Investigating the psychological determinants of rural volunteer firefighters’ health, occupational functioning, and resilience

Rural volunteer firefighters (VFFs) experience chronic occupational stressors and trauma exposure yet often face limited access to behavioral health resources, placing them at an increased risk for diminished well-being. Despite their critical role in protecting rural communities, little is known about how workplace behavioral health resources relate to resilience, occupational functioning, and physical health among rural VFFs. This explanatory sequential mixed-methods study examined relationships among coping, social support, resilience, occupational functioning, and physical health in 180 West Virginia VFFs using survey data, followed by interviews with a subsample of 10 participants to contextualize findings. Regression analyses indicated that problem-focused coping and perceived social support were positively associated with resilience, and resilience was positively associated with occupational functioning but not physical health. Qualitative findings suggest behavioral health was shaped through interactions among adaptive coping, peer and family relationships, leadership, departmental culture, and organizational resource limitations. Participants also described workforce shortages, limited access to first responder-informed behavioral health services, and normalization of maladaptive coping as barriers to maintaining well-being. Findings suggest interventions that strengthen adaptive coping, leadership, peer and family support, and access to contextually relevant behavioral health resources may enhance well-being and sustain emergency response capacity within rural VFFs.