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

3. SFRS Mental Health Strategy, Policy, Procedures and Arrangements

18. The SFRS introduced its first standalone Mental Health Strategy (2020 – 2023) at the end of 2019. The Service has recognised its moral and legal duty to support the mental health of its staff groups. A Fire and Rescue Service will by its very nature be called upon to attend operational incidents that have the potential to cause psychological trauma to its personnel. As well as this, there are many mental health triggers for people working in non-operational roles in the SFRS as well as from their lives away from work. The Service sets out in the strategy, its commitment to supporting staff groups and their families and gives a commitment to secure reach back mental health services for retired personnel.

19. The SFRS has in place a broad offer of help and resources for its staff to help secure positive mental health. This broad offer includes, but is not restricted to:

• Provision of an Employee Assistance Programme via an external company with a 24/7 helpline, face to face counselling and access to a range of app-based wellbeing information.
• A SFRS Mental Wellbeing Champions programme.
• An ongoing working relationship with the Rivers Centre⁵ for the provision of post incident support and other work-related activity.
• The introduction of a Post Incident Support Procedure (PISP) to systematically identify operational personnel who may suffer psychological trauma through attendance at operational incidents.
• An ongoing working relationship with the ‘Fire Fighters Charity’.
• An ongoing working relationship with the SFRS’ ‘Family Support Trust’.
• A range of working relationships with charitable organisations on an initiative basis.
• ‘Last Aid’ bereavement support training in partnership with Highland Hospice.
• A partnership with the City of Glasgow College to facilitate mental health First Aid training and for neurodiversity awareness.
• A longstanding partnership with the SFRS Chaplains.
• A reorganisation of the Health and Wellbeing Team to offer support for persons in need including immediate access to crisis intervention when needed.
• A dedicated health and wellbeing space on the SFRS iHub intranet, offering a wide range of accessible services for SFRS personnel.
• The introduction of the SFRS Agile Working Framework to provide greater flexibility around working hours and location of work for staff to enable a positive work life balance.
• The introduction of a new IT system for Health and Wellbeing to map, monitor and draw conclusions from data.

Good Practice 1: The SFRS makes a wide and comprehensive offer of mental health and wellbeing services to its employees. These services are a mix of in-house provision, via an external 24/7 Employee Assistance Programme, and The Rivers Centre through which professional psychological support can be accessed.

20. As can be seen above, the SFRS offers a broad range of support for its employees to help them deal with general life issues that are generated away from the workplace, fire service-related specific issues such as psychological trauma experienced at incidents and issues that relate to the roles that they perform within the Service. However, we consider that there are some gaps within the provision and/or the application of the processes and care that is on offer and make comment on these within this report.

The SFRS Mental Health Strategy

21. The SFRS Mental Health Strategy was introduced in 2019, just before the COVID pandemic, and this would clearly have been a period of disrupted service delivery. It has run from that period to date and despite the difficulties the SFRS faced during this time, the strategy implementation appears to have gone relatively well. With the introduction of its Mental Health Strategy the SFRS undertook a cultural shift in relation to mental health and wellbeing and how it is viewed within the Service. The Service aims to ‘create a positive and inclusive culture, and an open and supportive environment within which our staff can operate’. This shift was commented on positively by interviewees, but the consensus was that it was a “work in progress” and that there was still some way to go before it would be perceived as being complete.

22. The SFRS is a signatory to The Mental Health at Work Commitment (The Mental Health at Work Commitment – Mental Health At Work), which has six standards that organisations can commit to. One of the key foundations of the standards is to produce a ‘mental health at work plan’. This commitment was one of the drivers for the creation of SFRS Mental Health Strategy 2020 – 2023. During our fieldwork we spoke to a range of Service personnel, both serving and retired, as well as external partners who directly contributed towards the development of the strategy and the management of the work that it produced from that time to date. We were told that there was real passion and drive to make a positive change in the way mental health and wellbeing was viewed within the SFRS. It was recognised that an overarching strategy was needed. There were also senior employees within the Service who had lived experience of mental health challenges and who were prepared to share them. Importantly they had a desire and a willingness to create positive outcomes, “Nothing we had at that time was user friendly. We had lived experience and a desire to make things better”.

23. It was against this background that a group of senior members of the organisation and external partners, including from The Rivers Centre, devised the strategy which was endorsed by the Strategic Leadership Team (SLT) and the Board of the SFRS. A Mental Health Board was formed within the Service (2019) and workstreams evolved from this group resulting in the formation of sub-groups to support the achievement of outcomes.

Good Practice 2: The SFRS has taken the very important step of devising a specific Mental Health and Wellbeing Strategy. This allows an ambitious and strong focus to be maintained on mental health and wellbeing approaches and their outcomes.

24. We asked some of those who were part of the development process if they considered the strategy to be too aspirational and if it attempted to cover too much ground too quickly. The consensus was that it had to be necessarily aspirational and that it should challenge the Service to act on a broad range of fronts, and to tackle the challenges that were considered to exist in terms of mental health and wellbeing within the SFRS. It should be noted that we do not consider these challenges to be a concern for the SFRS only, there has been a generational shift in awareness across society and its institutions regarding the maintenance of a positive mental health for the population and for organisational workforces.

25. Having reviewed the strategy, it is our view that it was necessary for the SFRS to put in place a document that set out its ambition to be a leader in the care and holistic health of its organisation and workforce in matters relating to mental health and wellbeing. The SFRS has achieved many positive outcomes, however there are areas of the strategy that continue to remain aspirational with no set timetable for completion of outcomes for elements of it. Our view is that the next iteration of the strategy, which is now due, should be more focused in the breadth of its ambition and that this should be aligned to the necessary resource to ensure the outcomes and outputs that the Service is seeking to achieve. Currently the outcomes of work that have been derived from the strategy are mapped via a Mental Health Action Plan. The intended outcomes of the next strategy should be subject to early thinking regarding how these are to be achieved, and they should adhere to SMART⁶ criteria. Ideally outcomes should be achieved within the life cycle of the strategy in line with supporting action plans.

26. Where the Service has achieved significant forward movement on the aspirations of the initial strategy, there should be an evaluation regarding their effectiveness with a view to ensuring it can be embedded within the SFRS as exemplar business as usual (BAU). An example of this is the Services’ PISP. Undoubtedly the PISP is an excellent process, but it is not without implementation challenges such as low return rates for questionnaires, a general lack of awareness about the process and its value to firefighters across the SFRS. At a time of competing priorities regarding the allocation of resources, the SFRS must ensure that the maximum benefit is being achieved via the range of mental health services that are on offer to its workforce, to their families where this is appropriate and to retired personnel.

Recommendation 1: The new Mental Health Strategy should continue to be aspirational in that its offer for staff should be broad, but it also must be achievable and robust. The strategy should be subject to SMART assessment, action plans for achieving outcomes should be considered in advance of its publication. Adequate resources should be in place to support the strategy intentions.

27. A significant challenge that faces the SFRS is how and where to allocate its finite resources. These resources come in several forms but include financial and human capital. A theme that was regularly discussed during our interviews was the ability of the Service to maintain a long-term focus on “big ticket Blue Light items” or the next big challenge that may need to be faced. There was a consensus that the SFRS had a strong strategic focus on mental health and wellbeing when the Strategy was launched, but that over time this waned and then was superseded by “the next big thing, the new main priority”. When considering the key outcomes that it wants to achieve, the SFRS should take a considered view of the resources that it can realistically apply and of the operational capacity that is available amongst its officers and managers to achieve them. As stated before, any outcomes that are sought should have SMART criteria applied to them, a thought through plan for achieving them and appropriate governance and review processes.

28. Given the range of work that a service the size of the SFRS will be involved in, it is inevitable that new work streams will emerge that need a strong strategic focus. However, it is clear from our fieldwork that the perception within the SFRS workforce was of a mental health journey that was making positive strides, with a culture change and destigmatisation process underway, but that it was far from complete. In this regard it is important that the SFRS maintains focus on the ongoing mental health related work within the Service, and that it is also driven by a ‘corporate champion’, as it had been at the point of the original strategy launch. We were informed by interviewees, from grassroots level up to the most senior leadership levels of the Service, that there was a perception that “very senior people from the top had been driving it, but that drive has now lessened” and that there was “not the same momentum due to senior personnel changes…..we need a new champion who is passionate about the subject”.

Recommendation 2: The SFRS should consider the nomination of a Corporate Mental Health and Wellbeing Champion for the Service. The Champion should be of a sufficiently senior level to be able to direct action and ensure that appropriate oversight and governance is put in place to allow them to scrutinise progress against the next Strategy and any associated action plans.

The SFRS Mental Health Working Group

29. The SFRS established its Mental Health Working Group (MHWG) in 2020 following the publication of its Mental Health Strategy. The MHWG was set up to oversee the outcomes of the Mental Health Action Plan, and this was supported by the establishment and support of five thematic subgroups to cover:

• Document and Policy Review within the SFRS.
• Delivery of the SFRS Mental Wellbeing Champion model.
• Wellbeing and Inclusion annualised calendars and events within the SFRS.
• Learning and Development for mental health within the SFRS.
• Suicide Prevention within the SFRS.

30. There have been a number of positive outcomes and achievements for the five subgroups, but also a lack of progress in key areas of their work too. Document and Policy review is embedded as a process within the SFRS as it seeks to mainstream mental health in a similar manner to equalities. The Mental Wellbeing Champions (MWC) subgroup has established a network of champions across the SFRS, delivering training for that role in the process. The MWC role was discussed in detail during our interviews, and we make comment on this later in the report. The Wellbeing and Inclusion subgroup produces a wide range of information for SFRS personnel on a range of topical and mental health related issues. The Learning and Development subgroup has not made the progress that the Service would have envisaged for several reasons including access to the necessary resources and personnel to drive this work forward. We have made mention in this report about the challenges that the Service faces in terms of achieving the outcomes set out within its Mental Health Strategy and matching these to the necessary resources to produce tangible outputs. The Suicide Prevention subgroup produced the Suicide Prevention Plan 2012 – 2023, and this has been supported by access to crisis support via the Health and Wellbeing team. However, much of the excellent work that was achieved for suicide prevention was under the strategic drive and direction of a now retired member of staff. Since that time, the Subgroup appears to have lain fallow with no recent recorded meetings and no forward movement on the original objectives of the group. We mention the work of the Suicide Prevention Subgroup later in this report.

31. Securing appropriate resources and personnel support for the effective functioning of the subgroups has been difficult for the SFRS to achieve. We asked senior members of the Service about the makeup of the subgroups and whether they were an accurate reflection of the workforce within the SFRS e.g., age, gender, uniformed roles and support staff roles. We were told of the challenges of not being able to achieve this representative balance, much of which came down to the available corporate and individual capacity for the roles, or the inability to free up uniformed personnel to allow the time for them to sit on these groups and to undertake the work necessary to achieve positive outcomes. It is also worthy of note that despite the loss of retired key strategic personnel who had driven elements of the mental health cultural change within the SFRS, there remains a deep willingness to progress. An obvious example of loss of key personnel is the Suicide Prevention subgroup, as described above.

32. We interviewed an officer who appears to have the knowledge, attributes and a deep passion for the subject which, on the face of things, makes them an ideal candidate to take this group forward. Within the Service however there is a long-standing approach of filling these posts based on rank rather than ability. We would urge the SFRS to look within the ranks of all uniformed and support personnel, and to utilise their skills to best effect and to achieve the most appropriate membership demographic for the subgroups which are in operation.

Mental Health and Wellbeing Governance Within the SFRS

33. The SFRS has well developed governance routes for scrutiny of its mental health and wellbeing arrangements. These routes link the Board of SFRS and its committees, and in particular the People Committee, to the SLT of the Service and its strategic level boards e.g., the People Board. A member of the People Committee that we interviewed was content that the group received sufficient levels of mental health reporting information i.e., “we are kept informed and assured without getting into operational detail”. We did note however that following discussion regarding what an appropriate level of information was required for committee, that a much-reduced level of reporting detail now appears to be presented to the committee members. This reduced level of reporting was partly borne out of Board members concerns about the level of resource required to produce the reports. The committee has a strong focus on the levels of absenteeism within the Service due to a range of causes, including mental ill health.

34. During our inspection interviews we sought views regarding perceptions about the relative importance of achieving positive mental health outcomes in the SFRS from senior leaders, managers and FDOs. Many of these individuals commented that mental health may not now have the focus that it had at the point of the strategy launch in 2019. One senior SFRS manager, amongst others, reported that mental health and the pursuit in improving it within the SFRS “felt very important at one point, but this had now changed”. They felt this was reflected in the reduced level of information that was required at the People Committee for scrutiny, “the organisation has gone through challenging times and needs to be mindful of not dropping things”. When we asked a member of the People Committee about their views of the working of the MHWG subgroups, they offered that they had no direct knowledge of them, but within the context of the scrutiny information they receive there were no identified issues with them. As we will set out later within this report, two subgroups including the one set up to address suicide prevention, are to be closed by SFRS due to a lack of resources which has led to it not functioning for some time.

Recommendation 3: The Board of SFRS should assess if they are fully scrutinising progress of MH outcomes against the aspirations of the MH Strategy. Governance routes up to Board level should be reinvigorated and formalised to ensure scrutiny, oversight and transparent accountability are in place.

35. There are many detailed reports compiled within the Service that relate to mental health and associated issues such as absence caused by it. This information is available to both the non-executive and executive sides of the organisation. However, much of the reporting on work that directly relates to mental health such as the ongoing work of the subgroups is not as visible or readily available and accessible for personnel within the Service. There are several SharePoint sites that are set up within the SFRS that deal with mental health reporting. These sites however have a limited membership and the outcomes of the work that is being carried out across the SFRS is not readily available to be viewed across the wider Service. We queried this across a range of interviews and had this confirmed by a wide range of personnel from Local Senior Officer, senior manager level down to watch commanders (WCs) and so on. There is an assumption that a great deal of work in relation to mental health is ongoing within the Service, but a golden thread of governance that links outcomes to this work is not particularly visible.

Discontinuation of Mental Health Subgroups

36. At the time of writing this report the MHWG was due to consider a proposal to close two subgroups, Learning and Development and Suicide Prevention, due to an acknowledged challenge to secure appropriate resources that would be required to allow the groups to fulfil their remits. Within this report there is an acknowledgment of the necessity to secure appropriate training for SFRS personnel to raise awareness of mental health policy and procedures within the workforce that is at present below what the Service would in all probability be content with. We accept that the Service is seeking to reenergise the learning and development elements of the strategy.

37. During our inspection we asked principal level leaders about their views on governance arrangements for mental health structures and the Suicide Prevention Subgroup in particular. Among the comments we received for this group was that “the suicide subgroup is the one I am worried about the most, and the learning one is an issue too”. As we conducted our fieldwork, we discussed the lived experiences of SFRS personnel who had been impacted by the death by suicide of colleagues. The Service reflects society, and unfortunately suicide is an acknowledged issue that leads to the loss of friends and loved ones. Sadly, it is not uncommon for operational crews to attend incidents where death by suicide is a factor.

38. Suicide is a devastating event, not only for those who take their lives but also for the family, friends and work colleagues who are left behind. We gained first hand insight into the impact suicide can have on a Watch, which was described as “catastrophic”, and how this can lead to mental health issues for those who remain. HMFSI recognise and acknowledge the excellent work that has been undertaken to put in place crisis support for SFRS employees as well as the range of suicide prevention tools that reside on the iHub. However, it is not clear to us that the closure of the Suicide Prevention subgroup, without an appropriate and well thought through alternative being put in place beforehand, is the correct route to take. Given the catastrophic outcomes of suicide for individuals and their colleagues and considering the recent lack of strategic drive behind the subgroup, it appears more appropriate that the SFRS puts in place the necessary resources and people to continue the excellent work that has been achieved to date.

Good Practice 3: The SFRS has in place a ‘crisis button’ via its Health and Wellbeing team as well as a range of suicide prevention information packages within its iHub. We understand that the crisis button, which results in employees accessing professional help, is very well utilised and performs its function excellently. This suicide prevention information was very well regarded by interviewees during our inspection.

Recommendation 4: The SFRS should consider the suitability of the governance arrangements for the Suicide Prevention subgroup. If it is considered that this group cannot achieve the outcomes that are set out within the Mental Health Strategy, then the Service should consider alternative arrangements to replace it. Any new arrangements should ideally be in place before the current subgroup is disbanded.

Mental Health Consultation and Employee Voice within the SFRS

39. The SFRS sets out, within the Mental Health Strategy, that the views of its employees should be sought and considered when conducting long-term planning. Achieving ‘Employee Voice’ goes beyond communicating or even actively engaging with staff, it entails putting in place actions to support staff views and suggestions or actively saying why that will not be the case. Achieving employee voice takes time, but it is valuable for achieving buy in for any process or change that an organisation is undertaking. We asked for views about the level of communications, engagement and the level of achievement in terms of employee voice within the Service in relation to mental health services and approaches.

40. It was clear from the responses that we received that personnel within the organisation had not been consulted widely on the Mental Health Strategy and some had no awareness of its existence. Personnel were also not generally aware of the sub-groups that were set up to achieve the strategy’s outcomes. Staff could recall a Suicide Prevention Group being established and a former senior officer being the driving force for that but have not had any awareness since that person left the Service.

Mental Wellbeing Champions

41. One of the key elements within the mental health offer by the SFRS to its employees was the selection and training of a group of staff willing to volunteer to fulfil the role of Mental Wellbeing Champions (MWC). We understand that to date there are 212 MWCs across the geographical area that the SFRS covers, with a number awaiting training. The training for this group was delivered via a partnership with ‘Lifelines’ who are a national NHS project, hosted by The Rivers Centre in NHS Lothian. Lifelines work with, and deliver training on a contracted basis for, the Fire, Police and Ambulance Services in Scotland. The names, contact details and work locations of the MWCs are on the Health and Wellbeing section of the iHub.

Good Practice 4: The SFRS has established a Mental Wellbeing Champions network across the Service. This network covers all staff groups and the regions of Scotland. The Wellbeing Champions network can add value in the pursuit and maintenance of positive mental health for all of the Services’ personnel.

42. As the SFRS embarked upon setting up its structures to support its mental health outcomes, it initially considered training a cohort of Mental Health First Aiders (MHFA). This approach would have led to a first aider on every Watch (which is the aspiration for the MWC coverage) but would have involved training personnel in the role and also training a group of MHFA trainers. The SFRS has a member of staff within the Service who is qualified to conduct this trainer input, and they had discussions about the requirements to put in place the level of comprehensive cover that was desired. Given the level of resource input required, both financial and human, to put MHFAs in place across the Service, it was decided not to take this approach. The Service opted for the less resource onerous MWC approach and the training for this group was designed and delivered for the group coming live in November 2022.

43. When conducting our fieldwork, it became apparent that many personnel were not aware of the Mental Wellbeing Champions role. Some could say that they knew there were Champions in the organisation but did not know what their role was and sometimes did not know who they were. There was also a view that personnel would not always be willing to speak to a Mental Wellbeing Champion, particularly in the Watch environment. They would prefer to discuss any matters with their “trusted” watch colleagues and/or their Watch Commander.

44. The MWC role is a “bolt on” to business as usual and relies on the goodwill of staff. Most Champions want to undertake the role and are passionate about the role, but their focus will be on the day job and there is the danger that staff may feel they are letting colleagues down because they may not be able to deal with issues immediately as they arise. There is also the issue of ongoing Continuous Personal Development for the role and time to undertake this. Information relating to mental health support is frequently updated and staff need to keep their knowledge and skills up to date. Service staff may struggle to find the time within the working day to keep up their skills and therefore undertake any required training in their own time. Access to appropriate levels of time for training for mental health was cited as an issue during our inspection interviews.

45. We interviewed key personnel active in the setting up of the role, and a number who remain involved and engaged with it. As we understand it, the management and governance that is required for this group is a challenge. A single person is responsible for the group. Meetings of the whole group and a subgroup of Lead MWCs are infrequent, there does not appear to be formal governance processes in place for the group, no collation of the number of contacts made between MWCs and employees has been undertaken and no evaluation of this work has been conducted. The MWCs do receive a regular update from the subgroup lead which sets out notable information for the cohort. We do not believe that the MWC group has the visibility or has had the impact that the Service envisaged when this route was chosen over the MHFA approach.

46. HMFSI recognise that the MWCs are not trained to the required level or are intended to be a professional counsellor service within the SFRS. We also note however that the Champions do not have professional support for the role that they do perform. In forming our views for this section of the report we sought the views of mental health professionals. There are informal arrangements where they can contact the subgroup co-ordinator at any time. Within the realms of other counselling services, staff are required to have professional supervision where they can discuss what is going on for them with regards to their work and their role. This is an opportunity for them to highlight any issues or concerns and talk through any scenario, how they dealt with it and to consider if it could have been done differently. This allows the person to explore their practice in a safe and non-judgemental environment with a professional. There is concern that if Champions are dealing with several issues from colleagues that they themselves may become overburdened. We understand the role of the MWC, and that it is not a practitioner role but a signposting and supportive one. However, colleagues may disclose some difficult situations and information which Champions then must deal with and thus potentially be exposed to vicarious trauma. The support currently offered is a chat/discussion with the co-ordinator at any time. If a member of staff on a watch or shift system is assisting a colleague and they happen to be out with the normal working day, then the co-ordinator may not be available.

Recommendation 5: The Service should consider the most appropriate way that it can offer professional support for its Mental Wellbeing Champions. This support should include appropriate processes to track any interventions work of Champions, debriefing and evaluation of interventions and reflective supervision and support.

47. We agree that an individual placed within each work group across the Service, who has a knowledge of the signs and symptoms of poor mental health and who can then signpost individuals to professional support is appropriate, but we cannot conclude that the MWCs have achieved this to date. Within this report we refer to the Watch system within fire stations and what we believe should be considered by the SFRS to cover this employee population group.

Recommendation 6: Awareness of the Mental Wellbeing Champion role within the SFRS should be raised. The MWC approach taken to date should be reviewed and robust governance put in place to capture and analyse the work that they do and demonstrate its value. Their ongoing work should be subject to review to ensure outcomes.

SFRS Employee Assistance Programme

48. The SFRS has an Employee Assistance Programme (EAP) that is available twenty- four hours a day. The EAP can offer assistance and advice for a wide range of issues that may affect SFRS personnel. Their services include a 24/7 helpline, face to face counselling where that may be required and a range of other wellbeing services.

Good Practice 5: The SFRS Employee Assistance Programme was recognised by staff as being available and accessible on a 24/7 basis. This facility offers help and professional advice on a wide range of issues that may affect employees, and is not restricted to workplace related matters, e.g., financial planning advice, relationship advice and confidential helpline.

49. While the services offered by the EAP and The Rivers Centre are distinct, there can be overlap when personnel self-refer to either of them. In these instances, each service will advise those who have contacted them that the other service may be more appropriate in the circumstances. We were advised by SFRS managers during our interviews that the two services cannot provide a direct referral to the other due to data protection protocols. While this is understandable, we do think that it still leaves potential for people who are in crisis, and who have made the step to seek professional help, to have additional ‘perceived’ blocks placed in their path as they seek help.

Post Incident Support Procedure

50. The SFRS operates a Post Incident Support Policy and Procedure (PISP) that sets out arrangements for the provision of post incident support following attendance at challenging operational incidents. Attending operational incidents will always present the possibility for SFRS personnel to have to deal with traumatic events, and this could result in psychological injury. The PISP is a key foundation element of the SFRS mental health offer to its employees, with a focus on those who attend operational incidents.

The PISP is recognised by HMFSI as being an excellent example of a policy procedure that has been designed and set up to ensure a systematic approach to accessing support for firefighters who may suffer psychological trauma at operational incidents.

Good Practice 6: The SFRS Post Incident Support Procedure is an effective process for gathering information from operational staff who may have been exposed to psychological trauma during incidents. It allows a systematic analysis of the mental health of firefighters who have attended operational incidents by the professionally trained psychologists of The Rivers Centre, and intervention treatments thereafter should that be required.

Mental Health Awareness Training for SFRS Staff

51. During our interviews, we spoke to individuals and groups around access to what they considered was appropriate training and/or awareness raising input regarding mental health and wellbeing. Most interviewees were able to tell us that they knew there was a section of the front page of the iHub where a wide range of resources for mental health and wellbeing support and awareness resources could be found. Whilst few could go into detail about what was contained within this section, it was encouraging that the majority of those we spoke to knew where they could access information if it was needed.

52. When we asked specifically if interviewees could recall input that they may have received for a range of mental health and wellbeing associated information and/or training, the replies to this question were much less positive. Few could recall input on key areas such as the Mental Health Strategy, and of more concern, on the PISP. The Service may have been unfortunate that planned training for PISP was interrupted by the onset of the Covid Pandemic, which necessitated a reduction in group mixing and the face-to-face delivery of training. However, as we have set out in this report, the PISP is a key foundation of the mental health offer that the SFRS makes to its employees. It was concerning that there was a general lack of awareness amongst operational firefighters of the detail of the procedure, and perhaps more importantly, of the value that it offers them in the maintenance of positive mental health. We discuss the PISP in greater detail within this report.

53. We also consider the value of the WC on a Watch and how they can be a trusted person for personnel to go to for peer support or if signposting to professional support services may be required. We consider the WC role to be very important in this regard and one that offers the Service an opportunity to go a great deal of the way towards achieving its ambition of having a trained individual on all Watches regardless of the duty system worked.

54. An area of success in training input for the SFRS has been the introduction of mental health and wellbeing awareness to the trainee firefighters course. This base foundation of learning should provide a solid platform for the operational firefighter group going forward. The benefits of this should be realised in the years to come. Another notable example of input delivered on mental health related matters that we were informed of was the Mental Wellbeing Champions input that was delivered to every Watch in Glasgow by a single FDO. This was very commendable and has provided a greater level of awareness for the Champions role than is evidenced elsewhere within the Service.

Good Practice 7: The SFRS includes a training module within the Wholetime Trainee Firefighter Foundation Programme that operational firefighters must complete before being assigned to their stations. This input provides a solid foundation for mental health and wellbeing knowledge within this group.

55. A consistent concern that was raised during fieldwork was the ability of staff across the SFRS to set aside time during their working day to undertake mental health training or awareness raising. We were given examples of individuals who had undertaken this awareness raising during their own personal time away from the workplace. One notable example of a whole group who have had a time investment made in them as a group to undertake mental health related training through utilising the Lifelines resource contained on the iHub, was within the SFRS Administration team. This group had been given the required time to undertake study during the working day and as a result felt that an investment had been made in them and they were uniformly complimentary towards their managers as a result.

Good Practice 8: The SFRS Administration team were allocated time within their working day to undertake the ‘Lifelines’ mental health and wellbeing training modules. The allocation of this time has allowed a good knowledge of mental health to be developed within the group.

56. The administration team management also developed a protocol for their staff following their introduction to receiving telephone calls from the public to request Home Fire Safety Visits. The managers recognised the potential for difficult or abusive calls to be taken by their team and put in place a process to try to protect them through ensuring access to mental health support should that be required. While the actions undertaken by this management team are commendable, it is another example of a local intervention which is not driven by the corporate service.

Good Practice 9: The development of a protocol by Administration Managers for their staff to record details of telephone calls from members of the public, allows them to monitor issues that could result in negative psychological impacts for their teams.

57. When interviewing operational WCs and FDOs, we consistently asked about training input that they had received specifically in relation to mental health and wellbeing and for preparation for new promoted roles. A number informed us that they had received input for topical issues, such as the Mental Wellbeing Champion role, on a local basis and driven by an invested FDO such as the Glasgow example previously mentioned. In the main however there was little recollection of specific training, with one OC FDO commenting that “it’s a struggle to get through the work planner, without getting through additional items”. What was a concern was the lack of preparation for newly promoted roles, particularly for those that led to the individual leaving the Watch environment and the peer support this can offer, for a new managerial role which may entail managing personnel who are dealing with a mental health or wellbeing issue. We cover the importance of these two aspects of training and development later in this report. The inspection team do acknowledge that the Service has in place a Mentoring General Information Note and an Induction Handbook for FDOs, however neither of these has a focus on mental health and wellbeing.

Recommendation 7: The SFRS should review the adequacy of mental health training. The most appropriate delivery method should be considered for this training, face to face engagement on critical elements such as the PISP should be considered. Preparation for new roles upon promotion is essential, and mental health should be included within this.

Support for SFRS Personnel Families

58. Outside of their professional lives, the SFRS staff we interviewed reported that their family was the other major factor which could impact their mental health and wellbeing. They also told us that the impacts from their home and personal lives can spill over into their work life and have an impact upon that. Many of these issues were resolved through their interaction with work colleagues, when they were willing to share and had the opportunity to do so, particularly within the operational Watch environment. Many interviewees did say that their families were a particularly important support to them in maintenance of positive mental health, this view is validated by Hill et al (2023). Family and friends of SFRS personnel offer social support, whilst colleagues and Watch members can offer peer support.

59. Our investigations led us to conclude that SFRS personnel, especially those in operational firefighter roles, are often reluctant to share the operational details of incidents with family members, they do not want to burden them with shared vicarious trauma of those events. However, without a full understanding of the work activity, this means that the second most important (in relation to their work) source of support is potentially diluted. Positive family relationships, and the positive social support they can offer, will undoubtedly improve the personal resilience of not just those in operational roles, but all personnel employed within the SFRS (Hill et al, 2023). If families were more involved with the mental health and wellbeing approaches of the Service, then they could be better placed to understand why individuals may be affected by their work and be able to offer support or refer into the Service for professional support for themselves or the SFRS employee in question.

60. We have noted that a literature leaflet ‘Health & Wellbeing Signposting for SFRS Employee Family Members’ has been produced for the families of Service employees. This is of course welcome, but the access to the literature by family members appears to be only via Service employees. The SFRS should consider if this is the most appropriate and complete approach, as the possibility for an employee who is in crisis to not pass on this informative leaflet to their family remains.

Recommendation 8: The SFRS should consider how best to involve the families in supporting the achievement of positive mental health of their employees and offering social support away from the work environment.

The Fire Fighters Charity

61. The Fire Fighters Charity (FFC) is recognised as a significant partner by the SFRS as it seeks to support its employees. The FFC “offers specialist, lifelong support for members of the UK fire services community, empowering individuals to live happier and healthier lives” (About Us – The Fire Fighters Charity) and it does so on a UK wide basis. As part of our engagement with partners who are external to the SFRS, we interviewed the Chief Executive of the FFC. The Charity has a declared commitment to achieving positive outcomes for firefighters and their families across the UK, including within the SFRS.

62. Through our discussions with the FFC, we understand it has a wide range of resources and facilities that can be utilised to support firefighters and their families. We also acknowledge the active role that the FFC plays in support of SFRS employees and their families, and the coordination role for much of this via the Health and Wellbeing team. We do however believe that these resources are underutilised by the SFRS at both an employee level and an organisational level.

63. From our interviews we concluded that the knowledge of the resources available to SFRS employees, both operational and support staff, was limited. The common view was that you could perhaps access the resources and facilities of the FFC when you had a physical injury and were trying to return to physical fitness. Those that we found within the Service who had used the FFC services were extremely complimentary towards them. We also note that the FFC resources were used to great effect to deliver menopause awareness information sessions with the SFRS.

64. We queried past interaction between the SFRS and the FFC to understand why its resources may be underutilised. As we understand it, discussions have taken place on several occasions but have not led to an outcome where FFC resources are more often accessed by employees of SFRS. Offers of support from the FFC have been made, but no formal and systematic uptake of them has been arranged in collaboration with the SFRS. An example of offered support, which is relevant to this report, was to assist with pre-retirement seminars to cover the social and wellbeing challenges that personnel can face when exiting the Service at retirement. This is not to say that FFC resources are not used, however, we believe that there is significant capacity that remains for the SFRS to tap into on a more ongoing basis beyond that which is currently utilised via the H&W team. The SFRS has commitments within its Mental Health Strategy to identify and deal with mental ill health in its staff and their families. We have also set out the importance of social support that SFRS employees receive from their families, but also the relative lack of information that is available for these families to help them recognise mental health and wellbeing issues as they manifest themselves.

65. Awareness of these resources for families is also important. Currently there is a general lack of awareness and the SFRS does not appear to have a systematic conduit to the families of its employees. We believe that many of the necessary resources to equip the families of SFRS employees in this regard are available via the FFC and that the charity would be a very willing partner.

Recommendation 9: The SFRS should consider how it may better utilise the resources that the FFC can offer in the pursuit of positive mental health for all its employees and their families. This should be done on a systematic basis that allows families to be informed of resources that may be available to them, and how they can support their loved ones who serve in the Service.

The Family Support Trust

66. There is a long-established relationship between the Family Support Trust (FST) and the SFRS. This relationship predates the creation of the SFRS in 2013, indeed the FST is widely considered to be amongst the oldest firefighters charities in the world. The FST has a memorandum of understanding (MOU) with the SFRS to offer a range of services to serving employees, Service retirees, their families and their dependants e.g., the provision of financial support for those who have suffered bereavement, Christmas grants, access to their Childrens Investment Trust, respite services for families and access to charity owned holiday accommodation.

67. The Health and Wellbeing team regularly contact the FST to access assistance for personnel who are referred to them. During our fieldwork we interviewed a member of the Board of Trustees for the FST who confirmed that despite the regular signposting for SFRS employees towards them, and the MoU that is in place, that no formal referral route is used. The Board member also considered that the use of the FST “was not yet fully ingrained within the SFRS (as opposed to the original legacy Service)” and that there was a need to secure funding that would allow a focus on retirees, which he considers to be a gap in provision.

The SFRS Chaplaincy Service

68. Within the SFRS there is a Chaplaincy Service which is offered via a Church of Scotland Minister and a Roman Catholic Priest. Both offer pastoral care across Scotland, but their main effort has been historically focused in the West Service Delivery Area (SDA) of the SFRS. Within the Service, pastoral care is their main focus. Chaplaincy services were previously in place in other SDAs but folded due to a lack of local support from Church bodies for those who offered the pastoral care. They also have many years’ experience of working within the congregational communities that they serve. Additionally, both have worked within the National Health Service as mental health chaplains within hospital wards and The State Hospital at Carstairs. Both have extensive experience of offering care within mental health care environments.

Good Practice 10: The Chaplaincy Service within the SFRS works effectively on a regional basis within the West SDA. The chaplains offer their services on an SFRS wide basis relative to events that may occur including significant operational incidents and remembrance service events.

69. The Chaplains told us that they play no formal, systematic role within the SFRS in terms of mental health support, but they do work in conjunction with the Health and Wellbeing team and assist with personnel welfare issues they are informed of. SFRS Local Senior Officers will contact them to seek assistance with issues within their areas of responsibility, and where in their opinion, pastoral care may be appropriate. The chaplains have historically been informed of operational incidents that involve fatalities within the West SDA. Following these incidents, they will visit the fire stations affected and offer care and support. They also use their own local information networks to keep themselves informed of fire stations who have “been on a bad run of incidents” and use this to determine if they should conduct further visits to offer support. Both chaplains commented that during these visits they remind personnel of the counselling services that are on offer via the Service. Based on feedback they have received, both spoke highly of The Rivers Centre and the counselling services it can offer.

70. While the Chaplains are informed of fatal fire incidents that the Service has attended, they do not now have access to the Services’ Daily Incident Briefing Report which previously allowed them to keep abreast of operational activity. The Chaplains are aware of the PISP, but do not have any role to play within the procedure post incident. Both Chaplains are informed of “major incidents” and will mobilise to a scene of operations, or to attending stations post incident. They do not, despite working on an ad hoc basis with the Health and Wellbeing team, have a formal or systematic role within the SFRS mental health and wellbeing offer of services to its personnel.

71. The SFRS Chaplains have offered pastoral care across decades to all within the Service who may seek it. They are a conduit to personnel who may not seek formal support via the SFRS, but instead find comfort in talking with them.

Recommendation 10: The SFRS should consider if a formal role is appropriate for the Chaplaincy service within their mental health and wellbeing offer to personnel. Options to establish pastoral care across all of the SDAs of the Service should be explored.

Preparation for Operational Firefighters Entering Retirement

72. The SFRS gives a commitment to considering the implementation of a reach back service for retired staff members within its Mental Health Strategy. We understand that the Service is in dialogue with the Retired Employees Association and a range of external partners that former employees could be signposted towards for assistance with the maintenance of positive mental health and wellbeing in retirement. The Service recognises that while it does not have a legal duty of care for retired employees, it does have a moral one.

73. Through our interviews with Firefighters, FDOs, OC Firefighters and other staff groups within the SFRS, we know that personnel identify very strongly with their role. This is further confirmed by Hill et al (2023) in their recently published report. While we agree that financial planning is important for retirement, there appears to be little focus on how the SFRS prepares its operational firefighter and other staff groups for the social aspects of this significant life change.

74. There is academic research that shows that “retirement for firefighters represented a considerable period of identity change”⁷ (McNamara et al, 2021) as they lose the support of colleagues and the Service. Firefighters will often feel a sense of disassociation and loss which can affect their mental health and wellbeing. During our interviews we asked service operational employees about preparation for retirement and how they perceive this is handled by the SFRS. The response was that they felt there was a focus only on financial planning, with little or no mention of social issues that they may face. Traditionally the Service has hosted in person pre-retirement seminars that individuals can sign up for in advance of their exit from the SFRS. A significant portion of this input would deal with finance and pensions post retirement. The aspects of the life changes that retirement brings, and which can have negative mental health and wellbeing impacts for those who exit the SFRS, are not considered in a similar level of detail.

75. As we understand it, the retirement seminars are now, in the main, aimed at an online audience. We came across an instance of an individual who could not access a seminar before retirement due to the schedule that was proposed, given the options available we believe that this could be repeated. Through our fieldwork, we understand that the FFC has a wide range of retirement preparation resources that can be made available for firefighters. We also understand that they would be content, and have offered in the past, to present on social aspects of retirement at in person pre-retirement seminars.

Recommendation 11: The SFRS should consider how to best prepare its serving firefighters and support staff for life following their retirement from Service. These considerations should not be limited to financial planning but should also consider the social aspects of the change that retirement brings. They should consider collaboration opportunities within the fire sector to assist with this.