Mental health and psychological wellness have long been taboo subjects within the ranks of emergency services. The perceived weakness of human emotion (when exposed to extreme conditions and situations) has contributed to our culture of non-dependency, isolation of feelings and lack of personal outreach.
At times, we’re slow to respond to the tell-tale signs of post-traumatic stress because we question our role, our interference, our responsibility and the privacy of those effected.
As our members continue to experience natural reactions to traumatic environments, we must be prepared to step in. Without intervention, we’ll lose good people to the effects of critical incident/post-traumatic stress—in more ways than one.
Be Proactive
Have a conversation about the effects of emergency work. Consider your professional partners and establish a dialog that is inclusive of police, fire and EMS, especially those departments that work closely with each other and have an interpersonal dynamic.
If your public-safety providers know each other by name, regardless of discipline, it’s worth developing a shared employee-assistance policy and procedure.
Immediately following a critical incident, all emergency-service workers should have access to an incident defusing. The information that’s shared verbally (or not shared, nonverbally), can provide peer-assistance providers an opportunity to intervene before permitting distance and separation.
Employee Assistance Program (EAP)
Many municipalities/services rely on their EAP to provide assistance and direction following a critical incident. There’s no doubt that there’s value to having employee assistance, but the nature of the situation must be considered when selecting a care provider and facilitator. Many EAPs are not prepared or capable of addressing the needs and viewpoints of emergency responders.
If an EAP representative lacks perspective and professional aptitude, skepticism and avoidance among responders will limit the effectiveness of a debriefing.
Further, sessions with EAP organizations often take time to assemble, sometimes days. The immediate need for intervention suggests that support assets need to be local and available at a moment’s notice.
Peer Support
Peer-support providers must be carefully selected. It’s in the organization’s best interest to identify those who understand the importance of intervention and have a personality that allows for a nonjudgmental interaction. They must be approachable, empathetic and a good listener. Those selected must have field experience as a public-safety provider.
They must be able to relate to the incident and the issues. It’s also imperative that they commit to initial training and continuing education.
Observations have found value in having more than one peer-support member available for the initial defusing: one to lead the conversation, one to evaluate the impression of the group and the attendees. Peer-support members are bound to confidentiality and must always be available to follow up with those who need or request assistance.
Chaplaincy
Chaplaincy programs must not be focused on religion or a specific faith. Understanding the variables of a group environment, these programs must acknowledge that religion is a personal choice, not an imposed value.
However, chaplains provide another facet of assistance. Chaplains can be advocates for public-safety providers. They can spend time in the firehouse, police station and ambulance bay before an emergency. They can get to know the interpersonal dynamic of the organizations they serve. They understand the roles and responsibilities, values and mission of public safety. And they can attend training events, meetings and family functions.
They are, for all intents and purposes, members of our departments—a part of our organizations; they’re not strangers.
If by choice someone requests religious support and counseling, well, that’s available too.
Prevention
Although stress is not completely preventable, there are things that can reduce the effects of chronic stress and critical-incident exposure. Does your department address physical fitness through group and individual activities? Does it consider alternative health practices than can support and even build up your members’ mental and emotional state?
Be open-minded to prevention concepts and the power of planning/preparation.
A multifaceted approach to critical-incident and post-traumatic stress will provide options for the variables of your workforce. We simply can’t afford to approach this issue with an EAP alone. In this situation, our strength is our weakness. Just as others rely on us, we must rely on others. Recent tragic events within our industry and with our personnel provide us with enough incentive to adapt to the dynamics of mental and psychological wellness.
One parting thought: You’ve been in this profession for a while. You’ve seen some stuff too. Who’s taking care of you?