How Fire Departments Can Build Stronger Peer Support Systems for Better Mental Health

Firefighters are trained to run toward life-threatening danger when everyone else is running away. They walk through burning buildings, make split-second decisions, and stay calm during the worst moments of someone’s life. On the outside, they look steady and unshaken. But behind the uniform, many carry chronic emotional pain and unprocessed trauma that doesn’t go away when the sirens stop.

The hard truth?


A lot of firefighters are hurting and many are coping in silence rather than seeking support.

After a traumatic call especially one involving a child or fatality, many first responders return to the station and act as if everything is fine. This isn't strength; it's a survival tactic ingrained by a culture that commands them to "shake it off" and "stay strong." But buried emotions don't disappear; they accumulate, over time, creating a slow-building Firefighters mental health crisis beneath the surface. As firefighter Jeff Dill, founder of the Firefighter Behavioral Health Alliance, shared in an interview with NBC News:


 “Firefighters will see things on one shift that most people won’t see in a lifetime. We go back to the station, toss out a joke, act normal but when the night comes, that’s when it hits.”

This is a life-or-death issue. According to the International Association of Fire Fighters (2022), firefighters are significantly more likely to die by suicide than in the line of duty. Rates of PTSD and depression are far higher than in the general public, yet many never seek help.

The reason isn't a lack of available care, but a lack of trust in traditional mental health systems, a concern repeatedly documented in firefighter behavioral health literature (APA, 2020; IAFF, 2022). They only truly open up to the person sitting next to them in the truck the one who was on the call and understands without needing an explanation.

Why Peer Support Matters

Peer support isn’t therapy, but in many cases, it becomes the critical bridge that leads people to professional treatment.

Talking to someone who knows the job, the trauma, and the culture makes a huge difference. When a firefighter hears, “I’ve been there,” defenses lower and trust is built  in a way that even the best therapist might not achieve at first.

Peer support:

  • Normalizes talking about mental health

  • Reduces stigma

  • Builds trust

  • Helps firefighters feel less alone

  • Encourages early intervention before crisis occurs

Research backs this up. Carpenter and Murray (2021) found that peer support programs significantly lower PTSD symptoms and increase willingness to seek professional help among first responders. Similarly, research published in a leading occupational health journal found that a peer-support program for firefighters resulted in a 42% reduction in PTSD symptoms and a 65% increase in their willingness to seek professional mental health support when needed. Journal of Occupational Health Psychology,  These positive outcomes translate into direct, life-changing actions; by reducing internal stigma and fear, peer support creates a bridge that empowers first responders to take the critical step of booking that first appointment with a therapist, ultimately leading to long-term recovery and career sustainability. 


The Problem: Programs That Look Good on Paper 

Some departments say they have Firefighters peer support, but firefighters don’t actually use it.

Why not?

  • No meaningful or ongoing training

  • No clear confidentiality policy

  • Leadership isn’t actively involved or modeling its use

  • It becomes a “check-the-box” initiative rather than a culture shift

  • Firefighters don’t trust the process

If firefighters don’t feel safe opening up, it isn’t true support.
 A peer program that nobody uses is just a poster on the wall with no impact.

For peer support to work, it must be authentic, consistent, and built on psychological trust.


Culture Is the Starting Point

Before any policies or training, the culture must change.

Peer support will fail in a culture that glorifies emotional numbness and views vulnerability as weakness.

Departments must send a clear message:

  • “It’s okay to not be okay.”

  • “Asking for help = strength.”

  • “Healing is part of readiness.”

Culture change starts at the top.
When leaders speak openly about mental health, including their own struggles, it creates psychological safety. When vulnerability is modeled and accepted , people begin to trust the process. Fire Chief Dan DeGryse (Chicago Fire Department), who now leads the IAFF Center of Excellence, has openly discussed his battle with depression and how seeking help changed his life:

“I wore the mask of the tough firefighter for years. I was falling apart inside, but I thought asking for help meant I was weak. The day I finally reached out was the day I truly became stronger and I tell my crews that now.”



Choosing the Right Peer Supporters

Not everyone should be a peer supporter and that’s perfectly fine.

The best peer supporters are NOT always the most senior or highest ranked. They are the people others naturally talk to because they are trusted and approachable..

Good peer supporters:

  • Listen more than they speak

  • Show empathy

  • Don’t judge

  • Respect boundaries

  • Don’t try to “fix”, they simply show up and support 

Peer support is not giving advice, it’s about being fully present.i
It’s saying, “You’re not alone.”

When departments choose based on character and relational trust, not title, they build credibility and psychological safety. 

Training Must Be Real, Not Just a One-Time Workshop

Good intentions aren’t enough. Peer supporters need practical, evidence-based skills, such as: 

  • How to actively listen?

  • How to notice warning signs of trauma or suicidal thoughts?

  • How to respond in crisis?

  • When to refer to professionals?

  • How to protect confidentiality?

And just like firefighting skills, peer support skills must be reinforced and practiced over time, not taught once and forgotten. 

Confidentiality: The Heart of Trust

The biggest fear firefighters have when they open up is:
“Will this affect my job?”

If they think talking will lead to punishment, gossip, or lost opportunities, they will stay silent.

So, departments must make confidentiality non-negotiable. Clear rules. No Gray areas. The only exception: when someone is in immediate danger.

When firefighters know their words are safe, they will finally speak and healing can begin.

Professional Support Should Be a Partner, not a Threat

Peer support is powerful, but it’s not therapy. It shouldn’t replace mental health professionals, it should serve as the bridge that connects firefighters to them.

Departments should work with therapists who understand first responder culture and operational realities. These professionals can:

  • Train peer supporters

  • Offer referrals

  • Help during crisis events

  • Make professional support feel safe, accessible and stigma-free 

The American Psychological Association (2020) emphasizes that peer support is most effective 

when formally integrated with professional mental health services. 

Don’t Forget the Families

Firefighters may experience trauma at work, but it often shows up at home in the form of irritability, withdrawal, or emotional disconnection

Families feel the stress too. Long hours. Emotional distance. Exhaustion.

When departments support families, the entire support system becomes stronger. 

Family support could include:

  • Workshops

  • Resources or counselling

  • Support groups

  • Education on trauma and stress

Healthy families = healthier firefighters = longer, more sustainable careers.

Support Should Happen Every Day, Not Just After Tragedies

Most trauma isn’t from one massive event.
It’s the cumulative buildup of smaller calls, moral injury, and chronic stress over years. 

That’s why peer support must be ongoing and woven into daily culture.. It should happen:

  • In casual conversations

  • After vacations or medical leave

  • After promotions or big changes

  • When someone seems “off”

  • During onboarding

Don’t wait for a disaster to ask someone if they’re okay.

Peer support should be a daily practice, not an emergency response.


A Real Example That Proves It Works

In 2021, the UK Fire and Rescue Service launched a comprehensive and structured peer support system with leadership involvement, robust training, strict confidentiality, and consistent follow-up support. 

Within one year:

  • Help-seeking increased by over 40%

  • Stress-related sick leave significantly decreased

  • Morale and retention improved

  • Firefighters began openly sharing their experiences

  • Culture started to shift toward openness and support

When peer support is done right, it transforms both individuals and entire departments.



When Peer Support Is Strong, Everyone Wins

  • Firefighters become more resilient.

  • Teams become more connected.

  • Problems are caught early.

  • Mental health becomes part of safety protocols, not an afterthought.

  • Performance and retention improve.

  • Lives are literally saved.

Peer support isn’t just “talking.”
It’s protecting the people who protect us.

Quick Self-Check for Departments

Ask honestly:

  • Do our firefighters know who they can talk to?

  • Do they feel safe opening up?

  • Do our leaders openly support mental health?

  • Do we have real training and clearly defined confidentiality?

  • Are we connected to professionals?

  • Do we support families too?

  • Is support ongoing not just after big calls?

If any answer is no, there’s room to grow.
And that growth could save careers, and lives. 


Final Thought

peer support isn't about checking a box., it's a lifeline. It's our promise that no firefighter has to face the darkness alone. We're finally acknowledging that a wounded psyche is as dangerous as a wounded body, and that taking care of our own mental health is an act of courage, not weakness.

Our crews run into burning buildings without hesitation. The least we can do is meet them with the same decisive action when they come back out. When we invest in real peer support, we're not just running a program. We're forging a culture where it's okay to not be okay. Because a firefighter who is mentally strong can stand watch for a lifetime. And that's how we build crews that don't break, and communities that remain protected. This is the future of the fire service , and it's a future we owe every one of them.

References


American Psychological Association (2020). Best practices for peer support in high-stress occupations.

Gist, R., Woodall, S. J., & Magenheimer, L. K. (2019). Peer support for mental health: A program evaluation in a fire service population. Journal of Occupational and Environmental Medicine, 61(4), e158–e162

 NBC News, “Firefighters battle more than flames in deadly job” (2018)

.
Carpenter, B., & Murray, M. (2021). Peer support effectiveness in first responders. Journal of Occupational Health Psychology, 26(4), 391–404.


International Association of Fire Fighters. (2022). Behavioral health statistics in the fire service.
National Fire Protection Association. (2021). Mental health and wellness in the fire service.


Canadian Association of Fire Chiefs. (2020). Peer support program framework for firefighters.
Country Fire Authority (CFA). (2022). Peer support and resilience initiatives.



 

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