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The family connection: A missed opportunity for firefighter wellness

Departments that fail to engage the family in firefighter wellness are missing a powerful tool

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Recently, I presented at a fire service state leadership conference. In a gathering after the conference, the topic of involving the family in firefighter wellness came up. Many of their spouses were in attendance, and they chimed in all at once – they craved more information and involvement. The chief in charge wished he had known and set something educational up for them in advance beyond just inviting them to the evening banquet. A missed opportunity.

As the wife of a fire captain and a clinical psychologist specializing in working with first responder families, I live this issue both personally and professionally. Family members are uniquely positioned to observe and influence firefighter wellness – which has a direct impact on the contribution the firefighter makes (or doesn’t make) to the department. But too often, fire service leaders are missing this connection, leaving a valuable opportunity on the table.

The family-work connection

Regardless of our occupations, what happens to us at work affects us at home, and vice versa. But within the fire service, this family-work connection is greatly magnified. Fire service families regularly sacrifice for the 911 system. Just consider:

  • When a community crisis happens or natural disaster in your area, most people are trying to make it home to their family. Our spouses are more likely headed to the emergency.
  • We’re headed out on a date night and see a car accident no one has yet responded to. Most people call 911. Our spouses get out of the car and start doing what they can until others arrive on scene. Our reservations wait… even on our anniversary (yes, I lived that one).
  • There’s a crisis at home – maybe your kid goes into the emergency room, the water heater goes out, a fence blows down. Most people will leave work to tend to these family emergencies. Fire spouses, however, are more likely to get directions over the phone on how to handle it, asked who else they can call to help, and the message that they really can’t leave work if they can avoid it so “How bad is it?”

Not to mention, we regularly give up nights, holidays and vacations to support our partner’s occupational choice. We learn to be OK with them being gone at a moment’s notice and with not being their only priority. We adapt our whole life to support them. We battle with knowing their career carries high risks – not just of injury or death on the job, but long-term health impacts such as cancer and heart disease.
Without accurate education on how to best support our spouse and effective coping mechanisms on how to manage the unique stressors of our life, these factors create stress on the relationship that can in turn affect firefighter performance and have an operational impact on the department. Just consider the inevitable call home to report that you’re going to be forced back. Without open communication and a plan to handle these situations, the firefighter may feel they simply cannot ask their spouse to sacrifice yet again. So they go home sick to avoid the extra shift. Pretty soon, they’re maxed out on sick time, possibly looking at taking mental health leave, or even leaving the job all together. And the department is in a bigger staffing dilemma than ever.

The good news is there are effective strategies to help families cope with the stress of a fire career and to help family members prevent firefighters from developing many of the physical and mental health issues prevalent in the fire service. In fact, family is a force multiplier you’re probably not using to support firefighter wellness.

The family as force multiplier for firefighter wellness

Fire service work puts firefighters at higher risk for sleep disorders, suicidal ideation, heart disease, cancer, substance use disorder and post-traumatic stress disorder. Family is the “smoke detector” that can call an early warning for any of these issues – but only if they know to look for them. Any firefighter can (and will) say they’re fine if questioned at work, but at home, it’s much harder to hide. The spouse will know if the firefighter is drinking more, having nightmares or panic attacks, if their mood is off more than it’s on. The spouse will see that before the firefighter’s coworkers do.

So it’s a missed opportunity when departments fail to educate fire families about the common warning signs. Without this context, spouses and other family members may conclude such symptoms are normal, or they may fail to connect it back to the job. For instance, if their partner is detached, unmotivated and isolated, they may just assume the firefighter is unhappy in the relationship. They might not think to ask, was the firefighter exposed to trauma they are having trouble processing?

But family plays another force-multiplying role. If departments can help firefighter families effectively understand and manage the stresses of the job, they will reduce the chances of health and relationship issues occurring in the first place. A key example involves what Dr. Kevin Gilmartin calls the hypervigilance rollercoaster. During a busy shift, a firefighter goes into hypervigilance and the body gets depleted. So when they come home, they may be exhausted. The need to recover – to sleep, or to exercise to process the stress hormones. But their spouse – who has been alone, or single-parenting, for 24 or 48 hours or more – is likely expecting the firefighter to take over or at the very least to be present in family activities.

If departments talk about this with families, the message is often, “Your firefighter is going through a lot on the job, so when they come home, you need to be sympathetic.” That’s a start, but it leaves families asking, “What about us?” We need to acknowledge that the spouse and family have needs too and provide ways to help the whole family manage this lifestyle. When the family is functioning well it likely means people in that family are supporting one another, less stressed, sleeping better, better caring for one another’s needs. This reduces the firefighter’s stress, boosts their resilience, and will make them a happier and more productive employee. Every department needs more of those!

How to support the firefighter family wellness connection

Although some departments are doing a good job with family outreach, there is so much more we can be doing. Let’s think of it as falling into two buckets:

  1. Helping the family better understand and manage risks
  2. Helping reduce family stress so the firefighter can perform better

The first bucket is really about education. As I noted, the family is best positioned to see the early warning signs that something isn’t right. Education about what to expect should start in the academy and continue throughout the firefighter’s career. Consider holding a “micro-academy” for family members, hosting annual family health days and starting family support groups. These are great ways to share information, including:

  • The physical and mental health risks firefighters face
  • Red flags that indicate a firefighter may be having health issues
  • What to do when you see red flags – e.g., how to access EAP or peer support
  • Wellness lifestyle choices that can help reduce risks

We want our families to identify when something’s off because they see it early, when intervention is most effective. Equally important is enlisting the family in supporting healthy habits. If the spouse is the one who does the grocery shopping and prepares the meals, then certainly it’s helpful for them to know their spouse is at greater risk for heart disease and have access to healthy recipes that can lower that risk. Similarly, the family needs to know that exercise is essential for firefighters. Understanding how exercise can help the firefighter manage hypervigilance and stay fit for duty changes it from being seen as an indulgence to a way of taking care of themselves so they can be there for their family over the long term.

The second bucket is perhaps more difficult but equally important. Education is a start, but when it comes to managing the firefighter’s schedule, many families still feel helpless. They need practical tools to help them sit down and map out how they’re going to manage shift work, callbacks, overtime and seasonal deployments. Departments can bring experts in to facilitate these conversations.

In my practice, many firefighters defer almost completely to their spouse to manage the family schedule. They even talk of “floating in and out” of family life. Fire departments that can reach the person in charge of what’s happening at home unlock a big opportunity to influence firefighter wellness. Let’s engage the spouse in figuring out what the transition from work to home needs to look like for the firefighter., This includes understanding the firefighter’s needs for sleep, exercise and downtime. We should also explore the spouse’s support network beyond the firefighter and assess what additional support their family may require to manage these needs effectively, while also considering the family’s existing commitments and activities.

Fire service leaders can also get creative with scheduling to try to alleviate stress, even as mandatory overtime is required. Let’s return to that scenario of the firefighter being once again forced back. Without a family system in place, the firefighter will be reluctant, even afraid, to call their spouse to say they won’t be coming home. The spouse will be resentful and angry. They will both experience increased stress – and the department will pay the price.

But if the department provides options – for example, being able to choose from several extra shifts over the next several days – the stress is somewhat alleviated. And if the department has provided the family with calendaring tools to help identify what can be moved around, what can’t, what can be sacrificed and what can’t, the conversation centers around what option is best – rather than leaving the firefighter feeling guilty and the spouse to pick up the pieces.

You need us on board!

It’s time we stopped thinking about firefighter wellness as a firefighter issue. Yes, every firefighter must take responsibility for their well-being and work to reduce physical and mental health risks. But departments that fail to engage the family in firefighter wellness are missing a powerful tool. Spouses and other family members play a huge role in helping our firefighters stay resilient, prioritize their physical and mental wellness, and stay focused on the job – factors every fire service leader should care about.

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Dr. Rachelle Zemlok is a licensed clinical psychologist in California, specializing in work with first responder families. She serves as the strategic wellness director at Lexipol, supporting the content and strategy related to first responder mental health and wellness, with a special focus on supporting spouses and family members through the Cordico Wellness App. Prior to joining Lexipol, Zemlok founded First Responder Family Psychology, which provides culturally competent therapy to first responders and their family members. She is the author of “The Firefighter Family Academy: A Guide to Educate & Prepare Spouses for the Career Ahead.” For more information on Dr. Zemlok or to connect with her please visit her website.