1. Behavioral Health Response to Disasters, Author: Framingham, Julie:
For this week’s Forum, respond to the following: Our discussion this week focuses on the mental health needs of an often-overlooked population, the first responders of disasters. The links below provide powerful insights and testimonials to the importance of protecting one’s mental health and may be helpful resources in the discussion.
Beyond Debriefing: How to Address Responders’ Emotional Health http://www.emergencymgmt.com/training/Beyond-Debriefing-Responders-Emotional-Health.html
Former Emergency Service Workers Speak Out about their Experiences with PTSD http://www.abc.net.au/news/2015-06-03/former-emergency-service-workers-speak-about-ptsd/6518506
Psychological Trauma and First Responders http://americanmentalhealthfoundation.org/2015/04/psychological-trauma-and-first-responders/
· After reviewing the course materials, discuss, with detail, three things you believe are critical for first responders to know regarding potential threats of disaster response work to their mental health. These can be of a preparatory and preventative or a post-event recovery nature, or a combination. Selections should be critically important in maintaining or restoring one’s mental health.
Reply to the following response with 200 words minimum. (please make response as if having a conversation, respond directly to some of the statements in below post. This is not providing an analysis of the original post. Respectfully address it and even ask clarifying or additional questions.)
Being a first responder since the late 90’s I have seen a change in attitude towards the mental and well being of the responder. When I first began my service, I was told that I would see some tough things but I just had to push through it and move on to the next call. While there are some that still have this attitude, the mental health of the responder has been receiving more attention.
The first thing that must change is that mental health needs to be a priority at the management level. They must understand what services may need to be provided on the scene as well as the period following the event. This can not be something that is thought up once the event has happened but needs to be planned prior.
The second change that needs to occur is limiting the hours worked by responders. Most responders work until the job is done or they are replaced with a fresh crew. Waiting for a crew to reach exhaustion is to long for a crew to work. Once a crew hits exhaustion, they are in a worse position to take care of themselves. This “self-care” is when crews eat, hydrate and rest which are basic needs that each person has and should be met to promote good mental health (govtech.com).
The last change that I would suggest is that each responder should be empowered to recommend help to a co-worker. This responsibility should not fall solely on a supervisor since the subordinate may not feel comfortable to come forward with a problem. Each member of the team can make a recommendation for counseling for another member without fear of any negative action for possibly taking time off.
First responders have a very unique job that I would argue most people simply would not have the internal fortitude to do. These people regularly subject themselves to the worst tragedies society has to offer on a daily basis, and this decision is not driven by financial gain, or status but rather by an innate desire to help people. The problem with these jobs are they repeatedly subject these first responders to psychological trauma that can take a serious toll on anyone. The first critical skill I believe any first responder must master is compartmentalization, this is a psychological defense mechanism that can be used to relieve anxiety by preventing direct acknowledgement between separate states of being. Essentially this skill could prevent you from seeing a dead child at work, then seeing that reflected in your child when you get home, you compartmentalize what happens at work, from what happens when you are home. The drawback to compartmentalizing is if left untreated this can lead to hidden trauma by not addressing these tragedies, and allowing them to linger. Therefore the second thing I would recommend is to teach resilience, and understand how this can help a professional. When you spend your entire day existing in the worst of the world it is really easy, compartmentalized or not, to feel that this is all the world has to offer. Resiliency is the ability to force ourselves to draw from the power of positive psychology and see the good in the world, and focus on the positive, rather than the negative. And the final skill that I feel is crucial for a first responder is to remove any stigma that might tell you seeking professional help is a sign of weakness. When you spend your days as a fireman, nurse, police officer, EMT or any other first responder your shoulders are made to carry the weight of those you help, sometimes physically, sometimes emotionally, and even the strongest shoulders will wear out eventually. This is when you have to understand that seeking help is not only a sign of strength, but a necessity that can help make you feel “right” again. This help can manifest in a number of ways, from therapy with a psychologist, to time off to deflate and relax, “recharge the batteries”. Any of these measures can prove critical to allowing a first responder to mentally protect or heal themselves and enable them to continue their chosen vocation.
ASD is Acute Stress Disorder, now at first definition we see the words “acute” and “stress” and think oh, those are normal everyday descriptors of life. It isn’t until we get to that third word “disorder” that we see something may be wrong here. ASD is a psychological phenomenon or disorder that occurs within two to twenty-eight days after a traumatic event. We have become very familiar with PTSD that we have easily overlooked the starting point. Not the trauma itself but the direct effect of the trauma after it has occurred. ASD is present before PTSD in most cases. That is why understanding ASD is so important.
The three critical points that are crucial for all first responders are what I like to summarize as contain, care, and connect or CCC. The first C-contain, it is imperative that a first responder learn to contain their hours. It takes a special type of person to become and stay a first responder. The pay is not that great and the work in intense and in some cases constant. As a first responder there will be a tendency to want to go on past the regularly scheduled 12-hour shift. You get so wrapped up in your work that it becomes hard to stop and time seems to keep on moving. According to the article published by Adam Stone, many first responders just don’t know when to stop (Stone, 2013). Once you are in a disaster or on the scene of an incident you must see it through. The adrenaline is going and you feel like you can do it for another hours or so, or even more. One incident after another, on call after another and the urge to leave at the end of your shift or even take a break seems to fade away. Exhausting yourself after a grueling 12-hour shift could lead to physical exhaustion, a lack of efficiency, decision making is not as sharp, and among many other effects regrets. Rest, breaks, and stopping at the end of your shift is absolutely critical to an effective and healthy first responder.
The second C-care is absolutely paramount in the mental health of a first responder. They have to know that there are several forms of assistance available. Just because a first responder seeks help does not make them weak or less effective. The macho perfectionist persona must go, checking egos at the door and taking care of yourself first. An effective responder will not be that if they are not mentally intact. Taking care of yourself first before, during, and after an incident is number one. Taking care of each other then becomes priority number two. A responder may feel as if they are not comfortable talking to strangers or seeking help from outsiders but they may be more open to talking to one of their own. This is why it is so important to know your partner and your coworkers. When something just isn’t right, speak up and say something.
The finally C-connections, refers to outside sources that are readily available professionals that can be called on in the time of need and will respond. Making a good connections with a group or organization that is reliable and trustworthy makes the difference. Now, with the growing of several different post-traumatic stressors, more and more people are becoming aware of the need for post-incident mental health response. This is a great thing, however this means that any Nancy or Dr. Drew could come out of the woodworks to respond and that is just not conducive to an efficient program. Someone familiar, an organization that you have built a strong partnership with should be the only ones coming near your responders.
So, my three critical items can be summed up in the three C’s. Containment, Care, and Connections all extremely important in keeping a first responder, a first responder of sound mental health.
Stone, A. (September 30, 2013). Beyond debriefing: how to address responders’ emotional health. Retrieved from http://www.emergencymgmt.com/training/Beyond-Debriefing-Responders-Emotional-Health.html
** Please don’t just rephrase their info, but respond to it. Remember to answer question at the end if there is one. **