Mental Health and Wellbeing Support in the Scottish Fire and Rescue Service

1. Background

1. This is the report of an inspection by HM Fire Service Inspectorate (HMFSI) into mental health and wellbeing provision within the Scottish Fire and Rescue Service (SFRS).

2. The SFRS, as a responsible employer, is rightly sighted upon the issue of mental health and wellbeing for all its staff groups. The World Health Organization states: “Mental health is not just the absence of mental disorder. It is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to her or his community.” Research¹ into mental health in the blue light services in England and Wales identified that 61% of respondents working within the fire service reported ‘having personal experience of mental health problems’.

3. Mental health and mental illness are not the same thing. It is important that SFRS employees know the differences. Mental health refers to our emotional and psychological wellbeing. Mental illness encompasses a wide range of medically diagnosed conditions including mood disorders and personality disorders that affect a person’s thinking, feeling and behaviour.

4. The SFRS’ Mental Health Strategy gives a commitment to support its staff and to provide a positive and inclusive culture for staff to operate within, and to access appropriate information and professional assistance to maintain good mental health. During this inspection, the team considered this commitment and whether the Service workplace culture enables staff to seek assistance or interventions as appropriate when their mental health had been negatively impacted. We considered and reflected upon the appropriateness of current SFRS arrangements to support staff and reduce the impact and instances that can adversely impact on mental health.

5. We considered the workplace culture and its influence on the provision and uptake of mental health services that the SFRS has put in place. To best understand and identify any barriers that may exist to achieving the desired open and inclusive approach that the SFRS advocates in relation to maintaining good mental health, we accessed a range of workplaces including Fire Stations, Offices, Operations Control rooms and support workshops. In doing so we conducted 150 interviews across a diverse range of employee groups. Areas of specific focus included:

• Organisational Policy, current arrangements and procedures for mental health and wellbeing that are currently in place within the SFRS.
• Cultural aspects of working within the SFRS that may influence staff accessing mental health and wellbeing services.
• Progress on the creation of a positive and inclusive culture that supports all staff in the maintenance of positive mental health and wellbeing that enables destigmatisation.
• Arrangements and support for a return to the workplace for staff post Covid.
• The impact upon mental health and wellbeing of SFRS personnel relating to their operational experiences in the firefighter role.
• Analysis of Post Incident Support Procedure, its trigger points and the process for initiating it.
• Review of SFRS data and analysis of absence trends and outcomes relating to mental health and wellbeing services.
• Consideration of the SFRS as a learning organisation as it seeks expert advice on the design and development of mental health and wellbeing services.

This list was not exhaustive, and as our inspection fieldwork developed, we reserved the right to include other identified and related areas.

6. There are many factors that can negatively impact the mental health of SFRS staff and give them cause to access support. We gave this due consideration to seek to understand how such issues are being addressed. The inspection team were conscious that they were engaging with people who may have suffered or may be suffering from the impacts of poor mental health. Often these impacts will have been caused through external factors that the SFRS has had little initial influence upon, but ultimately these external pressures may impact the roles people perform within the Service. Given the nature of the operational work that the staff of the SFRS undertake, it is inevitable that some will encounter traumatic incidents that could affect their mental health. Staff may be affected due to their direct exposure to operational incidents, but also vicariously through their remote support for an incident or through their support of colleague’s post-activity. The inspection team analysed SFRS provided literature and data to understand how the trigger points for Mental Health interventions are decided and acted upon and whether these are appropriate.

7. As the SFRS resumed normal service delivery, we were mindful of the impact that the Covid-19 Pandemic had upon peoples’ mental health. As Covid restrictions are lifted, this inspection considered the impact upon the mental health and wellbeing of staff as they return to a more normalised way of working.

8. The Inspection Outline established terms of reference, as set out in paragraph 5 above, for our team to work within and these guided our fieldwork. Inevitably new areas of interest arose during the fieldwork process, and these are set out within the report. This thematic inspection into the SFRS’s mental health services provision, the utility of these services and cultural aspects that could impact upon the uptake of them was based on key lines of enquiry. The findings for each of these key lines of enquiry are set out within this report alongside complementary additional findings. Our report includes a number of recommendations and highlights areas of good practice.

9. During our inspection, key academic work on health and wellbeing within UK Fire and Rescue Services² (Hill et al, 2023) was published and became available to the inspection team. This work, which was commissioned jointly by the National Fire Chief’s Council (NFCC) and the Fire Fighters Charity (FFC), is comprehensive, and its methodology included a wide-ranging literature review relative to working within Fire and Rescue Services. It contains recommendations that are evidence based, which in turn allowed our inspection team to undertake a comparative exercise with the arrangements in the SFRS.