This report, authored by Dr Peter Cotton, found that the issues uncovered in the review of firefighters in the Metropolitan Fire Brigade (MFB) are not dissimilar from the findings of other inquiries into emergency service organisations like the police or the ambulance service.

The Executive Summary includes the following findings:

• Anxiety and Depression, grief and loss issues, relationship problems, fatigue and sleep issues and substance misuse are also common presenting issues.
• Suicide rates are comparable to other emergency services.
• The Employee Support Program needs more resources.
• “…the particular form of [mental health] stigma to be dominant in the MFB is ‘self-stigma’; denial and avoidance due to a perception of shame or a view that ‘I should be more robust and therefore should not need any help”.
• Revising the mental health strategy and extending it across the organisation.
• The management systems were unable to track “cumulative incident exposure” and so impeded risk management.  The inquiry called this a “key occupational health and safety risk”.
• MFB has “exceedingly poor occupational health and safety and workers compensation performance.”
• The MFB “has an excessively high tolerance margin for poor behaviour and inconsistent management, or a lack of appropriate management, of behavioural issues.”