussing or even acknowledging. Some individuals excel at identifying the elephant and openly discussing its presence, while others may remain oblivious until it grows too large to control, necessitating action. Fear is a common reason for avoidance. Some individuals fear the consequences of acknowledging the elephant. When the elephant is finally recognized, the focus may be deflected to questioning who brought it into the room, rather than understanding why it is there and how long it has been present.
Some individuals are aware of the elephant but choose to avoid it, fearing the responsibility or lack of knowledge required to address it. Others stubbornly refuse to get involved, believing that the elephant is not their problem and hoping that ignoring it will make it disappear. However, the elephant will continue to grow and eventually consume the space and the individuals occupying it unless someone takes the initiative to facilitate its departure through conversation, discussion or resolution. When a problem arises, someone must muster the courage to acknowledge it and address it head-on.
Small Bites equips first responders with the tools to effectively address problems within the fire service for themselves first. Participants learn to identify the purpose of a conversation, manage associated emotions, and communicate respectfully, directly and optimistically. Small Bites encourages individuals to prepare for different scenarios and conversations while promoting solutions over assumptions or accusations. It offers a systematic problem-solving approach based on resilience, retention, and successful outcomes.
Key to this is an individualized approach. Small Bites acknowledges that every individual’s experience is unique and dynamic, and no two people react to or handle problems in exactly the same way, even siblings raised in the same household.
In addition, Small Bites emphasizes inclusion, creating a sense of belonging and fostering a supportive community. This support network enables individuals to endure tough times and strengthens the mental health component. If an organization holds its members to high ethical standards, with integrity, professionalism, and compassion at the core of every decision, no individual would ever be left behind, and suicide would not feel like an option.
All about support
Firefighters, who are expected to be strong and fearless, often find it difficult to acknowledge their own struggles and ask for help. However, the consequences of neglecting mental wellbeing are far-reaching, affecting not only the individuals but also their families, colleagues, and the entire community.
It is imperative that we challenge the outdated traditions and stigmas surrounding mental health in the fire service. To achieve lasting change, inclusion must be at the forefront of our efforts. Every firefighter deserves a sense of belonging and support, allowing them to endure the challenges they face.
The Small Bites program offers a transformative solution, providing a tactical and strategic approach to difficult conversations that increases one’s emotional intelligence by identifying complex topics and breaking them into manageable pieces. By supporting one another and prioritizing our wellbeing, we can build a stronger and healthier fire service community for generations to come and ultimately improve how we serve the citizens in our respective cities.
About the author
Sheena Glover is a captain with the Omaha (Nebraska) Fire Department. She has over 22 years of experience in EMS and has served as a firefighter in Omaha for 15 years. Throughout her career, Captain Glover has addressed firefighter wellbeing through pushes for diversity and inclusion, transparent communication and education, and strategic risk reduction. Captain Glover holds degrees in EMS and fire science and is currently working on her capstone to finish the National Fire Academy’s Managing Officer’s Program while pursuing a master’s degree in organizational leadership. During her time in public safety, Captain Glover has served as a firefighter, fire officer, paramedic, certified law enforcement officer, fire investigation technician, hazmat technician, EMS/CPR/fire instructor, and CRR specialist, and is a peer support member.