Fire dept. to focus on mental health of firefighters
Recruits are educated about mental health from day one and the department is increasing its resource list for employees
By Caitlin Schmidt
The Arizona Daily Star
TUCSON, Ariz. — For years, Tucson-area fire departments have been working with a local health care facility to create a comprehensive medical plan that addresses stress and mental health in first responders.
April was a difficult month for the Tucson Fire Department, with a murder-suicide perpetrated by one of its own taking place days before the sentencing of a former captain for three murders.
On April 15, Frederick Bair, a captain, shot and injured his ex-wife and fatally shot her friend at Firebirds restaurant at La Encantada. Bair killed himself in the incident. Days later, former Capt. David Watson, was sentenced to life in prison for the murders of his ex-wife, her mother and her mother’s friend.
The shocking act of violence by Bair hit department members hard, but it also affected Dr. Wayne Peate, who’d known Bair for decades. Firefighters and paramedics across the department were shaken by the incident.
“One of the things that firefighters do well is work as a team. I could see them grieving, but I could start to see the team forming to support those who needed help,” said Peate, who has worked as a doctor with TFD since the 1990s and started a company that subcontracts with the fire department to provide health and wellness programs.
Fire departments across the country have seen an increase in mental health challenges over the years, which the Tucson Fire Department and the Tucson Firefighter’s Association have been working hard with providers to address.
In response, TFD has been taking steps to ensure the best mental and physical health of its employees, said Assistant Chief Joe Gulotta.
“Firefighters are normal people too, and people have stress in their lives,” he said. “Those things are what we’re trying to deal with.”
Recruits are educated about mental health from day one and the department is always increasing its resource list for employees, in addition to emphasizing early identification by coworkers, friends and family members, Gulotta said, adding the peer support program involves employees helping colleagues.
“We’re exposed to human conditions that are really difficult for most people to think about, “Gulotta said. “The violence that’s out there, the conditions where we arrive at a scene and a child is dead or there’s been a traumatic event. Things that most people just don’t see.”
The department has also developed a list of call types that will trigger the peer assisted response system, including cardiac arrest of a child, traumatic injury or death of a firefighter, mass casualty incident and a fire in which an employee was lost for a period of time or trapped.
Peer Operational Support Team, referred to as POST, was developed by Patricia Haynes, a clinical psychologist who works with TFD providing treatment and program development.
“We’ve created a system where trained peer supports go in after a critical incident and provide resources,” Haynes said. “The assumption is that people are going to be a little rattled after a tough call.”
The peer support won’t provide a mental health assessment, but rather just check-in and see how the employees are doing.
If its determined that an employee is experiencing symptoms, that person will have the option to get the rest of his or her shift covered, Gulotta said.
Seven days after the incident, Haynes enters the picture by sending an email to the involved employees.
“The gist of the information is that it’s really normal to experience symptoms in the aftermath of a potentially traumatic event so don’t worry, but here are some things you can do,” she said.
A month later, Haynes completes a post traumatic stress disorder screening with the involved employees.
“That’s really considered the key element of POST. It’s not the going out in the aftermath of providing the information, it’s really 30 days later,” she said, adding that the peer support team was designed as a bridge to get people professional help in a confidential and safe way.
Haynes, who specializes in sleep issues, stress and depression, is heading up a research program at UA examining the effects of sleep on veterans with PTSD.
The program is investigating how stressful life events can affect sleep and daily routine and can lead to an increased risk for depression and other stress-related disorders. She is also the primary investigator into a national study of the effects of sleep on veterans with PTSD, which Haynes said is helpful in her work with first responders.
Haynes provides eight hours a week of treatment or program development for TFD, a big part of which is trying to reverse the negativity associated with mental health issues and treatment.
“With firefighters, there is some stigma against mental health care, I think there’s a presumption or assumption that everyone’s immune,” she said.
Haynes also provides brief therapy to employees in need and is available to consult with department employees about getting help for those in need.
While Tucson Police Department has a full-time psychologist and two full-time sergeants devoted to behavioral health issues in the department, Haynes is the only clinical psychologist devoted strictly to TFD, which does not have anyone on staff specifically devoted to handle employees’ behavioral health.
Haynes work for TFD is possible through a subcontract with Well America, which Dr. Peate opened in 2001 after the department need for more elaborate physicals than could be obtained at typical occupational medicine practices.
Well America offers health and wellness solutions for roughly two-dozen agencies across the state, the largest of which is TFD.
“We try to take a very personal approach to treatment,” Peate said, adding that Well America has resources available that include dietitians, physical therapists, cardiology consultants, orthopedic specialists, a clinical psychologist and more.
During new physicals and annual exams, Well America uses a mental health evaluation and screening program that Haynes helped designed for the program.
“Firefighters, like the rest of us, of course struggle with emotional or other issues related to relationships, finances, work, etc.,” Peate said. “The fire departments have worked over the years to develop some programs and in many cases, firefighters have taken advantage of those programs.”
But “in many cases” that wasn’t good enough, so Peate said he decided he needed to do a better job in getting firefighters help with mental health issues. In conjunction with TFD and the union, Peate began collaborating with a variety of local groups to be able to refer patients for counseling services.
“We encountered that co-pays could be expensive ... and didn’t want the financial barrier to prevent people from getting valuable help,” Peate said. After trying a few different approaches to making counseling affordable and available, TFD expanded it’s contract with Well America several years ago to include mental health services and enlisted the services of Haynes.
While Peate is thrilled with the work Haynes does, it’s still vital that first responders talk to and look out for one another.
“Nothing really replaces that kitchen table at the station,” Peate said, referring to the casual conversations that employees have at the firehouse. “We try to tell people, if you see something, say something. If you see someone weeping, reach out and help them just as you would someone who was wheezing.”
In addition to TFD, Well America is working with other local agencies to develop similar mental health programs for employees.
Lisa Ritter-Baker has worked at Well America as a physician’s assistant since November but was previously employed as a firefighter and paramedic before joining the medical field.
“The stress that first responders face is an unavoidable part of their career,” she said. “We are well-aware of the psychological risk of this job and we’re actively working on a compendium of resources to be able to give to all the departments and all the patients we see here.”
Although the culture is changing, firefighters and paramedics are trained to help people and tend to want to fill that superhero role.
“They kind of think that they’re not the ones that should be seeking help and there’s also that stigma of weakness when you’re vulnerable,” Ritter-Baker said. “We know as health-care providers that vulnerability actually shows strength, but that’s hard to get across to the population.”
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