Some numbers are familiar to members of the fire service and first responder community. They tell a story. 9/11. 343. Two-in/two-out. NFPA 1500, 1401, 1001, 1002. These numbers represent the safety standards of our industry, the expectation of service we will provide to our crews and the communities we serve. They also represent an historic day of national tragedy, heroic efforts, and devastation to New York City, the Pentagon, and the passengers of Flight 93.
September 11, 2001 was a day of national tragedy that changed many things about how the nation and the fire service respond to disasters. It also cracked open a door to the need for behavioral health and wellness programs for the first responder community. The World Trade Center Health Program, which included coverage for mental health services and the acknowledgement of post-traumatic stress disorder (PTSD) as a legitimate risk in First Responder communities, was created after 9/11. This program legitimized behavioral health and wellness programs as a treatment path for first responders across the nation.
Numbers Only Tell Part of the Picture
However, the road to acceptance of mental health services in fire and EMS has been full of roadblocks. In recent years with attention focused on acquiring data as a means to provide care for those who need it most, three additional numbers are shoving the door wide open and exposing the dire need for not only additional but focused and effective behavioral health services for our first responders. 1,645. FF 36. EMS 4. These are the suicide numbers recorded by the Firefighter Behavioral Alliance: 1,645 since 2000, with 36 firefighters and 4 EMS members in 2021 alone. These are only the suicides that have been voluntarily reported1. When national databases are mined for information, the current situation looks no better. A recent Western Journal of Emergency Medicine article found in a comprehensive study that firefighters and EMT’s “died in significantly greater proportion by suicide than the general working population.” 2
How to Make a Difference
What can be done to help our brothers and sisters? More specifically, what can be done to assist the members of your department with issues of PTSD, suicide ideation, substance abuse, survivor’s guilt, and family challenges that add to the already stressful workplace? How is it possible to best keep your department members healthy in a culture that regards vulnerability and imperfection as weakness? Thankfully, there are programs and grants available through a diverse group of organizations that can assist you with setting up a program tailored to your department’s needs. There are also volumes of free resources available for use. A few of those resources will be listed here for those who need immediate help.
Behavioral Health: Rescuing the Rescuers
Think Big
The federal government has several grant programs that can be of use for behavioral wellness programs. The annual Assistance to Firefighters Grant (AFG) through FEMA can be used to set up a department-wide program focused on its specific needs. These programs are available for purchase from independent behavioral health and wellness organizations. Most of these incorporate a holistic (total body and mind) approach and will include physical fitness, nutrition, and mental health education and resources. Another large federal government agency, the Substance Abuse and Mental Health Services Administration (SAMSHA), has two basic ways to acquire funding for your department.
- You can apply for a specific grant offered by SAMSHA that will teach your responders how to work with and identify substance abuse and mental health issues in the community you serve. Some of these grants are based on specific programs your department creates. Some are based on programs they create and your department deploys.
- You can apply for a grant that is offered by SAMSHA to create or maintain a mental health and wellness program offered directly to your department members.
To apply for a grant from SAMSHA, it is necessary to register with the System for Award Management (SAM) and Grants.gov. The SAMSHA Funding Opportunity Announcement has all of the application requirements. Organizations such as the National Institutes of Health (NIH), the Centers for Disease Control (CDC), and the Health Resources Services Organization (HRSO) also have grants available for different programs throughout the year. If you can’t find what you are looking for, contact them directly. These types of grants may be smaller and not as heavily advertised as the larger, more common ones so it may take more digging to find them. The payoff, however, could be huge for your department.
Don’t forget to look for mental health grants offered by your individual state. For example, both Texas and Virginia have funding set aside by their legislative bodies specifically for first responder mental health programs. Do some searching on the web. If you can’t find anything online, contact your specific state’s department of emergency management and they will be able to point you in the right direction.
Think Small
Mental health and behavioral wellness are issues that connects the public and private sector. We are all members of families and everyone suffers from the premature loss of a person when they die by suicide or have substance abuse or mental health issues that impair their ability to function productively. It is even worse when the person is unwell because they have served their community or their country. The following organizations offer grants and programs for departments to establish or maintain mental health services for their members:
- The Gary Sinise Foundation-First Responder Outreach
- Firefighter Behavioral Health Alliance
- National Volunteer Fire Council-Share the Load
- IAFF Behavioral Health Program
For Immediate Use
If you have a department with members in need of services and are unsure of where to begin, here are a few places with resources you can use immediately while you plan the grant application process:
- Your locality’s employee assistance program
- Code Green Campaign
- The All Clear Foundation
Numbers don’t necessarily lie, but they don’t tell the whole story. Unfortunately, the history of the fire service has more PTSD, more suicide, and more behavioral wellness issues in it than we are even able to currently record. Now is the time to ensure the data improves—not by minimizing the issue, but by addressing the issue fully and making sure every department has the resources it needs to protect its members physically and mentally. It is our duty to ensure that Everyone Goes Home.
Mandy George is a lieutenant in the Chesapeake (VA) Fire Department. She is a training officer who works with a strong team to facilitate the training needs of a 500-member department of sworn and civilian personnel. She has a master’s degree in emergency and disaster management, a master’s degree in professional writing, and an associate’s degree in emergency medical services. She is also a Nationally Registered Paramedic (NRP).
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