Firefighters are exposed to traumatic and potentially lethal incidents that may inflict physical and psychological harm and negatively impact health and wellbeing. The impact of exposure to the trauma of others is often referred to as vicarious traumatization, burnout, compassion fatigue, critical incident stress and secondary traumatic stress.
Whatever term is used, firefighters may struggle with depression, post-traumatic stress disorder, alcohol or drug abuse, suicidal ideation, marital and familial issues and other challenges.
If these psychological threats are unaddressed, not only will individuals be at risk for these consequences, but the effectiveness of the entire department and the safety of the public may be undermined. Departments may see reduced productivity, abuses of leave and toxic relationships with coworkers, family and the public. Fire departments’ leadership in implementing relevant policies and programs can mitigate negative impacts to the individual, department and community.
I've been through some experiences in my life when I can reflect back and go, yeah, that's someplace that I don't want anyone to be at for personal or work reasons. Being happy and content with who you are and what you're doing is huge. It gets you to work. It makes you want to do all of those things that you were trained to do. If you're depressed and you’re not mentally healthy then all of that suffers. Your relationships suffer, work and personal. Everything suffers if you're not mentally healthy. Anything that your department can do to make that happen has got to be a priority. ~Investigator, Fire Services
The Vicarious Trauma Toolkit – A Resource for Organizations to Become Vicarious Trauma-Informed
The Vicarious Trauma Toolkit (VTT) is an online repository of research and resources for fire, EMS, law enforcement and victim-service organizations to use to address vicarious trauma. Its Compendium of Resources contains nearly 500 items:
- policies, practices and program descriptions
- research literature
- links to websites and podcasts
- videos and testimonials from each discipline
Each item in the Compendium has been vetted and organized by discipline and topic area.
The VTT recognizes that exposure to the trauma of others is an occupational challenge for first responders and victim-service providers that can have negative, neutral or positive consequences. The VTT was designed under the premise that organizations can mitigate the negative impacts of vicarious trauma—and that it’s their duty and responsibility to do so.
This requires that organizations become vicarious trauma-informed, as important as and part of being trauma-informed. The VTT helps organizations chart a course to achieving this goal. The first step is the use of an evidence-informed organizational assessment tool created and field-tested specifically for the toolkit.
This tool is called the Vicarious Trauma Organizational Readiness Guide or VT-ORG. It assesses an organization’s current capacity to address vicarious trauma in five areas that organizational and relational psychology research references as key to healthy organizations:
- Leadership and Mission
- Management and Supervision
- Employee Empowerment and Work Environment
- Training and Professional Development
- Staff Health and Wellness
The VT-ORG underscores strengths, identifies gaps and helps organizations navigate the toolkit to find helpful resources to fill their gaps.
Creation of the VTT
The toolkit was created by its intended users: first responder and victim-service agencies. Representatives from across the country provided input and submitted resources and tools they were using.
In addition, a draft toolkit was tested by seven pilot site teams consisting of each of the intended disciplines:
- Fire
- Law enforcement
- EMS
- Victim services
The pilot sites were chosen for their diversity in geography and demographics and included government, nonprofit and tribal agencies. The pilot site locations included:
- Allegany County, New York
- Austin, Texas
- Buncombe County, North Carolina
- Cambridge, Massachusetts
- Chicago, Illinois
- Glendale, Arizona
- Great Falls, Montana
The VTT project team provided guidance and subject-matter expertise throughout the process; the team included
- the IAFC
- the National Association of State EMS Official
- the International Association of Chiefs of Police
- the International Society for Traumatic Stress Studies
- the National Center for Victims of Crime
- the National Children’s Advocacy Center
- the Center for Violence Prevention & Recovery at Beth Israel Deaconess Medical Center
- the Boston Area Rape Crisis Center
Pilot Site Experiences
Here are some comments from pilot participants:
We use the term in the fire department “tools in your toolbox.” Every time they train us to do something different or to use some different tactic …they say that is a tool to put in your toolbox in the event that something happens. I would refer to this as a tool to go into our toolbox with regards to mental health. Me, being who I am, would be inclined to impress upon them how important mental health is in our profession. It is so important, and I don't think that I really embraced that … ~Firefighter
I explained it to someone I worked with as a {web} site with the most up-to-date research and resources for first responders and vicarious trauma and cumulative stress…it is a central location for all of the information that is out there since there is so much. ~Fire/Mental Health
The policies looked good, well thought out…well written. Again, you need the leadership to take the initiative to write the policies, review the policies, and put them into play. ~Firefighter
Conclusion
Fire departments that proactively address vicarious trauma can reduce the individual and organizational costs and better ensure public safety. As awareness has been raised about the risks inherent in work-related exposure to trauma, fire departments have become increasingly ready to address it openly and consistently from the start of a firefighter’s career. Healthy employees mean a healthy workplace, and that’s a win-win for individuals and executives alike.