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Report highlights lingering burden on volunteer firefighters

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Three thousand homes turned to rubble, 33 lives lost, 20 million hectares of land destroyed – the devastating toll of the 2019–20 bushfire season is hard to forget.
 
More than 82,000 emergency services personnel battled massive fire fronts that raged through bushland across every state and territory, spending an average of 3.5 weeks each trying to douse the sometimes 70-metre high flames.
 
One quarter of first responder employees and 31% of volunteers felt their life was at risk during this time.
 
And while much of Australia has recovered from the disaster, many of those crews are still battling.
 
That is according to the new Curtin University-led After the Fires report, which investigated the mental health and wellbeing struggles of first responders in the aftermath of the bushfires.
 
Researchers found that more than two years after the fires, rates of probable post-traumatic stress disorder (PTSD) and psychological distress remained high, but many individuals had not received adequate help, often due to stigma or lack of awareness.
 
The report made three key recommendations:

• Develop initiatives to reduce stigma associated with accessing mental health support and encourage openness to discussing emotional concerns
• Create opportunities for time out by putting in place strategies to ensure firefighters have access to scheduled breaks and support systems
• Expand mental health support services, especially for volunteer firefighters

Lead author Professor David Lawrence said it is particularly important to focus efforts on volunteers, which made up 78% of the Black Summer Bushfire’s first responders.
 
‘The major challenge for our future bushfire preparedness is sustaining a volunteer cohort to respond to large-scale events without the risk of burnout or mental ill-health,’ he said.
 
‘Alarmingly, two years after the bushfires, emergency services personnel were twice as likely as members of the general population to have seriously considered ending their own life, at 5.6% of volunteers and 4% of employees.
 
‘Cumulative exposure to traumatic events was identified as a significant risk factor for mental health problems in the emergency services sector, while the main protective factor for wellbeing was high levels of social support.’
 
After the Fires surveyed more than 4000 personnel, including 1000 volunteers, from fire and rescue, rural fire and SES agencies across Australia, both one year and two years after Black Summer.
 
For several of those participants, contact with formal clinical mental health services, including GPs, was the first time they had sought out formal mental health support.
 
The report included firsthand responses to seeing a doctor for a mental health appointment, praising the knowledge and calmness of GPs.
 
‘Well, the doctor said to me, “are you suicidal?” And I said, “hell no”. So that’s something a doctor can say, where someone else couldn’t say it,’ one firefighter said.
 
‘They don’t muck around. They just – they just ask you … and then it gives you permission then to not keep it to yourself.’
 
Another spoke about the special effort their GP made to take care of them throughout what was a difficult time.
 
‘I was lucky my – my GP just walks on water,’ they said.
 
‘If, during that 20 months I’d made a phone call to make an appointment, then I almost always got him the next day.
 
‘So, I get the sense that he was actually looking out for me.’
 
The report comes amid an early start to the 2023–24 summer bushfire season.
 
A number of out-of-control fires have already threatened towns, and on Tuesday, an emergency level fire burned out of control on the New South Wales Mid North Coast, claiming one life.
 
Despite the well-documented healthcare challenges affected communities face, the RACGP last month pointed out that general practice remains an underused and often poorly coordinated workforce during disasters, following the release of the Federal Government’s Alternative Commonwealth Capabilities for Crisis Response.
 
RACGP President Dr Nicole Higgins previously told newsGP there is an urgent need to embed general practice in disaster planning.
 
‘As we’ve seen in past bushfires and floods, GPs play a key role caring for people and communities when disasters strike, as well as during the aftermath and recovery,’ she said.
 
‘But GPs who’ve been on the frontline during bushfires have told us that they’re held back from doing all they can due to a lack of consistent communication and coordination from the disaster response team.’
 
The Curtin University report concludes that maintaining a sustainable workforce requires enough people and resources to share the burden of responding to the increasing frequency and intensity of disaster events.
 
‘Tragedy and loss have immediate and enduring consequences,’ it said.
 
‘While the property and stock lost can be replaced, the internal scars are less readily seen, can take longer to heal and may resurface in future fires.
 
‘Our largely volunteer workforce is the most valuable resource we have for disaster response. Their wellbeing deserves commensurate community support and investment.’
 
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bushfires emergency medicine mental health

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