When I became a firefighter in 1980, no one in the fire service talked about post-traumatic stress disorder (PTSD). That was the year the condition was officially recognized by the American Psychiatric Association and was first applied to veterans who had returned from Vietnam with chronic psychological effects from service there.
PTSD had been recognized historically among combat veterans under different names: “shell shock” in World War I and “combat fatigue” or “battle neurosis” in World War II. It was particularly prevalent among soldiers who served in Asia and the Pacific Ocean theater during World War II.
It is only more recently that has PTSD been increasingly recognized as an issue for those in public safety, medicine and other professions, as well as those who have survived personal trauma.
Fostering PTSD: Poor planning and lack of leadership
In his book “Fire and Fortitude: The US Army in the Pacific War, 1941-1943,” John McManus writes about the effects of PTSD among soldiers in the Pacific theater. The conditions they faced there were often beyond horrible: “mud, rain, heat, insects” was how one officer summarized it. Clashes with Japanese forces were often gruesome, close-range firefights. Movement through the jungle was nearly impossible, and accurate information about the terrain was hard to come by. Communication between units often broke down.
One important factor contributing to high rates of PTSD among troops in the Pacific was poor planning and preparation of soldiers prior to deployment. For example, the 43rd Division deployed to the Solomon Islands was “nowhere near prepared to fight in this environment,” according to McManus. They were not experienced in jungle warfare. Many were not in the best physical condition. Upon arrival at Guadalcanal, members of the 43rd Division had been terrified by experienced soldiers who carried forward a tradition of “scaring the rookies” by telling them tall tales of Japanese superhuman powers. They had almost no training in night fighting, a standard Japanese battle tactic. They were exhausted most of the time.
But perhaps the most significant factor contributing to high rates of PTSD among soldiers in the 43rd Division was a lack of good leadership, according to Colonel Franklin Hallam, the XIV Corps surgeon who treated many of the men. He discovered that, when sergeants and officers became combat fatigue casualties, many of their men did as well. “This gave us the first tangible evidence that incompetent or questionable leadership in small units was an important causative factor,” Hallam stated.
There are important lessons here for fire service leaders, particularly company officers. When first-level officers do not fully understand their responsibilities or have not earned the confidence of their people, mental and physical health may be at stake. If leaders are poorly trained in the conditions they face or if they allow their personal fears to dictate decisions, that fear can translate into panic and dysfunction among those they lead.
Preventing PTSD: First-line supervisor training and support
How can teams do better under difficult conditions, and thus help prevent PTSD in its causative stages? Preparedness is key. Everyone needs to know what to expect from the job and have the skills and ability to respond to challenges they face. But this preparedness is even more critical for first-line supervisors.
In the decades I have worked with fire departments across North America, I frequently ask the question, “How well prepared are company officers when they first assume this position?” In all those years, I have never had anyone from any department tell me that they feel their company officers were fully prepared.
Of course, it is hard to know how to fully prepare for most positions until you are in them, but there are many things that fire departments can do to give their new officers a better chance at success. Training is key, but not just technical training on things like incident command. Perhaps even more important is training on things like communication, giving and receiving feedback, coaching and counseling, and conflict management. Experienced firefighters who become officers are usually pretty good at the technical aspects of the job; however, they may have little or no experience with leadership in other areas.
It is also critical that new officers know that they have a support system in place, and how to access that support. Battalion chiefs are the logical next line of support in the chain of command, but many in this role have little training or incentive to act as mentors or coaches for the officers they supervise. Additionally, company officers should have the opportunity to meet with their peers apart from formal incident debriefs. The ability to ask questions, get input, and not feel alone goes a long way toward building confidence and competence in a new officer.
Supporting first-line supervisors in this way will lead to better incident management, more crew cohesion, and less disabling conflict. All members will feel that their voices are heard and understood. This feeling of inclusion and confidence in leadership is a critical factor, not only in achieving work goals, but also in mitigating the factors that can lead to higher levels of PTSD over time.
Editor’s note: Have you witnessed the impact of leadership on managing PTSD? Share your story at firstname.lastname@example.org.