Who Responds to the Responders?

There is a culture shift among first response agencies away from emotional suppression and toward healthy processing of traumatic events.

By Kristin Withrow, CSDA Communications Specialist

America’s understanding and de-stigmatizing of mental health is on the rise. The nation’s understanding of post-traumatic stress disorder has its roots in the need to help soldiers returning from war and struggling to repatriate into civilian life. The U.S. Department of Veterans Affairs first recognized the condition in 1980 when the American Psychiatric Association added it to the third edition of its Diagnostic and Statistical Manual of Mental Disorders.

Post-traumatic stress disorder is defined broadly as a condition that may last months or years, with triggers that can bring back memories of trauma accompanied by intense emotional and physical reactions. People who experience unprocessed extreme stress events have a higher likelihood of later exhibiting symptoms such as sleep disorders, aggression or irritability, anxiety, hypervigilance, or difficulty concentrating, among other things.

The recognition that a mental health condition can be caused from experiencing traumatic events opened the door to developing strategies to assist individuals in processing long-term or intense stress experiences to reduce the instance and severity of negative outcomes. America’s first responders are susceptible to mental health challenges due to the unique nature of their jobs. Firefighters and peace officers operate in shifts around the clock, causing physical and psychological stress for individuals working “swing” or “graveyard” shifts. Overnight work can cause a disconnection between family and social lives that may isolate these workers. Add traumatic calls that require literal life-and-death decisions, and you have an environment prone to causing stress by its very existence.

Historically, both police and firefighter cultures maintained a stoic view of mental health that required first responders to have a “suck it up” mentality of tamping emotions down to avoid processing the experiences that arise in the line of duty. Mental health advances have taught us that this “get over it” mindset leads to problems. The culture shift away from this mindset has begun with support from unions, state policies, and participation from police stations and fire houses across the state.

California State Senator John Laird introduced Senate Bill 623 in February to amend a section of the labor code. The goal of the bill is to expand the scope of protections for first responders, including peace officers, firefighters, dispatchers, emergency communications employees, and other groups that may be affected by the intensity of employment in first response industries, through January 2032, and make access to mental health services easier in the state-run insurance programs.

In May, Senator Laird tweeted ‘@SenJohnLaird #SB623 is such an important piece of legislation. Let’s ensure we help our first responders get the coverage and services that they deserve.’

At the local level, many districts have developed support programs. Stallion Springs Services District in Tehachapi provides police, fire, mail, parks and recreation, mail service, trash, wastewater, water and weed abatement programs for their remote mountain community of 2,500 residents.

The police department participates in a program called “Critical Incident Stress Debrief” (CISD). The debriefing after a traumatic incident includes a facilitator-led meeting by licensed psychologists, a group discussion including all parties broadly involved (dispatchers, ambulance drivers, etc.). The facilitator leads the group through an exploration of each person’s perception and experience to allow them to examine their interpretations and process the experience together.

“The department also uses Lighthouse Health & Wellness by APEX Mobile, which is funded by sponsors. The anonymous application allows personnel to seek the assistance of clinicians, either locally or virtually, in a confidential manner,” said Police Chief Gary Crowell. “Apps like this allow officers to find a way to process stress that is free of charge.” Chief Crowell also noted, “Police can be more isolated than other types of first responders because we generally work call-to-call. Where other types of agencies, like fire or ambulance, often live in departments together for stretches of time, police do not. The result can be a tendency to move on without talking to colleagues during down time, causing officers to internalize stress instead of process it.”

Chief Crowell is encouraging the culture shift away from stoicism in his department. “The goal is to remove the stigma that police culture has held that may cause officers who ask for help to worry they will be removed from duty or sidelined in some way,” he said.

At Montecito Fire District in Santa Barbara County, Firefighter Paramedic Andy Rupp is a leader of the six member Peer Support Team which is also part of a broader county peer support team in place throughout the entire operational area of Santa Barbara County.

To be a member of the Peer Support Team, Rupp said it is important that candidates be people who are perceived by their colleagues as trustworthy, non-judgmental and accessible. Agencies who want to adopt a program could start by identifying those colleagues to whom people are drawn to already. The firefighters who are already confided in make excellent candidates to receive training to be able to make their natural affinity broadcast further, while also formalizing the layer of confidentiality and trust.

“The team members receive training to recognize the signs of someone struggling with stress or experiencing challenges in their life that pose extra stress in addition to their job,” said Rupp.

Their Peer Support Team received training through an organization called The Counseling Team International. In addition, the International Association of Firefighters has peer support training available. The county programs are linked together as one team representing broad experiences and support opportunities through firestrong. org. Peer Support Team members upload their profile and background to the site to allow firefighters seeking support to find a member of the team that resonates with their experience.

In all cases, confidentiality and access are keys to acceptance and success of the programs. The mindset shift toward support embraces the reality that healthy personnel form stronger teams and achieve better outcomes in their own mental health as well as in performance of their duties, along with reduced sick days. These programs improve critical services to the community while supporting the men and women who serve in these important roles.