Author(s): John Montes. Published on January 2, 2019.

Buddy System

Peer-to-peer support has shown great promise in reducing behavioral health problems, but responders need to embrace their own roles in the process

I’ve read that first responders are eight times more likely than the general population to commit suicide. From my experiences, I believe it.

In the 18 years since I became an EMT, I’ve had 16 friends and former co-workers take their own lives. Each situation was different, and it’s impossible to know how much their work as responders contributed to their deaths. Even so, I still sometimes wonder what I could have done for them. Could I have been a better friend? A better co-worker?

Like many responders, I’ve struggled with my own demons from my EMT career. I’ve learned from working with a therapist that it wasn’t the large, high-impact events that strained me the most, but the heavy day-to-day workload and numerous dangerous close calls that added up like a thousand little paper cuts. The impact of those experiences is different for everyone, and the reality is that there are no simple solutions to the mental health crisis facing the responder community.

The good news, however, is that there is a big push underway to provide more and better resources to address the problem.

One approach that seems to be growing in both popularity and promise is peer-to-peer support. The approach encourages first responders to talk to people, such as coworkers or therapists with responder backgrounds, who can empathize with their challenges because they’ve lived it themselves. The growing popularity of peer support underscores the challenge many responders have had finding licensed clinicians who can relate to our jobs, what we see in the field, and how it impacts us. In therapy sessions, I’ve made several therapists cry just by telling them some of my work stories. How are they supposed to help me when I’m consoling them about my experiences?

The recognized need for more peer-to-peer support has already resulted in strategies that show promise. Many larger fire departments have developed internal peer support teams, comprising trained members of the department who are available to talk with coworkers experiencing stress or other symptoms. These support peers can also refer colleagues to trusted resources. Lately, I have also seen a number of regional peer support teams that are set up and jointly managed by multiple agencies to reduce the cost to individual departments. Smaller initiatives, such as departments that keep member-generated lists of trusted clinicians, are also occurring with greater frequency.

One of the largest peer support initiatives currently underway is at the International Association of Fire Fighters (IAFF) Center of Excellence for Behavioral Health Treatment and Recovery, which opened in March 2017. The 64-bed facility in Maryland offers IAFF members peer support and other mental health services from clinicians who are experts in their field and familiar with what first responders face on the job. The program has shown excellent returns in its first year. In addition, IAFF has launched a separate peer support team made up of of active and retired first responders trained to provide counseling and support. The team is deployed across the country whenever a department faces a major incident or requests the service.

While these resources are great steps forward, it is also critical that responders themselves act to reduce the impact of this crisis: letting go of stigmas around mental health, admitting they need help, and accepting help when offered. There are still a lot of responders who don’t understand that mental health deserves at least equal footing with other health-related needs.

The more active we are in spreading these messages, the more successful we can be in reducing the problem. I don’t want to lose any more friends, and I know you don’t either.

JOHN MONTES is specialist, Emergency Services Public Fire Protection, at NFPA. Top Illustration: Michael Hoeweler