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Mental rehab pays dividends for life

To stay healthy, firefighters must rehab more than their bodies; they need to rehab the mind and spirit

When we talk about rehab, we think about resting and monitoring our vital signs. However, we may be missing a critical component of our well-being long after the fire is out.

Recently, there has been a spike in firefighter suicides, at least it seems. In reality, firefighters commit suicide in this country more frequently than we want to admit. We do not talk about such a topic. It is taboo around the station.

Members of the fire service see people at their worst; it is the nature of the business. It may be family that lost its home, or worse, a fatal fire that took the lives of some family members.

We often relate the tragedies of others to our own situation and ignore dealing with the psychological aspects of our business.
The reactions may not occur immediately following the incident. Rather, it may be years down the road that a small trigger occurs that causes the mental stress. And depending on the person's state of mind, it may have devastating results. 

Training solution
Whose responsibility is it? We need to consider improving our training for personnel to monitor situations that may trigger such reactions. In reality, it goes even further.

Some departments use psychological testing as part of the hiring process. The fire service tests a candidate's physical ability and ignores the psychological aspect. Is it time that psychological testing become the standard when hiring a firefighter?

In addition, just as we are concerned with the physical condition of the firefighter, including the medical examination, we need to focus on the mental aspects of our personnel in rehab.

The Internet is chock-full of scholarly papers and research on firefighters and psychological responses of firefighters. The problems are not limited to suicides. There is a high incidence of alcoholism, divorce and domestic violence among firefighters.

Reducing on-scene stress
The continuation of personnel taking their lives is unacceptable. We need to incorporate psychological care of personnel into our rehab training. If we incorporate psychological awareness and account for the psychological aspect in rehab on the scene, we see a significant gain in reducing the stressors associated with the job.

When I was fire chief in Estero, Fla., we had a fire department chaplain who was very involved. He responded to all major incidents, whether it was a vehicle accident or a major fire.

He would initially assist those involved in the loss if possible, and then focus on the firefighters. He always handled things in a professional manner and looked out for the well-being of personnel. He also would follow up days, weeks, and months down the road.

There are a variety of resources that help deal with the psychological rehab of personnel. The Federation of Fire Chaplains is a great organization that provides the training for fire chaplains.

Fire Service Chaplains are a resource often overlooked and could be an integral part of the rehab sector. They can provide the psychological rehab that many of us are uncomfortable with because of lack of formal training in this area.

Our focus in rehab is on the physical and not the psychological. It is time we find ways through rehab to support our firefighters' mental well-being, and start heading off suicides and other manifestations of stress.

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