First responders recover with peer support

LAN Provides “Unconditional” Mental Health and Wellness

By Mark Maynard

Just off busy Liberty Street, near the core of downtown Reno, sits a nondescript two-story building. Upstairs is a quiet room overlooking the traffic, with a large window that lets natural sunlight in; Overfilled lilac-colored chairs and bright green houseplants invite one into the space. A box of Kleenex rests on a glass-enclosed coffee table.

This is the Ewald Room, named after Ewald. Tyler Ewald, a second generation firefighter for Truckee Meadows Fire and Rescue Ewald, who died by suicide in 2019 at the age of 32, was well known in the northern Nevada fire community; He was a Hot Shot wildland firefighter in the Bureau of Land Management, completed paramedic training at REMSA and fought fires for the Carson City Fire Department before serving at Truckee Meadows Fire and Rescue.

The road to burnout

For many, the initial appeal of firefighting comes from popular culture and stories of brave men and women risking their lives to save people from fires and other critical emergencies. In reality, most calls firefighters answer are medical calls.

In 2021, only 3.5% of Reno Fire Department calls were for fires. By comparison, 4.5% were false alarms and over 65% were for emergency medical services.

“People were drawn into this business thinking it would save people from the clutches of death,” said Adam Heinz, director of integrated health services at the Regional Emergency Medical Services Authority (REMSA). Heinz estimates he has saved fewer than 20 lives in his 21-year career, treating thousands of patients in medical emergencies.

Heinz said society sensationalized the work and created what he called “toxic heroism” that could lead to frustration. He said emergency responders might notice: “‘I didn’t sign up to go to the house of someone who fell out of bed at 2 a.m., defecating on himself – I need to clean them up, collect them and make a cheese sandwich.'”

Heinz said that first responders tend to be naturally altruistic, but the volume of non-critical calls can eventually lead to burnout.

Firefighters will make thousands of calls throughout their careers, and in addition to the physical dangers they may face, there is also long-term mental and emotional harm.

“I always called it a gut punch. “You really don’t know what’s going to hit you until you see it,” said Derek Reid, battalion chief at Truckee Meadows Fire and Rescue. “I gave CPR to a young boy and he looked like my son and I’ll tell you what, I kept my eyes on him at pool parties after that.”

Reid said work can also lead to spiritual wounds when something witnessed at work challenges one’s perception of right and wrong. “If you’re helping someone who has been brutally raped and beaten, those are really heavy.”

admitting the problem

Chaz Blackburn has seen firsthand what the stress of emergency response can do. He is the community service coordinator of the Great Basin Chaplain Corps, a group of licensed, trained and culturally competent clergy serving first responders.

Cultural competence is an experience-based deep affinity with the linguistic, occupational and lifestyle needs of first responders and is achieved through a combination of on-the-job experience and specialized training. Blackburn said it may take years for pastors to develop the confidence of first responders, and that clergy must uphold professional standards and understand that their role is support, not evangelism.

“We have to admit there’s a problem,” Blackburn said of the first responders. “Suicide rates are rising nationwide, particularly due to the pandemic and lockdown,” and unhealthy coping mechanisms such as substance abuse for police and firefighters are also on the rise. blackburn said fatigue affects the performance of first respondersand the length of their careers.

“What I see is burnout. “People are retiring early unfortunately because they’re so stressed, weak and frustrated.”

“Suicides have outstripped deaths on the job in a very high-risk occupation,” said Derek Reid, Chief of the Truckee Meadows Battalion, founder and chairman of the Northern Nevada Peer Support Network. “It shows that we are potentially more dangerous to ourselves than our job,” Reid said.

The reality of suicide has directly affected the close-knit local first responders over the past few years.

“Recently, our organization lost an employee to suicide,” said Heinz of REMSA. “It’s obviously very close and something our team continues to mourn. It’s hard work.”

While the data show that firefighter and police suicides occur at a higher rate than deaths on the job,because it is difficult to detect. limited to voluntary applications by fire departmentsand possibly underreported.

The causes are rarely simply attributable to overwork or even post-traumatic stress disorder (PTSD), both of which may be contributing factors. Reid added: “What we can gather is that where the cogs come off is when the most important relationships start to struggle. It is personal relationships that have been cited as the number one cause of suicide in the first responder group.”

This may include strained relationships or the inability to feel understood by spouses, children, and those closest to the respondent. And that stress between trying to find a balance between work and life outside of work can put tremendous strain on marriages and other close relationships.

“We make vacation plans like everyone else. When he called his wife and said, ‘I just became a mando, I’m not coming home today’. Do you want to see some significant others sad? That’s the way to do it,” Reid said. The level of stress the program can bring to a relationship, including mandatory overtime, also called the “mando train,” has even led people to leave the fire department altogether.

A safe place for first responders

A consultant and clinician at Truckee Meadows Fire and Rescue, Dr. “Anyone who has been in the fire service for more than 12 months would agree that this is a call for them,” said Steve Nicholas. “On a personal, professional level, you stand behind your brother and sister.”

Both Nicholas and Reid talk about “residual stress”: the stuff that builds up in the bodies, hearts and minds of first responders. One of the most effective ways to deal with this is to be able to share it in a safe, neutral space surrounded by understanding peers. This is one of the reasons Reid founded this company. Nevada Peer Support Network.

Originally created as a mental health wellness program through Truckee Meadows Fire and Rescue, the program has now grown into an active, coordinated resource network that supports local first responders, including firefighters, police officers, and other public safety and military service members. The network is hosted at a private facility at 330 E. Liberty St. where it shares space with Specialty Health, a contracted wellness provider for first responders.

The upstairs space is reminiscent of a large recreation room like you might find in an office or firehouse. There’s an emphasis on commons and dining – there’s a large kitchen area with lots of bar-height tables, a well-stocked fridge, and full coffee service. There are dedicated counseling offices for affiliated mental health practitioners trained in cultural competence. Entrances to these offices are screened for privacy and confidentiality – there is still a stigma of seeking mental health services in first responders.

The facility provides services that Reid describes as “unconditional”. “Swiss must be,” he says, so customers don’t have to use their department’s employee assistance programs.

Nicholas explains the importance of this. “We don’t go and tell your parents what’s going on. We’re actually here to help you. Nevada Peer Support Network also doesn’t have a financial string attached, so we won’t bill the insurance because the insurance is linked to a medical file that’s linked to a diagnosis.”

This makes first responders more vulnerable to their concerns because they don’t have to worry that a diagnosis could lead to them being declared. not fit for dutysaid Nicholas.

The space also offers an Alcoholics Anonymous group, yoga classes, meditation, and other wellness activities. The larger main room allows first responders to informally gather over coffee to tell stories or solve problems.

While the names of Tyler Ewald and his brothers and sisters who served as emergency responders are not featured in official commemorations alongside the “death in the line” of the Nevada Peer Support Network, the sacrifices small and large are never far from the minds of first responders.

“We forgot to talk to Humpty Dumpty when he was still on the wall,” Nicholas said. He explained that educators, first responders, and others are trained to recognize suicidal thoughts and behaviors—one of which may be an inability to focus on future plans—but they are not continually trained for what he calls “live thinking.”

Nicholas explained that applying a living idea encourages peers to focus on what one wants to do in the near future, emphasizing the desire to live another day. Nicholas gave an example: “Dude, it looks like the weather will be beautiful. I remember you telling me you bought that ski pass. [Mt.] Rose and Rose opens today!”

He hopes that the growing network of first responders working to help each other can develop a model that will foster strength, health and talent. “HE IS ultimately leaves weakness and pain behind.

If you’re in distress, call the 24-hour Suicide & Crisis Lifeline on 988 or visit 988lifeline.org for more resources.