Australian first responders dealing with fires, crimes, crashes and pandemics are in danger of being overwhelmed emotionally and they are three times more likely than other Australians to consider suicide.

That statistic has long worried former Victoria Police chief commissioner Graham Ashton, who will be announced tomorrow as chairman of Fortem Australia ^[1], a not-for-profit organisation providing mental health support to members of first responder agencies and their families.

Agencies include state and territory paid and volunteer emergency services, such as fire and rescue, police, ambulance, and rural and community-based firefighting services, along with national organisations such as the Australian Border Force and the Australian Federal Police.

Ashton headed Victoria Police from 2015 to 2020 after a long career in the AFP.

During his 40 years in law enforcement, Ashton developed a strong concern about the need to address mental health issues in policing. He ordered a major review of the adequacy of mental health and wellbeing services in Victoria Police, which was followed by a series of reforms within the police and the start of efforts to improve support for police veterans.

Ashton retired on 1 July and was asked to join Fortem to use his experience to help develop and expand services for a broader range of first responders and their families.

Fortem, which means ‘strong’ in Latin, was established by John Bale, co-founder of the Soldier On mental health support group for defence personnel. ‘Graham was instrumental in leading mental health reform with Victoria Police and brings to Fortem this understanding of how vital connection and support are for wellbeing and mental fitness’, Bale says.

For a time, Soldier On broadened its orbit to take in first responders confronting mental health issues but found that those issues and the levels of support already available were significantly different.

‘Defence is a massive organisation’, says Ashton. ‘What will emerge from the work of Fortem is that the issues in the first responder area are so significant that they need their own focus, not just to be part of, or pinned to, Defence.’

He says the whole concept of mental health and other support for law enforcement personnel and other first responders is not as mature as it is in the military sector.

Ashton says that everyone in the community will at some stage have issues with mental health, major physical health issues, death of loved ones or workplace issues.

‘First responders are living their lives like everyone else, but on top of that they are working in a stressful environment where their safety can be at risk and where they are often dealing with very traumatic things. That amplifies the operating environment they’re in beyond that which we all have to deal with on a daily basis.

‘It’s an area that has needed attention for decades and it’s very pleasing that Fortem exists with a dedicated focus to address these issues. Fortem has come along at the right time and I think it can make a big impact.’

Bale says that every day, more than 300,000 first responders are at work keeping communities safe. They are backed up by their families—partners, children and parents. All of them hold vital, challenging roles. ‘We help them to be well, and stay well, through mental fitness support services and wellbeing activities.’

Fortem connects with first responder communities to have a positive impact on their overall wellbeing. ‘We support first responder families to improve and protect their mental fitness, we  connect families to strengthen family bonds, we activate community and individual awareness and education, we collaborate with organisations to foster a collective effort to improve wellbeing, and we deliver evidence-informed, community-based health and wellbeing support programs specifically designed to address the unique challenges faced by the first responder community.’

These programs are delivered virtually as well as in person. A team of psychologists works in person, by phone and online to help first responder families, assessing and triaging needs. The specialists also run group programs on mental fitness designed for first responder families.

Ashton says a significant first step for Fortem is to provide independent clinical support to agencies and the workers within those agencies. ‘Sometimes there is not the trust between the employee and the employer in relation to mental health so that they’ll seek support or treatment. But they may be attracted to an independent agency.’

Another vital role for Fortem is in raising awareness and acceptance of mental ill-health.

‘In the first responder world, the culture has long been that you are the person who is expected to cope. So when things become difficult, you are not culturally encouraged to speak up.’

Ashton says that in the first responder community, that stigma is alive and well.

‘It’s a stigma in terms of their workmates, in the workplace. It’s a stigma in the community, and some of them think it’s a stigma within their family as well.’

‘Fortem can work on its own and also with other organisations to address that stigma issue in our sector so that we can get people more willing to seek support earlier for difficulties they may be encountering.’

Police work can be extremely stressful, as is working in fire or ambulance or in rescue services, says Ashton. ‘You’re often dealing with people at the most vulnerable time in their lives. You are trying to bring some sense of normality and order and progress to the issue that they are suddenly trying to deal with.’

Someone involved in a car accident resulting in death or injury will remember that for the rest of their life, he says.

A police officer attends that event and then they go to the next one, and the next one. They do that as a matter of course, but it can have a cumulative effect. The stress builds up and it can be challenging in terms of maintaining good mental health.

‘My own experience is of having been a first responder and then being in charge of first responders as a senior police officer, and also in having some lived experience in relation to good mental health’, Ashton says.

‘I suffered a period of burnout in 2017 and I was very public about that. I’ve got lived experience. I’ve been managed and I’ve taken a strong interest in managing and leading employees who had difficult times in their own mental health and more broadly for members of families.’

Fortem’s initial focus has been helping the recovery of personnel and families from the Black Summer bushfires.

‘It’s good that Fortem has both a clinical and a wellbeing focus’, says Ashton. ‘It’s able to provide on-the-ground clinical support, which is locals helping locals, and it’s very much also about ensuring that it can look after wellbeing and do the proactive work as part of that.

‘As a new agency, we’ll also learn a lot from this work that we’ll be able to apply in the years to come.’