The Culture of Mental Health in Fire and EMS

Mental health is an important topic for EMS organizations and Fire Departments everywhere. Statistics suggest that every organization has individuals on staff that have a diagnosed, or undiagnosed, mental health illness.

Over the past seven years, I have served as the Fire Chief for Burnsville Fire Department. During my time as Chief, the department has seen multiple staff members seek treatment for mental health illnesses. Dealing with mental health in our own organization is our new reality and can actually make our organization stronger. I feel the hottest topic related to mental health is post-traumatic stress disorder (PTSD). PTSD is prevalent in our industry because as first responders, we see things that we unfortunately struggle to forget. I may be an outlier amongst my peers in how we view mental health, but I believe it is important to create a culture of support around mental health.

The Impact of Patient Care

Treating patients with mental health for EMS providers presents a lot of challenges. Mental health can present across a very large spectrum in EMS; some patients you will find are in acute crisis while others are diagnosed with issues of a chronic nature. Challenges also arise from finding suitable access to health care for mental health patients. There are many areas that do not have enough mental health resources, such as inpatient beds, so patients are either released from the emergency department shortly after we drop them off and we will encounter them again, or the patient is transferred a long distance to get inpatient treatment. 

Being a first-hand witness to these failings in the system does not instill confidence in staff members that are potentially experiencing their own mental health issues. I believe that staff members are of the belief that if they get treatment for an issue related to mental health, they will not be able to work in our industry any longer. In my personal experience here at Burnsville Fire, we have seen many success stories of our providers getting help with their mental health issues and then return to full-duty work without issue.

The First Steps

In order to change the culture, we need to start addressing the barriers that keep our staff from getting help. In our organization, we took a hard look into explaining to our providers that psychologically-ill patients are just as much of a qualified medical patient as anybody else that calls 911; our mission is to treat and transport those in need of medical attention. We no longer accept complaining about those calls and continue to have conversations with our staff about these calls and how we relate to them as an organization.

I believe setting the tone within the department is important to creating a culture of supporting mental health. This initiative starts on the street: how do providers relate to mental health calls. So often in my experience, I hear about providers complaining to their partner about the mental health call they just had; often times people will say that they don’t feel they should have to go on calls of this nature. If that is how a provider talks to their partner about mental health patients, what is the likelihood that the staff member would bring their own mental health issues up to their partner while on shift?

With this in mind, the department is focusing on treating mental health illness no different than a physical injury when it comes to the health of our staff. When an employee’s mental health professional clears the staff member for full duty, we take that recommendation and put them back on full-duty. Just like any other illness/injury, we don’t send them for a secondary evaluation unless the staff member is not meeting the organizational expectations for their position.

The department has also bolstered the supportive opportunities we offer to our staff. Resources such as improving our Employee Assistance Program (EAP), that consists of specific public safety mental health providers to offer support and education. Many organizations just check the box and take the cheapest EAP provider; we have published a list of licensed mental health providers in our area that are both in-network for our health insurance and have experience treating public safety staff. There are many other programs we offer such as peer support and chaplains.

Burnsville Fire Department also provides mandatory training every year about health and wellness topics that include mental health. During the first few weeks of being hired on at the department, we spend time with all of our new employees to go over the symptoms of mental health illnesses and the resources that are available to them and their families.

The Reality

Our supervisors have been instrumental in carrying out the culture change. The peer-to-peer relationship and the peer-to-supervisor relationships that have been cultivated are truly helping make this culture change possible. At every level of the organization we want the stigma from seeking help with mental health challenges gone. There is nothing embarrassing or shameful about getting treatment.

I feel very fortunate that we have had a number of our staff that have gotten help for their mental health, come back to work and have been very open about their experiences. These success stories help others feel more comfortable talking about their own mental health concerns and their experiences when accessing resources if needed. If these staff members do not get help they will become less productive staff and many times they become problematic staff requiring performance management.

I have had peers that do not feel they can trust a staff member once they are diagnosed with a mental health illness, which I totally disagree with. I guess they would rather not have their staff get the help they need. Having healthy employees leads to a healthier and more productive organization. I challenge everyone at every level to help make changes in their organization to be more accepting of mental health illnesses.

Editor’s note: BJ Jungmann is a finalist for a 2018 Hooley Award in the New Frontier category. The Innovation, Service and New Frontier Hooley Awards will be presented at ImageTrend Connect on July 18, 2018.