Canadian Career Firefighters’ Mental Health Impacts and Priorities

Abstract

Firefighters’ perceptions of mental health can inform management. This qualitative study explored Canadian career firefighters’ experiences, needs, and research priorities with respect to mental health. Thirty-nine career firefighters (33 men, 6 women) of different ranks and geographic locales were interviewed using a semi-structured interview guide. The interviews were recorded, transcribed, and qualitatively analyzed using thematic analysis within an interpretive description approach. Firefighters reported that critical incidents and chronic job stressors contributed to mental health symptoms that led to burnout, compassion fatigue, and mental and physical injury. They were concerned with family impacts, like lack of full openness, reduced financial stability, and risk of divorce; and work impacts, like interpersonal conflict, lack of support to fellow firefighters, task avoidance, and absenteeism. A broad array of barriers and facilitators were found in firefighter work, culture, programs, social supports, health care, and societal factors. Variability in access to help, the changing fire service, and the complexity of knowing what to do to achieve mental health were evident across themes. Firefighters identified the need for research in four areas: awareness and monitoring, understanding etiology of mental health, better prevention and treatment, and access to care. Across domains of inquiry, context “two sides to the coin”, and uncertainty were overarching themes.

Mental Health Among Firefighters

“…Stigma was a major personal moderator that acted as a barrier to discussing mental health with others, which supports prior literature findings 19,20 . Study findings correspond with the findings by MacDermid et al 25 on Canadian firefighters who reported stigma toward mental health is perceived as a sign of weakness. To no surprise being a male-dominant profession, stigma toward mental health is prevalent in firefighters.…”

Biological Embedding of Psychosocial Stressors Within a Sample of Canadian Firefighters

“…Although the precise reason for impaired sleep quality may vary according to the jurisdiction studied, previous work has drawn attention to factors such as longer shifts and frequent emergency calls 3,44 . Regardless of its underlying cause, however, sleep disturbances can have a profound influence on the mental health of those in the fire service; for example, poor sleep quality has been associated with PTSD symptoms 45 and insomnia has been linked to clear elevations in the risk of both anxiety and depression 46 …”

“…3,44 Regardless of its underlying cause, however, sleep disturbances can have a profound influence on the mental health of those in the fire service; for example, poor sleep quality has been associated with PTSD symptoms 45 and insomnia has been linked to clear elevations in the risk of both anxiety and depression. 46 Along with identifying potential psychosocial stressors within the fire service, we also observed certain factors that seemed to influence the experience of these stressors. For example, we found that participants who engaged in regular physical activity each week reported lower levels of both work-related and general life stress.…”

Lifestyle and environmental factors may induce airway and systemic inflammation in firefighters

“…Firefighters’ work stressors may involve performing risky work task frequently in unstable, unfamiliar work zones with infectious/chemical hazards as well as long-lasting (24 h) shifts with rapid reaction periods between rest and emergency response (MacDermid et al 2021 ). Due to the specific nature of the work of firefighters, a high level of stress during workdays was noted (Santo de Oliveira et al 2012 ) and the severity of experienced stress increased with years of service (Santo de Oliveira et al 2012 ; Makara-Studzińska et al 2020 ).…”