For my ASL final exam, we students were tasked with choosing a topic on which to report, something that’s more academic than casual. Over the last few years, a beloved family member has been struggling with PTSD related to his time as a volunteer firefighter. Because he lives near the shore of a Great Lake, much of his time was spent doing water rescues. Well, more truthfully, they were water recoveries, as few people lost to a Great Lake come out alive. As traumatic experiences are repeated, firefighters develop mental health issues with few pathways to recovery. What follows is my (brief) research on the topic, which I presented in ASL for my final exam.
For my research, I tried to stick to studies that separated career and volunteer firefighters, as most mix the two together. Most of the research I located was about the 2019-2020 “Black Summer” fires in Australia, which required the use of many volunteers, who are now being studied for mental health effects from the intense service they did. Nonetheless, I found enough articles that separated volunteer and career firefighters in the U.S.
There are 1,115,000 firefighters in the U.S., of which 67% are volunteer and 33% are career. 66.4% of the firefighter departments in the U.S. completely volunteer run, typically serving communities of 25,000 or fewer people. People don’t call them just for fires, though. I mentioned water rescue, but there are calls for medical, floods, natural disasters, car accidents, terrorist attacks, even technological disasters.
Career career firefighters struggle with mental health differently than volunteers: they have a high chance of becoming alcoholic, and 56% binge drink, meaning one sitting during which a person consumes 5+ alcoholic beverages. However, if a career firefighter needs access to mental health support, they can get it.
Both career and volunteer firefighters suffer from insomnia and thoughts related to suicide. In addition, volunteer firefighters are more likely to plan their suicide, attempt suicide, and are at a higher risk for suicide. They experience higher levels of depression and stress. 46% binge drink, and 10% have gotten into a car after binge drinking.
Volunteer firefighters also experience higher levels of PTSD, and there are some ideas about why. In addition to volunteering, the people who serve have full-time jobs, making it difficult to complete training. Also, volunteers are less likely to have a mental health screening before being accepted to the department, meaning past trauma and mental health concerns can become exacerbated. Furthermore, the nature of small communities means everyone knows everyone, increasing the likelihood that a volunteer firefighter is responding to a gruesome scene where someone they know is the victim.
For fear of being judged, both volunteer and career firefighters tend to refuse therapy. However, the longer a person has worked in this field, the more likely they are to request therapy. In addition to fear of stigma, volunteer firefighters struggle with the cost and matching their busy schedules with available therapy. One of the more agreeable solutions is peer support groups, in which everyone involved understands the unique culture of firefighters. Telehealth is another option, pairing firefighters with medical staff while the patient remains in their home on their schedule, and without the commute.
Haddock, Christopher Keith, et al. “Alcohol Use among Firefighters in the Central United States.” Occupational Medicine 62.8 (2012): 661-664.
Jahnke, Sara A., et al. “Firefighting and Mental Health: Experiences of Repeated Exposure to Trauma.” Work 53.4 (2016): 737-744.
Johnson, Candice C., et al. “Enhancing Mental Health Treatment for the Firefighter Population: Understanding Fire Culture, Treatment Barriers, Practice Implications, and Research Directions.” Professional Psychology: Research and Practice, vol. 51, no. 3, June 2020, pp. 304–11.
Pennington, Michelle L., et al. “Career versus Volunteer Firefighters: Differences in Perceived Availability and Barriers to Behavioral Health Care.” Psychological Services 19.3 (2022): 502.
Stanley, Ian H., et al. “Differences in Psychiatric Symptoms and Barriers to Mental Health Care between Volunteer and Career Firefighters.” Psychiatry Research 247 (2017): 236-242.