Firefighters: Mental Health Support

John Howell Excerpts

Tuesday 18th December 2018 Westminster Hall

[Emma Dent Coad]

I concur absolutely with my hon. Friend. The London fire brigade has appointed additional counsellors and set up Mind blue light champions, who are volunteers from within the service who can signpost colleagues to the counselling and trauma service.

[John Howell (Henley) (Con)]

I congratulate the hon. Lady on securing the debate. She raises a pertinent point, which we should all pay attention to. She mentions the appointment of counsellors, which is absolutely crucial. The way to help someone to avoid mental health problems is for them to have somebody to talk to when they are experiencing the problems. There is no point in them just sitting there and experiencing the problems on their own; they need somebody to share them with and to help them.

[Emma Dent Coad]

I concur absolutely with the hon. Gentleman.

I hear that firefighters who came from fire stations near the fire are getting a higher standard of care than those from further afield. Call centre staff—many of whom spoke to people trapped by the fire, as we heard during the inquiry—are also traumatised, and some are not getting the support they need.

Let us remember that more than 300 firefighters were involved in the rescue attempt at Grenfell, and that it was not one single, terrible, catastrophic event. The fire raged for more than 12 hours, in which firefighters continually risked their lives in their attempt to save the lives of others. Some of the scenes they saw, and the choices they had to make, are with them every day.

Despite that, the psychological help that those brave men and women, including the call centre and support staff, so clearly need is very uneven. Some have received talking therapy. I have previously told the House that I have received that treatment myself, and it did not help me at all, although I accept it may help others. That treatment is available within the fire service.

Some people have been fortunate enough to receive eye movement desensitisation and reprocessing therapy, which I am told has been helpful, but it is usually available only from the Fire Fighters Charity, so capacity is limited—we are dependent on charity. Some have had very little treatment. I am told that many firefighters from stations across London who attended the fire have not had the support they need, and certainly not the emotional support from the community that many local officers have benefited from.

Three days after the fire, I dropped into one of our fire stations late at night. I drank tea and heard their stories. The team, who had fought back-to-back shifts on Tuesday and Wednesday, had had no time off. All leave had been cancelled. They were emotionally drained and physically exhausted. All I could think was, “Where is the back-up they’d need if there was another Ladbroke Grove train crash now?”. The terrible answer is that there is none.

Cuts to frontline staff mean that, even after a disaster such as Grenfell, there may be no capacity for compassionate leave. While nearly 20% of staff have been lost since 2010, incidents have decreased by just 12%, so fewer operational firefighting staff are attending more incidents each.

--- Later in debate ---

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Sir Roger.

I thank the hon. Member for Kensington (Emma Dent Coad) for raising this very important issue. I do not have a confession, but from the outset I have to declare an interest—that would be the best phrase—as I served for 31 years with Strathclyde Fire and Rescue Service, and it was a proud journey through my working life. In retirement, I became a local councillor who sat on the fire board, so I continue to have a great fondness and a great respect for the firefighters of today, although I am—quite clearly, for those who can see me—a firefighter from yesterday. I joined in 1974 and served until 2005.

Frontline firefighters—whether they are whole-time, retained or volunteer firefighters—who respond to emergencies, and those with specialist roles within the fire service such as fire investigators, frequently encounter seriously injured or even fatally injured persons in their day-to-day work. Preservation of the scene, particularly if it is a potential crime scene, may mean that anyone who is declared medically deceased must remain in situ, with firefighters having to work in close proximity to them.

Some incidents result in multiple fatalities. I will touch on some in the west of Scotland, but there are many others that I could cite between John O’Groats and Land’s End. For example, there was the Chinook disaster on the Mull of Kintyre, in which 29 individuals died. The first responding appliances to that incident were carrying retained personnel; they were not full-time professionals, but men and women who held down everyday jobs. There was the Lockerbie air disaster, in which 270 persons lost their life, 11 of whom were in the town of Lockerbie, particularly but not exclusively in Sherwood Crescent. Again, the first responding appliances to that disaster were carrying retained personnel, and I absolutely applaud the work that retained personnel do. There was the Rosepark care home fire in Uddingston not so very long ago, in which 14 residents died, and that was a modern facility, and there was the Stockline plastics factory explosion in Glasgow, which was attended by whole-time personnel; nine people died in that fire. That is to name but a few incidents, none of which I personally attended. However, having been part of the fire service, I have followed the stories about them with great interest.

There are also incidents that firefighters endure in which our colleagues are injured, or even fatally injured, in fires. It does not happen that often, but when it does, what a sad and dark day it is. We can even go way back to the Cheapside disaster in Glasgow in the late 1960s, in which I think 15 firefighters and four salvage personnel lost their life. That was an exceptionally horrific incident, but we have improved safety a lot since then.

Such repeated experiences without appropriate ongoing support from external counsellors or medical professionals may result in some firefighters and other emergency responders—I do not exclude other emergency responders who suffer similar pressures—succumbing to stress-related illness, leading to absence from work and, in the worst cases, to their being medically retired; indeed, as the hon. Member for Kensington said, they may even lead to firefighters taking their own life, which in itself is an absolute tragedy.

Believe me: firefighters give their all at incidents, both physically and mentally. They have to be constantly alert at an ongoing incident—alert for their own safety; for the safety of their colleagues; and for the safety of the general public. If the outcome of an incident is not what firefighters would wish for, their initial adrenalin rush turns to what I would describe as a devastating disappointment that they have not achieved their goal or what they had hoped for. Their bodies and minds must cope with sudden emotional changes.

There are also occasions when the judicial process exacerbates firefighters’ exposure to potential stressors, in that the police and, in Scotland, the Crown Office and Procurator Fiscal Service may be reluctant for immediate debriefs of crews to take place until they have met with individuals and taken their statements, to ensure that their evidence is not compromised. It is an added stress when firefighters have to speak to people in authority about what has taken place. We have seen on our televisions the grilling of some of the officers at the Grenfell fire. Those individuals did their very best that night, yet they are being grilled through the courts service and various inquiries.

Debriefs have immense value, not simply so that crews can learn lessons in relation to how an incident went—what they could have done better, and so on—but to provide individuals with the opportunity to express their feelings to their peers. They may not wish to burden—or may not be able to burden—their family and friends with those feelings, or confidentiality might prevent them from offloading those concerns on those outwith the service. All of these things may be worse for retained or volunteer firefighters, who live in the very communities that they serve; on many occasions, they may know the victims of an incident.

I will touch on two poignant road traffic crashes that illustrate that. In one incident, a firefighter said hello to four young individuals at a shopping centre in a small town. He knew the four individuals and their parents. An hour after a courteous conversation with the four individuals, his pager was activated and he responded to a road traffic crash in which two of those young individuals had died. As one would expect, he conducted himself professionally, but weeks, if not months, later that incident came back to haunt him. I am pleased to say that he received assistance from Strathclyde Fire and Rescue Service, and he made a full recovery.

There was another incident that had a good outcome. The driver of a retained appliance approached a road traffic crash and spotted his wife’s car; it was his wife who was trapped. As I say, there was a good outcome, as she made a full recovery. I attended that incident and it was quite a tense situation. I give credit again to those who serve their own community.

[John Howell]

What my hon. Friend is saying is very powerful. Does he believe that there is more that the fire service can do—I encourage my own local fire stations to do this—to have public exhibitions of what they do and show how they go about their work, because once the public understand that, there is a tremendous amount of additional support for the fire service and for the actions that they take? It would help if we gave firefighters a lot more encouragement to do that.

[Bill Grant]

I thank my hon. Friend for that intervention. Yes, a lot is already being done to encourage people and to raise awareness. The fire service in Scotland used to have an annual event at the old Strathclyde regional station, with the slogan, “Reckless driving wrecks lives”, where we brought along fifth and sixth-year schoolchildren. All the emergency services took part. We also make home safety visits now and we are very much part of the team that tries to prevent these events before they happen, through accident and fire reduction. Also, let us not forget the introduction of a very simple thing in people’s homes, which is the smoke detector. In Scotland, we fit them free of charge for anyone who approaches us, and they are worth their weight in gold; they are very effective. A lot has been done on the preventive side. It is a failure if the fire engine goes out; we should prevent all the fires and reduce the number of accidents.

Recently, while out driving in my constituency with a staff member, I turned to them and told them that we had just passed the site of a fatal road accident. The accident had happened 30 to 35 years ago, but decades later I could still vividly envisage the two deceased persons in that vehicle. What triggered that, I really do not know. For some people, there will be no trigger; regrettably, an incident will live with them and haunt them for the rest of their lives constantly. I am able to put such an experience back in the box and reflect on it; perhaps I am very fortunate in that way.

It is so important that rescuers themselves do not become later in life the people who have to be rescued from extensive mental trauma. Let us be proactive and protect, to the best of our abilities, our firefighters from mental trauma or mental harm. The Health and Safety Executive defines stress as

“the adverse reaction people have to excessive pressure or other types of demand placed upon them.”

That can apply to a lot of emergency responders, including the police, but it applies to firefighters in particular.

Most people, including most firefighters, can cope with the challenge of work demands, but when other life pressures are added accumulatively—for example, debt problems or marital problems—sometimes it just gets too much to bear and a tipping point is reached. Many workplaces offer stress management courses. In my time in the service, we introduced welfare officers as far back as the 1990s, along with external counselling. I am sure that continues today, probably in an improved way. Many workplaces also have in-house occupational health staff. The hon. Member for Kensington mentioned the fire service benevolent fund, which has been going for more than 100 years and is now called the Fire Fighters Charity. It offers invaluable support through its psychological rehabilitation service for serving and retired firefighters.

While people may be screened and tested for underlying illnesses, susceptibility to stress, as I understand it, may not be immediately apparent and the individual themselves may not know or wish to admit—that is one of the very sad things, and it was a very male-dominated service when I was in it, although I am pleased to report that that was changing for the better when I left—that their illness may be stress-related, given the previous stigma around mental health issues. To some degree that stigma remains.

When we see someone with an injury to their leg or a broken arm, we can see the physical injury, but we cannot see or feel a mental injury. Firefighters may wrongly perceive such an admission as a weakness on their part. It certainly is not. According to the mental health charity Mind, 37% of firefighters think colleagues would treat them differently in a negative way if they conceded or admitted that they had a mental health issue. The black humour and banter of my days—days gone by, fortunately; it is no longer politically correct, and that is quite right—was once a release valve and coping mechanism behind closed doors for firefighters, but they still have the camaraderie and they still work as a team. That is a form of therapy in itself, and it has immense value. When a whole-time firefighter returns to the station, they have that group. It is different for retained and volunteer firefighters. They return to their partners and wives individually, and that gives a different dimension to the situation.

According to Mind, 85% of people in the fire and rescue services—it is an inordinately high number—experiences stress and poor health at work. They are twice as likely as the wider workforce to identify problems at work as the main cause for their stress. Statistics obtained by Members of the Scottish Parliament through a freedom of information request indicated that in 2016, 137 employees of the Scottish Fire and Rescue Service—firefighters, control room staff and support staff—were recorded as taking sick leave due to stress. Regrettably, those figures appear to be on the rise, as the figure for those recording stress as a reason for absence was 77 in 2015 and only 27 employees in 2014. That is despite an apparent fall in the number of fires and incidents. We are doing well on fires, but we have got road accidents, factory accidents and farming accidents—there is a whole range of special services. We need to discover what has changed since 2014. What are the root causes and contributing factors? Most importantly, we need to address them.

An article in a recent Fire Brigades Union magazine, Firefighter—I am an out-of-trade member and I still receive it—highlighted a need for ring-fencing moneys within NHS budgets for mental health. That is a prudent thing to request. The Prime Minister said last year:

“I want to use the power of the government as a force for good to transform the way we deal with mental health problems right across society, and at every stage of life. Tackling the injustice and reducing the stigma associated with mental health conditions is a priority for me, which is why today I set the goal of providing 1 million members of the public with basic mental health awareness and first aid.”

That goal has to be welcomed. I understand that NHS England got a top-up of £50 million over five years, which is most welcome, but I do not know whether that will be enough to address the issues and the incident of Grenfell, the consequences of which will be felt for years to come, sadly.

When we consider how much it costs to train and equip a firefighter, together with the potential costs of their ill-health, such as absence or early retirement—they may even go to the extreme of taking their life—surely it makes economic sense to invest in appropriate support measures. Firefighters are the finest example of an asset to society. They serve it on a daily basis, and they must be properly supported. Should they stretch out their hand for help, we must grasp it and give that help. Better still, let us prevent them from needing to do that in the first place.