Time to “think outside the box” to develop a a standard for psychological services for fire departments

By: Robert Avsec, Executive Fire Officer

A fire service colleague, J. Gordon Routley, posted this comment in a discussion thread on LinkedIn about developing a standard for psychological services for fire and EMS departments.

I think it would be a great idea to develop some kind of a standard for psychological services for fire departments, however it will take significant effort.  It is covered within the overall scope of NFPA 1500 [Standard on Fire Department Occupational Safety, Health, and Wellness Programs] which basically states that a fire department should have that capability and then refers to NFPA1582 [Standard on Comprehensive Occupational Medical Program for Fire Departments] for the details.

Routley goes on to say “But [NFPA]1582, which is currently caught-up in the process of reorganizing and merging documents, is primarily directed toward medical and fitness standards and only makes brief mention of psychological health. It is within the syndrome of a subset of a subset.”

And therein lies my motivation for the title of this article. Developing a a standard for psychological services for fire and EMS departments is a need that has URGENCY written all over it! We’re losing 200+ firefighters every year to suicide (And we don’t even know if that’s an accurate number because the fire service has no data collection process like that which the International Association of Chiefs of Police (IACP), working with the FBI, stood up in January 2022 to begin collecting accurate data regarding law enforcement suicides).

I’m a staunch advocate for the development and implementation of NFPA Standards, when they apply to issues over which the primary stakeholders are fire service organizations and allied organizations (e.g., manufacturers of fire apparatus, protective clothing, SCBA). But I firmly believe that development of a standard for psychological services for fire and EMS departments MUST have other stakeholders who are not “fire service people.” And one need look no further than the development of NFPA 3000: Standard for Preparedness and Response to Active Shooter and/or Hostile Events.

How NFPA 3000 came to be–In record-setting time

The development of NFPA 3000 was unique compared to other NFPA standards. Typically, NFPA standards are developed through a consensus-based process that involves public input and committee deliberations over an extended period. However, NFPA 3000 was created with a sense of urgency due to the increasing frequency of active shooter and hostile events. This urgency led to a more accelerated timeline while still adhering to NFPA’s rigorous standards development process [1] [2]. See where I’m going with this?

The standard was developed in collaboration with a wide range of stakeholders, including law enforcement, emergency medical services, fire services, and private sector representatives, to ensure a comprehensive approach [2]. This multidisciplinary involvement was crucial given the complex nature of the incidents the standard aims to address. (I’m going to “connect the dots” for you in just a bit, so hang with me!).

NFPA 3000 is a comprehensive standard designed to help communities prepare for, respond to, and recover from active shooter and hostile events. Its applications are broad and include:

1. Unified Command: Establishing a unified command structure to ensure seamless coordination among law enforcement, fire services, EMS, and other agencies during an incident [3].
2. Integrated Response: Promoting collaboration between various agencies and organizations to create cohesive operational plans [4].
3. Risk Assessment and Planning: Conducting thorough risk assessments and developing detailed response plans tailored to specific community needs [5].
4. Training and Competencies: Providing guidelines for training first responders, including law enforcement, fire, and EMS personnel, to handle such events effectively.
5. Community Education: Educating the public on preparedness and response strategies to enhance overall community resilience [3].
6. Recovery Planning: Addressing recovery aspects, such as mental health support and rebuilding community trust, to mitigate long-term impacts [4].

We Need the Next Iteration of a “NFPA 3000”

Back to our urgency to develop a standard for psychological services for fire and EMS departments. It’s more than just the alarming number of firefighters taking their own lives by suicide because many fire and EMS departments are currently beset with many other issues like, sleep deprivation, dysfunctional organizations, psychological assessments (e.g., pre-employment, fitness for duty, mental health disability), and deaths and injuries where human factors are involved.

Developing a standard for psychological services for fire and EMS departments must involve collaboration among key stakeholders to ensure a comprehensive and effective framework. These stakeholders should include:

1. Fire and EMS Personnel: Active firefighters, EMTs, and paramedics can provide insight into the psychological challenges they face in their roles. Their firsthand experiences are invaluable for shaping relevant services.
2. Fire Service Behavioral Health Experts: Specialists in fire service psychology, like the fire service leaders, psychologists, and masters-level clinicians at the Fire Service Psychology Association, can contribute expertise in crafting educational content and evaluating programs that address mental health within the fire service community.
3. Mental Health Professionals: Psychologists, psychiatrists, and masters-level mental health clinicians with experience in trauma, occupational stress, and emergency response can offer clinical perspectives on best practices.
4. Fire and EMS Leadership: Chiefs, officers, and administrators can represent organizational priorities and ensure the feasibility of implementing psychological services.
5. Training Organizations: Bodies that certify and train fire and EMS personnel can integrate psychological services into ongoing education programs.
6. Government and Regulatory Agencies: Entities like OSHA and NFPA can ensure that the standard aligns with occupational safety regulations and broader mental health initiatives.
7. Peer Support Specialists: Fire Service personnel who have undergone peer support training can highlight the value of peer-to-peer interaction and contribute to practical program frameworks.
8. Family Representatives: The families of fire and EMS personnel can offer perspectives on the impact of the job on home life and suggest ways to support entire households.
9. Academia and Research Bodies: Universities and researchers focusing on occupational health and safety can bring evidence-based approaches and data-driven insights into the development process.
10. Community Stakeholders: Advocates, local government representatives, and community organizations can ensure that the standard reflects broader societal support for emergency responders.

Each stakeholder group would bring unique expertise and viewpoints, contributing to a well-rounded standard that prioritizes the mental health and well-being of fire and EMS personnel. Just like that diverse group of stakeholders did in creating NFPA 3000 in record-setting time.

What’s Next?

What we need to do is promote and amplify this concept to the stakeholder groups that I’ve identified in the article. With that support, we could then lobby NFPA to put the process in motion like it did for the development of NFPA 3000.

I still believe that an NFPA standard, developed like NFPA 3000, will be able to garner the response and acceptance from the fire and EMS organizations and departments because it would be an NFPA standard. But an NFPA standard developed “the right way.”

So, what are we waiting for? Let’s assemble representatives for those 10 stakeholder groups and “get cracking” on developing a standard for psychological services for fire and EMS departments. If you’re interested in helping to make this happen, contact me at [email protected].

References

1. https://www.nfpa.org/For-Professionals/Codes-and-Standards/Standards-Development
2. https://www.nfpa.org/codes-and-standards/nfpa-3000-standard-development/3000?l=235
3. https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/flrtc/documents/NFPA-3000-Fact-Sheet.pdf
4. https://www.jems.com/major-incidents/nfpa-3000-the-new-standard-to-keep-communities-safe-from-active-shooters-and-other-threats/
5. https://www.appa.org/wp-content/uploads/2019/03/NFPA-3000-Awareness-Training_Long-Version-FINAL-9-10-18.pdf