Mental Edge Mondays: The IKEA Problem in the Fire Service

Fire departments have invested in an impressive collection of wellness resources. The next may be building the system that connects them

Having all the right pieces doesn’t mean you have a system. Imagine that somebody delivers 14 IKEA boxes to your apparatus bay.

One contains an excellent EAP. Another contains a highly trained peer support team. There’s a chaplain in Box 3, three culturally competent therapists in Box 4, an app in Box 5, and several very good trainings distributed among Boxes 6 through 10. Somewhere under a pile of Allen wrenches is your wellness coordinator.

These are not cheap IKEA boxes, either. Your department has invested real money, time and energy into finding good resources. People care deeply about this. Your peer team has trained hard. Your clinicians have done ride-alongs. Your chaplain knows your people. Your EAP has been carefully selected.

There’s just one question I think we’re not asking often enough: What exactly are we building?

I started thinking about this because I’ve been having conversations with some very innovative fire departments lately, and I’m struck by how many excellent resources some of them have accumulated. This is unquestionably progress. Twenty years ago, the problem was often that firefighters had almost nowhere trustworthy to go. Now, in some departments, there are many places to go.

But this creates a different problem.

At my house, IKEA projects usually begin with unreasonable confidence. We open all the boxes, spread 147 pieces across the floor and look at the picture of the serene Scandinavian room we expect to step into in approximately 45 minutes.

Three hours later, there are two unidentified boards leaning against the wall, six leftover screws, and my husband and I are debating whether Step 17 actually depicts the same piece of furniture we purchased.

There’s nothing wrong with any of the individual pieces (usually). We just aren’t entirely sure how they go together.

I sometimes wonder if firefighter wellness has reached its IKEA stage.

The Problem With Really Good Pieces

Consider a department with an excellent peer team, a chaplain program, an EAP, a few culturally competent clinicians, a workers’ compensation system, risk management, a substance-use treatment resource, a suicide-prevention protocol and a wellness coordinator. A pretty impressive collection of resources when you think about it.

Now, let’s pan over to an actual human being.

Let’s say she’s a highly regarded firefighter who has been a little different lately. She’s still doing her job well, so this isn’t obviously a performance problem. Her marriage is under significant strain, but that’s presumably a personal issue. She’s drinking more, although nobody is quite sure how much. She’s furious about something that happened at work and can’t seem to let it go. Her captain knows part of the story. A peer knows another part. Her husband knows what’s really up. At some point, she says something dark enough that everybody gets nervous.

Now look again at our impressive list of resources.

Who quarterbacks this effort?

The peer team may be doing exactly what it was trained to do. The captain may be doing exactly what a good captain should do. The clinicians may be excellent but can only work with what the firefighter brings into the room. Workers’ comp has a particular role. Risk management has another. The spouse isn’t part of the department at all, even though he may be watching the situation more closely than anyone.

Nobody is necessarily doing anything wrong. The invisible chink in the system may exist in the spaces between excellent resources.

Human Beings Refuse to Stay in Their Boxes

This is one of the fundamental problems with the way we organize psychological support. Organizations need categories because categories create responsibility. Peer support does this. EAP does that. Clinicians treat these things. Command handles those things. Workers’ comp becomes involved when certain conditions are met.

Unfortunately, human beings don’t develop their problems according to our org charts.

Relationship stress affects sleep. Poor sleep changes patience and judgment. Something at work starts feeling more personal than it ordinarily would. Conflict at home increases. Maybe alcohol becomes a regular go-to at the end of the day. A disciplinary issue lands at exactly the wrong moment. Suddenly something that didn’t belong neatly in anybody’s box has become both a major career obstacle and a serious organizational risk issue.

We tend to notice this much more clearly in retrospect. Once something significant happens, everyone compares notes and the larger picture suddenly appears.

The captain knew this piece. The peer knew this other piece. The clinician knew what was disclosed in treatment. Command knew about the administrative issue.

Put all of those pieces on the table afterward and sometimes you can see the picture on the IKEA box perfectly. The question is whether anyone could see it while we were still assembling the furniture.

The Best Departments May Be the Ones Ready for This Question

Ironically, I think the departments most ready to confront this problem may be the ones that have already invested heavily in their people.

If your department has no meaningful psychological resources, the next step is obvious. You need resources.

But if you already have a strong peer team, trusted clinicians, good leadership, an engaged chaplaincy program, family support and thoughtful prevention efforts, adding another generic resource may produce diminishing returns.

The more interesting opportunity may be to look at the architecture.

Where are the handoffs? Where are the blind spots? What kinds of situations fall between roles? Who sees patterns that cross the boundaries between command, peer support, clinical care and organizational risk? When something doesn’t fit the normal protocol, who helps everyone think about it differently?

Those questions become especially important because the hardest human problems are rarely clean enough to arrive with an instruction manual.

They’re messy. Sometimes every individual involved can make a perfectly defensible decision while the system as a whole still misses something important.

This is why I think firefighter wellness may be approaching an interesting next stage. For years, the challenge was getting departments to recognize that psychological health mattered. Then the challenge became building better resources and earning enough trust that firefighters would actually use them. Some departments are still at these early “building” stages, while others have already built something quite sophisticated. For them, the next leap may not be another EAP, another app, another training, another clinical treatment provider.

And if there are six mysterious screws left over when you’re done, I wouldn’t ignore those, either.

Shauna ‘Doc’ Springer, PhD is a pioneering psychologist, award-winning Military Times podcast host, and one of the world’s leading experts on psychological trauma, moral injury, suicide prevention, close relationships and the unique needs of the military and first responder communities. Doc Springer provides highly specialized consultation and confidential advising to organizations and public safety agencies that support protectors and defenders through her company THIN LINE ADVISORY.