Download Mayday for Mental Health A very personal perspective from a US

May Day for Mental Health
UK Fire Chiefs Association
UK Fire Chiefs Association
May Day – When do you call for it?
Feel life endangered?
Save a Life?
Need to expand that concept!!!!
The 13th Life Safety Initiative:
“ Firefighters and their families must have
access to counseling and psychological
support”?
What are we doing about it?
UK Fire Chiefs Association
• Some questions and certainly not all
inclusive list will include:
•Is the concept of Mental
Health in our curriculum at
our academies at the entry
level?
•Are recognition of signs
and symptoms part of our
Company Officer Training?
UK Fire Chiefs Association
• (Questions Cont.)
•How do
volunteer/combination
departments deal with
this issue with no EAP?
•Who is your EAP and
what training do they
have about the fire
service culture?
UK Fire Chiefs Association
• Is there a psychological/counseling
component as part of the annual physical?
• How do we prepare to add valuable exmilitary personnel to the fire service who
have already been exposed to horrific
situations?
• As we go through definitions do you see
someone in the organization who fits into
one of these categories? Maybe you?
UK Fire Chiefs Association
• THIS IS NOT INTENDED TO BE A CISD
PRESENTATION!!!!!!
• MENTAL HEALTH IS A KEY COMPONENT OF
OVERALL FIREFIGHTER SAFETY
• NO ONE MAGICAL ANSWER!
• MANAGE VERSUS CURE
• SOME MATERIAL SENSITIVE
What qualifies me to speak?
Goals
• Keep it simple.
• Identify and agree on the need for addressing Life
Safety Initiative #13 in its’ entirety.
• Examine current practices in your jurisdiction
already in place beyond CISD teams.
• Go home with at least one idea
you realistically think you can make
happen.
Coping Mechanisms:
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Drugs
Pain Medicines
Alcohol
Smoking
Eating
CAN BE COUNTERPRODUCTIVE AND MAKE US
MORE REACTIVE (SENSITIVE )TO FUTURE STRESS
Management Tools:
Stress best managed by:
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Regular Exercise
Meditation or other relaxation exercises
Structured “Time Outs”
Learning new coping strategies
“The management of stress depends mainly on the willingness
of the person to make changes necessary for a healthy
lifestyle.”
Post Traumatic Stress Syndrome
Posttraumatic stress disorder (PTSD) is an emotional
illness that develops as a result of a terribly
frightening, life-threatening, or otherwise highly unsafe
experience.
PTSD sufferers re-experience the traumatic event
or events in some way, tend to avoid places, people,
or other things that remind them of the event (avoidance),
and are exquisitely sensitive to normal life experiences
(hyperarousal).
Post Traumatic Stress Syndrome
Almost half of individuals who use outpatient
mental-health services have been found to suffer
from PTSD.
As evidenced by the occurrence of stress in
many individuals in the United States in the days
following the 2001 terrorist attacks, not being physically
present at a traumatic event does not guarantee
that one cannot suffer from traumatic stress that
can lead to the development of PTSD.
Post Traumatic Stress Syndrome
" Approximately 7%-8% of people in the United
States will likely develop PTSD in their lifetime,
with the lifetime occurrence (prevalence) in
combat veterans and rape victims ranging
from 10% to as high as 30%.
Historical Examples
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Our Lady Of Angels Fire
Chicago, Illinois
December 1, 1958
95 Killed, 93 children
FF Richard Scheidt
10 year old John Jankowski
Houston Fire Department 2009
Way too common of a scene. Where are
those hugs after the fact? How far have we
really come since 1958?
Chicago video
Historical Examples “Baby Jessica
• McClure's rescue was credited mostly to
paramedic Robert O'Donnell and police officer
William Andrew Glasscock Jr., both of whom
received tremendous media attention. In
1995, O'Donnell shot himself to death while
suffering from posttraumatic stress disorder. In
2004, Glasscock was sentenced to 15 years in
prison on charges of sexual exploitation of a
child, sexual assault, and improper storage of
explosives.
Historical Examples
• Chicago FD
• FDNY
• US ARMY
• MGM Grand Fire
• Hinsdale FD
FF in distress video
Where do we usually turn for
answers?
• NFPA Standards
• Fire Service Organizations
• Training Institutions
NFPA Standards
• NFPA 1021 (Fire Officer Professional
Qualifications)
• NFPA 1500 (Occupational Health and
Safety)
• NFPA 1521 (FD Safety Officer)
• NFPA 1583 (Health Related Fitness
Programs)
Health and Wellness Guide for
Volunteer Firefighters
• Revised February 2009 (USFA and NVFC)
• Volunteers need direction also!
• Covers areas like: fitness, strength training,
diets smoking cessation.
• Noble goal of “reducing the primary cause of
on-duty deaths in the volunteer fire service –
heart attack and stress.”
• What’s missing?
IAFC Safety, Health and Survival Section
Joint Labor Management Wellness Fitness Initiative
IAFC SHS Strategic Plan 2009-10
Not there
Joint Labor Wellness Fitness Initiative
There!!!
Revised 2008
CHAPTER 5 — Behavioral Health
Management and Labor shall support the provision of a
behavioral health plan, which may be delivered either
through internal or external sources, based on specific
elements.
IAFC - IAFF Wellness Fitness Initiative
This chapter highlights the following:
• Introduction
• Qualifications of the Behavioral Health Specialist
• Periodic Behavioral Health Evaluation
• Comprehensive Counseling Services
• Incentive to Access Services
• Behavioral Modification
IAFC - IAFF Wellness Fitness Initiative
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Employee/Member Assistance Program
Substance Abuse
Stress
Marketing and Awareness of Program
ISSUES?
ISSUES!!!
• COST
• ACCESS
• TRAINED PROFESSIONALS
• CULTURAL ACCEPTANCE
• INSURANCE LIMITATIONS
Fire Service Training
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Be prepared
Fire Behavior
Suppression
Water Supply
Saving Our Own
Mental Health?
Course Feedback
Dept type (Vol./Comb./FT)
• Comb – “Not sure about this topic!”
• Vol – “Mental Health was very good, need more”
• Vol – “I think the final portion was excellent. Needs
to be incorporated in future classes and expanded
upon.”
• Comb – “This should be a must at this class”
• Comb – “Glad this was added to the class”
• Vol – “This is needed. I have experienced it in my
Department and need training and need places to
send firefighters in Southern Illinois.
Course Feedback
• FT – “Should be in every class and in conjunction with
conflict resolution this is an eye opener for me as a
company officer in my own feelings as well as others.”
• FT – “Excellent addition with the mental health part.
Needs to be fully integrated into the program.
• FT – “Mental health – Important but scares the hell out
of me.
• FT – “The FF mayday was the best of the weekend.”
• Vol – “The Mental health issue was very good. Please add
it to the course.”
Senior Officer Roles
• Be familiar with signs/symptoms
• Watch for behavioral changes-use your gut
feelings
• Learn about your Employee Assistance
Programs/Local counseling services
• What are the advantages/disadvantages?
Limitations of EAP
• Know your personnel- young or new
firefighters/women/ethnicity/culture
What are you doing about it?
MAY DAY SOP
We must create a MAY DAY SOP!
Mental health just as important as physical health
The “heroic persona” that enhances a firefighter
will work against them in this arena.
Look locally for help (local counselors, ministers)
Educate Mental Health Professionals:
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Sit with Fire Service Personnel
Provide Department history
Ride time
Add to annual physical evaluation?
What is covered in health insurance?
Lessons Learned
• Do you have a trained therapist you or your
people can turn to?
• You can impact how accepting the culture
is in your organization for those
to seek help by role-modeling
• Take the cape off before it chokes you!
• Those with mental health issues are great
people who deserve our respect!
MAY DAY SOP
• Need to address all 16 Life Safety Initiatives.
• Do not neglect #13 “ Firefighters and their families
must have access to counseling and
psychological support”.
• Unlike other potentially fatal diseases, there are
no physical signs of mental illness. I did not see
it until the end.
Contact Information
Chief Patrick J. Kenny, Retired
Assistant Executive Director
Illinois Fire Chiefs Association
5812 Plymouth
Downers Grove, Illinois 60516
W 630 964-0894
C 630 774-0320
[email protected]
For all you can help Sean says “Thanks!”
NFFF Executive Summary
• A framework and protocol for dealing with
occupational exposure to potentially traumatic
events has been developed and published (see
references in handout). These guidelines represents
an evidence informed best practices approach that is
designed to be integrated into existing organizational
activities. Workshop programs and continuing
education materials are under development.
NFFF Executive Summary
• Psychological First Aid, an evidence informed best
practices model developed under the guidance of the
National Center for Post Traumatic Stress Disorder with
support of the Substance Abuse and Mental Health
Services Administration, has become the standard of care
for early support. It has been adapted for use military
and Medical Reserve Corps applications, and NFFF has
contracted to develop modules to train firefighters and
EMTs in applying its principles to help the citizens we
serve and, as a part of active peer programs, to help one
another.
NFFF Executive Summary
• Web enabled, interactive programs for self-help and
education on behavioral health impacts have been
developed for military and veteran use (see, for
example,) http://www.afterdeployment.org. NFFF is
working with developers of pertinent platforms (such
as NCPYSD) to adapt these platforms to provide
similar assistance to firefighters and their families
regarding behavioral health implications of their
duties.
NFFF Executive Summary
• Industry standards for health and safety require that
all departments provide a member assistance
program but it does not specify what services should
be provided by what level of provider, nor does it
provide guidance with respect to protocols for
assessment or evidence based standards of
treatment.
NFFF Executive Summary
• Recommendations are being prepared to help
departments write specifications for
behavioral health programs that will meet
their specific needs. Work is also underway
on resources to assist potential providers in
developing effective proposals and programs
to satisfy those specifications.
NFFF Executive Summary
• Web enabled, interactive resources to help fire and
EMS organizations build, prepare, and support
effective peer support programs. Building on
successful programs and strategies from a variety of
departments, this effort seeks to help organizations
use peer personnel effectively to support the various
objectives of a comprehensive behavioral health
program and facilitate proactive utilization of its
resources by firefighters and their families.
NFFF Executive Summary
• The behavioral health personnel working with
firefighters and their families need cost-effective,
accessible ways to acquire skills in current evidence
based treatments if they are to be prepared to
provide the highest standard of care. The National
Crime Victims Research and Treatment Center at the
Medical University of South Carolina developed a
well researched platform to deliver training in
Cognitive Behavior Therapy (CBT), the current
standard of care for conditions such as PTSD and
depression, to providers caring for victims of abuse.
NFFF Executive Summary
• NFFF is working with NCVRTC to fund the
creation of a similar platform to bring this
level of training, focused on fire service needs
and issues, to mental health professionals
working with firefighters and their families.