Perceived Barriers to Reporting Mental and Behavioral Illness in the Fire Service

in International Journal of Athletic Therapy and Training
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Firefighters are exposed to psychological stress while on duty that could lead to mental and behavioral illnesses that may go unreported. We surveyed firefighters to identify their perceived barriers encountered when attempting to report a mental and behavioral illness with a follow-up question related to how difficult the selected barrier was in the reporting process. A total of 314 firefighters completed the instrument, with most indicating they experienced cultural barriers such as social norms from administration and peers. The findings demonstrate an overall demand for a cultural change within the fire service for a supportive environment that encourages reporting.

Thews, Winkelmann, Eberman, Potts, and Games are with the Tactical Athlete Research and Education Center, Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN. Winkelmann is now with the University of South Carolina, Columbia, SC.

Winkelmann (winkelz@mailbox.sc.edu) is corresponding author.
  • 1.

    Hansen K. NATA now: expansion into public safety. 2019. https://www.nata.org/blog/beth-sitzler/expansion-public-safety. Accessed March 10, 2019.

    • Export Citation
  • 2.

    Basinska BA, Wiciak I. Impact of work on the well-being of police officers and firefighters. Internal Security. 2013;5(1):247–258. doi:10.5604/20805268.1059491

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Sefton JM, Burkhardt TA. Introduction to the tactical athlete special issue. J Athl Train. 2016;51(11):845–845. PubMed ID: 28068161 doi:10.4085/1062-6050-51.12.16

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Poplin GS, Harris RB, Pollack KM, Peate WF, Burgess JL. Beyond the fireground: injuries in the fire service. Inj Prev. 2011:18(4):228–233. PubMed ID: 22117024 doi:10.1136/injuryprev-2011-040149

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Agency FEM. Firefighter injuries reported to the NFIRS (2012–2014). Topical Fire Report Series. 2016;17(6).

  • 6.

    Regehr C. Social support as a mediator of psychological distress in firefighters. Irish J Psych. 2009;30(1–2):87–98. doi:10.1080/03033910.2009.10446300

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Yamawaki N, Kelly C, Dresden BE, Busath GL, Riley CE. The predictive effects of work environment on stigma toward and practical concerns for seeking mental health services. Mil Med. 2016;181(11):e1546–e1552. PubMed ID: 27849488 doi:10.7205/MILMED-D-15-00489

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Seabury SA, McLaren CF. The Frequency, Severity, and Economic Consequences of Musculoskeletal Injuries to Firefighters in California. Santa Monica, CA: RAND; 2010.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Stanley IH, Boffa JW, Hom MA, Kimbrel NA, Joiner TE. Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters. Psychiatry Res. 2017;247:236–242. PubMed ID: 27930964 doi:10.1016/j.psychres.2016.11.037

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    NFPA. Firefighter injuries and fireground operations. NFPA J; 2015, 5(15):1–4.

  • 11.

    TriData Corp. The Economic Consequences of Firefighter Injuries and Their Prevention. Final Report Washington, D.C.: US Department of Commerce; 2005.

    • Search Google Scholar
    • Export Citation
  • 12.

    Gist R, Taylor VH, Raak S. Suicide Surveillance, Prevention, and Intervention Measures for the US Fire Service: Findings and Recommendations for the Suicide and Depression Summit. Baltimore, MD: National Fallen Firefighters Foundation; 2011.

    • Search Google Scholar
    • Export Citation
  • 13.

    Conrad KM, Batch GI, Reichelt PA, Muran S, Oh K. Musculoskeletal injuries in the fire service: views from a focus group study. AAOHN J. 1994;42(12):572–581. PubMed ID: 7893285 doi:10.1177/216507999404201201

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    de Castro AB. Barriers to reporting a workplace injury: recognizing the difficulties and encouraging a determined approach. Am J Nurs. 2003;103(8):112. PubMed ID: 12904737 doi:10.1097/00000446-200308000-00031

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Newton D, Sofian N. Fire Service Occupational Health and Fitness Program Evaluation (Doctoral dissertation, Seattle Firefighters (Union #27), 2007). Seattle, OR: The NewSof Group, 2-36. 2007.

    • Search Google Scholar
    • Export Citation
  • 16.

    Adler-Tapia R. Early mental health intervention for first responders/Protective service workers including firefighters and Emergency Medical Services (EMS) professionals. In M. Luber (Ed.). Implementing EMDR Early Mental Health Interventions for Man-made and Natural Disasters: Models, Scripted Protocols and Summary Sheets. New York, NY: Springer 2013:60.

    • Search Google Scholar
    • Export Citation
  • 17.

    Cohen N, Arieli T. Field research in conflict environments: methodological challenges and snowball sampling. J Peace Res. 2011;48(4):423–435. doi:10.1177/0022343311405698

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Sitzia J, Wood N. Response rate in patient satisfaction research: an analysis of 210 published studies. Int J Q Health Care. 1998;10(4):311–317. doi:10.1093/intqhc/10.4.311

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Hom MA, Stanley IH, Ringer FB, Joiner TE. Mental health service use among firefighters with suicidal thoughts and behaviors. Psychiatr Serv. 2016;67(6):688–691. doi:10.1176/appi.ps.201500177

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Wilmoth JA. Trouble in mind. NFPA J. 2014.

  • 21.

    Rappin CL, Wuellner SE, Bonauto DK. Employer reasons for failing to report eligible workers’ compensation claims in the BLS survey of occupational injuries and illnesses. Am J Ind Med. 2016;59(5):343–356. PubMed ID: 26970051 doi:10.1002/ajim.22582

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Rothmeier J. Challenging tradition: barriers to cultural change in the fire service. 2017. https://www.firerescuemagazine.com/articles/print/volume-12/issue-5/features/challenging-tradition.html. Accessed March 10, 2019.

    • Export Citation
  • 23.

    Harris MB, Baloğlu M, Stacks JR. Mental health of trauma-exposed firefighters and critical incident stress debriefing. J Loss Trauma. 2002;7(3):223–238. doi:10.1080/10811440290057639

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Owens GP, Herrera CJ, Whitesell AA. A preliminary investigation of mental health needs and barriers to mental health care for female veterans of Iraq and Afghanistan. Traumatology. 2009;15(2):31–37. doi:10.1177/1534765609336361

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Altheide D. What is a structural barrier? 2018. http://www.public.asu.edu/~atdla/womenandminorities/sld003.htm.

    • Export Citation
  • 26.

    Stanley IH, Hom MA, Hagan CR, Joiner TE. Career prevalence and correlates of suicidal thoughts and behaviors among firefighters. J Affect Disord. 2015;187:163–171. PubMed ID: 26339926 doi:10.1016/j.jad.2015.08.007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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