Mental Health Clinicians Jumping Into The Roles Of First Responders

CONCORD, NH – Imagine you are stretching hose lines and pulling them to a room that is approaching 1,000 degrees Fahrenheit, filled with smoke and there are potentially people, sometimes even children, trapped. Unable to see, you use the training you have and desperately search for anyone who might be caught in the smoke-filled room.

Imagine you pull up to a medical call and parents are screaming as their infant is unresponsive. You begin CPR and do everything you can to save their life but the infant dies and you have devastated parents who do not think you did enough.

Imagine your crew pulls up to a heavily damaged car, crushed from an accident and there are people confined inside. The occupants are screaming for help, depending on you to get them out. You smash windows, use the jaws of life and get the people out safely.

While you were doing all these heroic acts your mind is racing and when you are done you are left with questions of what you could have done differently. All you can think about is the infant who died, the screams of people confined in their car, and the victims you could not rescue from the fire. The images of those you could not save play over and over in your mind, haunting you in slow motion as you try to sleep.

The reality is Firefighters and EMS workers face these scenarios daily. Recently, services became more readily available for mental health professionals to better support Firefighters and EMS workers process and cope with the tragedies they see in order to continue their jobs, relationships, and parenting.

The clinicians they speak to usually sit across a desk and listen to these heroic stories and try to understand what the responder has experienced. It is hard for a clinician to truly understand the intensity of these experiences, but now 30 mental health clinicians have a level of hands-on experience they have never had before.

At a program held at the NH Fire Academy in Concord, 30 clinicians successfully completed “Treating Fire Service Members in Behavioral Heath Settings,”

This training is a first of its kind. The two-day in-person training program was designed to provide mental health experts with real life scenarios so they can better relate to the experiences and stress of Firefighters and EMS. The clinicians were faced with scenes responders often face in hopes this would better assist them with offering effective care and treatment to first responders.

The course - which included both traditional classroom instruction and hands-on live, simulated fireground operations was hosted at the New Hampshire Fire Academy and delivered by the International Association of Fire Fighters (IAFF), in partnership with the New Hampshire Department of Safety’s Division of Fire Standards and Training & Emergency Medical Services.

The classroom portion was delivered by a licensed mental health clinician and a professional firefighter with seasoned behavioral health experience.

Participants put on the same protective gear responders wear, and participated in four different fire and rescue scenarios, which were delivered by Fire Academy instructors and staff.

The training aimed to provide clinicians with:

• An understanding of common behavioral health challenges in the fire service and barriers to help

• Identifying foundational principles for treating fire service members

• Building a successful therapeutic alliance with a fire service client

• Applying best practices to achieve positive treatment outcomes with a fire service client

• Establishing effective connections with local fire departments or unions

• Gaining direct exposure to fire and rescue operations through live fireground training

The training program was offered to licensed mental health clinicians working in private practice, behavioral health treatment programs, employee assistance programs, or those interested in collaboration with fire department peer support teams. “This gave them some experience seeing what it’s like to rescue somebody, what it’s like to manage somebody having a medical emergency, to build that cultural competence and add to the level of training and professionalism that they already have,” said Division of Fire Standards and Training & Emergency Medical Services Director Justin Cutting.

“Being a clinician that has worked with this population for the last 5 years, we had to do a lot of our own legwork to get culturally competent, like showing up at the department,” said Candace Alizio, Executive Clinical Director of Forge Veteran and First Responder Healthcare’s Manchester location. “This is beyond words. This is going to help us help so many more people.”

“The loud popping, the glass shattering, the doors popping – the weight of it – those tools are about 50 to 60 lbs. each, and I had no idea,” said Emily Barton, a licensed professional counselor at Sunrise Counseling in Concord. “Parents might be in the background, other loves ones might be in the background, everyone is screaming and crying - so, just to have some understanding and gain a little bit more perspective into what that experience is like really helps us understand as clinicians.”

“We get into this career because we’re tough. Unfortunately, that can be to a detriment down the line,” said Brian Ryll, president of the Professional Fire Fighters of New Hampshire. “So, to put together a program like this, to allow clinicians to really relate to firefighters and understand what firefighters go through on a daily basis helps to break down those barriers.” Scott Robertson, a Behavioral Health Specialist with the International Association of Fire Fighters (IAFF), helped co-create the program following his experience battling The Station nightclub fire in Rhode Island in 2003, which claimed the lives of 100 people.

Robertson said he sought treatment from a clinician years later, but the clinician became overwhelmed with emotions from the details he shared and was unable to help him. “I need somebody that I can talk to, and the IAFF has done an amazing job training peers in the fire service,” said Robertson.

“Quite honestly, I don’t think there’s anything more important than what’s taking place with this training,” said Department of Safety Commissioner Robert Quinn. “And not only will it build the cultural competency, but I think what it will also do is start conversations between those in the fire service and those that are here to help, so that we can all have a better understanding of what they do day in and day out, and the experiences that they see – the unthinkable that most will never, ever have to go through.” Of the 30 clinicians that participated in the class, more than 25 of them currently treat emergency responders in New Hampshire.