Career Versus Volunteer Firefighters: Differences in Perceived Availability and Barriers to Behavioral Health Care

Due to occupational stress and exposure to potentially traumatic events, firefighters are at an increased risk for the development of many behavioral health conditions. While volunteer and career firefighters represent two distinct subgroups, little research has examined differences in the availability of, and barriers to, behavioral health care between these populations. This study examined perceived availability and barriers to behavioral health care services among 2,156 career and 227 volunteer firefighters. Volunteer firefighters were less likely to report availability of drug and alcohol or family and couple services, but more likely to report availability of a trained peer support system and follow-up care compared to career firefighters. Volunteer firefighters were over five times more likely to consider cost a barrier to accessing behavioral health services compared to career firefighters; however, they were less likely to report lack of support from leadership, fear of breach of confidentiality, and clinicians who are unaware of work culture as barriers. Volunteer and career firefighters were equally likely to report stigma as a barrier. These findings have important implications for understanding how to strengthen departmental resources and to design targeted interventions to increase access to behavioral health services. Impact Statement This study suggests that there are meaningful differences in availability of behavioral health resources between career and volunteer. While cost was a greater barrier to accessing services among volunteer firefighters, stigma was a common barrier for both volunteer and career firefighters. These findings have important implications for understanding how to strengthen departmental resources and to design targeted interventions to increase access to behavioral health services.