The only one who understands the amount of pressure and responsibility that a fire chief has is another fire chief. But imagine getting the phone call that one of your members has a substance abuse issue, hasn’t reported for duty, attempted suicide, or they actually completed the attempt.
The role of the fire chief in creating a behavioral health program is simple, it is a role of support and understanding. Like many other initiatives within the department, someone is passionate about this or someone is wanting to make a difference and the chief just needs to find those people andgive their approval to let them go out and do great things. And fortunately, the NFPA’s Urban Fire Forum (UFF) released a position paper last year outlining the components for a comprehensive behavioral health program and the first step is creating and establishing a Behavioral Health Committee and appointing a chair.
And while the committee can design and develop the framework of a comprehensive behavioral health program such as establish a Peer Support Team; provide education about behavioral health; review policies; tackle stigma; and seek out the needed resources, there are a few things that only the fire chief can address:
Zero tolerance policy is something that most every, if not all, departments have when it comes to drug abuse. But what happens if an employee blows their knee out on scene or tear their shoulder while lifting a patient? This is usually followed by surgery, being out of work for a length of time, rehab, and of course pain pills. And what happens when someone becomes addicted to pain pills? Does zero tolerance still apply? In most cases, it does. According to Dr. Cahan, Director and Chief of Pain Medicine and the University of Washington, states that 80% of patients prescribed opioids for longer than 90 days are still using them 5 years later. So, the question now becomes an employee who is addicted to pain pills who was injured doing the job they are paid to do now faces termination due to said addiction and we are ok with that? This is where the fire chief comes in. Maybe it’s time we revisit zero tolerance and create exceptions to the rule. This discussion needs to happen and they are the only ones who can begin this conversation.
The Employees Assistance Program (EAP) is another table that the fire chief belongs to, however probably doesn’t have a seat at. In most localities, EAP contracts are negotiated by Human Resources or Benefits Office. The biggest issue with EAP and public safety is the lack of involvement and customization to public safety. We are a unique group and require special attention and the typical EAP program doesn’t provide that. In order to bring this issue to light, the fire chief along with the police chief, the sheriff, emergency communications director, and other unique groups need to have a seat at the table during the contract reviews to ensure that the EAP company is able to provide what we need. In order to ensure we are providing what our people need we need to make sure we have a program that understands what it is we need.
As discussed in previous articles, there are several stressors that are unique to the fire service and at times, these stressors may require certain accommodations such as an alternative assignment (days) to work through. Maybe it’s a marriage issue or a childcare issue and it requires some time to be home in the evenings to work through it or even some time off. While we are all having staffing issues and shortages, the ability to accommodate employees for a short time may allow us to keep them for a long time.
And finally, support. The chief must come out in support of the program. If the program coordinator says that units or personnel need to be out of service for a peer support meeting, then the chief needs to support that. If there is push back from company officers or battalion chiefs on allowing this to happen or allowing a peer support team member to respond if needed, then the chief must come out and address this. We place units out of service for training on skills daily, why is it an issue to take a unit out of service to handle a stress reaction? The research is clear, left unchecked these issues can spiral out of control and ultimately cost the employee their job or worse and/or cost the department a good employee that they now have to replace.Training on skills keeps us alive on the fire ground, addressing stress reactions and stress injuries when they occur keeps us psychologically healthy for our career. As with a fitness program, this is has a solid return on investment (ROI).
Every fire chief I know is inundated with meetings with city managers, board of supervisors, budget and finance, and the list goes on. That’s why when adding a complex issue like behavioral health, the best thing the chief officer can do is to place it in the hands of people who have a passion and/or understanding of how important this topic is. Trust your people and support them and they will trust and support you. If you haven’t already started, it is a good time to do so on how we address this issue and how we talk about it and the fire chief is a good place to start.
This is part threeof a three-part series. Part one looked at the recruit and part two looked at the Company Officer’s role in firefighter behavioral health and stress.
About the Author
SIDNEY LUCAS began his fire service career as a volunteer with the Belle and Cedar Grove Volunteer Fire Departments (WV) in 1999 and currently serves as a Lieutenant with the Newport News Fire Department (VA) and is assigned as the Department Safety Officer. He has been with the department for over 11 years where he has served in various capacities. He is a former Chief of Quinton Volunteer Fire and EMS (VA) and a veteran of the United States Navy, serving onboard the USS Wasp (LHD-1) as part of the Crash and Salvage Team supporting the Global War on Terrorism. Sidney is a graduate of the Virginia Fire Officer’s Academy and currently serves on staff.