Health & Safety

The Power of Peer Support in the Fire Service

Firefighters on a hoseline
Photo courtesy the Indianapolis Fire Department

By Michael Lanning

Today’s fire service faces many adversities, including entitlement, increased risk of cancer, financial issues, and low staffing levels. However, one issue is continuously left off the list, namely firefighter mental health. These three words seem to be almost taboo—often ignored and swept under the rug. Too often, an administration would rather ignore the fact their members suffer from mental illness than to confront the issue. It may seem easier to ignore the idea that your members suffer than to admit the professed weakness within.

Mental illness in the fire service is nothing new, but through education and awareness it is beginning to receive the attention that it deserves. The issue with mental health is that it is invisible; the symptoms may not always be observed or known. Although most who enter today’s fire service are aware of the potential risks of our profession such as toxin exposure, many are not prepared for the daily attack on our mental well-being.  It has been well documented that we are exposed to various health-changing toxins and poisons throughout the course of our careers, but the profession are still uncovering the science as it pertains to first responders and the potential long-term repercussions that we may face due to our chronic traumatic exposures. We see things that most only dream of in nightmares. When I became a student of the craft 10 years ago, I wasn’t advised about this, I was never taught how to prepare my mind and body for the things I would encounter. A major factor in the lack of knowledge regarding my future was the mentality of the senior guys to whom I looked to for direction. Through no fault of their own, they were taught to “suck it up and deal with it.” Although this simple phrase may seem innocuous, it has led to the downfall of many careers. It may result in burnout, lack of compassion, post-traumatic stress disorder (PTSD) and firefighter suicide, as well as some otherwise good firefighters seeking out “safer” career alternatives.

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From the day fresh recruits report for the first day of academy through graduation, we teach them the basics of the job. They are shown the most up-to-date science-based tactics and operational procedures and how to use the most current technologies. Yet we often fail to provide new recruits with the tools to deal with the potential struggles they may face. We teach them how to show strangers compassion when they repeatedly fall in their bathroom and to how to come off the rig ready for the towering inferno, but we as a fire service fail our brothers and sisters when we exclude mental health from their training.  

 This issue is not new. For decades, our brothers and sisters have fallen to their personal demons. Although I am not a fan of statistics, as they can often be changed and manipulated to capture what the individual wants them to reflect, Dr. Janet Savia, wrote in 2007 that she had examined every death certificate of firefighters in North Carolina from 1984-1999. She found that we are three times more likely to die by our own hands than in the performance of admittedly dangerous job duties. Although this study taught us so much, the downfall is that the study only included those whose primary occupation was listed as firefighter. After all, we know that career firefighters only make up roughly 30 percent of the American fire service. This means 70 percent of firefighters weren’t included in the study, so arguably that 3:1 ratio could be substantially higher.

Enough with the studies and statistics, let’s talk reality. There is a dark side of this craft that we don’t like to discuss and would rather ignore. Sooner or later we will answer calls that feature death, destruction, the lifeless bodies of children, the mangled remains of car accident victims, the charred bodies of burn patients, and the passing of the “frequent flyers” whom we have grown to care for like family. These are the things that we have accepted as casualties of the job. We were taught that these circumstances were normal and that we must accept and deal withthem. What happens when the smells, visions, and other frequent reminders of past calls come calling once again? We know that these wounds are not visible to the naked eye and yet many suffer from their effects. Why are they not as accepted and legitimized as broken bones or bad joints? Why is it easier for a firefighter to call out sick from work because they have a stomach bug but a mental health day is frowned upon?

There’s Help Out There

Fortunately, there are various resources available, one of the easiest being peer support. Let me preface by saying that this won’t “fix” your mental illnesses, but it has been proven to help by simply lending an ear. Peer support has been around since the 18th century, so it isn’t a new concept. Its first roots are traced back to a psychiatric hospital in France, where the governor of the facility recognized the value of employing recovered patients as hospital staff. They were found to be gentler and more honest with patients than the staff. The same concept can and should be used in the fire service today. It is quite simple to do and with the proper training it can be as beneficial and productive as traditional therapies.

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 What is the secret to all of this? It is to simply create and provide a safe and nurturing environment for those affected. We must not only acknowledge their emotions and send them on their way but provide a haven with open and confidential dialogue.  The North Carolina Peer Support Team has recognized an efficient and productive system; to simply LOVE: Listen actively, Offer assistance, Validate through understanding, and Encourage them to never give up and seek additional resources. In addition to this, it is of the utmost importance that we convey that these interactions are 100-percent confidential. While this is our goal, there are situations such as when individuals consent and the threat of self-harm emerges, where confidentiality rules may be broken. Once that safe environment has been created, it is amazing the walls that will come down. I don’t write this as an administrator or line officer but a suicide attempt survivor who is also a firefighter. I can attest that when you know someone genuinely cares about you and will not place judgment on how you are feeling, the thought and urge to complete suicide decreases if not entirely goes away. After all, those experiencing a mental illness often just want the acceptance and understanding from others. Many of us offer peer support already and we don’t even realize it. How many times do you initiate your shift with a cup of coffee and front bumper conversations? Whether it be conversation about your relationships at home or just how your day is going, such instances demonstrate the power of meaningful conversation.

Becoming a peer supporter may seem intimidating or a little out of your comfort zone. Nevertheless, knowing that I can make a positive impact and possibly provide a life-altering choice for someone just by having conversation trumps any fear I have experienced. As rewarding as it is, we must also accept and understand that we cannot save everyone, and we aren’t there to be “fixers.” As peer supporters, we are simply a bridge from the individual to additional mental health resources. We also offer a place to decompress because no one understands better than someone who is like you. I urge you today to take a stand against the often-stigmatized mental illnesses we as responders endure and pledge to bring awareness and prevention for our brothers and sisters. After all, the life you save may be the one who is scrubbing the rig’s rims with you just because, the assistant cook in the station kitchen for dinner preparation, or the one you are willing to die for should they call a Mayday on scene and you respond as RIT.  If you are willing to stand side by side during those times, why not stand by their side when the demons in their head are winning?

Michael Lanning is the deputy chief of the Scotch Irish (NC) Fire Department.