Decades ago, business writers and speakers began to preach that people needed to reach beyond traditional, structured thinking and come up with new ideas.

In the fire service, chiefs like Ray Picard and Ron Coleman flattened the walls of traditional boxes through the development of fire-department accreditation and new levels of professionalism. Phoenix Chief Alan Brunacini wrote outside the box with his concept of “Mrs. Smith” and customer service. Deputy Chief Billy Goldfeder and former state-trooper Gordon Graham leaped out of the box when they created FirefighterCloseCalls.com to promote safety through lessons learned.

The fire service has seen significant changes — and attempts at change — in the past 10 years, but the one most talked about regards the fire-service culture. Five years ago, fire-service leaders gathered in Tampa, Fla., in, was encouraged to think out of the box and find ways to prevent firefighter line-of-duty deaths. That meeting generated the 16 Life-Safety Initiatives.

National and state organizations have embraced the initiatives, in whole or in part, in a collective effort to change the emergency-service culture and to be proactive in health and safety.

Part of the cultural change has included recognizing the importance of being physically fit. All of the fire stations submitted for the 2009 Station Style Design Awards included fitness rooms. And the National Volunteer Fire Council has made strides with its healthy-eating campaigns and cholesterol screenings at conferences.

But what you don't hear much about is mental health. While some departments conduct psychological screenings before hiring, and many departments have critical-incident-stress management or employee-assistance programs, the stigma over seeking help for mental health remains.

Earlier this month, the National Fallen Firefighters Foundation hosted its 15th annual memorial weekend. There were 1,100 survivors who were attending their first memorial weekend, and 1,200 who were returning attendees or volunteers.

As I walked around, I asked the volunteers why they were there. Each volunteer paid his way and used personal or vacation time to travel to Emmitsburg, Md. From the returning survivors manning the registration table to the escorts assigned to new families to the command staff behind the scenes, each person said it was the emotional connection that brought them back. The memorial weekend offers an environment in which it is free to talk about emotions.

Critical-incident-stress debriefing and stress-management tactics are a step up from kitchen-table therapy. Over the years, and on many different levels, we have become a society that finds camaraderie through networking via professional and social organizations. In difficult times, we find the courage to seek help through support organizations — we need to find others who have experienced the same pain and searched for a healthier state of mind.

At a recent conference, Mike Dubron, president of the National Firefighters Cancer Support Network, talked about his experience with cancer. The day Dubron received his diagnosis, he began the fight for his life. Dubron learned of other firefighters who had cancer and soon thereafter created the support network.

I recently met a young lieutenant at a fire department in North Carolina. He told me that a firefighter's emotions are like an attic. “You keep storing things in there and it begins to fill up,” he said. “You have to let it out or it's going to burst.” He encourages the new firefighters to exercise and to talk — and keep talking — for mental fitness.

Emergency-service responders see things that would horrify the average person. Part of changing the culture must include how to stay fit emotionally.