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Rick (not his real name) had been retired from his fire service career for several years when things started catching up to him.
“Thoughts of all the horrible calls I went on were coming back,” he said. “I began to isolate and withdraw. Thoughts of ending my life were popping up, and I realized I needed help.”
A friend told him about a program called the West Coast Post-trauma Retreat (WCPR). The friend, another retired firefighter, had attended the program and said it made a huge difference for him. Rick immediately called and was able to get into a retreat that was taking place in just two weeks. The result? “It saved my life,” Rick said.
Program origins
WCPR is a six-day residential program for first responders suffering from post-traumatic stress disorder (PTSD) and other stress-related conditions linked to their work. Participants include firefighters, law enforcement, EMS, dispatchers and other emergency personnel.
The organization that puts on WCPR and other retreats and trainings is the First Responder Support Network (FRSN). The nonprofit organization began in Northern California in 1999, when a group of first responders, mental health clinicians and a chaplain came together to discuss and plan how to help fellow first responders who are overwhelmed by the debilitating impact of critical-incident stress.
Modeled on a similar program in Massachusetts, the organization held its initial retreat in 2001. Since then it has expanded its offerings to include training and a retreat specifically focused on the needs of first responder family members called SOS (Spouses and Significant Others).
How the program works
FRSN currently has a dedicated retreat facility in Northern California and supports satellite retreats in Washington, Oregon, Arizona and Kansas. Each retreat is intense and personal, with only six participants at any given time.
Retreats might include participants from any aspect of emergency response. “Law enforcement is definitely more on board than fire,” said Dr. Joel Fay, clinical director and retired law enforcement officer. “But the agency that sends us the most people is CAL FIRE. Within CAL FIRE, if you want to go to the retreat, they help you go.” Other agencies, such as the San Francisco Police Department and California Highway Patrol, offer similar levels of support.
Retreat participants self-select into the program, although as Fay pointed out, “For most, not coming is not an option.” Some participants are given ultimatums by spouses or partners, while others may realize “they’re in trouble, they’re drowning due to stress.” For some, the program is their last hope.
Fay described the retreat experience as a “get back to life program versus a get back to work program.” The focus is on symptom reduction and just having the individual feel better.
Peer support is a critical component. All those who have attended a retreat are welcome to return in the future if space is available. Many veterans of the program go on to become part of the peer support team at subsequent retreats. And the organization sponsors 12-step programs in the Bay Area for first responders only, some of which Fay described as “JFU” meetings, which stands for “Just F****d Up.” Fay noted, “You don’t have to be an alcoholic or an addict; you just have to be JFU. It’s another way of staying connected.” In addition, those who participate in retreats leave with lists of contacts and resources.
FRSN had to stop advertising its retreats in 2007 due to high demand and lengthening wait lists for admission. There is a cost for the six-day retreat, but participants often get financial support from their agencies or other sources. Scholarships are also available.
The entire clinical staff at each retreat is composed of volunteers, an important element of the program’s approach. The organization had over 70,000 volunteer hours last year.
Weighing the stress
Do first responders face more stress these days or is the need magnified by the fact that people are finally paying attention to it? The truth may lie somewhere in between, Fay said.
“The current status of stress for law enforcement is worse,” Fay said. “There’s a lot of pressure on law enforcement right now,” adding that critical incidents are now highly publicized, and that law enforcement officers may make the wrong decision based on their fear of being the headline on the evening news.
Compared to law enforcement, the fire service has been slower to recognize the effects of stress, but recent incidents have underscored the need. Fay commented on the fact that the wildfire season in California is now year-round, and mega-fires force firefighters to be on the fireline for weeks and may require them to deploy back-to-back to major incidents. “They’re gone a lot, they see a lot of bad things, and that’s just on top of all the regular firefighter stuff they deal with,” he said. “The good news is that fire departments are way more aware of stress now and are willing to help.”
Working to connect patients to resources
There is currently a six- to seven-month waiting list to get into one of the first responder retreats, and Fay acknowledged that “it’s a horrible conversation when someone calls us and says, I need to get help, and we say great, we want to help you, but how about October? It almost makes you cry.”
FRSN will attempt to get potential clients connected to local resources in the interim.
Fortunately, other organizations are stepping up and recognizing the crisis in stress management for first responders. As the need to face critical stress for first responders becomes clearer, more initiatives to help will emerge.
