Submitted by Dr. JoEllen Kelly & Richard Gist, PhD

Baltimore, MD - Over two dozen academic, military and fire service leaders met in Baltimore on December 4 - 5 to launch a series of strategic steps toward implementation of the 13th Firefighter Life Safety Initiative-Firefighters and their families must have access to psychological support and counseling. Drawing upon the White Paper commissioned for the 2nd Firefighters Life Safety Initiatives Summit (Novato, CA, March 2007) and the output from the Summit, this group met to determine specific projects and products for enhancement of behavioral health in the fire service.

The meeting was facilitated by Dr. Richard Gist of the Kansas City [MO] Fire Department with assistance from Vickie Taylor, LCSW, Behavioral Health consultant to the National Fallen Firefighters Foundation. Chief Ron Siarnicki, Executive Director of the National Fallen Firefighters Foundation, welcomed the group and explained the importance of the 16 Initiatives, followed by an historical overview of NFFF's investment in behavioral health activities. Dr. Gist then led the group through a series of explorations focused on "knowledge translation," described as a critical feature of successful growth and development in any applied enterprise.

"The essence of knowledge translation centers on matching the needs of the applied domain with knowledge and skill sets developed in the research and academic arena," explained Dr. Gist. This process identified researchers and academicians who had developed solid programs that could be applied to critical fire service needs and connected them to fire service constituency groups that hold vested interests in behavioral aspects of health and safety and hold the capacity to disseminate best practices to their various constituencies.

Four areas were targeted for discussion:

1. Service-related fatalities are related to diseases and accidents in which behavior and lifestyle choices represent modifiable risks.
2. Impact of exposure to potentially traumatic events in the context of the occupation.
3. Dissemination of evidence-based practices to first-line behavioral health care providers (typically community clinicians and EAP personnel.)
4. Movement toward consensus standards for behavioral health services provided to fire and rescue organizations.

Academic programs represented included researchers from the Kansas City University of Medicine and Biosciences who have been strongly involved in military programs for cardiac risk management and are now working under the Assistance to Firefighters grant program's Research and Development aspect to do similar work with firefighters; representatives of the Center for traumatic Stress Studies at the Uniformed Services University of Health Sciences (the military's medical school) known for leading the field in areas such as combat stress and impacts of terrorism and mass casualty; the National Crime Victims Research and Treatment Center at the Medical University of South Carolina, whose web based programs to instruct journeyman mental health clinicians in evidence based treatments such as Cognitive Behavior Therapy (CBT) have been completed by more than 15,000 practitioners; the Hamovitch Center for Science in the Human Services of School of Social Work at the University of Southern California, the Education and Training Division of the National Center for Posttraumatic Stress, and the National Institute of Occupational Safety and Health. Fire service interests were represented by experts from the International Association of Fire Fighters, the International Association of Fire Chiefs, the National Volunteer Fire Council, the National Association of EMS Physicians, the North American Fire Training Directors, the Federation of Fire Chaplains, and the National Fire Protection Association. Several fire chiefs were invited and present to offer their input and analysis.

A second session is tentatively planned for February at the University of Southern California to explore the range of areas in which behavioral health consultation can benefit fire service organizations and how current models and concepts such as the Member Assistance component of NFPA 1500 and the behavioral health aspects of NFPA 1582 could be enhanced to reflect current science and contemporary best practices. Central to this session, as in the first, will be the design of systems to make the needed resource readily accessible at limited or no cost to practitioners assisting fire service organizations. Future work will center on similar knowledge translation in other health promotion and risk reduction activities.