Behavioral health programs in fire service: surveying access and preferences
Open accessAbstract
Due to the stressful nature of the job, firefighters are likely to be at increased risk for behavioral health problems. This study examined the access, attitudes, and preferences of a large sample of professional firefighters (N = 2,156) toward behavioral health services using an online survey. Overall, 81% of participants reported that they had access to behavioral health services through their fire service department, although smaller departments were less likely to offer such services. Despite available programs within fire service, firefighters most commonly reported that they would seek outside help from their spouse/family (67%) or private professional services (60%). Firefighters with fewer years in service were more likely to go to a spouse/family member, coworker, or officer for help, whereas those with more years were more likely to seek private professional services. Few firefighters directly stated that stigma would prevent them from using behavioral health services, yet a large percentage of firefighters (68%) reported that they would not recommend these services to colleagues, and stigma-related barriers were still among the most significant reported. "Clinicians who understand firefighter work culture" was rated as one of the most important components to a successful behavioral health program; a lack thereof rated as one of the most significant barriers. Offered together, these findings suggest that greater exploration of stigma in fire service is warranted, and attention toward training culturally competent clinicians to work with firefighters is needed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Emergency responders report stigma and privacy concerns regarding seeking care for mental health symptoms related, at least in part, to occupational stress.
“Emergency responders report stigma and privacy concerns regarding seeking care for mental health symptoms related, at least in part, to occupational stress (16, 71–74).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [72]
In one study of fire fighters, lack of provider awareness of emergency response culture (53%), fear of breach in confidentiality (51%), and stigma (43%) were rated as the top three barriers to behavioral health care.
“In one study of fire fighters, lack of provider awareness of emergency response culture (53%), fear of breach in confidentiality (51%), and stigma (43%) were rated as the top three barriers to behavioral health care (72).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [72]
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- Authors
- Gulliver, S. B., Pennington, M. L., Torres, V. A., Steffen, L. E., Mardikar, A., Leto, F., Ostiguy, W., Zimering, R. T., & Kimbrel, N. A.
- Affiliations
- Baylor Scott & White Health (US)
- Baylor College of Medicine (US)
- New York City Fire Department (US)
- VA Boston Healthcare System (US)
- Veterans Health Administration (US)
- ORCID
- Venue
- Psychological Services
- Published
- 2019-05
- Volume
- 16
- Issue
- 2
- Pages
- 340-345
- ISSN
- 1541-1559 (ISSN-L)
- 1939-148X
- OpenAlex
- W2790164919
- Cited by
- 52
- References
- 0
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 4 · 2023: 10 · 2022: 8 · 2021: 7 · 2020: 6 · 2019: 2 · 2015: 1
- FWCI
- 9.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychological Services (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Funders
- Federal Emergency Management Agency (EMW2007FP02550)
- Department of Veterans Affairs (IK2 CX000525)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- firefighters, behavioral health services, access to mental health care, help-seeking preferences, stigma, occupational stress, organizational culture, length of service
- MeSH terms
- Adult, Mental Disorders, Female, Health Services Accessibility, Humans, Male, Mental Health Services, Middle Aged, Patient Acceptance of Health Care, Patient Preference, Social Stigma, Firefighters, Culturally Competent Care
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