I imagine we all know someone who has suffered with some form of mental health problem; anxiety, stress, depression, OCD and phobias are all common examples given on the National Institute for Health and Care Excellence (NICE) website. We live in a world full of pressure to keep busy and motivated, we are immediately contactable via technology 24/7 and many of us do not give our minds and bodies time to rest and recover from the stresses of our busy lives. As a consequence, we suffer. Add the responsibilities of firefighting to these pressures, and it is no wonder that when mental health charity Mind conducted a survey in 2015 to initiate their Blue Light Programme for emergency services, they found that 85 per cent of people within the fire and rescue services have experienced stress and poor mental health at work.

I am not at all surprised at this figure from Mind, or that blue light staff are twice as likely to identify problems at work as the main cause of those mental health problems than the general workforce. The top five answers from fire and rescue personnel in 2019 to causes of poor mental health, as reported by Mind, were:

  1. Excessive workload
  2. Trauma
  3. Pressure from management
  4. Long hours
  5. Organisational upheaval.

In 2015, the same survey revealed the same top five answers, except that “trauma” was then the fifth most common answer. Four years later, it moved up to second. Considering recent tragedies, such as Grenfell, multiple terrorist attacks and the current Covid-19 situation, I am not surprised that trauma being a cause of poor mental health is on the increase. However, what does surprise me, quite significantly, is the stigma attached to the subject of mental health that stops people coming forward and asking for help.

When Mind was awarded funding for the four-year Blue Light Programme in 2015, researchers immediately worked to gather evidence on the mental health of staff and volunteers working within the emergency services. Worryingly, the results indicated a workforce largely struggling in silence – our everyday heroes hiding the fact that they are, ultimately, human beings. They found that ‘mental health problems are stigmatised within the blue light community’ and that within the fire and rescue services, ‘37 per cent think that colleagues would treat them differently – in a negative way – if they spoke about mental health problems at work’. Mind dedicated the next four years to developing lasting change and creating a legacy that continues today, but mental health, stress and wellbeing remain significant issues for the emergency services due to the nature of the job.

Raising Mental Health Awareness

Christopher Wilson is an operational leading firefighter with the London Fire Brigade. After witnessing the effects of poor mental health on colleagues, and experiencing stress and anxiety himself during a difficult period of industrial relations, Chris felt resolved to learn more, and in 2015 he signed up to become a Mind Blue Light Champion – an employee or volunteer who takes action in the workplace to raise awareness of mental health problems. Chris is actively involved in a popular fire services’ forum and kindly allowed FIRE magazine to quote his very encouraging views on the subject of mental health. “One of the main challenges around poor mental health is how it is perceived by individuals, particularly those who believe they will never be affected. Overcoming the stigma and the negative stereotypes is a challenge… It is important that we [all] learn to recognise the signs, symptoms and causes of poor mental health; in ourselves and our colleagues. For years we have educated the public on how to reduce the risk of fires, giving them common sense advice and preventing deaths and serious injuries... it is now time we did the same for each other.”

On the subject of asking for help, Chris continues: “If people are obliged to see a counsellor, there is the danger that it will be perceived as a ‘tick box’ exercise and, even if the individual could benefit from the visit, they may be resistant to opening up honestly about their mental health. So, rather than compulsory attendance with a counsellor, I would advocate learning more about mental health and its relationship with physical health and social wellbeing. Encourage more open discussions between colleagues, build peer support networks and be more aware of how to identify if you or a colleague may require additional support, and where it can be accessed.”

Chris told FIRE magazine that he continues to be very much involved with championing mental health within the LFB: “I am also part of a London Fire Brigade employee support group called United Minds, which provides peer support, mental health first aid and informal training within the LFB… Bringing all of us together, signing the Time to Change pledge and creating United Minds has been a great legacy for the Mind Blue Light campaign.”

Gloucestershire’s Pledge

Another fire service that has worked with available support to improve the mental health of its personnel is Gloucestershire Fire and Rescue Service (GFRS). In January 2017, GFRS signed its Blue Light Pledge, confirming its “commitment to challenge mental health stigma and promote positive wellbeing within [their] service.”

A team of counsellors from Gloucester County Council was asked to help improve mental health within the service. Lisa Jenner, one of the counsellors who worked with GFRS, reported in an article she wrote about the project: ‘Given Mind’s findings about stigma within the blue light community, we didn’t expect it to be easy, and the defensive body language as we walked into that first station confirmed our expectations. Ninety minutes later, those same firefighters openly admitted that they hadn’t wanted to come, but that it had been ‘an eye opener’. Subsequent feedback included: ‘I’ve learnt I’m not alone,’ ‘I’ve learnt it’s good to talk,’ ‘I’ve learnt it’s OK to not be OK,’ and ‘I feel less afraid to be open now’.’

The project continued to work on breaking down the stigma of talking therapy, with promising results. One employee from GFRS recorded a video of himself talking openly and honestly about his own traumatic experience of poor mental health, which was shown to all the group sessions within the project. His courage in coming forward was applauded by his colleagues with no evidence of the feared “negative reactions”.

Lisa concluded her article on the project with the following: ‘Improving the mental health of blue light personnel nationally is a huge task, requiring a multifaceted approach, and that is also true in Gloucestershire. The mental health awareness workshops we ran were only ever intended to be a start. The real solution will take time and will be through meaningful cultural change. Challenging mental health stigma and providing psychoeducation are just a small part of that’.

Emotional Resilience

I spoke with Daran Bailey, the Wellness and Resilience Programme Lead for Aster Housing Association. Daran is a qualified psychotherapist and has worked as a mental health professional for 20 years, providing support and training that deals with overcoming stress, anxiety, panic attacks, depression, self-harm, and other related mental health problems. I wanted to find some answers to more immediate questions, such as: how can we overcome the fear of speaking out? What can we do if we are worried about a colleague?

Daran’s training methods include courses in wellbeing, emotional resilience, mindfulness and mental health first aid. As I have read repeatedly throughout my research, Daran confirmed that talking, whether that is with a colleague, a family member, a group of friends or a professional, is the best form of therapy to get to the heart of a problem. But the word “stigma” is once again raised – the thing that stops us asking for help. Daran explained: “There is the fear of being judged; the fear of appearing to be weak; the fear of letting people down. But where do these thoughts come from? If a friend or a colleague told you they were struggling and asked for your help, what would you say? Would you tell them to pull themselves together and stop being so weak? Of course not. So why do we say it to ourselves?”

Daran explained that when we feel low, we tend to talk negatively to ourselves. We judge and put ourselves down. “Give yourself a break. Tell the inner voice to ‘shut up!’ Give it a name if you want, I do!” Daran is very open about his own struggles with mental health. He has bipolar disorder and has learned to manage his symptoms through understanding them and knowing how to work with them. He recommends a simple and effective method for managing your mood on a daily basis: “Check in with yourself regularly. We all have good and bad days; we are supposed to. Use a scale of 0-10, with 0: feeling suicidal and 10: feeling in love with the whole world. If your score is unusually low, why is that? Firstly, discard anything you can’t control; Brexit or Covid-19, for example. Have I felt like this before? How did I deal with it? Am I still doing those things?”

Daran’s methods cleverly ask us to question our feelings and encourage us to talk kindly to ourselves and find activities and methods that improve our mood, and then stick with them for lasting result. Exercise and good nutrition, as discussed in the last two issues of FIRE magazine, will help. Daran also suggests: “Do something expressive – something you enjoy – artwork, dance like no-one’s watching, cry if you feel like it – we have tear ducts for a reason – to stop our heads exploding under pressure!”

Daran then told an inspirational story that speaks volumes about the power of sharing; of a time when his mood was dangerously low. His friends dragged him to the coast, in January, on a surfing trip. They knew his history and that he was struggling, and they encouraged him to join in with the normality of banter, huddling around a BBQ on the beach in zero temperatures, and talk about how he was feeling. “It was freezing; we were the only people in the sea. It’s really hard to feel suicidal when you get slapped in the face by an ice-cold wave! But my mates were what I needed right then. When I went home after that weekend I was a different man.”

I asked Daran what we should do if we think a friend or colleague is struggling. He said: “Ask them. And when they reply, ‘I’m fine’, ask them again, with feeling. And then be quiet. Give them that moment to think and, if they’re ready, to voice their concerns.” Daran then pointed out the necessity of mental health training in the workplace and how important it is to know how to point a colleague in the right direction and what support is available.

Looking ahead, the FBU’s Executive Council, as reported in their 2020 Executive Report, have approved a research project on firefighters’ mental health, which will update and evaluate all policies and guidance on the subject and review the training and advice given to FBU officials. This project is currently ongoing and is expected to conclude in the spring of 2021.

Ultimately, the message here, and everywhere that offers mental health support, is that we are not alone. There is help and support if we can ask for it. But remember – if that little voice starts telling you “you’re not worth it, no one can help you,” just call it Dave, and tell Dave where to go!

The following organisations offer mental health information and support services:

The Fire Fighters Charity offers a wealth of support for all Fire Service personnel and their families. Their mental health support includes:

  • Telephone or online counselling
  • Self-help resources
  • Residential stays
  • Recommended wellbeing apps
  • Support groups
  • Guided relaxations.

Visit their website at https://www.firefighterscharity.org.uk/how-we-can-help/mental-health or call their support line on: 0800 389 8820.

Mental health charity Mind can offer information and support via their website: https://www.mind.org.uk/information-support/; or call the helpline on: 0300 123 3393.

References:

Websites:

  1. https://www.firefighterscharity.org.uk
  2. https://www.mind.org.uk/news-campaigns/campaigns/blue-light-support/
  3. https://www.fbu.org.uk/mental-health-guide
  4. https://www.firefighterscharity.org.uk/latest/public-spotlight-on-mental-health/
  5. IOM Occupational health risks in firefighters: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/330372/occu-health-risk-in-firefighters.pdf
  6. https://www.who.int/news-room/feature-stories/mental-well-being-resources-for-the-public
  7. https://www.nice.org.uk/guidance/lifestyle-and-wellbeing/mental-health-and-wellbeing
  8. https://www.hse.gov.uk/stress/mental-health.htm

    Publications:

  9. FBU Mental Health at Work – AN Initial Guide for FBU Reps, 2016
  10. FBU Executive Council’s Reports 2019 and 2020
  11. House of Commons meeting on mental health support of firefighters, December 2018
  12. Talking feelings with firefighters, Counselling at Work, Autumn 2017, Issue 94, by Lisa Jenner
  13. Mind Blue Light Mental Health Networks: Pilot year evaluation report

Correspondence and conversations with:

Christopher Wilson, operational leading firefighter with London Fire Brigade

Daran Bailey, Wellness and Resilience Programme Lead for Aster Housing Association