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Many Cal Fire firefighters told CalMatters they are fatigued and overwhelmed, describing an epidemic of post-traumatic stress in their fire stations. Veterans say they are contemplating leaving the service, which would deplete the agency of their decades of experience. Some opened up about their suicidal thoughts, while others – an unknown number since Cal Fire doesn’t track it – already have taken their own lives.

Interviews with Cal Fire firefighters, including many high-ranking battalion chiefs and captains, and mental health experts paint a picture of the state agency’s sluggish response to an urgent and growing crisis:

– – Cal Fire has an unyielding policy of 21-day shifts and forced overtime. Staffing is insufficient as firefighters battle thousands of fires year-round, sometimes for 40 days in a row, year after year. The nonstop work and increasing overtime are contributing to on-the-job injuries and post-traumatic stress disorder.
– – The workers’ comp system is difficult to navigate for firefighters suffering from post-traumatic stress, even suicidal thoughts, beginning with skepticism among managers about the legitimacy of their unseen wounds. Some say to get help or be reimbursed for mental health care, they have to hire lawyers, who told CalMatters that claims are routinely denied.
– – In California’s rural areas, where many Cal Fire employees are based, there are inadequate numbers of qualified mental health care providers. And many won’t accept workers’ compensation cases because of the extensive paperwork and low compensation. As a result, firefighters say they can’t find help when they desperately need it.
– – Work conditions and stress are driving an exodus from the department, which loses invaluable institutional knowledge and field experience. Last year 10% of Cal Fire’s permanent, non-seasonal workforce quit.
– – Firefighters say suicidal thoughts and PTSD are rampant. But Cal Fire collects no incidence data on suicides or PTSD. Experts say the agency can’t develop an effective program to combat them if they don’t understand and monitor their scope.
– – Cal Fire’s behavioral health unit ramped up slowly despite the growing problem. Although created in 1999, it had no permanent budget and no permanent employees for 20 years. It began with one staffer — and six years later there were two. Now it has 27 peer-support employees, who assist a permanent and seasonal workforce of more than 9,000.

An administrative claim notice from Cal Fire’s firefighters’ union had a Dickensian tone, like a logbook from a 19th century sweatshop: Forced overtime, punishing working conditions, little sleep, workplace injuries, an inhuman system of indenture.

“Employees have been known to work 30 days or more without any time off due to forced overtime, and the most egregious cases include employees on duty for 49 days or more straight without a day off. Overworked beyond the point of exhaustion,” says the claim, which union attorneys sent in February to the state’s Division of Occupational Safety and Health (Cal OSHA) and the Labor Workforce Development Agency.

Cal OSHA rejected the request, saying it has no jurisdiction because there are no workplace standards for overtime and it is not illegal for employers to make employees work long hours as long as they are compensated.

Medical help is the endgame. Workers’ compensation benefits, paid by the state, cover the costs, which average $60,000 for first responders’ cases, according to a Rand Corp. estimate. But the barriers to firefighters’ claims are myriad.

The long wait for workers’ comp insurance “is hugely frustrating,” said Gena Mabary, Cal Fire’s injury and accommodation manager. “When you are dealing with psychiatric stress, you are already stressed out. It adds another layer of stress. It means that sometimes people won’t go through the process.”

Cal Fire workers’ comp claims for mental health problems “are more frequent. I am expecting them to increase still more,” Mabary said. No data, however, was available.

In 2020 SB 542 changed Labor Code section 3212.25, and recognized that all first responders engage in stressful and dangerous occupations, and made PTSD “presumptive” for workers’ comp benefits – codifying that a mental injury is a legitimate medical claim, although it must still be proven. That law sunsets at the end of 2024.

Before the law was enacted two years ago, California firefighters’ PTSD cases were denied workers’ comp benefits 24% of the time – almost three times more often than their claims for other medical conditions, according to a RAND Corp. report. They were also denied more often than PTSD cases filed by people in other occupations.