Mutual aid: Responding to the mental health needs of first responders

LIMA — It is often one of the most stressful situations one can face, whether it is dealing with a sudden death, being the victim of a crime or losing everything in a fire or other calamity. It can be a moment of chaos with emotions running high and tension filling the air.

For most people, the crisis of the moment passes and some semblance of normalcy eventually returns, even as they deal with the aftereffects of what happened. For first responders, be they firefighters, emergency medical technicians or law enforcement officers, this can become a way of life as each new call for service takes them from one emergency to the next.

“Cops [and other first responders] are seeing that every day,” Allen County Sheriff’s Office Maj. Andre McConnahea said.

Working in such a traumatic and potentially hazardous environment has had an effect on the mental health of first responders. A 2018 publication by the Substance Abuse and Mental Health Services Administration said that an estimated 30 percent of first responders develop a behavioral health condition, such as depression or post-traumatic stress disorder, compared with 20 percent of the general population. Firefighters were reported to have a higher rate of suicide ideation and attempts while between 125 and 300 police officers committed suicide every year as of 2016.

“The issues have largely existed over time, but our professions have been somewhat low-key and kept it below the radar,” Prevention Awareness Support Service executive director and former Bluffton Police chief Rick Skilliter said. “There’s now much more awareness for the need to provide safe outlets for our peers to have peers understand that they’re not automatic robots without feelings and without impact from these situations.”

Contributing to the problem

When it comes to high-stress occupations, one of the longtime strategies for dealing with that stress has involved compartmentalization with first responders putting their emotional reactions to the side and focusing on their training and what they need to do in the moment.

“There certainly was a time when maybe you came back after a call and talked it over a little bit with your crew,” Bath Township Fire Department Chief Joe Kitchen said. “But the general operating procedure was you just kind of tried to put it behind you and put it out of your mind and move forward.”

Despite those efforts, the stress and strain of responding to calls can build up over time, Skilliter said, and that trauma can lead to poor coping mechanisms.

“For some people, it becomes overwhelming,” he said. “Then we see the substance use increase and the healthy decision-making decrease. Careers fall apart, families fall apart. We don’t want that to happen.”

As departments have also become more diverse in recent years, it has also become more apparent that people react to these stressful situations differently, according to Skilliter.

“We’re seeing a more diverse population providing emergency services,” he said. “For instance, females have joined the ranks and have been welcomed in, which is a needed approach. But we’ve not typically done a good job recognizing that the needs are different between males doing this work and females doing this work. So setting a work environment that is welcoming and supportive is what we’re starting to see, that awareness of putting time and effort and energy behind those types of initiatives.”

Addressing this issue is not only necessary for the well-being of first responders, but also the welfare of the community.

“Not only are you putting yourself in danger, but there are other people, co-workers and society in general, where you have to be cautious and make sure they’re not in any danger because your mental health is not where it should be to do this job,” McConnahea said.

Finding solutions

As departments have seen the negative effects of poor mental health among first responders, greater efforts have been made to address this situation.

“For a long time here in Lima and Allen County, we have had a pretty robust critical incident response team,” Kitchen said. “That is a group of specialized, well-trained individuals who can come in and provide some aftercare for fire, police and EMS after an incident.”

Skilliter has been a resource for area departments through PASS, working with area health departments to provide mental health resources.

“With smaller agencies, our local mental health board in Allen, Auglaize and Hardin counties have actually assisted with a number of these agencies to get employee assistance programs,” he said. “Even the volunteer departments that don’t traditionally provide mental health services for their volunteers have that resource available.”

The Allen County Sheriff’s Office has worked with a therapist in Montgomery County to help provide counseling for deputies when needed, working with department supervisors to help assess when a deputy is mentally ready to return to duty.

“That’s certainly no disrespect to our local therapists,” McConnahea said, “but it just seems to make the officers more comfortable speaking with someone completely detached from the community.”

One strategy more departments are utilizing involves peer-to-peer support. The idea is that having someone who can personally relate to a first responder can help that person open up and deal with traumatic experiences.

“The International Association of Firefighters has really stepped forward to provide training for peer support,” Kitchen said. “These are firefighters and paramedics who get specialized training on how to assist fellow firefighters who are in crisis.”

This approach is not limited to firefighters as law enforcement agencies are taking a peer-to-peer approach.

“The Lima Police Department is implementing a Peer Support Group,” Maj. Ronald Holman said in an email. “The officers in the group receive extra training in counseling officers who have been through a traumatic event. We also offer counseling through our employee assistance program.”

In a time when the actions of first responders can come into question, especially in law enforcement, Skilliter is also encouraging the public to be mindful of the stresses faced by people in these positions even as they work to hold them accountable.

“Our public safety people are tasked with making very rapid decisions, and we train them very well to be able to do that,” he said. “So we should give them the benefit of at least hearing things out before people take a strong side and get impassioned. That can destroy a human being and, in some cases, completely devastate a needed service in the community.”