Transforming Behavioral Health in the Fire Service

March 20 • 2020

Since opening in March 2017, the IAFF Center of Excellence for Behavioral Health Treatment and Recovery has helped more than 1,200 IAFF members struggling with behavioral health problems.

Each member’s decision to get help not only starts their individual journey to recovery but can have a lasting impact on surrounding family, the department, community and culture.

A significant number of members admitted to the Center of Excellence are seeking treatment for the first time — in some cases, after years of suffering in silence.

In a 2019 follow-up survey conducted one month after discharge from the Center, 54 percent of members treated reported they would not or probably would not have sought treatment without access to a facility exclusively for fire fighters.

“Members seeking treatment at the IAFF Center of Excellence can be assured they will be embraced by a brotherhood and sisterhood that understands life in the fire service,” says General President Harold Schaitberger.

“Our focus on combatting the emotional toll we endure has been profound,” says General Secretary-Treasurer Kelly. “The Center of Excellence is credited with saving many members’ lives.”

“Being in treatment with other IAFF members — including retired members like me — who were experiencing very similar issues — was some of the best therapy,” says Bill Allenbaugh, an active-retired member of Baltimore County, MD Local 1311.

Ray Glover, a member of Memphis, TN Local 1784, says his life is forever changed after seeking treatment at the Center of Excellence. “It was the best thing. I was treated along with brothers and sisters who understood what I was going through.”

“My brothers and sisters at the Center and the tools we were given to help each other work through our struggles were tremendous,” says Eric Fessenden, a 32-year veteran fire fighter and active-retired member of Montgomery County, MD Local 1664. “The true brotherhood and sisterhood were a great help during and after my time at the Center.”

Richard Stack, a 27-year fire captain and member of North Attleboro, MA Local 1992, says, “I was with fellow fire fighters and staff who understood how I was feeling. The Center of Excellence was the only place I felt surrounded by those who honestly got it, and that was a sense of relief for me, especially knowing that I was not all alone in this battle.”

“I could have gone to a local treatment facility in Omaha, but I chose the Center of Excellence because everyone there has walked the same walk as I have,” says Mike Borman, a member of Papillion, NE Local 3767. “We’ve all seen death, fire and other mass casualties. We have so much in common as fire fighters, but to go to a facility where everyone there wants to better themselves is amazing.”

Following treatment at the Center of Excellence, many members leave feeling restored, refocused and energized to share an important message with their brothers and sisters: recovery is possible, and you are not alone.

While program graduates are strongly encouraged to focus on their continued recovery as the top priority in the first year after discharge, many are using their recovery experience as a steppingstone to become involved in their local peer support team, wellness committee and other initiatives to help increase behavioral health awareness.


Peer Support Programs Change Lives

The stresses faced by fire service members throughout the course of their careers — incidents involving children, violence, inherent dangers of firefighting and other potentially traumatic events — can have a cumulative impact on mental health and well-being. Peer support programs have been demonstrated to be an effective method for providing support for problems that fire fighters face at work, home and in between.

The IAFF Peer Support Training program is a two-day interactive course taught by experienced peers from the fire service and behavioral health clinicians.

Brandon Dreiman, an IAFF peer support instructor and peer support coordinator for Indianapolis, IN Local 416 and the Indianapolis Fire Department, says Indianapolis’ thriving peer support program has encouraged locals in Indiana and across the country to get involved with fire fighter mental health.

Now seven years in recovery from his own behavioral health challenges, Dreiman conducts regular leadership meetings to ensure that each fire fighter in his area knows that mental and behavioral health are a priority.

His overall goal is to be more involved in the day-to-day needs of fire fighters to normalize the conversation about mental health. “By having conversations about behavioral health on a regular basis, members are empowered to ask for help when a difficult situation arises,” says Dreiman.

A 20-year veteran fire fighter, Greensboro, NC Local 947 member and IAFF peer support instructor Justin Price has dedicated his career to helping other fire fighters process challenging calls and circumstances through the Greensboro peer support program.

A captain in the busiest station in Greensboro, Price has encountered many difficult and traumatic calls alongside his IAFF brothers and sisters. He began his behavioral health work for Local 947 after participating in a beta class of the IAFF Peer Support Training, which helps promote a culture of understanding, compassion and communication. Now an IAFF peer support instructor, Price teaches throughout the United States and Canada.

Coming on the job in 2000, he says, “You didn’t talk about calls. You didn’t check to make sure everybody is okay.” Slowly, the conversation around mental health has shifted as fire fighters have realized the positive impact of opening up.”

Greensboro Local 947 President Dave Coker says, “The peer support program has helped us change the culture of our department and, in some cases, has quite literally saved the careers and lives of members.”

After his brothers and sisters struggled with a series of losses, Mike Wells, a member of Prince George’s County, MD Local 1619, in his role as a peer support leader helped strengthen bonds in the firehouse and beyond.

“When a member reaches out for help, peer support includes ensuring that the member’s basic needs are met and understanding how they are coping,” says Wells. “When a member calls, it’s because they know there is something off, so identifying that early on can help peer supporters provide the best assistance.”

The Prince George’s County peer support program provides camaraderie and a wealth of resources to help members who may be struggling with family, work-life balance, mental health, addiction or overcoming a tough call without fear of repercussions or stigma associated with asking for help.

“It’s been really exciting to see the impact of peer support throughout our district,” says 4th District Vice President Andy Pantelis. “For a brother or sister who is struggling, knowing they can reach out to someone who has walked in their boots makes a difference. It can be the difference between getting help or struggling in silence.”

Whether your affiliate or department has a peer support group or not, there are many resources available. If you’re interested in starting a peer support program in your area, contact your department chief or visit


Increasing Access to Help

As more fire departments recognize the value of treatment and rehabilitation, some are surprised to learn they have little-to-no behavioral health coverage for members to seek treatment at the Center of Excellence or other residential behavioral health facilities. If insurance doesn’t cover basic behavioral health services, such as outpatient counseling, family therapy, addiction treatment and inpatient behavioral healthcare, a member in crisis could be left with very few options to get help.

Insurance that covers the cost of treatment can make a significant impact on the overall expense and the type of care members are eligible to receive. Knowing what benefits your members have and what your health plan covers — in network and out of network — is critical. Insurance can cover part or all the cost of treatment, depending on the policy.

If you’re not sure what is or is not covered by your plan, contact Kelly Savage at [email protected] for assistance explaining your eligible coverage, copays and deductibles. Affiliate leaders can also contact their district vice president to request a review of their local’s health insurance plan and benefits, recommendations on how to improve coverage and assistance in negotiating benefit packages.

The decision to invest in quality and comprehensive behavioral health coverage has been a major focus in the fire service occupational health arena in recent years. Closer scrutiny of behavioral health insurance coverage has also helped lay the groundwork for advances in state and provincial presumptive laws for workers’ compensation to cover post-traumatic stress disorder (PTSD).

In 2019 alone, five additional states and one province passed PTSD legislation, for a total of nine states and eight Canadian provinces with PTSD laws.

Thanks to these advances, when a fire fighter is diagnosed with PTSD as a result of the job, the law is now on their side to help recover lost wages and pay for treatment.