Firefighters Supporting Firefighters: Peer Supporters Perspectives
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(Video & Handout)
Overview
This presentation outlines the findings of a small yet impactful study exploring the experiences of Peer Support Workers in an Irish Fire based EMS organisation. It was noted that there was a gap in the literature pertaining to the voices of those first responders who provide peer support to their colleagues and so a qualitative research approach utilising semi structured interviews was carried out. Interpretative Phenomenological Analysis was used to examine the results and findings revealed four master themes, namely Giving Back, Old versus New, Personal Transformations and Frustrations. These, along with their twelve superordinate themes, will be presented using direct quotes from participants transcripts. Much of the research on peer support in first responders reports the negative effects of critical incident stress but this study demonstrates that there are positives to be gleaned from this essential work. Reflexivity of the researcher will be described as it is of the utmost importance in this study and the quality of the work will also be addressed. Recommendations will be made on the implications for possible future research in this area.
Learning Objectives:
- Describe the ‘Shattered Vase’ metaphor.
- List some of the components of post traumatic growth.
- Outline the benefits and challenges of providing peer support in emergency services, from the peer supporter perspective.
Presenter
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Michelle L. O'Toole, BSc, GDip EMS, MA
Researcher (Former Firefighter/Advanced Paramedic)
Royal College of Surgeons in Ireland
Formerly a Firefighter, Advanced Paramedic and CISM Team member with Dublin Fire Brigade, Republic of Ireland, I was recently appointed to full time researcher role in the Simulation Dept of Royal College of Surgeons in Ireland. I'm an Accredited Paramedic Tutor and CISM Instructor with an interest in enhancing mental health and wellbeing in all first responders, particularly following traumatic events. I have completed a MAsters in Psychological Trauma at University of Nottingham (UK) which sparked my interest in Post Traumatic growth following adverse events. My presentation will be based on peer supporters perspectives of providing support in an Irish context.
Related products
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Overview
The International Association of Campus Law Enforcement Administrators (IACLEA) featured the above named article in the 2021 Winter edition of their Campus Law Enforcement Journal. The action plan described in the article is consistent with recommendations from the National Consortium on Law Enforcement Suicide: Final Report, published October 1, 2020. ‘Unspoken Questions’ refers to the reluctance to and/or avoidance of asking direct and specific questions, due to concerns of stigma and negative occupational impact, that can occur when a law enforcement employee experiences a personal mental health issue. Despite being generally aware of available mental health services, skeptical perceptions exist regarding accessing mental health care. For the agency, this skepticism contributes to the suspicion of intent and general distrust among employees. Consequently, the specific and direct questions may never get asked and remain ‘Unspoken Questions’. The worst case outcome is death by suicide or ‘loss of a whole life’. Another tragic result is that an employee may continue to experience the pain and despair of unresolved mental health issues, ‘the loss of a partial life’. This bold action plan challenges agency leadership to demonstrate organizational commitment by endorsing two separate transparent trainings that call for the integration of command staff and designated human resources representatives in the actual training in order to provide a forum for employees and give a voice to those ‘Unspoken Questions’.
Learning Objectives:
Upon completion, participants will be able to- Be instrumental in leading an agency-wide culture committed to promoting physical and mental health and wellness.
- Play a critical role in the agency’s transparent integrated approach to ensure that suicide prevention is prioritized and that norms and practices that support mental health and wellness are integrated into every aspect of policing.
- Be more capable to support efforts to reduce law enforcement deaths by suicide and eliminate the stigma associated with law enforcement personnel who experience mental health issues.
Presenter
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Kevin W. Condon, LCSW, BCD
Owner
Law Enforcement Response to Mental Health, LLC
Kevin W. Condon, Licensed Clinical Social Worker (LCSW), Board Certified Diplomate (BCD). In June of 2002, Kevin retired from the Coral Gables (FL) Police Department (CGPD) as a lieutenant with over 25 years of service. He served as Commander of the Crisis Negotiation Team and SWAT Team. Kevin participated as a member of a CISM team for emergency responders serving Miami-Dade County. Kevin received the CGPD Life Saving Award for his interaction with a person with a mental illness.
Following his retirement, Kevin moved to Georgia and began a second career as a mental health professional. He held positions as a community Child and Adolescent therapist, Clinical Director of a State of GA residential program, and therapist at the University of Georgia. In March of 2018, after over six years with the Department of Veterans Affairs (VA), Kevin retired from the position of LCSW.
Kevin is certified by Georgia Peace Officer Standards and Training Council (P.O.S.T.) as a Lecturer on Law Enforcement and Mental Health. He is a certified instructor for Mental Health First Aid - Public Safety. Kevin has developed and presented training courses on issues of law enforcement and mental health.
Kevin has been recognized as a Subject Matter Expert (SME) on law enforcement and mental health by the Collaborative Reform Initiative-Technical Assistance Center. CRI-TAC is a partnership with the Department of Justice's (DOJ) Office of Community Oriented Policing which is implemented under the leadership of the International Association of Chiefs of Police (IACP).
In November of 2018, Kevin founded ‘Law Enforcement Response to Mental Health, LLC’. He provides training, consultation, and presentations related to law enforcement and mental health. During Kevin’s early years as a law enforcement officer, he experienced his own mental health issues. Kevin shares his personal journey in the interest of ‘paying it forward’.
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Overview
Learning Objectives:
Upon completion, participants will be able to:- Estimate surge of mental health distress
- Define CISM
- Explain why CISM is the standard of care for COVID
Presenter
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George S. Everly, Jr., PhD, ABPP, CCISM
Co-Founder
The ICISF, Inc.
George S. Everly, Jr., PhD, CCISM is an award-winning author and researcher. In 2016, he was ranked #1 published author in the world by PubMed PubReMiner in the field of crisis intervention. He holds appointments as Professor in the Department of International Health (affiliated) at the Johns Hopkins Bloomberg School of Public Health, Associate Professor (part time) in Psychiatry at the Johns Hopkins School of Medicine, and Professor of Psychology at Loyola University in Maryland (core faculty). He is considered one of the founding fathers of the field of disaster mental health. He was a co-founder of the Dept of Psychiatry at Union Memorial Hospital and served on the management committee 12 years. In addition, he has served on the adjunct faculty of the Federal Emergency Management Agency, the FBI’s National Academy at Quantico, Virginia, and ATF’s Peer Support Team. He is an advisor to the Hospital Authority of Hong Kong. Dr. Everly is co-founder of, and serves as a non-governmental representative to the United Nations for, the International Critical Incident Stress Foundation, a non-profit United Nations-affiliated public health and safety organization. He was Senior Advisor on Research in the Office of His Highness the Amir of Kuwait. Prior to these appointments, Dr. Everly was a Harvard Scholar, visiting in psychology, Harvard University; a Visiting Lecturer in Medicine, Harvard Medical School; and Chief Psychologist and Director of Behavioral Medicine for the Johns Hopkins Homewood Hospital Center.
Handouts
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Overview
Power point presentation to include the St Luke’s response to the COVID-19 Pandemic with specific attention to the mental health of our 22,000 network employees in our major University Healthcare network. How we identified needs, what we did to address needs, and what we continue to do to ensure the mental and physical health of our hospital employees. Attention to PTSD, Acute Trauma, Acute stress reactions. How we have supported our nextwork from the mental wellness aspect in order to mitigate long term critical incident stress disorders.
Learning Objectives:
Upon completion, participants will be able to- Verbalize 3 programatic elements they can add to their care of hospital, healthcare, first responder employee mental health.
- Plan live, large support group sessions for hospital and first responder personnell.
- Name evidenced based depression and trauma scales that can be used during and after pandemic or prolonged stress.
Presenter
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Amie Allanson-Dundon, LPC,CCTP,CAADC
Network Director, Clinical Therapy Services
St Luke's University Health Network
Amie Allanson-Dundon, MS, LPC, CFAS,CCTP, CCDPD, CAADC is Network Director, Clinical Therapy Services for Behavioral Health Services at St Luke’s University Health Network.. Focused on the treatment of substance use disorders, trauma, critical incident stress, and mood disorders, Amie assesses and supervises complex cases, consults with network physicians, and is a lead for the Crisis Response Team at St Luke's. Working with St Luke's University Health Netowrk since 1997, Amie oversees the clinical programming and teams for School Based Psychotherapy, Partial Hospitalization services, Outpatient therapy and Integrated mental and physical healh care. Amie is also Program and Facility Director for the DDAP certified and DOH approved level 4.0 Medical Detox at St Luke's Sacred Heart Campus in Allentown Pa. Amie completed her graduate work at Villanova University, has certifications in trauma, addiction, forensic addiction and is a licensed professional counselor in PA & NJ.
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Overview
Health and safety legislation exists to protect the mental health of workers, including those at high risk of psychological injury, by separating the responsibilities between the worker (for self and others) and the manager (for the work environment). However, the traditional clinical viewpoint seems to ignore this in favour or seeing all psychological injuries as phenomena in need of medical, psychiatric or psychological expertise once symptoms have emerged and persisted. For example, symptoms of posttraumatic stress disorder (PTSD) have to await the passage of 28 days before diagnosis and treatment, while health and safety law demands immediate action. As crisis intervention is designed for immediate action and clinical guidance requires a delay, crisis intervention appears to be in keeping with legislation created to secure mental health. The tension that exists between the clinician’s advice to ‘watch and wait’ and the peer’s compulsion to ‘act now’ might be resolved by a psychological risk assessment undertaken in the immediate 28 day post-incident period.
Risk assessment for any health condition has three steps: 1. Identify the hazard, 2. Intervene to minimise or eliminate the hazard, and, 3. Monitor to ensure the intervention has worked. An online portal that measures depression, anxiety and PTSD and reports results to the completer themselves has several advantages. First, the assessments can be the same as those likely to used by the clinician should symptoms persist and recovery does not occur. Second, the completer is now aware of their likely condition and the level of risk exhibited by the scores. Third, the organisation can be informed of the overall levels of mental health by demographic variables including team, department and location. With information shown to the worker and statistical patterns shown to the manager both carry their own legal responsibility to act to ‘minimise or eliminate’ the hazard represented by high scores on clinical assessments.
Taking the discrepancy that exists between the clinical viewpoint and the crisis intervention viewpoint a secure online portal has been designed to meet the health and safety demand for risk assessment by informing the worker themeslves (with contact details for support and guidance), informing the organisation’s managers of ‘hot-spots’ of mental health hazards in the workplace and putting both ‘on notice’ that they should now act. The ‘I didn’t know’ claim to justify inaction would become invalid for both parties. This presentation will show how the backdrop of health and safety legislation justifies the use of crisis intervention following critical incidents. It also offers a means by which workers can self-assess and decide how they will tackle the risk they have been informed of, In addition this will allow managers to shape the workplaces structure and policies in light of the patterns emerging from the de-identified data generated by the workers collectively. The potential to use the data generated to underpin mental health policy, identify training needs and show the effectiveness of crisis intervention will be discussed.
Learning Objectives:
Upon completion, participants will be able to:- Recognise key indicators that return to duty is safe following a critical incident
- Assess risks to mental health in compliance with workplace safety and health legal demands
- Complete assessment, intervention and return-to-duty within 28 days of a critical incident
Presenter
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John Durkin, MSc. PhD
STAGE-28 International
John Durkin Ph.D sits on the Boards of the International Critical Incident Stress Foundation (ICISF), Crisis Intervention Management, Australasia (CIMA) and is co-director of STAGE-28 International offering training, research and consultancy in crisis intervention and psychological risk assessment. His interest in posttraumatic growth took hold in his early career as a firefighter and was later strengthened by his role in the post-9/11 support effort at New York’s fire and police departments. Convinced that critical incident stress management (CISM) delivered by peers had the potential to prevent a number of mental disorders he sought enhancements that might challenge clinical therapies for effectiveness. Further qualifications and training persuaded Dr Durkin that peers delivering crisis intervention in a person-centered fashion would prove superior to standard treatments for PTSD and facilitate posttraumatic growth. A number of pilot projects have supported this and led to training a team of firefighters in CISM, informed by person-centered theory. When Dr Durkin was called to lead the crisis response for the Metropolitan Police Service following London’s 2017 terrorist attacks and Grenfell Tower fire, the same team of firefighters came in support. Over 80 police officers were seen and no report of PTSD or depression had been received three years later. Growth in police officers and firefighters has been widely reported and awaits empirical confirmation in future projects. The legal demands of occupational safety and health were met during this period leading to the design of a psychological risk assessment for use in the emergency, medical and military services.
Handouts