New law boosts mental health support for Californian firefighters

When Oakland Fire Department (OFD) Captain Christopher Foley and his coworkers learned that one of them had been killed in a San Jose shooting, not long after 36 people died in the Ghost Ship warehouse fire, they needed help—and found it in the department’s peer support program. 

“I was shocked at some of the people who I would have considered at the time to be kind of the crusty old-timers, who reached out and offered their full support,” said Foley, who started and still leads the program with a colleague.

The program, which offers individual and group discussions, launched in October, 2016, just two months before the Ghost Ship fire. At the time, it was one of just a few peer support programs for firefighters in the state, modeled after examples in New York City and Phoenix. Now, the California Firefighter Peer Support and Crisis Referral Services Act, signed earlier this month by Governor Gavin Newsom, will help make those programs the norm statewide. That boost comes as experts acknowledge how critical it is to recognize—and address—the trauma firefighters face on the job.  

Relatively high suicide rates are one consequence of that trauma. Firefighters today are more likely to die by suicide than in the line of duty, according to a 2018 study by the Ruderman Family Foundation. In 2017, approximately 103 U.S. firefighters committed suicide, while 93 died in the line of duty. But the Firefighter Behavioral Health Alliance, which educates firefighters and their families about behavioral health issues, estimates that only 40 percent of firefighter suicides are reported, which would more than double the number of firefighter suicides. 

That underreporting may be linked to a common attitude among firefighters, who, according to Foley, are often told to “suck it up and tough it out.” 

But that attitude is slowly changing, and small but important shifts might be making the difference. 

Justin Ironside, president of the Berkeley Fire Fighters Association, said one such change is the use of the term “Post Traumatic Stress Injury”—as opposed to “Disorder”—to describe the trauma firefighters experience. 

The Trauma Treatment Act, which Governor Newsom also signed this month, will consider post-traumatic stress an injury for firefighters and peace officers. By categorizing trauma as an injury, those affected will be able to apply for workers’ compensation—if their injuries occur after January 1, when the act goes into effect. 

The peer support program bill, which Newsom signed the same day, will guarantee confidentiality to all information firefighters share in peer support program conversations. 

Carroll Wills, the California Professional Firefighters’ communications director, said that confidentiality will hopefully make firefighters feel more comfortable sharing their feelings, without worrying that it will put their employment at risk. 

Last year, former Governor Jerry Brown, once Oakland’s mayor, vetoed a similar peer support bill, covering both firefighters and law enforcement officers, citing the different nature of the jobs, existing standardized training for law enforcement officers, and its failure to guarantee confidentiality.  

The enacted bill, which will go into effect in 2020, will not make peer support programs mandatory. The promise of confidentiality, however, will remove barriers that have impeded participation in such programs in the past, Wills said. 

In Foley’s department, the peer support program became popular soon after it was launched. Three years ago, the program started with only two firefighters. Today, the OFD has trained 25 firefighters to offer peer support.