More and more fire departments are not only recognizing the need to prioritize the mental health of their members but also taking steps to normalize conversations around mental health through new programs and initiatives.
The Fargo (N.D.) Fire Department is one such department, seeking a proactive approach to mental health that simplifies the sometimes-difficult step of asking for help. Specifically, the fire chief implemented a mandatory annual mental health visit with a practitioner trained and experienced in psychological trauma. Follow-up sessions are authorized as needed in full confidentiality between the provider and member.
Division Chief Craig Nelson shared additional information about Fargo’s program with FireRescue1.
FireRescue1: What was the impetus for developing the program?
Chief Nelson: We began to see more mental health issues with personnel. Also, our call volume has continued to increase, so our personnel have been seeing more and more traumatic incidents.
Who was involved in the creation of the program?
Assistant Chief Travis Stefonowicz with the Fargo Police Department called and asked if Fargo Fire was interested in working together on a public safety mental health program where all personnel are provided at least one annual visit with a trained and qualified counselor. I then reached out to our fire department health and wellness committee and members of our fire department peer support team to gauge interest and acceptance. The feedback from both groups was positive toward having visits, but there was much debate over whether they should be mandatory.
What was the reasoning to make the program mandatory?
We felt that it would make it easier for personnel to attend a counseling session if they knew everyone had to do so. That way, if you didn’t want to admit needing or wanting to see a counselor, you could blame it on the department as the visit you are required to attend, and nobody would know if you were having issues you want to talk through.
The other reason is that we feared those who need it most may be the least likely to attend. The point of the program is to take care of our people, so if someone needed help and didn’t get it because we didn’t require it, it could lead to a bad outcome.
Did you need approval from any boards or community stakeholders?
The personnel from our health and wellness committee and peer support team truly led the way promoting the program. We also worked to educate and gain support from our city administration, mayor and commission. All were in support of the program. The biggest group we needed approval from was our own personnel.
Why was it important for your team to have culturally competent practitioners working for the department?
It was important to have counselors trained and experienced in trauma related issues because they are better able to help our people. In the past public safety personnel have not had good luck with traditional counseling programs because the traumatic events encountered in public safety can be frequent and extreme. Many counselors are not prepared to handle this.
How do you guarantee confidentiality for members?
The members are informed ahead of time and at their appointments that counselors are not allowed to share anything from the visit unless there is a concern that is life-threatening. Members are informed that they can go and talk about whatever they want, the visit is for them. If they want to talk about football for an hour, they are free to do that and leave.
What was the general timeline, from first ideation to roll out to members?
Initial discussion began in summer 2022. We initially had several members attend appointments to get their feedback on them and the counselors. After feedback came back positive, we began the process of selecting a vendor, getting the program approved, and setting up informational meetings. The program launched in January 2023.
Describe the initial logistical steps to get the program off the ground.
After gaining support, the initial steps involved setting up the messaging and training for personnel so they knew what the program was and how to access it. They can choose the provider they feel most comfortable with in the program. The program provides several options for counselors.
Once members knew how to schedule, we developed a way to track completion of their appointment. We use our training software to assign annual health and wellness appointments as a credential that must be completed. After a member attends one of their required wellness appointments, they simply mark it completed in the credential. The software allows them to see their progress with their various health appointments.
How is the program funded?
The program is currently funded out of money for employee health, specifically medical and mental health. We would love to find a better source, but for now it allows all personnel to get at least one appointment, plus a few additional appointments as needed.
Can you share any success metrics or anecdotal stories that highlight the program’s success?
One of the best metrics has simply been the lack of negative feedback. Fire personnel are not afraid to share their feedback about anything. Since the program began, we simply have not heard really anything negative. We have also heard a lot of positive feedback.
What tips can you offer other agencies that are interested in replicating your innovation?
I strongly encourage other agencies to pursue a mental health program. I would also encourage them to make it mandatory. Again, the point is to make sure we are taking care of our people — to make sure those that need help get help.
