The Whole Package: Developing a total wellness program

By Mike Ong

Having participated in many health and fitness symposiums over the years, I’ve had the privilege of meeting firefighters from all over the world, and I’ve entertained a variety of questions regarding the development of wellness programs for their respective departments. In short, I’ve learned a great deal about other departments and the challenges they face in developing or growing their programs.

Most attendees of health and fitness symposiums are either department fitness coordinators or motivated people serving in that role. Whichever the case, the two things that remain constant are the level of passion that these individuals have for fitness and a motivation to improve their department’s fitness levels.

One thing that surprised me in talking with other departments is the lack of resources and energy allocated to mental wellness. Heart disease still remains the number one killer of firefighters, and it would be fair to say that the mental stressors associated with our profession contribute to this condition just as readily as inactivity and poor diet.

The health and safety of firefighters are imperative to the success of any department. Annual medical exams are key to maintaining physical wellness, but we must also consider nutritional education and mental health as major factors in our overall wellness. Photo courtesy Portland Fire & Rescue

Developing relationships with equipment vendors or retailers often results in discounts for departments that buy in bulk or on a regular basis. Some of the large fitness equipment manufacturers will allow a department to beta test some of their equipment prior to purchase. Photo courtesy Portland Fire & Rescue

Getting Started = Building Relationships

A successful wellness program entails a large resource list, and accumulating those resources is a matter of building relationships. Example: A department that’s struggling with a large number of work-related injuries would benefit from identifying an injury prevention specialist or physical therapist in their area and having them conduct some lectures or station visits regarding injury prevention. An apparatus ride-along or visit to the training academy prior to the lectures would enlighten them as to the physicality of the tasks that firefighters perform, thus making their lectures more applicable.

Subject matter experts can be a tremendous asset to fire departments and can provide a variety of information and guidance on many different wellness-related topics, including nutrition, fitness and mental health. Many times, these subject matter experts will perform their services at reduced rates or even pro bono. In return, they build their client base to include firefighters, which in turn increases their marketing appeal. It’s a mutually beneficial relationship.

In addition, developing relationships with equipment vendors or retailers often results in discounts for departments that buy in bulk or on a regular basis. Some of the large fitness equipment manufacturers will allow a department to beta test some of their equipment prior to purchase. This is a great way to see and compare the latest innovations in fitness equipment from a variety of different manufacturers.

Tip: Contact some of the bigger fire departments to find out their preferred equipment and vendors. This will save you time and trial when your department is in the market for equipment. We all know that firefighters have a sixth sense when it comes to finding deals, so take advantage of this trait.

One of the biggest impacts to firefighter health and fitness can be made with nutritional education. At my department, we have employed the assistance of a registered dietician and certified nutritionist to educate our members on healthier ways to cook some of our favorite firehouse meals. We then publish this information in a department newsletter that’s distributed electronically to all e-mail boxes; we also send hard copies to all fire stations. It’s a great way to distribute wellness information in a timely and cost efficient manner.

Look Within
Some of your best resources may be found within your department itself. Search your department for members who have education and experience in health and wellness areas, and utilize their knowledge. These members can contribute information to your newsletter that’s both practical and relevant to the department. Furthermore, using the knowledge of these individuals is virtually cost-free, and the information can be written in “fireman-ese,” making it easy for everyone at the firehouse to understand.

A computer-savvy firefighter on light duty or in a staff position can easily format this information into a colorful and graphic newsletter. Distribution of this newsletter is as simple as converting it to a PDF file and pressing the “send” button. Our department has members with backgrounds in strength and conditioning, physical therapy, coaching, athletic training, nutrition and personal training, all of which have contributed greatly to the education of our department.

Mental Health & Suicide
Now to shift gears, an article on wellness would not be complete if the subject of mental wellness was not addressed. As stated earlier, this is often the most overlooked aspect of total wellness. Talking about fitness is energizing. Fitness makes us feel good and look good. It makes us perform our jobs better and is critical to our safety on the fireground. Mental health, on the other hand, is a dark and sensitive subject. Mental health issues are often viewed as a weakness, especially in the “warrior professions” of firefighting, law enforcement and the military. But as critical as physical wellness is on the fireground, mental wellness is equally critical to life outside the firehouse.

Our department has experienced a number of suicides in the last few years. This is an issue we take very seriously. The health, safety and wellness of our members have always been of the utmost importance to our department. As such, we mandate yearly medical exams for all of our members and have even expanded our program to include a Tier 4 Program. This program highlights five tests within the comprehensive medical exam and compares them with parameters or “tiers” set forth by our medical director. Tier 1 exemplifies the healthiest standards and systematically degrades to Tier 4, in which a member’s test results are so poor that they may be removed from active operations until improvements are made to their health.

The goal of this non-punitive program as to rehabilitate and restore the member to healthy levels. Components include pulmonary function, blood pressure, fasting blood sugar, body fat composition and cardiovascular efficiency in the form of MET output.

Unhealthy parameters from these medical tests are relatively easy to decipher, but testing for unhealthy mental parameters can be challenging, because the member has to be willing to divulge some sensitive information. Included in the yearly medical exams is a confidential, one-on-one consultation with the attending physician in which mental issues can be addressed, if the member is willing.

Our department has also recently developed a Mental Health Task Force to identify issues that are affecting our members, as well as ways to address these issues. Some solutions include suicide awareness training, therapist accessibility and independent behavioral health studies. These are tools we can add to our tool box that our members can access to help themselves or co-workers.

Similarities between Police & Fire
Robert Douglas, the executive director of the National Police Suicide Foundation, has studied and lectured around the country on the subject of suicide, and he recently gave a lecture to our department. Although this was his first time lecturing to a crowd of firefighters (as his material is generally directed toward law enforcement), through researching our department and talking with our members, he managed to bridge the gap between law enforcement and firefighting and uncover some common characteristics that lend themselves to suicide.

First, our profession attracts people with Type A personalities who aren’t quick to ask for help. In fact, they can become big obstacles when help is needed. Firefighters are fixers; we’re the ones who quickly respond and fix things when others are in need, so it’s often viewed as a weakness for us to ask for help, especially if the issue is mental.

Firefighters, like police officers, have a high rate of divorce, separation and alcohol abuse. Drug abuse is becoming more prevalent as well. The stressors of the job wear and tear on the mind just as much, if not more, than the body. Furthermore, the transition from station life to home life every third day can be difficult, lending itself to relationship issues.

In 1997, Douglas surveyed 500 police officers in nine major U.S. cities and asked them whether they would consider suicide an option if certain dilemmas arose within their life. There was then a follow-up question that asked which dilemmas would promote suicide as an option. Four hundred and eighty-two out of the 500 officers surveyed stated that suicide would be an option if certain problems arose in their life. Of course, firefighters don’t exactly mimic police officers in behavior and thought, but this information highlights the fact that public servants who mitigate emergencies have similar stressors and responses to those stressors.

According to Douglas, most family members and co-workers of those contemplating suicide have no idea of the signs and symptoms of a potential suicide. He went on to say that a basic understanding and recognition of those signs and symptoms, coupled with appropriate intervention, could greatly reduce the possibility of suicide.

The point: A mental health section needs to be incorporated into every department’s wellness program and should include suicide awareness. Departments need to develop ways to address and educate their members about mental health and suicide prevention, and should be delivered by a qualified subject matter expert familiar with our profession and its stressors.In addition, resources should be available to family members to access if needed.

Last but not least, the overall program must have “buy in” from the top down.

There are many factors working against our physical and mental health: perilous fires, hazardous materials, terrorism, stress, heart disease, high blood pressure, sleep deprivation and even financial issues, to name a few. Building a wellness program within a fire department also has its challenges, such as funding, compliance, buy-in from the members and time constraints.

But the benefits of establishing a wellness program far outweigh the challenges. You can’t put a price on helping a fellow firefighter improve their health, no matter whether it’s mental or physical. Their state of wellness could easily mean the difference between life or death on or off the fireground.

Mike Ong is a battalion chief with the Phoenix Fire Department. He also served as the division chief of the Phoenix Fire Department Health Center and as the department’s wellness coordinator. He has been involved in the health and fitness industry for more than 20 years and has a background in training, writing and presenting.

Copyright © Elsevier Inc., a division of Reed Elsevier Inc. All rights reserved.

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