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Education and Employment References Committee
25/09/2018
Mental health conditions experienced by first responders, emergency service workers and volunteers

CONNELLAN, Mr Malcolm, Deputy Commissioner, People and Culture, Fire and Rescue New South Wales

DONOHOE, Mrs Alison, Director, Work Health and Safety, Fire and Rescue New South Wales

[15:01]

ACTING CHAIR: I welcome Deputy Commissioner Malcolm Connellan and Mrs Alison Donohue from Fire and Rescue New South Wales. I understand that information on parliamentary privilege and the protection of witnesses and evidence has been provided to you. Could you confirm that please.

Mr Connellan : Yes.

ACTING CHAIR: I remind senators that the Senate has resolved that an officer of a department of the Commonwealth or of a state shall not be asked to give opinions on matters of policy and shall be given reasonable opportunity to refer questions asked of the officer to superior officers or to a minister. This resolution prohibits only questions asking for opinions on matters of policy and does not preclude questions asking for explanations of policies or factual questions about when and how policies were adopted. Officers of the department are also reminded that any claim that it would be contrary to public interest to answer a question must be made by a minister and should be accompanied by a statement setting out the basis for the claim. I invite you to make a short opening statement, and then we will ask you some questions.

Mr Connellan : Thank you. On behalf of Commissioner Baxter and my Fire and Rescue New South Wales colleagues, I'd like to thank the committee for the opportunity to contribute to today's hearing as part of the committee's inquiry into the role of all levels of government in addressing the rates of mental health conditions among first responders. Being proactive in this area is a particular focus of Fire and Rescue New South Wales. The debilitating impact that mental illness, and in particular post-traumatic stress disorder, can have on our firefighters, their families and our colleagues is something that we have unfortunately witnessed firsthand. While mental health and resilience has been identified as a priority in the current strategic plan of Fire and Rescue New South Wales, the reality is that enhancing our approach to maintaining the optimal mental health of our firefighters has been a continually evolving focus area for the organisation for some time, and in particular for the last 10 years.

The traditional role of a firefighter has expanded beyond those of fire prevention and suppression to now include ambulance assist; rescue services, including motor vehicle accidents; concern for welfare; suicide; and bystander engagements, such as dealing with family and others on scene. The unique psychological risks that have been added to the traditional occupational stresses have led Fire and Rescue New South Wales to undertake significant work in this important yet extremely challenging area. While traditional chaplaincy, EAP and critical incident peer support programs formed in the eighties and nineties have created the foundation for Fire and Rescue New South Wales in its support program, it has been the developing relationship with lead researchers, and subsequent research undertaken, that has positioned Fire and Rescue New South Wales to apply a far more contemporary and proactive approach.

This contemporary mental health journey commenced in 2010 whe n we partnered with the U niversity of N ew South Wales and Sydney University to survey both incumbent and retired firefighters , in order to identify the extent to which psychological injury was impacting on the health and wellbeing of our workforce. The survey also explored what support services our firefighters were finding effective in dealing with occupational stresses. The results of this survey were subsequently published in t he Australian & New Zealand Journal of Psychiatry by Professor Sam Harvey , and revealed that , amongst current firefighters , rates of PTSD and depression were eight per cent and five per cent respectively , while four per cent reported consumption of more than 42 alcoholic drinks per week. Retired firefighters reported significantly greater levels of symptom s, with the prevalence of PTSD estimated at 18 per cent , d epression at 18 per cent and heavy drinking at seven per cent . T here was a significant positive linear relationship between the number of fatal incidents attended and rates of PTSD , depression and heavy alcohol use. The survey also revealed that 86 per cent of firefighters will turn to their colleagues for support and guidance in the first instance.

On the back of that survey , Fire and Rescue N ew South Wales has been able to build on its partnerships and change from the traditional and very reactive approach that had been historically applied to first responder mental health to one that acknowledges the need for evidence based prevention and early intervention. In 20 11 we confirmed this new direction with the publication of our first standalone mental health policy , where we committed to delivery of programs under the four pillars of our mental health strategy : awareness , prevention , response and support. These are couched within a total policy aimed at addressing all stages of employment for our staff , from entry into the organi s ation to exit and on to retirement.

I'm conscious of the committee's time and I'm not going to cover all the entire program of work . H owever , there are a number of key initiatives and areas of publish ed research that Alison and I would be happy to detail if require d . In summary , the program covers : recruit training to challenge stigma ; promoting early help - seeking behaviour and positive coping strategies ; g rowth , development and the proactive focus of our peer support program —and w e've got 25 new peer officers being trained right now ; an e- base d r esilience p rogram ; m anager training on mental health literacy and welfare management ; and development of a retiree peer s upport p rogram .

T he above proactive approach has resulted in a positive trend in reporting , from 10 per cent of reporting in 2015 to 59 per cent in 2018. This is a great result. However , it does increase expectation and demand on our support programs , particularly our wellbeing team. This is an importan t consideration moving forward.

Underlying this work at a cultural level is de mystifying and breaking down the stigma of mental illnesses and getting firefighters talking amongst themselves. Fire and Rescue New South Wales also collaborates through the AFAC M ental Health and W ellbeing Network , a national body of fire and land management agencies with common operating issues , where ideas are shared and guidance is being produced at a national level. There is no doubt that this is a challenging area , particularly given the need to systematically address stigma and barriers across a geographically dispersed workforce. We feel that , as an organi s ation , we've taken a lot of proactive steps in line with the resourc ing available to us. However , we know there's room for improvement , and hence the positioning of mental health and resilience as strategic priorities for the organi s ation. It's also an area where research needs to continue , to inform best practice. Thank you.

ACTING CHAIR: Thank you very much. M r s Donohoe , do you have anything you wish to add ?

Mrs Donohoe : Not at this stage, thank you.

ACTING CHAIR: I'll just kick off with a couple of questions. Deputy Commissioner , we've heard from earlier witnesses reflecting on police service —but I suspect we could possibly make some comparisons that it was almost a self-protection mechanism that colleagues who saw someone suffering from PTSD or a mental illness , basically , in their own mind , said , ' That's a weakness within that person. ' So t hey effectively put up a barrier to say , ' It's about them. It's not something that could happen to me. ' Could you just comment on whether you think that is an issue with in your service and whether that's something that you are addressing through the kinds of policy changes that you've talked us through ?

Mr Connellan : I certainly think it was a problem in our service. I'm a recent arrival at Fire and Rescue ; I've been here 35 years in November . So I've seen significant change over the years . As I say , when I first joined , all of our officers had come out of the Second World War , or the new er ones had come out of the Vietnam War . It was a very , very particular organisation back then , which doesn't exist now. There were, exactly as you said, a lot of protectionism and saying nothing and not speaking up. However, looking back at that time, I think things have radically changed today. We have worked very, very hard to demystify the stigma around mental health illness and injury.

We have a raft of firefighters now who are willing to stand up in front of others and talk about their experiences. We're now partnered with our insurer to run seminars on mental health and mental health injuries, and we hold panels with firefighters who talk about their experiences—how it manifested in them, what their experiences through treatment were and how they feel now. Our peer support team, which is 100 strong now with the new 25—they're the on-shift ones, and we have another cohort for our retirees—certainly get out and about amongst our population of firefighters. Part of their role is championing really good mental health, demystifying the stigma and talking about the ups and downs of our journey through our career. I've just returned from a journey up through the north-east of New South Wales—to Tenterfield and back. Part of that was meeting crews, and at the end we closed with a talk about mental health, including what my experiences are, how I've dealt with it and what they should do and that interaction together.

ACTING CHAIR: Thank you. In terms of this idea that PTSD in particular has a cumulative nature—the more stressful episodes you're involved with, the higher the likelihood that you're going to get PTSD—do you track how many hours of stress individual officers are part of?

Mr Connellan : We track critical incidents. With our injury notification system, there's a notification of exposure. The notification process, as I said, has moved from 10 per cent to 59 per cent of people declaring things that they've been exposed to. So we are changing the culture. We believe that to make real reform and change in this space it's going to be a lot more enduring if we can change the culture and get the change driven from them rather than overlaying something on them as a workforce.

ACTING CHAIR: Has it got to the point where you can say, 'Okay Officer A has been to 30 critical incidents in the last year, so we need to stop and take a look and make sure everything's okay'? Is it to that point? How is your tracking of these incidents actually working in practice?

Mr Connellan : We track all our incidents and who goes to them all, for example, whether it's just an automatic fire alarm and they reset a panel or it's a critical incident, so we can certainly interrogate the data and find out who went to what incident. But the piece that you've talked about—that they've gone to 30 incidents—is the bit that I'm not sure of because we all react to different stimuli and different matters and process them in different ways. As Professor Harvey said, some people go through their whole career and come out the other end fine; some people can see one incident and it can have a profound and everlasting effect on them. That line in the sand becomes a blurred line or a hard line to lie down, so then we go back to our peer support program and the conversation and the support that we have to try to identify people.

ACTING CHAIR: Finally from me, we've heard that organisations are taking this on at the top but that it hasn't necessarily permeated through the culture of the organisations yet. I'm not talking about yours. Are you confident that within your organisation the messages aren't just sitting at the top and they're actually getting through into the organisation?

Mr Connellan : I'm confident we're on that journey. I'm confident that it's permeated through in some places and that at some levels. Mr Kirwan, one of your witnesses from this morning—he rang me up to tell me he was coming—is an example of a really forthright person who wants to get the message across and who donates considerable time to making sure that the message goes across the organisation, down the organisation and up the organisation. So, yes, we have pockets where I think we have good practice—where we are trying to achieve best practice—but we still have considerable work to do.

Senator URQUHART: Thank you and congratulations, because I think you guys are way in front of a lot of other organizations in terms of tackling this. We heard from Peter Kirwan earlier and I have to say that he was probably one of the most positive examples that we've heard throughout this inquiry, which was lovely to hear. But he had a couple of negative points and those were on the first couple of poor supports that he got from EAP psychologists. I'm interested in how you were addressing that, from the fire perspective.

Mr Connellan : I've spoken to him about that, as well. That's part of a broad part of getting support, which is that, if you don't have a connection to the person who is offering you support, you need to find someone you do have a connection with. Particularly with that type of injury, you're not going to have a relationship with someone who is going to help you through that if you don't have a connection. What we missed back then was probably that information, whereas we have it stronger now that, if you don't have the right person in front of you, get the right person. Peter, to his credit, has that as part of his presentation that he pushes out to people. There's definitely a downside to that—that is, people tend not to want to tell their story too often. That's the next roll of the dice in that. If I don't have a connection with you and I get a connection with someone else I actually have to tell my story again. But I think we're getting better at allowing people to realise that we support them in that process. I don't have any hard data around this, but hopefully they've got the impression that we're supporting them through the process and we're not treating them as we did in the past, as Senator Brockman said, as someone that's unusual or as something that I need to avoid.

Senator URQUHART: Professor Harvey, who was here just a moment ago, talked at length about the training course for, particularly, that sort of management level within the fire service. It seemed like it was quite positive. I think he indicated that it was actually starting to change culture. Can you talk a little bit about what the success of that program has been, how it has work within your system and if you are sharing that with other first-responder organisations.

Mr Connellan : Sure. That program assisted middle managers with having difficult conversations. I don't call them difficult conversations, because they are easy conversations. They are quite difficult to have and more so to initiate. It gave middle management the skill to pick up the phone and ring someone while they were off work. What we found through that, and what they found through the research, was that those they made contact with were more inclined to come back to work earlier and make a sustained recovery at the earliest stage in their injury. That was through that research. But we found there are unintended consequences of that. It is not just in the mental health space; it's about an injured worker who might have been off for a while—who traditionally might have been off for six weeks, whereas now they're more likely to get a phone call after a couple and maintain that connection.

The other thing we found is that people who are off work for a considerable amount of time with a musculoskeletal injury can possibly be underdiagnosed, or pick up a mental health injury, as well, just through the disconnection. We found that we're making better inroads in that area, as well, and we are sharing it. I am the chair of the National Mental Health and Wellbeing Network, with AFAC. That is a really good network for sharing initiatives about who's doing what and where. Western Australia is doing a really nice piece on transition to retirement. Now we're doing a piece on it and at some stage we will come together and compare it and then share it with the wider audience.

Senator URQUHART: Western Australia are also doing some work around having an arrangement with their insurer about presumptive PTSD legislation—or not legislation but acceptance of policy. Are you looking at something similar to that?

Mr Connellan : We still don't have presumptive legislation for cancer.

Senator URQUHART: You still don't have it for cancer?

Mr Connellan : No. I think they're debating it in parliament today.

Senator URQUHART: Let's keep everything crossed then! Are you aware of what's happening in WA in terms of the fire service and the discussion they've had with their insurers?

Mr Connellan : No.

Senator URQUHART: Okay. They've had discussions with their insurers, and what they actually do is that the fire service itself, particularly the health and welfare person, actually delivers all the information to the insurer about the types of issues and the types of jobs that that person has gone to and then puts a proposal back to the insurer and says, 'We believe this person is suffering from this because of these types of incidents,' which takes away some of that combative approach. So you're not looking at doing that. Who is your insurer, by the way, for workers comp?

Mr Connellan : EML.

Senator URQUHART: Who are they?

Mrs Donohoe : Employers Mutual.

Senator URQUHART: Is that a state government body?

Mr Connellan : We get them through icare, which is a state government body. Insurers are taking a more proactive approach now. As I said, we pay more for our claims up-front, because if we get a musculoskeletal injury we'll get a screen as well to see if there's anything else going on and to see if we can get an early diagnosis and accurate treatment in relation to mental health illness. What we're finding is that, by spending a little bit up-front, we're really reaping the benefits down the track, because we're getting people remaining at work and not suffering the more serious cases. That's reflected in downward trends in our rates of injury and our lost-time injuries, particularly around mental health injury.

Senator URQUHART: I just have a few questions around the report that came out of the New South Wales Legislative Council legal affairs portfolio committee. There were about 27 recommendations in that. Recommendation 27 talks about Fire and Rescue New South Wales implementing a widespread information and recruitment strategy which includes women in publicity campaigns, school visits and community events, and they maintain attention to the mix and composition. Can you just talk me through how you are moving with those recommendations.

Mr Connellan : We're doing a review of all of our external internet based publications to see what the representation is and what vision is going out. AFAC has signed up for Male Champions of Change at the national level. Commissioner Baxter is the president of AFAC. We'll do a deep-dive audit. He's committed to doing a deep-dive audit on all of our equipment through the Male Champions of Change to see where we're positioned through all that. We'll launch our next recruitment campaign, I think, on 2 November. Part of that is promoting diversity and showing inclusive workplaces. We'll never attract the diversity we want to if we just show one part of an organisation, so you won't see me in it.

Senator URQUHART: That's because you're a newcomer! Recommendation 23 specifically talks about reviewing the disciplinary measures in place for bullying, harassment and discrimination and taking appropriate and consistent action in response to inappropriate behaviour.

Mr Connellan : Yes.

Senator URQUHART: Can you tell me how you're broadly dealing with that but also addressing bullying in your organisation.

Mr Connellan : Our last three-year bullying and harassment program was called the Be Heard strategy. It was to give people a voice and, again, that culture to actually speak up about what they've seen and what they've witnessed. That came to an end earlier this year, and our new one is the Respect, Reflect, Reset program. It's the next iteration. It's about being introspective about your behaviour and your impact on others, which aligns with our antibullying action plan. So they're the two pieces of policy that go behind it. Structurally, we're looking at the make-up of our professional standards unit to make sure it's fit for purpose and that we're processing those types of issues in a timely manner, because delays in processing issues creates the illness or injury in the worker. We've also got access to—I've just lost her name—the antidiscrimination commissioner from Victoria, who is aligned with Male Champions of Change and is coming up to talk to us about what to do and her views on best practice in relation to sexual harassment in the workplace.

Senator URQUHART: You talked about the changing culture, breaking down stigma and how the reporting has gone from 10 per cent to 59. That's a huge cultural change, really, over 10 years or something, isn't it?

Mr Connellan : No, that was over five years.

Senator URQUHART: It's massive over five years.

Mr Connellan : Yes.

Senator URQUHART: Tell us what makes that program work. What is the program? What makes it work? You said you're a newcomer—35 years—so we can't give credit to you, because you've been there for longer.

Mr Connellan : Too long.

Senator URQUHART: So what actually was the catalyst that made that turnaround?

Mr Connellan : I actually don't think the catalyst came from management; I think it came from the floor. I've got strong memories in about 2008 of someone using the email system across the organisation, and it was the first time I'd ever seen someone talk about mental health on the email system. One person criticised them for that, but the overwhelming response after that was, I think, our watershed moment where a lot of other people stood up and said: 'No. This is a real thing for us.' For me that was the bit in the workforce where it changed.

Certainly, through the organisation's investment into the well check programs around our EAP providers, we've, again, through the insurer, upped the time for a consultation from 60 to 90 minutes for every consultation. We've broadened our peer support program, particularly with our growth in capabilities across the organisation or the state in that time and have access to better data. So, in the last 10 years, we've certainly had a lot better data to make more informed decisions on what we're providing and, most importantly, there are the partnerships with the universities to know that what we're delivering makes a difference.

Senator URQUHART: Having that research to back up what you're actually doing. My final question is—because I want to share this around with others—you talked about doing the country run to Tenterfield, and we've heard this in a number of inquiries about sometimes the isolation of more rural and regional based operators. Do you find less reluctance from people in small towns to talk about their mental health issues, or is there less support? How do you deal with those issues?

Mr Connellan : Our peer support network is spread out across the state, so we've certainly got far-reaching peer support programs. I think there are some unique issues regionally, and so there's a smattering of career firefighters out there and most of them are on call—

Senator URQUHART: So do they partner with volunteers in those regional areas as well?

Mr Connellan : Yes, they do. They co-respond with volunteers, but I always say the difference between them and my career is: I've always had the luxury of being able to move around and work elsewhere. They're working in their own communities. It's not very often when they respond that they don't have a direct connection, or know someone with a direct connection, to the people they're responding to, so there are some unique issues in those areas. On the upside, they are quite tight units. They're a community unit out of that particular town, and we try and support them in the best possible way and, again, make sure they've got the culture that they know to reach out for help. That's part of the reason I go out, apart from, say, that I can't run an organisation from head office. I like to go out there and tell them my story, listen to theirs and hopefully set up that environment where I can glean maybe where they're up to and what we need to design moving forward.

Senator URQUHART: And that growth from—sorry, this is my last one—10 per cent 59 per cent reporting, is that widespread across the state; is it higher in regional areas as opposed to more metropolitan areas; or have you not broken that down?

Mr Connellan : No.

Mrs Donohoe : We could get back to you on that, but we don't

Senator URQUHART: If you could take that on notice, that would be useful.

Senator LINES: Thanks very much for coming in. Your evidence has been really interesting. Senator Urquhart just talked about the culture change, but was there a catalyst for this? Because not only are you talking the talk; you're walking the walk. You've put dedicated resources in. You're looking at retirees. You've got it as part of your strategic plan and your strategic goals. So how did you get on the journey?

Mr Connellan : Our last commissioner, who was our commissioner for 13 years and who retired 18 months ago, always embedded that safety was our highest priority. Once you make that as your stand and start progressing with health and safety plans, it just becomes a bit of a natural evolution that you arrive where you arrive. As an organisation, we can be quite technical and a little bit less soft-skilled. Once you set up a plan around safety and you do the technical stuff, all that's left this is the soft stuff, and that's the bit that make the difference, in particular safety. Then you look at your injury rates and what's happening with injury rates. Certainly, mental illness and injury has become a growth industry over the last 10 years, and it would have been foolish of us to ignore it.

Senator LINES: Ye s. M y ears also pricked up and I was a former union official , and you often see the bad side of things when you said you phone people when they're off on workers comp . Part of me would think , ' Why are you doing that ?' and part of me would react to that . But you're obviously doing it in a positive vein . So how do you ensure that the workforce see s that in a positive vein ?

Mr Connellan : I think it's through the workforce telling stories. It has to be their narrative . We've got to get it right , because the only news that always travels fast is bad news. No-one ever rings you up and says they 've had a good day. So you have to actually get a lot of that good news out there. We still get the odd person who says , ' I don't want to be run g,' s o we try and look for someone that may have a contact with them , because the stats show that the longer they 're isolated , the less chance we're going to have to get them back to work , and t hat's a really poor outcome for them.

Senator LINES: Yes. O n these kind of strategies , do you work proactively with the union ? What's your engagement there?

Mr Connellan : No.

Senator LINES: Well! We've found a little chink in your armour!

Mr Connellan : A t the moment , we have a mental health and wellbeing strategic priority. We have a working group to drive that. We've invited them to be a member of that working group . That's a whole matrix of different initiatives moving forward. We've invited them to be part of that working group.

Senator LINES: Thanks very much .

Senator PATRICK: My a pologies for not being in the room for your opening statement. Senator Lines did give me a bit of an overview , so that's good. These chaps have media machines ; I have to do all my own. So my apologies.

Senator LINES: We don't have media machines!

Senator PATRICK: They're all back in their party offices!

T his comes from my project management background , so I'm going to be pretty forensic here. Nothing ever gets done unless there are resources and money allocated . So I presume you have a plan in place , across the fire service . Is that how it works?

Mr Connellan : That's correct. Unsurprisingly , there are a couple of plans. M ental health is certainly embedded in our safety strategy , t he 2018

Mrs Donohoe : Two thousand and twenty.

Mr Connellan : two thousand and twenty safety s trategy. As I said , we've got th e plus p lan , which is our five- year plan moving forward , and the commissioner has got his seven priorities —which are actually 10 !

Senator LINES: He says seven, but you reckon there's 10?

Mr Connellan : T he first priority is safety and wellbeing , and , under that , there's mental health resiliency and there's the minimise d exposure to carcinogens progr am . O ut of all those programs , there's a strong project management methodology , where all programs and projects come up regularly to executive leadership team . I've got an all-day meeting tomorrow , and , for more than half of that , we're going through all those project plans and program plans and having a look to make sure they're fit for purpose , they're realistic , they're deliverable and , if there's any budget line to them , where that budget comes from . W e have park ed money for strategic programs , and it's just the priorities of those programs and how they get through the system.

Senator PATRICK: On the c ommissioner ' s count ing, my daughter always says, 'There's three types of people in this world: t hose wh o can count and those who can't!' Your plans state the resources that are required . So do y ou have an FTE allocation to any particular objective that the commissioner has set ?

Mr Connellan : Y es . As part of the overall plan , the working groups have FTE allocate d to them , apart from our regular jobs. But people are really engaged in moving the organisation forward and , in particular , the direction we're head ed in . As to the individual program and project plans , part of that process is : what resourcing do they require to be activated ? If you need additional FTE, or if you need capital funding or you need recurrent funding , they're identified in those plans , and we sit around and decide which ones are worth ier going forwards , and which ones may have to wait til l the next year .

Senator PATRICK: What sort of funding has been allocated to mental health within the fire service and how has that changed over the last three or four years?

Mr Connellan : Currently we allocate around half a million dollars to mental health. That's to run it and run programs within it. I do know that we're going to have a couple of bids going up through this process. The world is our oyster with the new plan and, if you don't ask, there's no-one to say no. We'll do whatever we can to expand that, but at the moment we allocate half a million dollars. That's probably doubled in the last five years.

Senator PATRICK: That's probably three or four people across the organisation for that sort of money, I would imagine.

Mr Connellan : Yes. We get a lot of in-kind work. As I said, we've got 100 peers on shift that donate their time helping others in the mental health space. Plus we have retired firefighters delivering the service to other retired firefighters. We've never done any work around what the return on all that is, but that's a considerable investment by them.

Senator PATRICK: Sure. Is the plan public or at least internally well distributed and available to anyone to look at?

Mr Connellan : I know they are internally available. We can make them available to you.

Senator PATRICK: I'm just curious. This is my test criteria as a project manager. I talked to the South Australian fire department, who came to the hearings. I do thank you for coming. We do note the absence of the ambulance service and the police service—if Senator Urquhart didn't throw that in already. When the South Australian fire service came along they talked about a whole bunch of stuff but actually there was no money allocated, which gives an indication of the seriousness an organisation takes to a particular issue. So if you could come back on notice and provide some indication of the budget that has been spent, if that is available, that would be appreciated.

Mr Connellan : Okay.

Senator PATRICK: How much money is being allocated to retirees? You've taken the positive step of dealing with people who've left the service. How much money gets allocated to assisting people who've left the service?

Mr Connellan : Through the retiree peer program they have ongoing training courses. So there's an investment in those. It's an opt-out program not an opt-in program, so it's compulsory for them to participate in that. We've only had it running for 12 to 18 months, so we're still evolving what other elements goes with that. We're partnering with our insurer EML and next month we're doing a transition to retirement seminar with some retired military people to discuss their experience and how that can relate to us. So not all the investment comes from us; some of it comes from our insurer. They certainly see the value of keeping even retired firefighters fit and well and the impact it then doesn't have on them.

Senator PATRICK: Do you get a reduced premium as a result of the effort that you are undertaking to deal with your own people in a positive manner throughout their career?

Mr Connellan : We believe we do. We've receive refunds in our hindsight adjustments for the last three years in a row. Part of the downward trend is not only through our management of our injured staff but also in lost time injuries with our mental health injuries as well. So there is a direct correlation between the work we're putting in with early identification and making sure we get accurate diagnoses and appropriate treatment—and therefore the premiums that pop out at the other end.

Senator PATRICK: Do you ever sit down and talk with the insurance companies and say, 'If we did this, would that result in a reduction in premiums?' Do those conversations take place at all?

Mrs Donohoe : We meet with the insurer on a regular basis—weekly, if not more. All of our focus is on getting the injured workers back to work. All of the evidence suggests that if you get your injured workers back to work, even if they have been medically discharged, and you can return them to some form of suitable employment that will have an impact on your financial position. While, yes, we do have those conversations, the intent is always the same: to get someone back to work.

Senator PATRICK: I'm not talking about getting people back to work; I'm talking about whether making sure people are managed so they never leave work has a monetary value attached to it from an insurance company.

Mr Connellan : I don't think we've ever done the calculations. It's more of an outcome based on our efforts with the injured worker.

Senator PATRICK: I don't mind if you use that idea the next time you talk to them. I'm just seeing what the trade-off might be. There might be some investment. What's the order of magnitude of your insurance premiums? Is it millions?

Mr Connellan : Yes—tens of.

Senator PATRICK: It is tens of millions of dollars.

Mrs Donohoe : It's $22 million.

Senator PATRICK: In terms of a half a million dollar investment that you're making, I'm just wondering if there's a levering of, 'If I spent $2 million, would that reduce my premium by a certain amount?' Throw in some competition there, and you never know what might fall out.

Mr Connellan : You're right. If memory serves me right, I think Mr Harvey's research or other research indicated that dollars spent and return on investment, particularly in mental health, is money well spent.

Senator PATRICK: Volunteers—I'm sorry, I don't understand the structure of the NSW fire brigade. Do you deal with volunteers within your organisation or is that a separate organisation?

Mr Connellan : We do. We have three structures within fire and rescue. There are full-time career firefighters. In fringe areas around Sydney and most regional centres, we have what they call retained or on-call firefighters. We pay them a retainer, they turn up for training, they carry pagers and they respond in their own town. We do have a network of 6½ thousand community fire unit volunteers. They typically live on a street that is on the urban interface with bushland and they'll just look after their own street. It's not active firefighting; they do preparation before the fire and clean up after. Typically, they don't have the same exposures as the rest of the organisation.

Senator PATRICK: Is anything done to those people? We heard that in South Australia, for example, there were a number of volunteers who occasionally got called out to a motor vehicle accident, particularly country fire people. They were exposed to trauma but, because they're volunteers, weren't necessarily getting the same attention as a full-time firefighter.

Mr Connellan : This is a very tight group. All they do is bush firefighting in their own street. That's it. What a study did find after the 2013 fires up at the Blue Mountains is that their resiliency was quite high, and the communities that had community fire units in them actually recovered quicker than the rest of the area.

Senator PATRICK: Do you interact with other services—perhaps the NSW Police and/or ambulance service or, apples and apples, with the Victorian or Queensland fire service and so forth—in talking about approaches such that the investment, research, findings and successes of the programs can be shared amongst the different entities?

Mr Connellan : There are two parts to that answer. Within the state, we certainly do discuss programs and projects with the other emergency services. The previous mental health commissioner, who only retired late last year, was very good at bringing all the agencies together and he worked up a strategy for emergency services and first responders throughout the state. That was a great forum within the state, across the jurisdictions. As I said, nationally, through AFAC, I chair the mental health and wellbeing network, where all fire and land management agencies come together to discuss different programs, projects and ideas. We're very good at begging, borrowing and stealing stuff and rebadging it and saying it's our own. It's a sharing network, and it's very surprising how people can do things differently across Australia—how we can all pick what suits our particular organisation and use that internally. We're the largest urban fire service in Australia. Sometimes we can pick something out of a state emergency service in South Australia that looks like it's working really well and adapt that for us and vice versa.

Senator PATRICK: My really last question is—and I don't know if Senator Urquhart covered this—in the context of those conversations, have you ever come across an impediment to achieving something and you thought, 'Damn,' because there's a federal law or a federal regulation or something that fetters you on the federal domain from doing that?

Mr Connellan : I'm not sure, but if you're asking where the Commonwealth could step in—

Senator PATRICK: Yes, basically.

Mr Connellan : then it is specifically around the area of research. Doing that broad research across all jurisdictions across this big, wide land we have would be invaluable to all the agencies that sit within it. As Dr Harvey should have shown, because we work with him, research is invaluable in what we do but is sometimes out of reach for individual agencies. Overarching research should be provided for or all of our agencies in the area of mental health. It is a common area for all of us, it's a growth area for all of us and it's something we're all committed to working on. For me, personally, that'd be a great intervention.

Senator PATRICK: Thank you very much. That was very helpful.

ACTING CHAIR: We've finished—done, through and out. Thank you both very much for appearing today. That concludes today's proceedings. I thank all witnesses who have given evidence to the committee. Thanks also to broadcasting and to the secretary.

Committee adjourned at 15:46