In Nov. 2023, South Korean President Yoon Suk-yeol promised to enhance support for the welfare and safety of the nation’s firefighters, including advancements in disaster response. However, the deaths of two firefighters in a Mungyeong meat processing plant fire earlier this month highlighted a persistent challenge: the inadequacy of mental health support for first responders.

The issue of providing sufficient mental health services for firefighters in South Korea is highlighted by recent statistics from the National Fire Agency that show a significant number of firefighters are struggling with stress-related symptoms.

According to the agency’s survey shared with Korea Pro, about 40% of firefighters suffer from mental health issues like post-traumatic stress disorder (PTSD), depression and sleep disorders. The survey further revealed that 43.9% of respondents felt a need for management or treatment of mental health concerns, with specific issues including PTSD (6.5%), depression (6.3%), sleep disorders (27.2%) and alcohol abuse (26.4%).

Despite efforts to provide counseling and mental health care, experts have raised concerns regarding the effectiveness of these initiatives. The challenges faced by firefighters are systemic, with experts advocating for a more comprehensive approach to improve mental health awareness and care within this profession.

Firefighters conduct search and rescue operations at the site of the Osong underway flooding incident, July 16, 2023. | Image: National Fire Agency via Twitter

SEEKING PROFESSIONAL HELP

In response to mental health concerns among firefighters, exacerbated by events such as the Itaewon crowd crush disaster, the National Fire Agency has reinforced its commitment to providing specialized psychological support. This includes the introduction of several programs aimed at enhancing mental healthcare, such as financial support for mental health services and resilience training against stress.

A notable initiative was the adoption of online psychological counseling by the Seoul Fire Emergency Headquarters in May 2023, marking a significant first step forward in accessibility to mental health resources. Additionally, the National Fire Agency announced in January its plans to expand the number of “peer counselors” — firefighters trained in counseling — to offer more specialized mental healthcare services.

The agency told Korea Pro it established a “mobile counseling” system in 2015, where psychological counselors visit fire stations monthly, offering treatment and educational services. The agency also complements this approach with the work of firefighters trained in psychological counseling, with 33 peer counselors serving at 18 different fire station headquarters in the country.

Yeon Eunhee, a former senior psychological counselor at the North Chungcheong Province Fire Station Headquarters, shared her insights with Korea Pro, confirming the survey’s depiction of firefighters’ mental health challenges.

She highlighted the occupational hazards that contribute to a decline in firefighters’ psychological resilience, including repetitive exposure to stressors, physically and mentally grueling work and irregular work hours. 

“The majority of the personnel I’ve worked with come from law enforcement, the military, or similar fields where mental toughness is constantly required. As a result, some might have never opened up about their struggles before,” Yeon said.

The transition from mandatory to voluntary counseling sessions at the North Chungcheong Province Fire Station Headquarters illustrates a growing openness toward mental health support among firefighters.

“Realizing that they [firefighters] could share their personal struggles and emotions with me, often with tears, they deeply valued the support that helped them carry their burdens. As a counselor, it was incredibly fulfilling to achieve this,” she told Korea Pro.

President Yoon Suk-yeol greets firefighters during a visit to a traditional market in South Chungcheong Province, the site of a fire that left more than 227 shops destroyed, Jan. 23, 2024 | Image: ROK Presidential Office

INHERENT CHALLENGES

Throughout her service as a fire station counselor, Yeon encountered deep-seated skepticism toward mental health support among firefighters. A common belief she noted was the misconception that counseling is intended only for severe mental health issues, such as suicidal thoughts, major depression, or significant sleep disorders.

“More than half of the firefighters I interacted with believed that counseling was only for people with diagnosed psychiatric conditions or those in immediate crisis,” Yeon recounted.

This misunderstanding led to hesitancy among many firefighters in seeking help for what they perceived as lesser concerns, with some firefighters feeling their issues did not merit professional intervention or fearing stigma for seeking help for seemingly minor problems.

Kong Ha-sung, a professor at Woosuk University’s Department of Fire and Disaster Prevention, identified an additional obstacle in the hierarchical culture of fire stations. He noted that seeking counseling might be viewed as an inconvenience that disrupts operational duties, potentially attracting disapproval from superiors.

“If one firefighter needs counseling, a colleague from a different shift might have to take over their duties. This arrangement can wear out the covering colleague, especially if it happens often, making it hard to keep up with regular mental health treatments.”

Yeon also highlighted the mismatch between the number of firefighters needing support in North Chungcheong Province and the limited number of available counselors.

“We’re significantly outnumbered. While there are more than 3,000 firefighters needing support in our area alone, we have just 12 to 13 counselors available,” she informed Korea Pro.

A 2020 report spotlighted the persistence of this issue, showing only 72 counselors available across 18 fire station headquarters nationwide. This means each counselor is tasked with supporting personnel from three or more stations, pointing to a stark shortfall in the availability of counselors.

Moreover, Yeon pointed out the inadequacy of counseling facilities, with a lack of dedicated space requiring counselors to conduct sessions in less private settings like restaurants and meeting rooms within the fire stations, further complicating the delivery of effective mental health care to firefighters.

A firefighter and a rescue dog wade through natural devastations during search and rescue operations at the site of the Osong underway flooding incident, July 16, 2023 I Image: National Fire Agency via Twitter

GOOD MENTAL HEALTH

Kong from Woosuk University stresses the critical need for a comprehensive approach to meet the mental health requirements of firefighters and to navigate the obstacles they encounter.

He pinpointed the necessity to dismantle hierarchical structures that hinder the provision of consistent mental healthcare. Kong proposes mandating monthly counseling sessions for firefighters and incentivizing attendance to encourage firefighters’ participation and commitment to these programs.

Further, Kong advocates for the expansion of specialized mental health therapy sessions designed expressly for the unique challenges and needs of firefighters.

“We could set up mental wellness centers with specialized counselors across different regions nationwide to improve access for firefighters,” he said.

Yeon agreed with Kong’s assessment, highlighting the importance of counseling programs that are specifically adapted to the varied needs and experiences of firefighters. She emphasized the need for counseling to encompass a range of personal issues, including family dynamics, stress management and emotional health.

“Allocating an appropriate budget for counseling services within fire departments is essential. Such an investment in mental health support will markedly enhance the health and resilience of firefighters.”

Edited by John Lee