I wanted to see what the general thoughts were on how we, as the fire service, believe our mental health is handled when faced with LODDs, those "hard-calls" that we all have had, and something so simple as retiring from the job we all love and having to walk away.  I bring this up because a number of my brother and sister firefighters are struggling with the recent "end of watch" of one of our community's police officers from a tragic gunfight.  As with our community only having a population of 47,000 in the immediate area, you can all imagine that both the police and fire departments have a close relationship with each other.  I understand most departments have C.I.S.D. teams in place, but what could we do better to prevent the silent mental anguish that many experience or the sometimes inevitable retirement that is from not dealing properly with the scenes, emergencies, events, and images that we all endure because of our profession.  Please feel free to post what your department does, what you think we could do better or do what we do right, and how we can help one another out!

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I have first hand experience with mental health due to what I have witnessed in both fire and EMS since I was 14. I feel this is a sensitive issue, but an issue we need to talk about nonetheless. Where to begin...
We as emergency responders (using that to cover all agencies, fire, EMS, Police, Etc.) need to be aware of the dangers involved with what we do, and for some reason, until recently, the mental dangers have always been swept under the carpet in hopes they would disappear... This needs to stop.
I witnessed a tragic death in a house fire when I was 18, fresh out of basic firefighter school and ready to go to work. It was late one night we got the call for a fire with entrapment. I responded and was first through the door to do a search, and I found him. But he was far too gone, and nothing we could do. But I still felt guilty, mad, frustrated, like there was something we did wrong or could have done faster...I took it hard. I went to the Critical Incident Stress Debriefing (CISD) and was ready to share my feelings with my older peers, but as they went around the room and I heard their take on the whole thing, I noticed that it was like they werent as bothered about it as me, and they were all strong and showing no emotion. I got scared to share the way I felt, and I held it in and acted like there was nothing wrong, and it damaged me.
The bottom line for us as first responders is keeping us healthy, not only physically but mentaly as well. We all need to learn the warning signs of stress and be able to listen as well as talk to our peers. At my CISD my peers should have been more open and realised they had a younger member who needed to talk it out, but they played the macho card instead.

There needs to be as many ways possible to allow a responder the avenue to talk out problems, and get things off their chests, whether it be a CISD meeting, group talks at drills or meetings where everyone is open and supportive, or one-on-one with an officer or pastor of the station. You can not keep it inside, you must talk about it and see that others feel the same way in order to start the healing, and it wont end there. It needs to be continuous, and people need to be monitored for their health at future calls to see if they react differently. Like my very next house fire, I was searching for a possible victim (no one knew if they were home or not) and I got 10 feet in the door and froze...I could not move. I pictured the other victims face coming out of the smoke and it paralyzed me in fear. My partner shook me and talked to me to see what was wrong and I snapped out of it and continued. No one was home, but that few seconds to a minute of being frozen could have been the difference of life or death if someone was inside, and that bothered me and made my situation worse.

Now that I am older, more experienced and serve as Captain I always have the "Open Door" Policy (even though I dont have an office) anyone can approach me and say "I need to talk" and I am all ears. This needs to be a requirement for officers.
We need to address the issues with each memeber and not let it go, it can not be ignored in hopes it goes away, it wont. Talk to others, share how you feel in a constructive way, be prepared to listen to fellow responders and notice if they need more help than what you can give and make it known to an officer. Together we can help each other because noone in the outside knows what its like.

Stay safe and healthy.
Moose
I personnally think there should be a CISM "social network" where folks can share in a peer-driven environment and maybe a network which is dedicated to allowing folks to Skype or conference online with people who are well-versed in CISM.
Moose,
Thanks for the great reply! I agree with you 100% percent. I think that by having that open door policy, we make that first step towards people knowing that it is okay to be a tough, strong firefighter but still be able to have feelings. I plan on doing more research on this for my grad school dissertation this fall, but wanted to start getting a feel from all the fellow brothers out in the field too. I appreciate the post.
Stay safe!
Steve
Mike,
I think that is a wonderful idea. Having a place where people can share their experiences in a constructed and not criticizing manner is an excellent idea. By providing an avenue for people to turn to, when CISD is maybe too much, would maybe stop the bleeding early on when negative feelings are starting up. I would love to investigate the possibility of people actually using something like this, I only fear that some people will hide behind the macho-ism of our job. I hope by you writing that more people feel more comfortable with themselves and also join in. Thanks again for your input!
Stay safe!
Steve
I went to the Critical Incident Stress Debriefing (CISD) and was ready to share my feelings with my older peers, but as they went around the room and I heard their take on the whole thing, I noticed that it was like they werent as bothered about it as me, and they were all strong and showing no emotion. I got scared to share the way I felt, and I held it in and acted like there was nothing wrong, and it damaged me

I would say this is a downfall of a CISD because incidents can affect some people moreso than others. I have had a couple incidents where a CISD was called for because one member wanted to talk and that was fine. I have been on several other calls where one person was affected, but there wasn't an actual debrief because the other members were fine. So in the end it does depend on the effectiveness of a CISD, because not everyone has the same feelings and emotions, and it isn't always about fronting a "strong, tough" stance.

The bottom line for us as first responders is keeping us healthy, not only physically but mentaly as well. We all need to learn the warning signs of stress and be able to listen as well as talk to our peers

Yes. The ability to talk to others does help and in many cases it is easier to open up to another coworker in a private setting vs an open CISD. Which is why any CISD I've been through, this was part of it, looking out for each other as well as having places to turn, because in the end, a CISD doesn't always address the issues that may be there.


At my CISD my peers should have been more open and realised they had a younger member who needed to talk it out, but they played the macho card instead.


Once again, it does come down to the individual. As I mentioned there have been calls where I wasn't emotionally affected, yet someone else was. There was one where a member asked for a CISD because he wanted to talk, and it was fine, however, no one else really spoke. It wasn't about a "macho" thing, but an individual thing where a call may affect one moreso than another. I think it can be easily construed as a "macho" card type of thing if people don't talk, but then again, it is up to the individual. Like one who may want to use a CISD to talk, it is also one's perogative to NOT say something as well. Nobody should be forced to talk, even if one person does.


There needs to be as many ways possible to allow a responder the avenue to talk out problems, and get things off their chests, whether it be a CISD meeting, group talks at drills or meetings where everyone is open and supportive, or one-on-one with an officer or pastor of the station.

There should be several ways and should be an "open door" for officers, but each FD should also have some more professional means in place for members as well. A dept should have access to something like Employee Assistance etc that a member can go on an individual basis, because in the end a CISD, peer meetings, group talks, etc do not account for the professional issues that may be incurred. In the end, despite whatever means are in place, sometimes it does take a professional approach for some people and as such FD members should have that access available.


Now that I am older, more experienced and serve as Captain I always have the "Open Door" Policy (even though I dont have an office) anyone can approach me and say "I need to talk" and I am all ears. This needs to be a requirement for officers.

Absolutely. The first duty of any officer is to look after their crew and this takes on many forms from training, daily duties, to the fire scene, to afterwards. An officer should be approachable and professional. Although an officer also needs to know just because they fill that role, there should also be channel to where they also can turn and sometimes this can be the crew itself.
"I would say this is a downfall of a CISD because incidents can affect some people moreso than others. I have had a couple incidents where a CISD was called for because one member wanted to talk and that was fine. I have been on several other calls where one person was affected, but there wasn't an actual debrief because the other members were fine. So in the end it does depend on the effectiveness of a CISD, because not everyone has the same feelings and emotions, and it isn't always about fronting a "strong, tough" stance."

I agree, I believe the whole CISD system is still a work in progress and not much has been done to improve it. But I also feel it was a break down of the family, the "Brotherhood". They all knew that I was the one that found him, was young, it was my first victim and it was effecting me. That night I walked from the scene back to the firehouse, only a few blocks away, but I was in a trance, I just walked, fully geared with a pack still on and ended up at the station. An older member and past chief was in the truck bay and he just looked at me and asked if I was OK, he said I just walked into the meeting room, dropped the pack and sat in a chair. The mutual aid department was in our day room downstairs and their chief was in the kitchen, he saw me and luckily he talked to me, and got me to relax a little. But overall, the support from my own department was next to nothing. I had a few that called or stopped by a few times to see how I was but that was it.
My main point was probably more geared towards the support from my brothers being very low. They all sat there at the CISD and just looked around the room and didnt talk to me or try to support me. Afterwords it was coffee and donut time and like it never happened.

I learned the hard way, and I just wanted to express to all of the members of the nation (the ones that are actually reading this anyway) that it is important to talk it out with your peers and officers and not hold it inside. I held it in for YEARS and it almost ruined me. It destroyed my first marriage, made me loose several jobs and affects my attitude and self esteem still to this day. So if you experience bad shit out there dont hold it in, come and talk. Im open to the members of this forum just as much as the crews at my station.
Stay safe out there and have a great 4th of july weekend.
C.I.S.M remember is just one tool that fire departments can offer to their members but there are limitations unless you have a very proactive CISM team who understands the dynamics of the situation. I have spoken to hundreds of firefighters and come to the belief that the junior FF won't usually speak because they don't want the senior FF to think he is "weak" and senior officers or FF won't say much because they have to be leaders and not show weaknesses. A third view is that after calls we are still in the "FF mode" and it takes us a while to digest what we saw and how we feel. A department needs to have the full support of the upper management as well when it comes to mental health. In regard to retirement I promote that FD's need to address firefighters when they know they are leaving and this should be done a year or two prior to retirement. It is a shock to the system when you leave because of the stressors of the job, the schedule, being home and not living within the fire service culture. I have been doing some research into FF suicides and their is a connection between retirement and suicides for firefighters. I have spoken to several widows who have given me some great insight on what happened to their husbands after they retired and ended up killing themselves. (Side note: Please, if you know of FF suicides please visit www.csff.info and fill out the tab called FF suicides. This is a confidential report where I don't know who sent it. I have been compiling data about these tragedies that effect the fire service. I only need year, state, age and rank plus if there was any military experience. This information helps me to help my brothers and sisters.) Thank you. Jeff
I think we’ve got a long way to go in accepting that CIS (or whatever other acronym you want to give it) is acknowledged and accepted as a real issue.

There’s many examples on these forums (as examples) where people are very quick to suggest that we need to toughen up and it’s part of the job.

I also acknowledge that it’s easy to hide behind a keyboard and make comments like that.

It is real. It can have very harmful long term affects.
Recently posted a piece on this at pipenozzle.com related to the suicide of a 31-year-old Philadelphia firefighter last week: http://pipenozzle.com/?cat=338 Also wrote about PTSD on the same site. My brother trained in CISM and server with Warwick, Rhode Island FD in that capacity. Every department, large and small, should have access to CISM or, if you wish, CISD, when needed. He simply made himself available for those who wanted to talk. He was part of a team trained in CISM who stood by at Ground Zero following 9-11. And I read today in the Washington Post that the US Army is now including emotional fitness as part of soldier readiness. Mental health is important, and the Army now knows preventing or dealing with PTSD is more than simply telling someone to suck it up. The Philly firefighter who killed himself was an ex-Marine.

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