By MnFIRE Assistance Program partner, Optum

People in the fire service experience much higher rates of mental health challenges than the general population – particularly in the areas of sleep disorders, depression, substance abuse, post-traumatic stress disorder and suicidal ideation/action. The stigma associated with mental health conditions causes many firefighters to stay quiet about what they’re really experiencing – and not seek treatment. They might perceive themselves to be “weak,” feel ashamed, or tell themselves it’s “just a phase” that’ll pass if they push through. They might worry about being treated differently or losing their jobs. Or, they just might not know where to begin finding help.

This is all to say, one of your fellow firefighters may be suffering in silence. You can help set the tone in your department so mental illness is destigmatized, and people feel encouraged to seek out help when they need it.

Learn the signs

While different mental health conditions have different symptoms, with variances depending on the person, early warning signs include behavior changes over time that last for two or more weeks. For example, a previously energetic, reliable colleague now consistently seems fatigued, shows up late and looks disheveled. They also seem angry, irritable, and prone to outbursts.

Some common signs of mental illness include:

1. Excessive worrying or fear
2. Persistent sadness, hopelessness or “empty” feeling
3. Lack of concentration
4. Extreme mood changes, including irritability or anger
5. Changes in eating habits, energy level or sleeping patterns
6. Delusions and/or hallucinations
7. Increased use of alcohol or other substances
8. Persistent physical aches and pains
9. Suicidal thoughts
10. Lack of interest in activities
11. Inability to carry out daily activities or handle daily problems and stress
12. Intense fear of weight gain or concern with appearance

Reach out

If someone you know is showing warning signs and needs help coping with a situational or chronic mental health condition, reaching out can make a difference. Consider using the method like “NOTICE. TALK. ACT.™” from American the Psychiatric Association.³

If you notice a person is exhibiting the warning signs that last for two or more weeks, find a quiet place to ask, “Are you OK?” Compassionately and nonjudgmentally provide a few examples of what’s worrying you. Do not assume you know what is going on. Listen with the aim to learn more from their perspective. Remind them we all have challenging times in life, and getting extra support and guidance can help us get through those times. Recommend they consider taking advantage of the free counseling sessions available to them through the MnFIRE Assistance Program, or to call MnFIRE’s 24/7 peer support hotline, both available at: 888-784-6634.

Then, check back in with the person in a day or two to see how things are going. Please note: If you are worried about the person’s immediate safety, do not leave the person alone. Seek emergency assistance.

Be an ally

You also can help create a supportive environment, increase awareness and reduce stigma for those in your department who are struggling. For example, commit to using respectful and compassionate language to describe or talk about mental health. Using derogatory terms perpetuates discrimination and stigma. It also dehumanizes the people living with mental health conditions, dismisses their experiences and can discourage them from asking for support.

In addition, intervene if you overhear others using verbally abusive language, and challenge misconceptions when you see or hear them.

You can make a difference.

Most of us have probably felt the strain of our job or the difficulty of balancing the fire service with other areas of our lives. It’s easy to try to muscle through it knowing we have an important job helping others and keeping them safe. However, there comes a point where we need to let others help us. And it doesn’t need to be a crisis to reach that point.

With May as Mental Health Awareness Month, we at MnFIRE want to make sure all fire service members know the resources available to those of us in the field. Through the Hometown Heroes Assistance Program (HHAP), every active firefighter in the state – full-time, part-time, paid-on-call or volunteer – has access to mental health support – all free!

It comes through the MnFIRE Assistance Program (MAP), one of the three elements of the HHAP. In the fire service, we encounter unique emotional and mental stresses. We need people who understand the distinct and specific stresses and challenges we encounter. This program focuses on providing mental health care specifically to us – firefighters and our families. And it doesn’t matter the size of the help needed, whether through a big crisis or a small issue, the MAP program can steer us in the right direction. There are two ways to access help – calling 888-784-6634 or visiting www.mnfireinitiative.com/hhap/#MAP.

One of the best parts about this program is having it available to our families. Our time in the fire service affects them, too. They have their own unique set of stressors. Any member of a firefighter’s household, including children living away from home, can access the interactive website or contact a trained specialist. Each firefighter and/or their family members can receive up to five counseling visits a year with additional support ensured as needed.

No call or inquiry is too small. Simply look at the website or dial the phone. There is someone there to talk you through what is available. If something major happened in your life or if you’re just feeling stressed, the MAP program is here to help.

Another great part of MAP is the peer support program where firefighters are paired with a trained peer supporter who knows firsthand the difficulties firefighters face. They are fellow fire service members in Minnesota who are there to lend a listening ear or offer support, all completely anonymous. They are well-equipped to walk alongside us as we encounter life at the firehall, on calls and beyond.

We don’t need to muscle through challenges alone. There are people ready and willing to help no matter the size of the problem. It doesn’t need to be a crisis to ask for mental health help.

International Firefighters’ Day is observed each year on May 4. Born out of a tragic loss of five firefighters in a wildfire in Victoria, Australia, this day was created to honor their lives, as well as firefighters around the world.

This International Firefighters’ Day, we recognize and honor the sacrifices firefighters make across the globe, and especially those here at home in Minnesota, to ensure their communities are safe. Thank you for all you do!

We also want to honor the firefighters who have been lost in the line of duty or passed on before us – many due to the occupational hazards of cardiovascular disease, suicide and cancer.

We value the work and contributions our volunteer and career firefighters dedicate to our communities every day. As we reflect on that, we know investing in their health and well-being is a moral imperative!

In Minnesota, we can show our support and appreciation to firefighters at home by making sure they have all of the physical and mental health resources they need to prioritize and protect their health, and prevent and/or tackle cardiovascular disease, emotional trauma and cancer.

Thankfully, the Hometown Heroes Assistance Program is now here to provide free resources for all of Minnesota’s active firefighters – volunteer, paid-on-call, part-time and full-time. These vital resources include:

• The MnFIRE Assistance Program, offering expanded emotional trauma resources for firefighters and their families, including five counseling visits a year and peer support.
• An up-to-$20,000 Critical Illness insurance policy which covers diagnoses of cancer, cardiac and other critical illnesses.
• Ongoing health and wellness training on the different health risks facing firefighters.

We invite you to honor and support your local firefighters today by making sure they’re aware of these important – and completely free – health resources.

Christian Worby, a firefighter for the Coon Rapids Fire Department, at first thought the pain in his side he started experiencing in summer 2020 was a fractured rib. The 42-year-old didn’t seek medical attention because he figured the treatment plan for such a break is allowing it to heal on its own; however, when the pain continued off and on for over a year, Christian knew something else was wrong.

In October 2021, a biopsy revealed Christian had multiple myeloma, a non-curable cancer of the plasma cells. It is a situation becoming all too familiar with firefighters across the state. According to the National Fire Protection Association, more than 68% of all firefighters will develop some form of cancer in their lifetimes, a rate much higher than the general U.S. population.

Thankfully for firefighters in Minnesota, the Hometown Heroes Assistance Program (HHAP), the most comprehensive firefighter well-being legislation in the nation, passed through the legislature last year. The HHAP offers financial support for cancer diagnoses through the MnFIRE Critical Illness program, which provides a lump-sum cash payment up to $20,000 to assist with expenses. The Critical Illness benefit also covers diagnoses of cardiac, COVID-19 and other critical illnesses. Christian said this program has allowed his family to focus on treatment rather than financial worry due to the cancer diagnosis.

In addition to maxing out their deductible, the Worby family has been paying out of pocket for gas money to travel to weekly appointments at the Mayo Clinic in Rochester, along with accommodations while away from home and receiving treatment. Plus, Christian will not have enough sick time to cover the minimum of six weeks he is away while having chemotherapy treatment and a stem cell transplant. The Critical Illness program can help with all of these extra expenses.

“I was blown away when I heard about [the Critical Illness program],” Christian said.

Christian thought submitting a claim for the Critical Illness program was an easy process. After making a phone call, creating an account and sending in paperwork, his application was approved.

“It’s great having the extra financial support,” Christian said. “It’s an extra safety net. It’s an expensive deal having a major illness.”

For five months after his diagnosis, Christian was able to continue working while doing a mild chemotherapy treatment. At the beginning of April, Christian started an intensive six-week chemotherapy treatment and stem cell transplant, which requires him to stay in Rochester.

“They take my stem cells out to keep them safe and then give me a traditional high dose of beat-the-heck-out-of-you chemo,” he said. “Then they slowly give me my stem cells back and let my body figure out which way is up again.”

To show support, fellow Coon Rapids Fire Department firefighters shaved their heads the day before Christian began his treatment, a moment highlighted on KARE 11 recently.

While multiple myeloma is found in the general population, it is found more often in firefighters. Only 20% of the cases found are discovered in those under the age of 50.

“Because I’m so young it wouldn’t surprise me if being a firefighter was a contributing factor,” Christian said.

While Christian knows the cancer is not curable, it is treatable. And Christian wants to fight the illness to gain as much time as possible to share time with his wife and together watch their two young sons – ages 7 and 2 – grow.

“For some people, it’s aggressive cancer, and some people, it’s not, so I just cross my fingers and remember I’m comparatively young,” he said.

While the diagnosis is challenging for his family, he is thankful for the HHAP.

“We’re very fortunate in Minnesota we’ve had people working on [the Hometown Heroes Assistance Program], and that we have it available to us,” Christian said. “It’s a smooth application process and if you qualify and you heard about it, then why wouldn’t you apply? It would be really unfortunate if someone was able to apply for this assistance but had no idea it existed.”

Christian was also recently interviewed by WCCO about these new HHAP resources.

All Minnesota firefighters have been automatically enrolled in this statewide Critical Illness insurance policy. To learn more about the Hometown Heroes Assistance Program or to file a claim, visit mnfireinitiative.com/hhap.