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Behavioral Health Resources

Behavioral health is as important as physical health to the well-being of firefighters and emergency medical personnel. Use these resources to focus on behavioral health issues in your department.

Most people are aware of the physical demands that first response activities place on firefighters and EMS providers. But it is important to also realize the impact that fighting fires and responding to emergencies has on the mental wellbeing of emergency personnel. Firefighters and EMS providers face the risk of many behavioral health concerns such as anxiety, depression, burnout, and post-traumatic stress disorder, among others.

Taking care of your mental health is as important as managing your physical health. It is critical that the emergency service community recognize the importance of mental well-being and create a culture within the department that makes behavioral health a priority. Use International Fire/EMS Safety and Health Week to open the dialogue within your department about behavioral health issues and focus on what you can do to foster positive behavioral health practices all year long.


Firefighter Life Safety Initiative 13 – Mental Health
National Fallen Firefighters Foundation
Initiative 13 of the National Fallen Firefighters Foundation’s Life Safety Initiatives focuses on the mental wellbeing of firefighters and their families. The initiative asserts that firefighters, EMS personnel, and their families must have the resources and help available to deal with the various complications that their jobs can bring to their lives, especially issues regarding emotional and psychological stress. The new Firefighter Life Safety Initiative 13 web site contains important resources, training, and research, including the new model for exposure to potentially traumatic events and stress aid for fire and EMS personnel.

NVFC Member Assistance Program
National Volunteer Fire Council and American Addiction Centers
The NVFC and American Addiction Centers have teamed up to provide the National Fire Services Member Assistance Program to all NVFC members and their families. NVFC members and their families can call the free, confidential Member Assistance Hotline any time day or night to help with issues affecting your life, such as alcohol or drug addiction, anxiety, depression, stress, PTSD, relationship problems, work-related concerns, legal problems, financial management difficulties, critical incidents, or psychological problems.

National Institute for Occupational Health and Safety
NIOSH is the federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. The Institute has released many resources for managing stress in the workplace, including:

Your Guide to Healthy Sleep
National Heart, Lung, and Blood Institute
This booklet from NHLBI provides information about important sleep topics such as common sleep myths and practical tips for getting adequate sleep, coping with jet lag and nighttime shift work, and avoiding dangerous drowsy driving. It also includes information on sleep disorders, such as insomnia, sleep apnea, restless legs syndrome, narcolepsy, and some parasomnias.

Depression Section
Medline Plus
Medline Plus is a service of the U.S. National Library of Medicine and the National Institutes of Health. The Depression Section of Medline Plus provides a compendium of resources, tools, and information about this mental health topic.

Emotional Health Center
Everyday Health Media
This online resource center contains information and articles on mental health topics including anxiety, depression, and stress.


Suicide in the Fire and Emergency Services: Adopting a Proactive Approach to Behavioral Health Awareness and Suicide Prevention
National Volunteer Fire Council
Members of the fire and emergency services face a variety of daily stressors that can have lasting effects on their mental and emotional wellbeing. This report explores various behavioral health concerns and identifies resources and best practices for mental wellness and suicide prevention. The report includes data from a behavioral health survey conducted by the NVFC. A webinar providing an overview of the report and survey is also available.

White Paper: Suicide Surveillance, Prevention, and Intervention Measures for the US Fire Service
National Fallen Firefighters Foundation
This white paper presents the findings and recommendations of the National Fallen Firefighters Foundation Suicide and Depression Summit, which convened on July 11-12, 2011.

Issues of Depression and Suicide in the Fire Service
National Fallen Firefighters Foundation
This report is a summary of the National Fallen Firefighters Foundation’s white paper on the topic of depression and suicide in the fire service based on the summit on this subject held July 11-12, 2011.

White Paper: Firefighter Life Safety Initiative 13
National Fallen Firefighters Foundation
This white paper provides an overview, best practices, and recommendations concerning Firefighter Life Safety Initiative 13 – “Firefighters and their families must have access to counseling and psychological support.”

The Effects of Sleep Deprivation on Fire Fighters and EMS Responders
U.S. Fire Administration and International Association of Fire Chiefs
This report and accompanying computer-based education program presents background information on normal sleep physiology and the health and performance effects of sleep deprivation. Countermeasures for sleep deprivation are reviewed, which relate to identifying those particularly susceptible to risks of sleep deprivation, individual mitigating strategies, and work-related issues.

Courses and Webinars

Preventing and Coping with Suicide in the Fire and Emergency Services
National Volunteer Fire Council
The NVFC, with support from the United States Fire Administration, developed this online training course focusing on suicide awareness and prevention. Presented by Jeff Dill, founder of the Firefighter Behavioral Health Alliance and a certified counselor, the course contains three modules that examines the signs and symptoms preceding suicide, highlights available resources for departments and individuals, and discusses the healing process when coping with a firefighter suicide. The course is offered on the NVFC’s Digital Chalk training platform; new students must create an account before accessing the course catalog.

Fire Service Suicide and Behavioral Health Concerns
National Volunteer Fire Council
This webinar provides an overview of behavioral health issues facing the fire service, with a focus on firefighter suicide warning signs and prevention. Additionally, the results of the NVFC’s recent behavioral health survey are analyzed.

Behavioral Health
National Volunteer Fire Council
This webinar discusses the history of how behavioral health is woven into the fire, emergency, and rescue services, what it means to you and others, cultural progress, and future potential. Taught by Jeff Dill, founder of the Firefighter Behavioral Health Alliance, this webinar delves into some of the many concerns for firefighters, EMS personnel, and their families that are impacted by the job. To access this webinar, click the link above and register as a student using access code 6832.

After Action Review
National Fallen Firefighters Foundation
The first step in observing stress in firefighters and EMS personnel begins with an After Action Review, where every call and response is discussed. This course discusses the five questions that should be asked in the After Action Review every time firefighters and EMTs perform their duties.

Curbside Manner: Stress First Aid for the Street
National Fallen Firefighters Foundation
This course presents a new way to approach and care for the citizens that firefighters and EMS personnel encounter every day. The treatment that citizens receive from firefighters and EMS providers can affect their experiences during and after a fire or medical emergency and their capacity to recover and move on in its aftermath.

Dealing with a Line of Duty Death
Firefighters Support Foundation
This 50-minute program presented by first responder psychologist Dr. Ellen Kirschman discusses different aspects of dealing with the line-of-duty death of a firefighter.

When a Child Dies on a Call
Firefighters Support Foundation
This 20-minute program presented by psychologist Dr. Anne Bisek tackles the issues firefighters may face when a child dies on a call and ways firefighters can prepare for and cope with this tragedy.

When to Seek Therapy
Firefighters Support Foundation
This 30-minute program presented by psychologist Dr. Anne Bisek answers questions she has found that first responders frequently have about seeking therapy.


American Academy of Experts in Traumatic Stress
The Academy is a multidisciplinary network of professionals who are committed to the advancement of intervention for survivors of traumatic events. Resources include Crisis Talk, which has a forum for emergency responders.

Firefighter Behavioral Health Alliance
The Firefighter Behavioral Health Alliance is a nonprofit organization that aims to educate senior fire officers, firefighters, EMS, and supporting personnel about behavioral health, the mental stressors that this type of job can have, and the consequences of not recognizing them.

Firefighter Cancer Support Network
The objective of the Firefighter Cancer Support Network is to provide timely assistance to all fire service members and their families in the event of cancer diagnosis.

International Critical Incident Stress Foundation
The International Critical Incident Stress Foundation provides leadership, education, training, consultation, and support services in comprehensive crisis intervention and disaster behavioral health services to the emergency response professions, other organizations, and communities worldwide.

Life Challenge Program
This program was founded by Shawna Legarza and is supported through the Wildland Firefighter Foundation. The Life Challenge Program is a grassroots, peer support based group that helps firefighters, friends, co-workers, and families to better understand, prevent, and deal with suicide.

Mental Health America
Mental Health America is a nonprofit association dedicated to helping all people live mentally healthier lives. Their resources and activities include information on mental health topics, a help line, Mental Health Monthmaterials, National Depression Screening Day, advocacy programs, and prevention and recovery programs.

Mental Health Foundation
Based in the United Kingdom, the Mental Health Foundation provides information, advocacy, and programs to help people survive, recover from, and prevent mental health problems.

National Institute of Mental Health
The mission of NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure. The site contains research, information, and resources on a wide array of mental health topics, including anxiety, post traumatic stress disorder, depression, and suicide prevention.

North American Fire Fighter Veteran Network
NAFFVN offers resources and information to educate firefighters about behavioral health issues such as stress, job burnout, and post traumatic stress reactions in order to better respond to the needs of first responders.

Screening for Mental Health
This nonprofit organization provides online, telephone, and in-person mental health screenings, as well as sponsors annual events such as National Depression Screening Day and National Alcohol Screening Day. SMH programs include both in-person and online programs for depression, bipolar disorder, generalized anxiety disorder, post-traumatic stress disorder, eating disorders, alcohol problems, and suicide prevention. Resources include anonymous online mental health screening tools among many others.

Sleep Foundation
Sleep is vital to a person’s health and wellbeing, yet millions of Americans do not get enough sleep. The National Sleep Foundation is a 501(c)(3) charitable, educational, and scientific nonprofit organization dedicated to improving sleep health and safety through education, public awareness, and advocacy

Substance Abuse and Mental Health Services Administration
SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities. The web site provides information, resources, programs, and publications, on a variety of mental health topics, including coping with traumatic events, stress, anxiety, and much more.


B.E.S.T. Practices and Stress
By Chief Jeff Cash, National Volunteer Fire Council
In this article, which was published in the December 2009 issue of Firehouse Magazine, Chief Jeff Cash examines the stress first responders face, the difference between ‘good’ and ‘bad’ stress, and ways to manage stress.

Firefighters and Stress Management
By American Addiction Centers for the National Volunteer Fire Council
This article looks at the stress firefighters face and explores coping mechanisms to help ease stress.

A Check Up From the Neck Up
By Billy Hayes for
This article focuses on Firefighter Life Safety Initiative 13 – “Provide firefighters and their families access to counseling and psychological support.”

Behavioral Health: Minding Stress on the Job
In this article, a medical team from New York discusses their experiences with the FDNY and offer advice that can be applied to all firefighters who are regularly exposed to traumatic incidents.

Identify, Manage Firefighter Emotional, Behavioral Issues
By Jeff Dill for Fire Chief
Fire officers need to be able to recognize when a firefighter is suffering from emotional or behavioral issues caused by traumas experienced on the job or at home.

Firefighter Behavioral Health: Taking Care of our Own
By Fire Chief Mike Thompson for
This article looks at the behavioral health program at the Spokane Valley Fire Department.


Behavioral Health Podcast
Ron Siarnicki, Executive Director of the National Fallen Firefighters Foundation, explains why behavioral health is especially important for first responders and looks at some initiatives in the area of behavioral health in the emergency services. This podcast was recorded for the NVFC in August 2009.