Notes and Mentions
Content warning: We very briefly mention suicidal ideation in this episode.
Next Rung https://www.nextrung.org/ If you are looking for peer support with a first responder like you, please CALL or TEXT 1-833-NXT-RUNG (698-7864). If this is a life threatening emergency, please dial 9-1-1 or go to your closest hospital.
SAMHSA Disaster Technical Assistance Center Supplemental Research Bulletin First Responders: Behavioral Health Concerns, Emergency Response, and Trauma: May 2018 https://www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdf
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Tina: Hi everyone. I’m Tina!
Serena: And I’m Serena.
Tina: And we are the Mental Health Mamas.
Tina: Welcome to our podcast, No Need to Explain, we are so glad you’re here!
Serena: First, as always, a quick disclaimer. We come to you NOT as mental health providers or experts in the field, but rather as the parents of kids who struggle with their emotional health.
Tina: If you or someone you love is experiencing a mental health crisis, please seek professional support. You will find a variety of resources in our episode notes and on our website, NoNeedToExplainPodcast.com.
And just a quick warning about the content today. We do mention suicidal ideation very briefly in this episode.
Serena: We are very excited to be bringing you a special guest today. He is a firefighter and an EMT, he is a strong believer in the importance of mental health. And, well, Tina?
Tina: He happens to be my son! He is one of the twenty somethings I often refer to in our podcast.
Serena: Welcome, Tyler, thank you so much for joining us today!
Tina: Yes, thanks Tyler. I know that you are a very busy person and we certainly appreciate you taking the time from your two jobs and paramedic school to join us!
Tyler: Thank you both for having me! I’ve been looking forward to this for quite a while.
Serena: So let’s start by having you share just a little bit about the work that you do.
Tyler: So as Serena shared earlier, I’m a full time firefighter and EMT, and I also work part time for a separate department as a firefighter. I’ve also worked on an ambulance in the past, and frequently work with and practice emergency medicine in the field. And we do anything from the stereotype of a cat stuck in a tree to a full blown house fire.
Serena: So wait, it’s true? Like, do you really rescue cats from trees?
Tyler: So I’ve never rescued a cat from a tree, but I have rescued a dog from under a porch! So, similar ballpark.
Tina: And as your mom, I certainly am uber aware of the physical dangers that first responders encounter on a daily basis. I grew up with a police officer father and I guess it’s not surprising that both you and your sister have followed in those first responder footsteps. I certainly saw the stress these sorts of jobs caused but until recently, I, I think I’ve perhaps underestimated the toll of mental health on our first responders. It’s kind of ever-present in every newsreel that you see, so much stress out there. And as we know, you know, just like physical health and physical health tolls, we all have mental health. How did mental health become an area of interest for you, Ty?
Tyler: So, mental health became an interest of mine pretty early on in life. As you both know, people close to me have struggled with varying diagnoses relating to mental health and I wanted to go to school to learn more. I studied psychology in college and I currently hold a Bachelor’s in Science in Psychology. Separately from that I’ve worked in the field of first response for almost 6 years and doing so made me realize how neglected mental health is in my field. One of the most glaring observations I’ve made in my short career is that mental health is almost never talked about, and rarely addressed. When it is brought up, at least in my experience, it’s often brushed off.
Serena: So I was curious about the statistics around mental health in first responders and I found a report published by SAMHSA in 2018. So SAMHSA stands for the Substance Abuse and Mental Health Services Administration and we will include a link to the report in our notes for anyone who would like to perhaps take a look at this information, explore it further. (https://www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdf)
So there were a couple of things that stood out to me in this publication. The first was a quote about first responders and it reads, “One of the core risk factors for first responders is the pace of their work. First responders are always on the front line facing highly stressful and risky calls. This tempo can lead to an inability to integrate work experiences. For instance, according to a study, 69 percent of EMS professionals have never had enough time to recover between traumatic events (Bentley et al., 2013). As a result, depression, stress and posttraumatic stress symptoms, suicidal ideation, and a host of other functional and relational conditions have been reported.”
So that’s a lot. And then the second quote that stood out to me was specifically about firefighters and this one said, “The nature of the work of firefighters, including repeated exposure to painful and provocative experiences and erratic sleep schedules, can pose significant risk to firefighters’ mental health (Stanley, Boffa, Hom, Kimbrel, & Joiner, 2017). To add to that risk, firefighters face many barriers to seeking help, including stigma and the cost of treatment.”
So Ty, I’m curious about your reflections on these statements. In your experience, do they seem accurate?
Tyler: So they are certainly some of the largest contributing factors to a decline in mental health of any first responder. I’d first like to address the comment on having a lack of time to respond or recover to trauma. This is something I’ve personally experienced on multiple occasions both working fire and on an ambulance. From my observation two main things can lead to this. Number one is a lack of help or, in the field we call it staffing and two, it’s a lack of caring of the employer. Often while firefighting, the issue is much more based in staffing. Where I work we only have two people on shift, so whatever comes in we have to deal with. Some days we’re not even able to make all the calls in our district because we have so many calls at once and just, there aren’t enough people to come in and help. This lack of help is often attributed to a lack of funding from the town, and is a problem in almost every emergency service in the country and especially in departments that rely solely or heavily on volunteers.
Tina: Yeah, so you’ve talked about clearly how incredibly busy and stressful this is. We had to delay this recording because there were so very many calls. How many 12 hour days have you worked in the last two weeks, Ty?
Tyler: So I have worked now, nine 12 hour days in the past 14 days. Even on my “off” days I still get called in as extra help, usually once a day, maybe more.
Tina: And this speaks to the extreme value of making sure that our states, counties and towns pass the funding needed to provide the protection, that quite frankly, all of us benefit from.
Tyler: Right. Absolutely and that, that funding is very important. So, the second aspect relating to the lack of caring by an employer is, has a much greater occurrence in the private sector. I used to work for a large ambulance service that was a private service in a big city, and oftentimes after traumatic calls, the supervisor would be there at the ER to make sure we were back out on the road within our set time. That was the company policy that you had to be back out on the road. There was one specific call that I struggled with for a long time because I didn’t have time to decompress after that call. No one really reached out outside of my partner and I never got professional help for that call until, you know, months later which I sought out personally. These systems that are in place for professional help for those services, mainly CISM Teams or Critical Incident Stress Management Teams, are in place for a reason and they’re not often utilized, especially by these big companies.
The quote specifically relating to firefighters is totally accurate and I can’t agree with it more. Sleep is one of the most important things I can suggest to anyone and is often sacrificed to any first responder.
Tina: Sleep. Yes. We’ve mentioned this before and sleep certainly was a priority and still is in our household! Even though you don’t live with me, I’m hoping it is in your household. And it is one of the things as a mom, I often check in with you about, right Ty?!
Tyler: Yeah, absolutely. I mean we check in almost every day and you just make sure I’m not too wiped out.
Tyler: As a firefighter on call for both my full-time and my part-time department, sleep is often interrupted and I have to go in to support my community whenever that bell rings. I wouldn’t change either of my jobs. I do love them, I just wish it was more widely known that most firefighters rarely get more than a few hours of sleep when they’re going on shift. Or even in between calls in the middle of the night. Even when we get home and we’re off shift, we can still be on edge from our pagers going off all day, or we don’t get time to rest.
Serena: Hmm. Yeah, I can’t even imagine that kind of sleep deprivation. As a parent, I’ve certainly experienced a lot of sleep disruptions involving kids and babies, but it’s not like I have to get out of bed and go save somebody’s life. And the adrenaline rush you must be experiencing after a call…
Tyler: So that adrenaline rush is something that’s actually very interesting to me. Every time that pager goes off, you do get that boost of adrenaline and one of the main ingredients biologically that comes out of that is cortisol. And if I get woken up in the middle of the night by one of my two pagers that I have, sitting by my bed, one on my nightstand, that goes off and it’s a call not relating to me but maybe the pager goes off for a different town and the dispatcher hit a different button, that adrenaline still goes off because that has been conditioned to me to the tone for me to get up and work. And that cortisol ends up sitting like, you know, plaque in our arteries just like eating a bunch of bacon, which I also love to do. In that, there’s a big correlation between, you know, firefighters and heart disease and I wonder if it isn’t just the physical health side of things. Maybe it is that cortisol build-up after all these years of listening to those pagers.
Tina: Mmm. I can’t imagine it. You know how important sleep is to me. And so we have to ask, given all of these challenges, what sorts of things are you doing to take care of your mental health?
Tyler: So, I’d like to address this in two parts, both Professionally and Personally.
Professionally in the past I’ve sought out counseling and therapy. And you know, as I mentioned earlier, these CISM teams are a resource out there for first responders as a way to gain access to help. I have personally used them and I think some people benefit from them significantly more greatly than others, but sometimes the way they’re conducted isn’t beneficial for everyone involved.
Serena: Mmm. Yeah, I really appreciate you mentioning counseling and normalizing the conversation around something that’s clearly not talked about enough in the first responder field, or I would say, in any field for that matter. So back to that self-care. What do you do for yourself personally?
Tyler: So, personally I know it sounds, it’s simple, but I like to do things that make me happy. Sleep is the number one thing I do. When I have the opportunity, whether that’s getting a full eight hours which is pretty infrequent or, I like to take cat naps. And my roommates say it best. I fall asleep like an old man. I’ll fall asleep sitting in a kitchen chair.
Tina: No offense to old men.
Tyler: No, no no no. Not at all. I think it’s a power that we have.
Serena: That’s a great skill!
Tyler: I also like to spend time with my friends. I have four other roommates. And obviously as safely as we can because there is still a global pandemic in progress. I also like to watch TV and while I do that I like to at least make myself feel more productive so I recently took up knitting! I made my first successful piece as a gift for Christmas and it went over pretty well.
Tina: It did! Nice!
Tyler: I also love to play music and sing, often with one of my roommates who is also a musician.
I also found a huge solace, especially when I started to see my mental health decline a little bit when I first started in the field, in physical fitness. When I first started I noticed a lot of first responders, especially in the older generations, turned to what I call “The Big 3” - Food, Alcohol and Drugs. And this is something that I was very aware of and tried to stay away from so instead I said, you know, when I’m starting to feel a little down, why not go to the gym. I wasn’t really, I would consider, a healthy person when I first started in the field, and I am really fortunate to have found this physical fitness as a way to get endorphins. At the time, I had no idea the science behind it, but I’m glad I was able to find a constructive way to put sort of these negative feelings into physical progress.
Tina: That’s awesome. So you mentioned a little bit ago the pandemic and we wonder how this affects your work and your personal life?
Tyler: So at work things were definitely difficult at first, but through nine months of it, it’s become more normal. We certainly have to clean more and disinfect more and make sure we have masks in stock because for awhile there was a massive PPE shortage (personal protective equipment). And we’re still, we still run low on things like gloves which we’re doing our best to find what we can. Personally it’s weird. You know, I’m 22 years old and most 22 year olds like to go out and be in the community and be and do things with big groups of people. You know, I certainly can’t do that, but I’m very fortunate that I have, you know, four people that I live with that I’m always in close contact with and we can spend time together with whatever’s going on.
Serena: Yeah, I, thank you for sharing all of that and I can appreciate that self-care is even harder right now, in the midst of the pandemic and I’m glad to hear that you’re also continuing to find ways to take care of yourself! So, I wonder, is there anything else that you’d like to put out there to the first responder community?
Tyler: So, I mean, generally, and this is for everyone, not just the first responder community. There’s nothing wrong with asking for help. We all joined this field to help others and you need to put yourself first. You need to help yourself before you can help anybody else. If you’re struggling there are resources out there for you and they’re specially geared towards first responders and the traumas that we experience. One resource that I have really enjoyed is something called Next Rung. I located them on Instagram and they have resources for those who are struggling. They have a, looks like Monday through Friday hotline that you can call or text and they can pair you with counselors or just someone to talk to and I believe they also have greater resources out there within Next Rung.
Tina: Yeah, so we’ll include those, certainly, in the notes. Important resource. Thanks for sharing that Tyler. One more question. What advice would you give to all of the people listening out there who might have a young adult in their life who is struggling with their mental health? How can we, as caregivers, best support you?
Tyler: Reach out and be present is the biggest piece of advice I can give. If you haven't heard from someone in a while or you notice signs that someone is struggling or, you notice signs that someone is acting different even. It’s something as little as pointing out someone may be reacting differently to a similar idea, it’s a quick way to notice these changes. I cannot stress enough how important, you know, the community aspect of mental health is.
Serena: Yeah. Tyler, thank you so much for joining us today and sharing about such a vulnerable topic. We really do appreciate your willingness to speak about mental health and we really believe that the more we talk about it, the easier it will be.
Tyler: I absolutely agree. I think getting it out there and breaking down that stigma is one of the most important things that will be progress to addressing mental health as a whole and not just as, you know, here and there. I really appreciate you both having me on this podcast! When I first heard about this podcast being made I was really excited and I thought it would be an excellent way for those who may be struggling to get resources or for those interested just to hear stories about mental health, especially in this different time. If anyone out there, first responder or not, reached out to someone or this affected somebody’s life from something they have heard today, it would make me unbelievably happy.
Tina: That’s awesome. That is totally awesome. And you have talked about so many themes that we Mental Health Mamas embrace like taking care of yourself before you can take care of other people because that’s what moms do and apparently that’s what firefighters and EMTs do. So thanks. So I want to thank you for joining us. And as a mom, I am so very proud of the way you not only normalize mental health but also the ways you are doing your best to take good care of yourself. So podcast friends, if you like what you’re hearing, please leave us a rating, subscribe and share with others. You can also find more content on our website, NoNeedToExplainpodcast.com.
Serena: As always, this is your gentle reminder to take good care of yourself while also taking care of your people.
Tina: Thanks for listening!