Summertime in Las Vegas. For some that means vacation, for others, it means hiding out in air conditioned buildings; for first responders, it means an increase in child drownings. Word of a child drowning is devastating for the average person. Despite the training and support first responders have, the child’s drowning can be just as devastating. Some crews see multiple children drown in a month, in a week, or even in a shift.
“Many of us have been doing this a long time and have exceptional training, but that doesn’t exempt you from trauma or post-traumatic stress” said Mike Courtney, Clark County Firefighter and member of the CCFD Peer Support Team. “This past year there was a nationwide study that showed suicide amongst firefighters has risen above heart disease; this is the first we’ve seen that.”
Suicide rates among firefighters and police officers are higher than the national average. According to the Firefighter Behavioral Health Alliance, 117 firefighters, EMTs and paramedics died by suicide in 2015. The Badge of Life sites that 108 police officers died by suicide in 2016. Both data sets come from the United States.
Despite being highly trained to save lives and help others, first responders are also more heavily prone to addiction, depression, and post-traumatic stress disorder.
“We go on calls every day, but certain calls can be more heinous than others,” said Courtney. “Mass casualties, calls that involve children or child death, dramatic blood and body parts; Certain calls are harder for the mind to wrap around than others.”
Another way that trauma can take someone down is through the passing of time. Senior firefighters and police officers can be unbothered by the more intense calls for years, but eventually the stress of the job, and seeing what they see daily, gets to them.
“After a certain amount of years, the ‘honeymoon phase’ wears off,” said Jeremy Levy of Las Vegas Metro. “You get exposed to the gruesome reality of life, and of human behavior. You become very hurt and very bothered because your blinders have been taken off. Everyone is different in what can get to them, but eventual something breaks you down.”
Although these occupations are high-risk, individuals and their loved ones don’t always anticipate the long-term mental health effects. The idea that after years of helping and saving others, one will eventually need to mask their pain and stress through drinking, drugs, or even by taking their own life is difficult to understand then accept.
One of the main solutions to this calamitous issue is relatively simple: talk about it.
“I couldn’t speak to my friends and family about the things I see,” said firefighter John Feggestad. “I couldn’t unload on my wife about the horrors. They understand your job but not the things you see and do. It eats you up after a while because you have no one to talk about it with.”
Feggestad’s trauma started manifesting itself through substance abuse after being a firefighter/EMT for eight years. He went to treatment at Desert Hope, one of several American Addiction Center facilities with a special program created by first responders. “The program was a great help to me. I needed to discuss the trauma that we deal with. At work, there’s an ego issue where everyone is supposed to be real tough and just deal with this stuff. You also feel compelled to keep your mouth shut around normal people. There was no one left to help me.”
The “tough guy” stigma amongst first responders and the inability to process feelings with friends or family drives many dealing with work-induced trauma to alcohol, drugs, other unhealthy habits, and sometimes inevitably to death.
Carolyn Cox, MS, MFT, LCADC, is the First Responders program therapist at Solutions Recovery. She said that the clients respond remarkably well to the special program because they have a similar connection that allows them to break the stigma associated with their daily roles.
“They tend to become trusting quickly with each other, it doesn’t take long to let down those guards,” said Cox. “They get to debrief and process; realize that they are having a normal reaction to an abnormal situation. No one is supposed to see body parts on the side of the road or children dying in fires. They finally are getting the chance to speak with others that have experienced these things too. It really helps.”
This is why CCFD, Las Vegas Fire & Rescue and Las Vegas Metro all have systems in place to allow their first responders to share. Their programs that are meant to be proactive instead of reactive, so they can get their men and women the help they need before they may even realize they need it.
Levy started in law enforcement in 1996 and has been on the Police Employee Assistance Program for 10 years. “We respond to all critical incidents that involve our members,” said Levy.
“Whether it’s a traumatic scene, officer involved shooting, mass casualties; we come to the scene and walk through it with our officers and we assess what went down and how they are feeling about it. On top of that we follow up and make sure that anyone then is having an issue gets the proper support and more, if needed.”
PEAP members are alerted if an officer needs help dealing with something or if someone notices that they aren’t sticking to their normal routine or characteristics. Levy emphasizes that it is a cumulative effort of everyone looking out for each other and supporting each other that saves lives. “We (police officers) live 17 years less than the national average and it is all because we are not taught how to deal with our emotions.”
Clark County Fire Department’s Peer Support Program is relatively new, but has already had success in saving firefighters. “For years we didn’t really address mental health in the way that we should have been,” said Courtney. “It was kind of swept under the rug that you should be a tough guy. We are currently battling that stigma.”
When the Peer Support team gets a call that they’re needed, they head over to the station to speak with the full crew. They debrief and each person walks through the call from the time of dispatch to the time the person(s) or body(s) were transported.
“It’s a trip how much we lay on ourselves when the call is over,” said Courtney. “‘I could have done more,’ or ‘I could have done better.’ A lot of what the peer support team does is remind our crews that A. We didn’t cause this to happen. B. We performed to the utmost of our ability. C. There is only so much we can do. We feel guilt and remorse before we want to save everyone, and that can’t always happen.”
Similar to PEAP, the Peer Support team alerts crew members to look for different signs that someone is struggling. They also let everyone know that there are people in the department that care and are there to talk when they need it – stressing that eventually they will need it.
Officers and firefighters are taught to look for changes in mood, behavior, appetite, workout regimen, and more. Nothing is too small of a change to overlook. “Even if someone keeps describing their calls with a common theme,” said Courtney, “we need to pick up on those repeat words like ‘child’, or ‘blood’, or ‘body part.’”
When someone does have trauma or post-traumatic stress that they need help with, the department is quick to action. CCFD makes sure that their men and women get time off or are taken out of a shift immediately if they need time to process or de-stress. They also are put in touch with therapists and psychiatrists through the union and their insurance, so they get one-on-one help, at no cost to them (six visits). Metro also has therapists and professionals set up for officers or their family members to get help and support.
The stigma still holds true for some of the senior officers or new first responders on the block. It is hard for some to take steps to ask for help and assistance, and some opt out of their debriefing or trauma counseling opportunities because of ego. This is where anonymous online support groups, phone numbers or websites can be helpful, though they are sometimes a weak last line of defense.
“If you don’t tell somebody that something is wrong, it’s going to get much worse,” said Feggerstad. “We need to feel comfortable reaching out to other first responders, because no one will understand it like them. Your fellow [first responders] will support you absolutely because they’re having these same feelings as you. Just speak up.”