Features Health and wellness
A new firefighter wellness program

Mental health in the fire fighting community is becoming more widely discussed and prioritized amongst departments throughout Canada. Many mental health supports are focused on reactive solutions to preventative problems, and it was from this perspective that I developed the Wellness Plan for Firefighters, a free, preventative training program that establishes a baseline and then offers opportunities for refreshers across a career. 

The Wellness Plan for Firefighters is a psychoeducational, interactive training plan that focuses on mental wellness while also incorporating aspects of physical, emotional, and spiritual well-being. The program includes cognitive behavioural therapy (CBT) based activities and diagnostic assessments to establish baseline levels of wellness supports and coping strategies, as well as scores for mental health assessments. Created to provide an initial training immediately after recruitment and having the ability to provide focused refresher training specific to certain aspects of mental health, this plan can help improve a firefighter’s ability to stay in the field longer, be healthier and catch mental wellness issues early. 

The development of this program included support and input from multiple mental health workers and active firefighters. Each module of the plan is rooted in research from the DSM-5 and evidence-supported practice exercises. The assessments within the plan include commonly used publicly accessible tests that are used to screen for various mental health disorders. The program started with an extensive literature review stemming from primarily Canadian studies to provide evidence-backed research into the skills and theories taught in the program. 

The literature review served to identify gaps in mental health training, stigma, and education already present in fire fighting organizations, giving specific areas of focus for the program and expanding on knowledge and skills already provided in training by having information on those basics already provided, narrowing and expanding parts of the program by infusing them with research from interprovincial and international studies. The resulting paper allowed a wellness program to develop that can teach a firefighter from the time they’re hired to the time they retire (which is the ultimate goal, for a firefighter to retire on their own terms, not due to mental wellness issues) with skills that allow for self-care, mental health assessments and access to supports in their own local communities. The goal of the paper was to develop a program that focused on preventative measures to improve mental health instead of reactive measures, which is what it did. 

The next step to developing the program was integrating personal experience and learning from firefighters in local communities. This collaborative approach to developing the program fostered an understanding of what is needed on the ground in terms of mental health supports for firefighters, as well as explore improving upon basic mental health training for new recruits. Analyzing the connections between mental health and other aspects of wellness, as well as personal and professional supports in and out of EAP programs, and including social and community connections, are key aspects of a well-rounded program. The concept of being proactive in accessing support and retaining employment without leave is crucial and is the largest influence of this program’s creation. 

The use of basic psychoeducational techniques is meant to establish a baseline of skills and resources at the beginning of the career and then further develop these skills with activities solely based on CBT skills taught in a therapeutic setting. The use of CBT activities is purposeful as it is a commonly used and evidence-backed modality of therapy for firefighters suffering from a variety of mental health issues. Learning these skills before problems arise can make it easier to practice the skills when such things happen, and mental wellness becomes an issue. This piece was added by consulting mental health professionals with expertise in trauma, depression, anxiety, and professionals who were well versed in CBT as a practice model. The use of CBT-based activities was intentional based on the structure of this modality which often fits well with people who thrive in structured settings, or in other words, CBT has been proven to work well with firefighters (Johnson et al., 2020).

Incorporating the diagnostic screening tools directly into the program allows for a starting point to monitor progress and catch signs and symptoms early. These tools are not meant to be used as the only method to diagnose a mental wellness issue, but as one way to make a person aware of any symptoms they may be experiencing and then to allow them to get help earlier because of this awareness. The screening tools are simple enough to be self-administered in terms of instructions. They are also easy enough to score to be able to monitor scores progressively. All the assessments are also available online so anyone can get one and fill it out easily enough to monitor themselves regularly if needed. 

The program was developed to be a tool for a firefighter throughout their career. Optimally, a new firefighter would complete the full program, including all assessments and exercises, shortly after recruitment. The screening tools are based around specific amounts of time, for example, symptoms in the last two weeks, and intended to be completed about once a month to establish regular patterns and to notice any irregular scores quickly. The other exercises and activities throughout the program can be revisited at any time although reviewing them every few months is recommended as well. The information and educational pieces in the program are current and as research is updated and changing, looking at different evidence can also be useful as needed. 

After the initial program, refresher sessions can be implemented regularly by the department or by the firefighters themselves if they feel like it is needed by a crew. These refreshers can also be done informally and alone. They can be as simple as reviewing a specific section or sections of the program as needed or reviewing the entire program as a whole. Reviewing pieces of the program regularly is recommended in both formal and informal sessions at least once a year to ensure mental wellness is a priority among crews.

Implementing the program with not-so-new firefighters is also very possible and useful. The experience brought to the table by more experienced firefighters can enhance connections and improve discussions during exercises and activities. For example, a real situation or call experienced by a firefighter or crew can be used to discuss how to improve responses to a difficult call for an entire department, by making everyone aware of differences in the effects of a call among crews or individuals. The program notes that the assessments are there to establish a baseline and to flag potential future problem areas, but they can also highlight areas that may require additional support in the moment for firefighters who have been working for a while. As previously noted, these scores are meant to make firefighters aware of their mental health, not to diagnose mental wellness issues.

The Wellness Program for Firefighters is useful to all members of a department at any stage of their career. The program is meant to be revisited regularly both in formal and informal settings allowing for individual and group exercises. The program incorporates psychoeducation, evidence-based activities, and exercises to improve mental wellness, and assessments to establish baselines and note any marked changes in scores to catch symptoms of mental wellness issues early. The whole program is backed by extensive current research and incorporates recommendations from mental wellness professionals and firefighters themselves. It offers flexibility in when to do refreshers, complete assessments and adds a level of focus to other areas of wellness beyond mental throughout the program. To access the program, please email jabolzon@lakeheadu.ca. •

References: Johnson, C. C., Vega, L., Kohalmi, A. L., Roth, J. C., Howell, B. R., & Van Hasselt, V. B. (2020), Enhancing mental health treatment for the firefighter population: Understanding fire culture, treatment barriers, practice implications, and research directions. Professional Psychology: Research and Practice, 51(3), 304–311. doi.org/10.1037/pro0000266. 

Jordan Bolzon got their BSW at Lakehead University and their MSW at the University of British Columbia, eventually becoming connected to the fire fighting world through a placement with Nick Halmasy at After the Call.