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Heroes program will receive grant, donation, and fundraising money. It will have a list of good, vetted providers, and will pay them to see first responders. They will be reimbursed at $75 per session (including groups). There will not be a need for a significant diagnoses, explanation of affected areas, or significant notes. Dates of services and what method (CBT, narrative, ect.) is only what’s needed.
Heroes program will have funds to pay providers to see first responders. It will have limited paperwork, less invasive diagnoses, no need to go through any employer program. Many insurance, EAP companies have a need for paperwork, diagnoses, and/or an explanation of how the person is affected. This creates a barrier to first responders seeking help. They want privacy, fear retaliation and/or how it may affect their job. Many insurance and EAP companies have a limited number of sessions, and insurance often comes with high cost to the responder.
Why is there a need?
First responders are routinely and repeatedly exposed to traumatic incidents, incidents that have effects on psychological and physical wellbeing (Piattaro 2019). They are shift workers, have long shifts, and have little control over their workload. They are often sleep deprived due to their erratic schedules and are unable to regroup from one incident to the next. Stress has a cumulative effect and the chances of them developing serious issues increases over time. People who have experienced a prior trauma are more likely to develop Post Traumatic Stress Disorder when exposed to another trauma, making responders risk high because they are exposed to trauma repeatedly (good therapy). There are major incidents, but there is also cumulative everyday trauma, stressors, and these can be just as harmful. Left untreated, both are linked to higher rates of depression, divorce, substance abuse, and infidelity (Jany). Biomed central states all firefighters, law enforcement, and paramedics will at some point suffer from PTSD from both major traumas and microtraumas.
Many first responders experience anxiety, burnout, and depression. They may have mild insomnia, fear, worry, sadness that lasts a short period of time, or they can have longer intrusive memories, flashbacks, nightmares, fear, tension, agitation, emotional numbness, and desire to avoid talking or thinking about event. Substance abuse, depression, and suicide occur at higher rates in first responders than general population. In dispatchers, emotional distress and secondary trauma are at the same rates as police officers. These symptoms can lead to inadequately performing duties, avoiding work, carry over to personal lives (good therapy).
Officer rate of suicides are higher than deaths in the line of duty nationwide. Two twin cities area police officers commit suicide in this past year: Sgt Cory Slifko, 20 year career, Blake Neumann, 5 years, John Laluzerne Oct 2018. (Jany). Insomnia and substance use (both are PTSD symptoms) have been identified through research as contributors of high suicide rates of fire and ems professionals. Other contributors are struggles with regulating emotions, heightened emotional reactivity, and alcohol consumption (which can be part of culture) (Ryan).
Correctional Officers and Probation Officers experience the same struggles as law enforcement officers. Probation officers often receive threatening letters, verbal intimidation, erratic client behaviors, heavier workloads, smaller budgets, and they are to supervise offenders in the system. They conduct investigations and create reports for court with deadlines to meet. Officer Wellness Steering Committee is raising awareness about mental health conditions and the importance of mental wellness for probation officers and staff. Suicide in probation officers is a growing problem, and is at a “significantly higher rate” than previous years. (Committee Target officer Stress). Probation officers are exposed to psychological and physical safety risks, frequent travel and fieldwork to high-crime neighborhoods, and in contact with hostile family members, friends, and relatives. They often have heavy caseloads due to understaffing. Like other criminal justice professionals, officers risk burnout and depression. (Heibutzki)
Correctional officers often face insufficient staffing and other job-related stressors such as feeling unsafe at work (Bar). Over time, negative work experiences and distress may have a cumulative impact that shapes personality adversely and causes individuals to develop a more pervasively negative outlook. They often witness violence injury, or death on the job. Many report being in the prison or jail itself causes mental health effects ( Dawe). Correctional officers are tasked with controlling prison inmates, will remaining professional and responsible. They face exposure to personal danger, violence, death, and inhumane conditions inside prisons. Studies conclude that corrections officers are expose to the
same levels of violence and deadly events are firs responders, and may even experience a greater number of situations in which they are personally subjected to violence (Correctional Officer edu).
Massachusetts nonprofit, Blue HELP, found that officer suicides rose from 143 in 2016 to 228 in 2019 . This is believed to be a conservative tally (Jany). Burn out estimates from Firefighter and Behavioral Alliance suggest 400 firefighter an EMT deaths occur by suicide each year (good therapy, first responder issues). Suicides among police at 1.5x the national rate and somewhere between 4 and 14% of all officers are estimated to have suicidal ideation. Current estimates that fire/ems suicides are undercounted by as much as 60%. Alcohol abuse is involved in more than 85% of officer suicides. (Statesman Journal)
Depression and PTSD effect 30% of nations first responders, compared to 20% of population. 3.7% of Americans contemplated suicide, vs 37% for fire and ems professionals. .5% Americans attempted, vs 6.6% firefighters and EMS professionals. Half of male firefighters and 39.5% of female firefighters report binge drinking (ryan). 40% EMTS report engaging in high risk alcohol use. After 2 years on the Police force, 27% rookies go on to develop alcohol use disorder, 4 years on force this increases to 36%. (Envisagenow)
On average, 10 correctional officers die in the line of duty per year, while 156 correctional officers commit suicide per year. In a study done in 2012, the researchers found that 27% of correctional staff are diagnosed with PTSD and a 26% with depression (Dawe, 2019). 10% of correctional officers have considered suicide, and retired correctional officers are at 31%. Half of the officers stated that the don’t feel safe at work. (Barr) 20% reported and inability to find pleasure in anything, 50% had no energy or were excessively tired, 44% reported headaches. (Sultan)
Prevalence of stress in probation is high but it is difficult to put an exact number on it because of lack of reporting and studies. Depression and anxiety are being reported at higher rates as are PTSD, substance abuse, and anger problems. Most officers feel it is the supervisors/place of work that causes burn out vs. the job itself. In a study of 711 officers, 87% disliked supervisor. 39-55% of POs have been victims of work-related violence. 38% report emotional symptoms, 11% report physical symptoms. 16% supervisors feel burned out at least 1x a week. 25% report that being victimized has had negative consequences for their family. Only 25% officers were satisfied with pay. (Finn, Kuck 2003)
Many first responders delay treatment, fail to adhere to treatment regimens, or receive inadequate care from inexperienced clinicians. EMS workers report they don’t seek services because they have: concerns of retaliation, negative job evaluations, job changes, and they distrust mental health professionals (Piattaro 2019). First responders often deny or resist seeking mental health care due to stigma. They have fear of ridicule, prejudice, discrimination, and labeling (Brown, 2017). In studies, some officers report that they believe what they say to the therapist will get back to supervisors, colleagues, could get them ruled unfit for duty, thus many don’t seek help. Many receive mandatory critical incident debriefings but they don’t address secondary trauma (Jany). In addition to those barriers, many find it difficult to seek help due to societal expectations, idealizations of these people as strong or tough, and
seeing mental health as weakness (good therapy), fear of losing fire arm, and fear of losing identify as first responder (Anada).
In a survey that looked at perceptions about mental health, 93% first responders agree MH is as important as physical health, 8 in 10 believe people who receive counseling generally get better. 47% believe there would be repercussions on the job for seeking counseling. 53% felt that would be treated different by coworkers for seeking help, 52% felt they would be treated different by supervisors. 46% report that felt they would be perceived as weak by colleagues/peers.
67% percent have considered counseling. Those who have not site reasons: not feeling comfortable speaking to another person about their problem (20%), not wanting people to perceive them as weak (19%), feeling judged by colleagues (19%), feeling like it would effect career/promotion (17%). When team leaders spoke about their own experience with mental health, 82% of responders felt encouraged to seek counseling, and when peers/close colleague or friend spoke about it, 89% were encouraged. We need a safe space where first responders can discuss mental health confidentially without judgment or repercussions. (Dutton)
Studies on probation officers report that they state there is resistance because officers worry about their jobs if they admit a weakness. (Committee Target officer Stress). Oftentimes, a first responder receives care from a provider who does not understand/have training in first responders or trauma. EAP programs do not require special training to work with responders nor do insurance companies.
- Sharon Smith
- Amber Rosier
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