13. Psychological Support


Firefighters and their families must have access to counseling and psychological support.

Initiative 13 means that firefighters and EMS professionals and their families must have the resources to deal with the various complications that their jobs can bring to their lives, especially issues regarding emotional and psychological stress. They must also have help available to deal with the problems in living that all of us sometimes face, regardless of the work we do, especially regarding family, finances or even drug and alcohol issues. Health and safety standards (like the NFPA 1500 Standard on Firefighter Health and Safety) require that assistance programs be made available to ensure that such services are there when needed.

ACT: Help a Firefighter Struggling with Suicidal Thoughts

Ask. Care. Take.

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Things to Consider:

  • Calling them today.
  • Asking how they are doing after that call.
  • Grabbing a cup of coffee with them after your shift.
  • Encouraging them to get some help or support.
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National Suicide Prevention Lifeline 1-800-273-TALK (8255)

Inside Initiative 13

flsi13modelNew Model for Exposure to Potentially Traumatic Events

Understanding the new model for Initiative 13 dealing with firefighter behavioral health begins with an overview of the Protocol for Exposure to Occupational Stress. At the heart of the following flow chart or model is an understanding that firefighters and EMTs do not all respond similarly to traumatic events-thus, we have adopted the practice of calling them potentially traumatic events (PTEs). What’s different about firefighters and other first responders and why understanding their occupational stress is critical has to do with the “unfortunate regularity” of these workers to horrible, dangerous and stressful situations.

The model and accompanying notes explain the components of determining who is impacted and who may need assistance. It recommends the use of the Trauma Screen Questionnaire as a widely accessible tool for individuals to understand if they are in need of behavioral assistance.

» Recommended Protocol: Occupational Stress Exposure
» Trauma Screening Questionnaire (TSQ)

From Employee Assistance Programs (EAP) to Behavioral Health Assistance Programs (BHAP)

Firefighters and EMS personnel have chosen careers that can sometimes magnify the stresses, strains and issues in living that all of us face. Those careers can also add additional layers of stress and demand due to the nature of the work involved and the conditions, schedules and circumstances under which the work is done. The need for work/life assistance programs is therefore a critical part of both occupational health and wellness programming and an essential feature in any employee benefit package. Often fire departments are confused as to the type of behavioral health assistance they should offer. Likewise, many EAP providers are not familiar with the fire service and therefore do not know what help they should market to first responder organizations. The guide From EAP to BHAP will help both fire departments and providers craft solutions that will best serve their firefighters and EMS professionals.

This area of the Initiative 13 website provides fire departments with information on the current standards and a template for building and evaluating an effective Request for Proposals (RFPs) to recruit BHAP providers. The site also provides prospective vendors with guidance as to how to build a cost-effective proposal by utilizing resources available from Everyone Goes Home® partners and other easily accessible programs to satisfy the requirements of the standard.

Depression & Suicide in the Fire Service

Increased attention to suicides among firefighters has led to a strong sense of urgency among many fire service organizations, and a heightened desire to take strong and immediate preventive action. However, up until this point there has been very little in the way of strong evidence to shape those responses or guide responsible action.

As a first step in coordinating industry-wide efforts to address this issue, the National Fallen Firefighters Foundation (NFFF) convened a summit meeting July 11-12, 2011 in Baltimore, Maryland to discuss Issues of Depression and Suicide in the Fire Service. The NFFF, as a part of its Firefighter Life Safety Initiative 13 of the Everyone Goes Home® project, has been at the forefront in developing a consensus-driven agenda to focus efforts and resources to address the behavioral health needs of firefighters and their families.

» Read More: Suicide and Depression White Paper

» Meeting Report: Issues of Depression and Suicide in the Fire Service
» Second Meeting Report: Confronting Suicide in the Fire Service


» Suicide: What you need to know A Guide for Clinicians
» Suicide: What you need to know A Guide for Fire Chiefs

For more information on any of the behavioral health programs,
email [email protected] or call 703-201-1238.

As part of its commitment to bringing the best resources available to Initiative 13, the National Fallen Firefighters Foundation (NFFF) brought leading experts in employee assistance research and practice together with representatives of major fire service constituency organizations to determine the best practices, approaches and standards of care currently available, and to develop ways to ensure that firefighters and their families could have ready access to cost-effective and clinically efficacious assistance.

Among the products of that three-year effort were revisions to NFPA 1500 with respect to behavioral health assistance programs (now referred to as BHAPs) and occupational exposure to atypically stressful events (formerly referred to as “critical incident stress programs”). Based on input from researchers, practitioners, fire departments and fire service organizations, the new standards are designed to help fire departments clearly specify the services their members need through these programs; the levels and standards of care they should expect; and provide a framework for evaluating proposals and programs to determine the best for their agencies. The Firefighter Life Safety Initiative 13 effort also developed a number of resource programs to assist providers of behavioral health care in acquiring the latest in evidence-supported best practice skills through easily accessible, low-cost products developed by leading research and training programs in behavioral sciences and behavioral health. Working in concert, this will allow departments and their providers to ensure that firefighters and their families receive the best care and assistance at the lowest possible cost.

Checking In: A Behavioral Health Size-Up Podcast

Checking In
This podcast supports this initiative by providing information on behavioral health topics that fire departments face every day. The goal is to provide a foundation for a discussion on how to address behavioral health practices to help firefighters and their families. This podcast is managed by the National Fallen Firefighters Foundation and is hosted by Craig Luecke.

Listen to the Checking In: A Behavioral Health Size-Up Podcast

Latest Initiative 13 News

  • Strategic Vision Helps Ensure Firefighter Safety and Enhance Service To help fire departments around the nation adopt the 16 initiatives, the National Fallen Firefighters Foundation has created a new handbook, The Strategic Vision Guide: An Action Plan Using the 16 Firefighter Life Safety Initiatives.
  • Newport News Safety Officer Promotes Mental Health Awareness, Awarded Virginia Firefighter of the Year Newport News Fire Department Safety Officer Lt. Sidney Lucus was named Virginia’s Firefighter of the Year for a new mental health peer support program he organized and help launch for the city inside station #1 downtown.
  • ACT Now to prevent firefighter suicides The risk of firefighter suicide is a growing concern within the fire service. More research has become a priority to better understand the issue and assist in developing interventions. A recent study of 893 firefighters by Florida State University and published in the latest issue of the Journal of Psychiatric Research shows a strong relationship between post-traumatic stress symptoms (PTSS) and suicidal thoughts and attempts among firefighters.
  • Do you recognize the stressors and symptoms that can lead to firefighter suicide? Within the past decade, there has been an increased awareness that the stressors of fighting fires and responding to stressful incidents are taking a significant toll on the behavioral health of firefighters. A recent study of 893 firefighters by Florida State University published in the Journal of Psychiatric Research shows a strong relationship between post-traumatic stress symptoms (PTSS) and suicidal thoughts and attempts among firefighters.
  • Help Researchers Learn More About Suicide and Mental Health Among Women Firefighters The Carson J. Spencer Foundation and researchers at Florida State University are collaborating to conduct a national study on the behavioral health of women firefighters.
  • Firefighter Life Safety Initiative #13 Update This fall, the Behavioral Health team will be launching several new resources to provide the fire service and their families with access to counseling and psychological support.
  • Balance Firefighting and Family A 24-7 COMMITMENT lifestyle means that you can balance a dream career like firefighting without sacrificing family. And so can your spouse. We’re going to help you determine what actions you can take to live out your dream, while doing the job you love, living with no regrets, and making every moment with your loved… Read more »
  • NFFF New Goals Campaign: Wildland Firefighting From the October issue of Firehouse® Magazine By Chief Ronald J. Siarnicki Our hearts were heavy this past August when three wildland firefighters were killed battling the Twisp River Fire in Washington State, and two died battling fires in California. These tragedies shook their communities and saddened our nation. These devastating deaths and other injuries… Read more »
  • New study sheds light on questions about suicide in the fire service Every day the public relies on firefighters to respond without hesitation to manage and resolve multiple emergencies, often while putting themselves in high-risk situations. In the wake of multiple suicides within departments around the country, fire service leaders have asked if firefighters are more vulnerable to suicidal tendencies.
  • One Step at a Time Rituals with Laura Ling is a series that takes viewers on a journey through the psyche and habits of extraordinary individuals to find out how they survive, thrive, and gain focus. This episode shares the ritual of Greg Collaco, a San Francisco fireman who uses stair climbing to fight PTSI.