Taking care of first responders' mental health

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Although they may not talk about it, Prince Edward Island’s volunteer fire fighters deal with traumatic events every day. Researcher Amanda Brazil wanted to know how disturbing experiences were affecting fire fighters.

A fire fighter herself with the Crossroads Fire Department, Brazil conducted a study last summer with 102 volunteer fire fighters from five Island departments, about 10 percent of the fire fighter population. She focused on critical incidents, defined as anything outside the day-to-day human experience that causes emotional and mental stress.

“I started out wanting an idea of the number of critical incidents people are being exposed to,” said Brazil, who is also director of programs and policy with the PEI Division of the Canadian Mental Health Association. Based on her interviews, Amanda found that 34 per cent of the fire fighters had experienced more than 20 critical incidents during their career, and 85 per cent said they had been involved in critical incidents within the past two years.

Traumatic and stressful events can cause unusually strong emotional feelings and reactions, more than a person can cope with normally.

Stress reactions can appear immediately, a few hours later, or even days later.

Symptoms include physical, mental, cognitive and behavioural responses that, if left unresolved, can create physical and mental health issues. This can lead to increased sick leave, marital breakdown, loss of employment and other negative impacts.

“This is very real for our fire departments,” she said.

Fire fighters told Amanda that they recognize the importance of training to deal with critical incident stress management and post-traumatic stress disorder (PTSD), but more than half hadn’t received any training.

“Knowledge is power. It helps people understand the difference between a normal reaction to a traumatic event and a problematic reaction or response,” she said. “That’s why having education around this is very important.”

She pointed out that without awareness people who suffer PTSD may turn to negative coping tools, like alcohol. They can also suffer anger outbursts, nightmares or increased anxiety.

“The traumatic event needs to be processed properly,” she said, noting that things like vigorous exercise and sleep can sometimes help.

Brazil’s research found that 10 per cent of respondents opted out of post-exposure interventions available to them. She notes that younger fire fighters are less likely to participate in these interventions for fear of appearing weaker to their more experienced colleagues. This, she says, speaks to the need for senior ranking officers to change departmental culture, a sentiment echoed by the Province’s Fire Marshal Dave Rossiter.

“Historically we have always focused on the physical well being of our fire service," said Rossiter. "But in recent years we have realized that the mental wellness of our members is equally or more important to keeping a sustainable delivery of fire protection services within the province.” 

The province has a Critical Incident Stress Management Committee (CISMC), a volunteer group that came together after CIS training with the Provincial Corrections Service in 1994. Bell Aliant recognized the group’s efforts with a $15,000 donation in 2012 to provide one time awareness level training on Critical Incident Stress to the PEI fire service.

The team is comprised of mental health professionals, employee assistance workers, nurses, social workers, police, paramedics, search and rescue personnel, fire service personnel and representatives of child welfare. Since 2008, close to 300 firefighters have benefitted from services provided by the CISMC.

Brazil is currently working with the PEI Fire Fighters’ Association to help build capacity within the fire departments so volunteer fire fighters can be better equipped to recognize the warning signs of suicide and apply intervention skills.

The findings of Brazil’s research have practical applications, not only for the Prince Edward Island fire service, but also for the countless jurisdictions that rely on volunteer fire services.

“There needs to be more education, more awareness, more normalization brought into the fire service,” she said, “so we can work to be well.”

Brazil’s paper “Exploring critical incidents and post-exposure management in a volunteer fire service,” has been published in the Journal of Aggression, Maltreatment and Trauma.

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