First responders reveal significant mental health problems not being addressed

The long term impact of the Black Summer bushfires on emergency volunteers has revealed significant mental health problems among first responders, many of whom thought they would die fighting the fires.

In what is likely to be a ground-breaking study of volunteers, the report also raises issues about the effectiveness of community and workplace mental health responses.

After the Fires is a national survey of the wellbeing and resilience of Australia’s emergency services personnel conducted in two waves studying the responders both one year and two years after the fires.

More than 4,000 personnel, including more than 2,000 volunteers, from fire and rescue, rural fire and SES agencies across Australia participated in the surveys.

The most startling findings were that 25% of employees and 31% of volunteers felt their life was threatened during the Black Summer Bushfires and that the rate of PTSD among responders is running twice as high as the general population.

After the Fires lead author Professor David Lawrence from Curtin’s School of Population Health said the findings are particularly important given that volunteers are likely to continue to play a significant role in responding to major bushfires in the foreseeable future.

“I’m not aware of similar figures being collected from previous fires,” Lawrence told Cosmos. “But we know that the Black Summer fires stand apart from previous fires in terms of their duration, intensity and magnitude.

“Over 80,000 people were involved in the fire response, of whom almost 80% were volunteers. Volunteers each committed an average 3 weeks to the fire response. This in itself is a large scale commitment compared with previous fires.”

The impact of the fires on mental health was the same for men and women.

“Volunteers tend to be older,” Lawrence said. “Overall there is a substantially lower proportion of females in the sector. However, we found that males and females were equally likely to be impacted by their experience in the fires, and equally likely to experience probable PTSD, high psychological distress and suicidal behaviours.”

In terms of demographic factors, personnel who had experienced previous traumatic events during their emergency services work, and those with lower levels of social support had higher risk.

“The rates of probable PTSD and suicidal ideation among personnel responding to the bushfires were about twice as high as the general population.

“Compared with first responders who didn’t have traumatic or life-threatening experiences during the bushfires, those that did were 3-4 times more likely to experience probable PTSD and suicidal behaviours.

“Our study was focussed on first responders and did not specifically examine communities affected by the fires. The Australian Government has funded another study to consider that issue, and I have not seen the results of that yet. “ 

The results call into question the value of mental health campaigns and treatment in Australia’s regions with large numbers of first responders not prepared to seek support.

“There is some evidence that stigma has improved a bit but there is still a long way to go,” says Lawrence.

“We conducted Answering the Call, the first national Mental Health and Well-being Study of Police and Emergency Services on behalf of Beyond Blue in 2017-18, and we found modest but significant improvements in markers of workplace culture including workplace stigma in career firefighting services between Answering the Call, and After the Fires.

“We did not see any significant change, however, in the volunteer sector.

“One of the issues underlying stigma in the emergency services sector is people’s concerns that if they talk about emotional issues they will be negatively impact in their work or volunteer work, that it could affect their ability to undertake operational roles or even mean they may not be able to continue working.

“Unfortunately there are lots of examples that people know of other people who have been treated badly as a result of mental health issues. Until people see others discussing and recovering from mental health issues, and being fully supported by their agencies, this stigma is likely to continue.”