Contributed by MnFIRE Mental Health Director Melinda Coscarelli, PhD, LPCC, LADC

As firefighters, you’re taught to always be prepared. Your department spends hours practicing and preparing for that moment when someone calls for help. But how do you answer the call from one of your own?

Mental health problems can come in all sizes, from a firefighter facing burnout to one who is having suicidal thoughts. With the mental demands and emotional toll of firefighting, fire service leaders must be prepared to offer support to their fellow firefighters when needed. After all, firefighters with more supportive cultures and departmental resources perceive their work environment as less stressful, which can lessen manifestations of mental health problems such as anxiety, substance abuse, insomnia and depression.

Here are a few things you can do to be better prepared.

Get trained

Fire service leaders should receive training on how to talk to their crew about mental health concerns. These situations are delicate and at times need to be handled differently than your typical calls. MnFIRE provides access to suicide prevention classes and emotional wellness deep-dive trainings. Because with proper education, you can identify the warning signs for emotional trauma and feel more comfortable having these conversations with your firefighters.

Build awareness and support

Making small changes now can help build a stronger foundation to stand on later. Put up posters around your department with messages and tips for managing different symptoms such as sleep deprivation or moodiness. Posters can be placed in prominent areas like the kitchen, or more discrete locations such as the restrooms. MnFIRE also offers educational materials on resources to help, which show MnFIRE’s free helpline for getting support 24/7.

While a few posters or brochures won’t change the fire service culture, having them visible and accessible can be helpful to someone suffering in silence and start building awareness for the support that’s always available to them.

Be proactive

Several departments have started doing regular check-ins with their crews. A good time for doing this is at roll call or shift changes. It can be as simple as asking your crew to rate their current mental status on a scale of one to 10, with 10 being mentally maxed out. If one of your firefighters is at a seven or higher, pull them aside and ask them what you can do to support them. A simple check-in adds accountability and shows the crew that you genuinely care.

It’s also helpful to develop a safety plan for your department so you know what process to follow to de-escalate any type of crisis situation.

Stay calm

If a mental health emergency does arise, stay calm. Ask the firefighter what you can do to support them through their difficult situation. Steer clear of offering advice, but rather listen and empathize.

Be attentive

Taking a class like MnFIRE’s emotional wellness training or the suicide prevention skills training we put on for our peer supporters can be very beneficial to learning warning signs for someone in distress. Non-verbal and verbal language both give clues about when a firefighter’s mental health may be starting to decline, or they may even become suicidal. It is best to recognize these signs before they escalate into a dangerous situation.

Call MnFIRE

If you don’t feel prepared, know that we are. The MnFIRE toll free number is staffed by masters-level clinicians all day, every day. From one-on-one calls to department debriefs, during the middle of a crisis or after a tough call, we are here for you. Don’t hesitate to use this free, confidential resource available to all full-time, part-time, on-call and volunteer firefighters in Minnesota. Just call 888-784-6634.

To Our Minnesota Fire Service Sisters and Brothers:

Everyone at MnFIRE joins the entire state as we mourn the loss of Burnsville firefighter/paramedic Adam Finseth and police officers Paul Elmstrand and Matthew Ruge in yesterday’s tragedy. During this difficult time, please remember that the full resources of the MnFIRE Assistance Program are available to all Minnesota firefighters and their families.

Confidential help – including connection to no-cost mental health care and peer support – is available anytime for any Minnesota firefighter and/or their family. Phone lines are answered 24/7 by Master’s-level trained mental health professionals who provide confidential support, guidance and mental health resources.

For immediate, 24/7 support call 888-784-6634.

Any member of a firefighter’s household can use these important Hometown Heroes Assistance Program (HHAP) resources. Each firefighter and/or their family members can access up to five counseling visits a year (additional support is available as needed). Firefighters are also matched with a member of MnFIRE’s team of trained peer supporters who know firsthand the difficulties firefighters face and are well-equipped to walk alongside a firefighter in need as they navigate their situation.

If you’d like to talk, we’re here.

For more information or for help, call 888-784-6634 or visit liveandworkwell.com, access code: MnFIRE.

While nutrition alone can’t solve the complexities of a mental health condition, a growing body of research is showing how diets that support brain health can benefit mental health and well-being, and also help reduce stress and improve focus.

How nutrients support you

Your brain and body need a variety of nutrients to support your health. It’s important to note – despite the claims of ads, trends and friends – no one food or drink (or supplement for that matter) can uplift a down mood or cure a mental health condition. Generally speaking, your brain and body regularly need a balance of proteins, fibers, carbohydrates, vitamins, minerals, (unsaturated) fats and water to fuel them properly. Each one plays a role. For example:

• Protein helps your brain produce the chemicals it uses to regulate your thoughts and emotions.
• The healthy omega fats found in salmon, avocados, nuts and seeds, among other sources, support your brain function.
• Your body turns carbohydrates into glucose (a kind of sugar) that travels through your blood to feed your brain. Complex carbs found in whole grains, for example, produce slow and steady sugars to keep your brain fueled. Without them, you may experience low blood sugar, which can make you feel tired, irritable and depressed.
• The foods you eat also help promote a healthy gut – stomach, intestines and colon – with the right amount and kinds of bacteria to process and break down your food. Fiber aids in the digestion process, and so do foods with probiotics, like yogurt, sauerkraut, tempeh and kimchi.
• If you don’t drink enough water, you can become dehydrated. Dehydration makes it harder to focus and think clearly. It also can depress your mood and energy level.

On the other hand, foods low on nutrients can make you feel mentally worse. For example:

• The trans fats often found in highly processed and packaged foods have been linked to bad moods.
• Similarly, highly processed, sugary and fried foods have been linked to hyperactivity, aggression, poor concentration, depression and anxiety in children and adolescents.
• And the caffeine so many people rely on for a boost of energy can actually overstimulate you, causing feelings of irritability, anxiousness and depression. It also can keep you from sleeping soundly.
• Diets low in nutrients also affect gut health. As noted above, this system helps you digest your food properly and eliminate waste. If it’s off, so is your body’s ability to absorb nutrients and feed your brain.

Risks of poor nutrition

Interestingly, much of this brain-nutrient-mental health support system can work both ways. If you’re already feeling stressed, anxious or sad, you may find it difficult to eat, much less prepare, healthful food. The lack of rich nutrients makes it harder for your brain to function properly, which in turn aggravates your already struggling mental health, and can even worsen how you already feel.

When you’re not feeling well or eating well, it can also affect your gut. You may feel stopped up, stirred up, bloated or gassy, all of which throws off your digestive system. If your digestive system is malfunctioning, your brain isn’t getting the fuel it needs, and, hungry, struggles to function properly.

Help yourself eat nutrient-rich foods

Follow these three general guidelines to choose more nutritious options:

1. Eat more:
   • Vegetables
   • Fruits
   • Whole grains (bread, brown rice, quinoa)
   • Legumes (lentils, chickpeas, soybeans, and kidney, black or pinto beans)
   • Fish and seafood
   • Unsaturated fats like those found in oily fish (salmon, mackerel, sardines), avocados, seeds, nuts and olive oil
2. Eat in moderation:
   • Red meat (beef, pork lamb, goat and venison)
3. Eat less:
   • Refined sugars (from cane, beets, coconut, palm and corn)
   • Processed foods, especially those high in saturated fat, salt and sugar (such as pre-packaged instant and canned soups, deli meats, sausages, snacks and breakfast cereals)

Fresh foods may be more expensive or harder to access in some areas. So, frozen, canned and dried options are a great choice, too. Look for ones that are minimally processed and have limited additives or preservatives.

Also, consider these ways to help yourself steer toward nutrient-rich foods daily:

• Prepare and store healthy meals and snacks in advance.
• Make one-pot meals – stews, soups and casseroles – to save yourself time and hassle.
• Make plans to cook in rather than eating out with family and friends.
• Have food delivered if getting to the store is too time-consuming or difficult.

A nutrition guide designed specifically for firefighters

Even small changes can make a difference over time. If you need recipe ideas, consider looking online for dietitian-approved options or asking your health care provider for help.

Firefighters can also learn more about nutrition and how it can help them perform more safely and efficiently while on duty, as well as at home, by scheduling a MnFIRE training on Fitness & Nutrition for your department. Learn more here.

Repurposed from MnFIRE Assistance Program partner, Optum.

 

Sources

BetterHealth Channel. Food and your mood. betterhealth.vic.gov.au/health/healthyliving/food-and-your-mood</span. Accessed October 16, 2023.

American Society for Nutrition. How to boost mental health through better nutrition. nutrition.org/how-to-boost-mental-health-through-better-nutrition/. Accessed October 16, 2023.

BetterHealth. Gut health. betterhealth.vic.gov.au/health/healthyliving/gut-health. Accessed October 16, 2023.

Dietitians Australia. Diet and nutrition health advice: Mental health including anxiety and depression. dietitiansaustralia.org.au/health-advice/mental-health-including-anxiety-and-depression. Accessed October 16, 2023.

Harvard Health. Nutritional psychiatry: Your brain on food. health.harvard.edu/blog/nutritional-psychiatry-your-brain-on-food-201511168626. Accessed October 16, 2023.

Mental Health Foundation. Diet and mental health. mentalhealth.org.uk/explore-mental-health/a-z-topics/diet-and-mental-health. Accessed October 16, 2023.

Mind. Food and mental health. mind.org.uk/information-support/tips-for-everyday-living/food-and-mental-health/. Accessed October 16, 2023.

World Health Organization. Mental disorders. who.int/news-room/fact-sheets/detail/mental-disorders/?gclid=CjwKCAjwvrOpBhBdEiwAR58-3F0CEF39A_G2i0LFhhAHl2NLCvU1axJCRNFiPv62ZGJDoo92coQw7BoCbtAQAvD_BwE. Accessed October 16, 2023.

When you’re going through something stressful or feeling anxious, negative thoughts can make difficult situations and feelings even harder. That’s because how we think affects how we feel, and how we feel affects how we behave.

Learning how to get ahead of unhelpful thoughts and reframing them to be more positive can help you get through those moments. It also can help improve your overall mental and emotional well-being.

While we generally cannot control the thoughts that come into our minds, especially after a tough call, we can control what we do with them. And we can train ourselves to alter our thinking patterns to be more helpful. Let’s look at how this works.

Types of unhelpful thoughts

First, let’s consider the kinds of negative thinking that may affect you. Here are some common ones:

Expecting the worst to happen.
This sometimes takes the form of “but what if?” thinking, too. In either case, even if something is going well, you expect the worst and think of all the bad things that could happen. As a result, you find it difficult to enjoy good times or be present in the moment. For example, if your boss sets up a meeting with you for the next day, an unhelpful thought would be, “I must be getting fired!” A way to reframe that more positively would be, “My boss wants to meet with me tomorrow. She isn’t on shift today, so I cannot ask her why. Tomorrow I will know why she wants to meet, and I can deal with it then.” 

Focusing on the negative.
Even if something good happens, you tend to think only about what went wrong or could have gone better.

Seeing things only as good or bad and ignoring the range of possibilities in between.
This is also called “all or nothing” and “black and white” thinking. This pattern oversimplifies situations. For example, thinking “if you don’t win, then you lose” overlooks the benefits of participating in something you enjoy, such as a tennis match, or in pursuing opportunities, like applying for a promotion.

Making negative assumptions.
For example, if something bad happened, you assume it will keep happening. Like, if you once failed a test, going into every test believing you’ll also fail them. But realistically, you have passed many more tests than you’ve failed, and you’re prepared for this one. A more helpful thought would be, “I failed that test, but I prepared well for this test – and I’ve passed many more tests than I’ve failed.”

Blaming yourself when bad things happen. Or blaming others for bad things that happen to you.
This thinking pattern fails to consider all the other factors that could contribute to a situation or event. If you didn’t arrive at the scene early enough to help someone, it can be easy to spiral or blame yourself. In the fire service, having to navigate survivor’s guilt also isn’t uncommon, especially if there has been a line-of-duty death. We must remember that placing blame on others does not honor the sacrifice of the fallen. Use critical incidents as an opportunity to learn from possible mistakes, but try to give yourself and your crew the benefit of the doubt when it comes to this uniquely challenging work.

In each of these thinking patterns, you aren’t considering the positive possibilities and variety of perspectives. You’re also not considering the full story or thinking about the facts. Many factors contribute to and come into play in every situation. Try to pay attention to where your brain goes in a difficult time.

If you find yourself getting trapped in one of these unhelpful thinking patterns, ask yourself questions to center your thoughts and see other perspectives. For example:

• Why am I so worried about this? Has this happened before? If yes, how did I manage that situation? If no, how likely is it to happen in this situation? And if it does, what can I do to get through it?
• Are there other reasons or explanations why this could have happened? For example, maybe my friend’s partner does not feel well, so they need to reschedule dinner. Or, I failed that test because I didn’t prepare properly, but I am prepared for this test – and I’ve passed many more tests than I’ve failed.
• If someone I cared about were in this situation, what would I tell them? Would I be as hard on them as I am on myself?

Another way to reconsider unhelpful thoughts is to go through this step-by-step exercise. Ask yourself:

1. Why am I stressed and/or having anxious thoughts? What happened?
2. What unhelpful thoughts am I having?
3. How do those thoughts make me feel?
4. What evidence supports these unhelpful thoughts?
5. What evidence challenges these unhelpful thoughts?
6. Based on the evidence, what is a more helpful, realistic and/or balanced way to think about this?

Then, take a deep breath. Let the other perspective sink in, and reset.

Going through these reframing processes can help you feel calmer in the moment and shift your thinking patterns over time to be more positive. With practice, thinking more positively can become part of your life – and help improve your overall mental and emotional health and well-being – both in the fire service and in your personal life.

Want to learn more or get more mental health support like this?

Confidential help is available over the phone or online, anytime for any Minnesota firefighter and their family through the MnFIRE Assistance Program (MAP). The MAP targets emotional health and stress unique to the fire service through connection to mental health care and peer support. For more details or for help, call 888-784-6634 or visit mnfireinitiative.com/hhap/#MAP.

Repurposed from MnFIRE Assistance Program partner, Optum.

Sources

MyHealth Alberta, “Learning about thought reframing.” myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk7438. Accessed September 22, 2023.

NHS, “Reframing unhelpful thoughts.” nhs.uk/every-mind-matters/mental-wellbeing-tips/self-help-cbt-techniques/reframing-unhelpful-thoughts/. Accessed August 8, 2923.

Small Steps, “Reframing thoughts.” smallsteps.org.nz/reframing-thoughts. Accessed August 8, 2023.

Mental health conditions affect people of all ages, backgrounds and lifestyles in all kinds of ways. In fact, about one in five people globally live with a mental health condition. For firefighters, the rates are even higher than the general population – particularly in the areas of sleep disorders, depression, substance abuse, post-traumatic stress injury and suicidal ideation/action.

And too many of these firefighters are suffering in silence.

Mental health conditions are treatable illnesses. Yet, despite how common mental health concerns and conditions are, stigma persists. And most people don’t seek help.

Here are seven ways you can help stop stigma, so people feel safer and more comfortable getting the help they may need:

Be kind

A simple rule of thumb is to remember people are people, not conditions. Treating people with kindness and compassion can go a long way toward creating a welcoming, supportive environment.

Study the facts

There is a lot of bad information out there. Check your source before you repeat or repost a tidbit off the internet. It may not be accurate. Consider the motivation behind a dramatic portrayal on a TV show before assuming it’s credible. Educate yourself, so you can help set the record straight. It’s best to start with legitimate resources that are committed to raising awareness and mobilizing support for mental health. The World Health Organization is a great example. Learning about common conditions, like depression, anxiety disorder, post-traumatic stress disorder and others, will help you spread good information.

Be an ally

Encourage respect and dignity for all people. If you hear someone saying hurtful or false things about mental health concerns or conditions, politely speak up and address it.

Talk openly about mental health

Listen respectfully and invite open conversation about the importance of mental health and well-being. People should not feel ashamed or reluctant to get the benefit of professional help.

Foster understanding

Encourage yourself and those you influence to view mental health just as you would physical health. If, for example, a friend sprained an ankle or broke an arm, you would encourage them to seek medical attention. The same should be true for mental health conditions.

Share your own experience

If you have personal experience with mental illness, consider telling others about it. Sharing your story can foster understanding and provide perspective. The MnFIRE Peer Support program provides a confidential outlet for firefighters to share what they’re going through with someone who understands.

Get involved

Around the world, people are working hard to improve mental health care perceptions, systems and policies. There are many ways to show support. Make sure you post only accurate information on your social media. Drive a friend to a therapy appointment. Make your vote count in local elections. Donate time or money to an advocacy organization like MnFIRE. Every show of support helps normalize the conversation around mental health and wellness.

The emotional and disturbing calls we go on can stick with us – and it’s important to recognize how the stresses of the job can negatively impact our mental health. MnFIRE’s emotional wellness training can help your department de-stigmatize talking about mental health, as well as provide practical information around how to properly debrief after a difficult call, ways to maintain emotional well-being and what resources are available for those who need help.

Confidential peer support and mental health resources are available to Minnesota firefighters and their families for free through the MnFIRE Assistance Program. For more details or for help, call 888-784-6634 or visit mnfireinitiative.com/hhap/#MAP.

Repurposed from MnFIRE Assistance Program partner, Optum.

 

Sources

American Psychiatric Association, “Stigma, Prejudice and Discrimination Against People with Mental Illness.”
psychiatry.org/patients-families/stigma-and-discrimination Accessed July 17, 2023.

BetterHealth Channel, “Stigma, discrimination and mental illness.”
betterhealth.vic.gov.au/health/servicesandsupport/stigma-discrimination-and-mental-illness#challenging-stigma-associated-with-mental-illness. Accessed July 17, 2023.

Mind, “Mental health problems – an introduction.”
mind.org.uk/information-support/types-of-mental-health-problems/mental-health-problems-introduction/stigma-misconceptions/. Accessed July 17, 2023.

NAMI, “Pledge to be stigmafree.”
nami.org/Get-Involved/Pledge-to-Be-StigmaFree. Accessed July 17, 2023.

By MnFIRE Assistance Program partner, Optum

As the world at large wrestles with the pandemic, systemic racism and social injustices, among other complexities and difficulties, one thing you can control is how you treat yourself. It’s so important to support your own health and well-being. Whatever you’re going through — good, bad or neutral — are you being kind to yourself? As firefighters who spend all day serving others, this is a question we need to ask ourselves often.

Being kind to yourself is not about feeling self-pity or blaming others; it’s about understanding that life sometimes brings tough times and uncomfortable emotions. It’s also about understanding that everyone endures difficulties and makes mistakes — it’s part of being human.

Self-compassionate people are far more likely to acknowledge and process difficulties to find a path forward. In fact, research shows practicing genuine self-compassion can help you:

• Feel more motivated and optimistic
• Feel safer and more secure
• Be more resilient
• Be more confident and authentic
• Adopt a healthier lifestyle, including being more active and eating more nutritiously

People who practice self-compassion also tend to take greater personal responsibility for their actions. This includes being more likely to reflect, learn and take steps to correct course, such as making amends with someone or something, and looking for ways to be and do better.

Practicing self-compassion

This does not necessarily come naturally. Difficult circumstances and hard times more often trigger people to criticize themselves or to blame others. Both reactions increase stress, and chronic stress can lead to mental health conditions like depression and anxiety.

However, you can cultivate self-compassion by consistently practicing it.

For example, think about when a friend is going through something difficult, such as something someone else might have done to them or something that happened beyond their control. If you’re like most people, your impulse is to try empathizing with what your friend is going through and figure out how you can help them. You acknowledge their pain. You try to be present and actively listen. In those moments especially, you don’t second-guess and criticize them, and you don’t tell them what they should have or could have done differently.

Odds are you would also encourage them that they can and will get through this hardship. Odds are you would try to help them think about how to overcome it.

Do the same for yourself.

Taking care of yourself is an important part of coping with tough times, and steeling yourself for the challenges to come. Eating nutritious foods, getting enough sleep, exercising regularly and doing things you enjoy will help you be and feel stronger physically, mentally and emotionally.

MnFIRE also offers a deep-dive training course on emotional wellness. This two hour class will help de-stigmatize talking about mental health in your department, as well as provide practical information around how to properly debrief after a difficult call with your team, ways to maintain emotional well-being and what resources are available for those who need help. Get your department signed up today!