A new take on Trauma and the Fire Service.
Recently, I had read that PTSD awareness may be impacting on recruiting for the services. Indeed, when the image of heroism is tempered with the issue around the trauma, we would expect to see a decline in our recruiting pools. When people have 100 percent of the story, they are able to make more informed decisions. We need to be careful not to direct our upset and anger at the fact that the cat is out of the bag, but instead recognize that there is a much larger cultural awareness around the inevitable. We WILL experience traumatic scenes and engage in them. Any short period of time within the service will see to it that this is true. We might not develop any disorders from this experience (and this is a whole other topic), but we will experience trauma. Yet, our approach seems to be trying to escape from this reality.
Are we running from something that we can’t outrun?
Trauma is here to stay. Perhaps the fire service will become a fully automatic fire suppression service in the not-so-distant-future, but for now it’s real hands-on. As I have written on previously, it is what we do after all, not what we see that impacts us. But, when we talk about the on-going (and, never ceasing) trauma that is involved in the fire services we have followed a rather predictable reaction. We have focused first on what to do with those who currently are struggling, then on what to do with those not yet affected. In Ontario, we have taken a rather progressive piece of mental health legislature, and named it absurdly “The PTSD Prevention Plan”. And, when we continue to see signs of PTSD in our brothers and sisters, we will soon be demanding why this prevention plan isn’t working.
The issue has become that we are so narrowly focused on one disorder, notably the worst disorder, and have neglected, ignored, or pretended that there isn’t a breadth of other mental wellness concerns than can affect us as well. I think there is a saying, “If all I have is a hammer, everything looks like a nail…”
As a mental health professional, this is infuriating. As a former first responder, this too is infuriating. I continue to meet with people who have this overburdening idea of a PTSD diagnosis being the end to not just their career, but to their lives, because this is the association that has been widely made by media outlets and other agencies. Of course, the worst does happen. But, we’re first responders after all and we should be awake to the fact that this world has some dark corners. Painting everyone with the same brush, however, does little to solve our problems.
We need to be training our folks in basic mental wellness training. I believe that it’s too soon in the conception of First Responder specific mental wellness programs to suggest any reasonably specific programs that are outlining great results; however, information is important. What is more important than the information, is the “right” information. This is where we as mental health professionals have done a poor job. And, this is what I spend much of my time both educationally and professionally trying to un-do.
After all this, and as I continue to research and write on the topic, I feel that I have come to the conclusion that trauma is not going anywhere in our field. Unless we boast a zero causality, zero significant injury call history, we are going to be engaging in scenes that remind us that the worst is, indeed, possible. Our role is to accept this reality for just that. And, to create an atmosphere where we don’t run and hide from the trauma, but take it head on.
I think it is important to make this caveat: what I am not saying is that we drop our investment in preventative education and programming. How vitally important this education is should become clear at the end of this article. The issue lies with calling it “preventative”. Going forward, I will call this early education, “proactive”. And proactive education is exactly what we need within the fire services, and all first responder services.
There is a growing body of research that illustrates that many folks experience Post Traumatic Growth as a result of treating their PTSD and traumatic experiences. The crucial point of this is that they engage actively in their mental wellness and received the proper help through the entire process. This may very well require a paradigmatic change from the reactive/proactive approach that we have been establishing and working on. However, in order to maintain mental wellness, we need to step away from our black and white thinking on this matter and recognize that mental wellness is on a continuum.
Engaging in an active mental wellness program is certainly an investment. And, while reasonably accessible mental wellness services remain private and governmentally covered mental health services remain long-waitlisted and underfunded (in Canada, at least), this will continue to be costly. Therefore, there needs to be a systemically situated program in place where it is both cost effective organizationally and available to those who will engage in it. However, with the amount of monetary loss coming from long-term sick leaves and turn-over within our organizations, the amount of money lost in staffing concerns will (if it isn’t already) be much more costly in an on-going staffing issue than in proactive mental wellness programs. Therefore, if we take our eyes off the immediate and look at the long term, this short-term investment would pay off for your organization long term.
Tapping into the research on Post Traumatic Growth also allows us some latitude towards developing the cultural ideal that engaging in the First Responder field can lead to traumatic issues with our mental wellness, but can also lead to a development of a better self, a more resilient self. And, it can lead to a wide range of coping skills and tools that will allow you to develop a better life, not simple keep mental wellness issues away.
We can continue to talk awareness, however, we are missing the part where we have to do some actual work. There is a difference between providing all the information and then leaving the individual to identify what they need to do and where they need to go. Having the basic mental health resources involved is certainly better than none; but, do you want to provide the clear message to your folks that mental wellness is important to your service? Then we need to understand that awareness programming is simply the start. Awareness, after all, is the first stage of our Hazmat training, and it certainly doesn’t then state “now figure the rest out yourself”.
We might not be as heroic as our cultural image portrays us, and we certainly are not as impervious to the issues that come from this job. But, we can provide our members the necessary programming so that when they join, sacrificing their time, their mental wellness and sometimes their lives, their time spent with our organizations can help them to develop into better, stronger people. After all, and having likely stated this too much, it’s much more heroic to face the demons in our minds than the easy ones outside of our minds.