A Call for More Mental Health Training

The Missouri Department of Public Safety is deploying training courses around the state on Critical Incident Stress Management (CISM) for all first responders. These sessions, according to this report, will ‘focus on coping with stress and the psychological trauma that comes from responding to critical incidents’. Missouri is offering two programs. The CISM training is three days, and includes individual and group crisis intervention. A two-day peer support training is also offered.  

I applaud Missouri DPS for this initiative and challenge all states to offer similar programming for public safety professionals – but in higher volume and with a broader range. Overall, we are wildly ignoring the prevalence of mental health related trauma and injuries we see across public safety. I’m glad Missouri is offering a range of courses, in shorter format and longer courses. These can all be non-clinical, intended to help responders help themselves and support their colleagues. There may also be a need to further broaden this, depending on what needs to be accomplished and trained, perhaps courses in duration of one, two, and three days.

We also need regular frequency of delivery. These courses need to be part of the regular catalog of training offered by emergency management offices, perhaps in cooperation with state mental health agencies or other related partners. Oftentimes, programs such as what is being offered by Missouri DPS are one-offs (I’m not sure what Missouri’s plans are long-term for this), which doesn’t even scratch the surface of public safety professionals that will benefit now or in the future from such training. States offer incident command system (ICS) training at varying levels, often on heavy rotation. There is no reason to not offer courses like this on a regular rotation as well.

If we are truly dedicated to supporting the mental health of our public safety professionals, we need to make this kind of training and the resources that can come with it a regularity. Mental health injury can build over a career and/or come from a single event or series of events. They can lead to anxiety and depression, burnout, and suicide. Public safety professionals dedicate their lives to supporting our communities. We need to dedicate resources to supporting them. The more we talk about it, the more normalized it will become and the less stigmatized it will become. Talking about a bad knee or rotator cuff is commonplace, and discussion on mental health should be the same. Similarly, I’d like to see more requirements and standards in this matter. State and federal labor and occupational health and safety agencies should be including more mental health requirements just as they do for physical health and safety. Standards setting organizations, such as the NFPA and membership-driven organizations that we see in all facets of public safety should be advocating more heavily for this.

Keep this conversation going. What best practices in mental health matters are you seeing in public safety?

© 2022 Tim Riecker, CEDP

Emergency Preparedness Solutions, LLC®

Twenty Years

It’s been nearly twenty years since the terrorist attacks of September 11, 2001. It simultaneously feels like it happened just a few months ago, if not a lifetime ago. I can still feel the fear, anxiety, sadness, anger, and exhaustion from the incident and the long response.

I spent most of the response in the NY State EOC in Albany. Although disconnected by distance, it was still a traumatic and impactful event for the people there. Everyone has their own personal story of 9/11. I won’t bore you with mine.

With this 20th anniversary, there are a lot of panels, documentaries, and writeups about the attacks, the impacts, the people, the response, and the recovery efforts. For those of you who weren’t yet working in emergency management at the time, or perhaps were even too young to recall much of it, I urge you, if you can, to consider checking out some of the fact-based materials new and old. Among those, I suggest reading the report from the 9/11 Commission. There were an abundance of lessons learned, many of which we have applied, some of which have been unfortunately left to the wayside. Lessons learned from the 9/11 attacks were the catalyst for some significant changes in emergency management, including a newfound and sometimes awkward partnership with homeland security, a concept rarely heard of before then.

I urge everyone to be respectful of those who lived through the event – survivor, responder, or civilian. While some like to tell war stories, others prefer to maintain some emotional distance. A few years ago I stopped attending 9/11 memorials. I’ve come to feel rather overwhelmed by them. I still honor those lost with my own remembrances and in my own way. Do whatever feels appropriate to you: Attend a memorial. Volunteer. Donate blood. Make a charitable donation. Thank a responder.

If you feel a lot of distress on this anniversary, please talk to a friend, family member, or a therapist, or call the National Suicide Prevention Hotline at 800-273-8255 (this link provides numbers for suicide prevention hotlines in other nations around the world). If you know anyone who struggles with their emotions from 9/11, please do check in on them over the next few days. It can make a world of difference to them, and it may even save their life.  

Never forget.

TR

Responder Depression, PTSD, and Suicide

This week the world lost two celebrities to suicide. These losses are absolutely tragic, and even if you didn’t know them personally, it raises awareness of mental health matters. In the last few days the world also lost many people to suicide that so many of us don’t know, but they were a son, daughter, father, mother, brother, sister, aunt, uncle, cousin, friend, spouse, lover… Some of those were also responders, dispatchers, doctors, nurses, or others that deal with tragedy every day and make our communities safer. They may have been a coworker or colleague. A brother or sister on the line.

Despite a lot of efforts to change perspectives, depression, PTSD, and suicide are still labels that are associated with shame and weakness. There is nothing shameful or weak about them. They are a reality of life. If you haven’t been effected by them directly, you know someone who has.

When you work in public safety, you deal with some pretty bad shit. Not just once, but over and over. You see people at their worst. Your see death and devastation. You see hopeless and desperate people. Broken people. Sadness and anger. We see more than most people do. On top of that, we deal with our own personal issues. Maybe a divorce, illness of a family member, or death of a pet. Finances might be tight.

How do we deal with it? We build walls. We make it impersonal. We stay professional and work in the moment, focusing on what needs to be done. But what do you think about after the call? Or the next day? Or even years after? Sometimes it doesn’t hit you right away. Sometimes it’s something completely different that triggers memories and emotions. What then? Maybe we shrug it off, or maybe we shut down for a while and have a bad day. But that bad day turns into another and another. Soon you may not be able to remember happiness.

What should we be doing? Talk to people. Maybe a coworker, a friend, or a mental health professional. If you are in a paid service, you may have an employee assistance program. Fuck the stigma, the shame, and the macho bullshit. This is as serious as cancer or a heart condition. You can’t ignore it and expect it to go away.

Maybe it’s not you, but a friend or coworker. You notice changes. Irritability. A lack of focus. Dramatic loss or gain of weight. Alcohol and drug abuse. Talk to them. Find a professional to talk to them. Yeah, it’s a tough call to make, but it could save their life.

Depression, PTSD, and suicide suck. We can’t ignore their impact on society and on public safety professionals. We need to work harder to end the stigma and ensure better access to services so people can get the help they need and stop suicides.

©️ 2018 – Timothy Riecker, CEDP