Recently, a young firefighter was talking with a concerned friend about a cardiac arrest call he responded to—a 15-day-old infant. Responders understand that calls involving children add to already stressful situations. This was also the firefighter’s first cardiac arrest and his first time performing CPR. They were first on the scene before the paramedics arrived.
A psychological debriefing did not take place after the call. The team was made aware of available support services the department offered, but the crew did not feel they needed them. However, it was clear by the young firefighter’s body language that he was not okay. His friend suggested that he should talk with a professional, even if he felt fine. Setting up some time to just talk it through would make a difference, now and in his future. Part of his hesitation was the stigma. He did not want to be seen by others as weak. He may have felt that he was the only one struggling after the call, and he did not want to be seen as inadequate to the job. He said he would seek help—if he had time. Why wait?
The firefighter admitted without hesitation that he would visit a doctor if he had hurt his knee at work. He confidently claimed he would get an MRI or an X-ray if needed. Emotional trauma should receive the same level of care and concern. However, despite possibly injuring himself emotionally, he did not consider seeing someone for help. Taking that first step to speak to someone would start the healing process. This situation was no different than if he had hurt his knee climbing down the ladder. Why wait?
Just Another Example
A senior police officer, who had been struggling emotionally for some time, finally made the decision to take a break from work and seek help for alcohol dependency. The officer made a call to a treatment center, which had availability within three days or in six weeks. Rather than packing immediately, the officer decided to wait to take the opening a month and a half later. The officer had too much to do and saw no way to possibly leave in three days. Why wait?
Despite recognizing that care was necessary, the officer did not appear to think that delaying it was problematic. The excuses continued as if to justify not going at all. If it were chest pains, and cardiac surgery was recommended with the same scheduling options, there would be no hesitation in taking the earlier option. If a shoulder injury kept the officer out of work, someone would cover the job. Going to a treatment center should not be viewed differently. In the next month, the officer risked facing more demons with alcohol for support. A lot can happen in a month, including tragedy. Why wait?
Is It Okay to Not Be Okay?
Until catch phrases like “normalizing mental health” and “it’s okay not to be okay” are reflected within the cultures of emergency organizations, people will continue to put off mental wellness care. If organizations are reluctant to allow paramedics to take an hour out of their shift to talk to a professional, then mental health is not normalized. Until it is acceptable for all those on shift to say, “That was a hard call,” it is not normalized. Until colleagues neither sense nor cast judgment on others for mental healthcare appointments, an organizational culture is not in full support of routine mental healthcare.
People often wait until it is too late to seek help. They wait until their performance at work has suffered. They wait until their partner gives them an ultimatum. They end up broken, and some never recover. Many responders end up on long-term leave or retire early, but without the quality of life that their retirement should provide. Some lose loved ones and friends by not getting help in time. Sadly, too many end their lives because they can no longer tolerate the pain. According to
Until leaders demonstrate self-care, neither will younger responders. Leaders are often in their positions due to their experience. Often gained through tenure, that experience has placed them in a higher probability of operational stress injury. The fact is, the more time on the job, the more likely they are to experience traumatic events. Leaders must be comfortable and confident enough to let others, including their direct reports, know that they incorporate mental wellness into their lives. Fewer actions will have a greater impact on a junior responder than when a senior colleague admits that they have sought help for their mental health when needed.
Take Action to Strengthen the Mind as Well as the Body
First responders are put through rigorous physical fitness in their academy classes. Fitness is a part of the regular routine for police officers, firefighters, and paramedics to prevent injuries and to prepare individuals to respond in the worst of situations. However, these professionals do not treat mental fitness with the same vigor as physical fitness—and are not expected to. Stress management and mental health management need to be more integrated into firefighter and police academies as well as other first responder programs.
Police, fire, and paramedic stations have gyms. Staff have opportunities to exercise before, during, and after shifts to remain physically fit and ready for duty. It is time for these professions to also add quiet “brain break” rooms to their facilities to support these professionals for the mental demands of their job.
While many agencies and organizations provide employee assistance, peer support, and graduated return-to-work programs, the challenge is getting individuals to access these supports. Psychological support services are great; however, having culturally competent healthcare providers who understand work that responders do is key. Organizations can pay for all the services in the world, but unless providers understand the unique challenges that responders and their families face, responders will not access those resources.
Organizations need to ensure that they are providing adequate funding for their culture of wellness. Departments can show support to staff by having mental wellness providers available in person with immediate access 24/7/365. However, the solution is more than signing a contract with a provider to be on call when employees need access to resources. There must be adequate staffing levels for individuals to take breaks during their shifts to speak with a care provider or, if need be, to take time away from the workplace to recover. Agencies should incorporate “brain break” rooms into their facility designs.
Mental wellness must go beyond fundraisers, an annual awareness week, and obligatory social media posts. To normalize mental wellness, organizations need to move beyond push-up or ice-bucket challenges and take serious steps to address wellness before injuries happen. Do not wait.
Pascal Rodier
Pascal Rodier began his career as a paramedic in Vancouver, British Columbia, in 1988. After 25 years and achieving the rank of superintendent, he joined Ambulance New Brunswick from which he retired in 2018. He has over 35 years of experience and progressive leadership roles in public safety and emergency management. He is a Certified Emergency Manager and a Certified Healthcare Executive. He holds an M.A. in leadership, certifications from emergency management and emergency exercise design programs, as well as an extensive education from the Federal Emergency Management Agency and the U.S. Department of Homeland Security. He is currently a lead instructor in the Incident Command System in Canada. A decorated first responder, his honors include being an Officer of the Most Venerable Order of the Hospital of St. John of Jerusalem and receiving the Service Medal of the Most Venerable Order of St. John of Jerusalem, the Governor General’s Emergency Medical Services Exemplary Service Medal and 30 Year Bar, the Queen’s Diamond Jubilee Medal, the Queen’s Platinum Jubilee Medal (Nova Scotia), the Order of St. John Priory of Canada Provincial Council Chair’s Commendation, and the King Charles III Coronation Medal. He has been a presenter, facilitator, and an emcee at many public events, courses, workshops, and national and international conferences.
