Occupational stress is strongly associated with mental and physical health. We know how many firefighters are lost in the line of duty, yet we do not know how many are lost to preventable mental and physical strain that result in physical health ailments and psychological distress.

In many departments, the typical stress management program is tailored to helping firefighters improve their level of physical fitness and quality of sleep, acquire healthy eating habits and stop smoking. However, seldom are there any efforts directed toward enhancing firefighters' social support networks — their families, friends, significant others, spouses, union, managers and co-workers.

Research has clearly shown that social support is a protective factor against occupational stress and subsequent psychological distress among firefighters. To use this resource effectively, chiefs and senior officers need to understand stress management models; social support dynamics in mitigating distress; the connection between social support, healthy organizations and personal resilience; and practical actions fire departments can implement to improve social support networks at work and home. They need to think non-traditionally regarding the responsibility of fire departments toward personnel and their families regarding stress management, and consider implementing preventative and intervention strategies that take advantage of the benefits of social support and address the problem of stress and stress-related disorders on individual, organizational and external levels.

Misguided methods

Many fire departments unknowingly continue to approach stress management based on the person — environment fit model. This model states that certain events occur in the environment that produce stress and lead to physical and emotional strain, and its focus is the identify these factors. This has led to the current genre of stress management programs, which highlight the traumatic stress associated with the dangerous and hazardous environmental conditions firefighters encounter.

However, firefighters continue to identify organizational dynamics as more stressful than emergency operations. These stressors include clashes between labor and management, conflict among co-workers at the fire stations, unsupportive and inadequate commanding officers, lack of proper equipment, and inadequate policy and procedures.

The IAFF and IAFC consistently have recommended that fire departments address organizational dynamics in their wellness initiatives, but many of today's stress management programs neglect organizational stressors' impact on firefighters mental and physical health. Because of this neglect, the fire service continues to observe tremendous strain in its personnel.

This reluctance also results in social support being ignored as a viable option in mitigating the strain firefighters experience. Research studies identify the support of family and friends as being the most salient in helping firefighters to cope with the various job stressors. Others have stated that co-worker and supervisor support matter the most. Despite the mixed findings, it's clear that a positive social support network at home and at work helps firefighters cope with the stress of their occupation, improving mental and physical health outcomes.

Look internally

A positive social support network has proven to be a protective factor against depression, occupational stress and PTSD. Specifically, job satisfaction and morale is strongly associated with a positive social support network at work. Likewise, negative or conflicting social support networks have been correlated with poor morale, job dissatisfaction, firefighter's perception of increased levels of job stress, depressed mood and increased risk for PTSD.

Additionally, a positive social support network in the home and workplace promotes resilience among firefighters. Resilience is the capacity to rebound from a crisis or trauma by drawing from the experience new information that can be interpreted and used for betterment. People develop resilience when their environments encourage it through caring and support, high positive expectations for integrity and achievement, support for dreams and goals, strong community connections, positive attitude toward the future, and meaningful participation and involvement. A positive social support network would ensure that many of these protective factors exist within those environments.

So what must occur for fire departments to cultivate positive social support networks, taking advantage of their benefits? The first step is a change in attitude among all ranks regarding the importance of organizational factors. Unlike businesses that have to continually improve productivity to produce good quarterly earnings, fire service professionals often fail to consider the negative influence of organizational factors on the organization. Those factors have personal and professional consequences for firefighters such as poor service delivery, low productivity, absenteeism, lowered morale, marital discord, substance abuse, poor public relations and increased costs for citizens.

A positive social support network is typically the outgrowth of a healthy organization, one with trust, integrity, open and honest communication, and efficiency. Healthy organizations result in fewer occupational stressors and, subsequently, less negative impact on employees' home environments.

Chiefs and their senior staffs must take the initiative to create healthy organizations. This consists of identifying organizational factors that create stress, establishing an atmosphere of collaboration among management and line personnel through team-building, creating opportunities for personnel to actively participate in shaping the department, and ensuring the commanding officers have extensive training in conflict resolution and communication.

When polling personnel to determine what organizational practices and policies are creating unnecessary stress and strain at work and home, make sure it is an anonymous process so that personnel feel safe to express their true opinions. Enlist the help of the various employee groups to develop and distribute the survey and collect the information. All areas of the organization should be addressed.

Chiefs should not conduct such a survey unless they are prepared to act on the results. Failure to act will only exacerbate stress and resentment within a department. Elicit the input of personnel in developing solutions and interventions to resolve the identified problematic areas.

Act externally

Conduct a series of supportive and informative workshops for the spouses and significant others of fire department personnel. Begin a new recruits' spouse/significant other job orientation session, which would help the families of firefighters gain an understanding of the job requirements, demands and benefits. Offer a second workshop for spouses, significant others and departmental personnel that educates them in regard to the potential negative impact that job stress can have on interpersonal relationships and communication, preventative measures that they can take, the early warning signs, and where and how to seek help for relational difficulties. Finally, offer marital enrichment workshops.

Next, initiate ongoing psycho-educational workshops as a part of in-service training about a variety of relevant mental health topics for fire department personal such as depression, PTSD, secondary trauma and substance abuse. This will communicate to personnel the importance of these areas, as well as enable them to recognize symptoms early.

Finally, provide a resource for departmental personnel to obtain individual, martial or family counseling. There often is a stigma associated with using mental health services, therefore chiefs and their senior staff must create a departmental culture that accepts and encourages the use of these services. Efforts that can be taken to achieve this include ensuring confidentiality, publicizing availability of the services through brochures and flyers throughout the stations, and making sure commanding officers are well-trained in procedures for accessing such services.

A mental health professional can assist a department with implementing most of these interventions. The department might consider using their employee assistance program as a resource if this is feasible. Another option is to identify and establish a relationship with a mental health professional in the community who has an understanding of fire service culture.

Few departments address organizational dynamics in their wellness initiatives, despite urgings from national organizations and the mental health community. With continued neglect, the fire service will continue to lose countless members to mental and physical fatigue before their time.

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Portia Rawles, Psy.D., serves as an assistant professor in the Doctor of Psychology program at Regent University in Virginia Beach, Va. Prior to becoming a licensed clinical psychologist, Rawles served 13 years with Norfolk (Va.) Fire and Paramedical Services, now Norfolk Fire and Rescue. She retired as a captain and continues to serve locally on the regional CISM team and consult with public safety agencies. She can be reached at portraw@regent.edu.