HUNTINGTON — As part of an attempt to address "compassion fatigue" among its first responders, the city of Huntington offered mental health training to its firefighters last week, hoping more will seek treatment for undiagnosed mental health issues after responding to traumatizing scenes for years.
The focus comes after the city was selected earlier this year as one of 35 finalists to receive $100,000 to develop ideas to solve a situation impacting their city as part of the Bloomberg Philanthropies Mayors Challenge. The $5 million prize, which firefighters have said they hope goes toward a wellness center, is an uphill battle as Huntington is one of the few cities with an idea that is not a tangible item. That's why data collection is important for the program's success.
The wellness program includes yoga, meditation and massage therapy courses, as well as educational presentations on topics the police officers and firefighters have requested.
The most recent presentations have focused on mental health in firefighters. The training teaches them signs of deteriorating mental health, while also giving them resources on how to reach out to each other and professionals when they see a change in mental health.
As the program has been adjusted to fit the needs of firefighters at their requests, at least one has said the grant has helped improve communication with the city and wellness among the workers. However, at least one firefighter's wife is questioning if the mental health training is enough or is going in the right direction after seeing her husband struggle with his diagnosis and alcohol dependency in recent years.
Positive mental health
As the number of increasingly brutal calls for first responders has skyrocketed as part of the opioid epidemic, so has the amount of compassion fatigue in the job, Huntington City Manager Cathy Burns said. Compassion fatigue comes from responding to the same events or location several times and not seeing different results.
When Krishawna Harless, a Wellness and LEAD (Law Enforcement Assistant Diversion) triage coordinator, initially took her job, it was to save the lives of those struggling with drug dependency. What she didn't realize is the mental health challenges that firefighters and police officers have and how the city was ill equipped to deal with it.
While highly trained on how to respond to a scene, she said she found they aren't trained on decompressing after the incident.
With that information, the city applied for the Bloomberg grant.
The money allows for the development of the wellness program for Huntington's first responders and for Harless to extend her services to them. She responds to emergency calls, eats dinner with and gets to know each of them.
The developing program is living and breathing, changing any moment its creators feel tension from the participants, Harless said. As an example, she used a previous presentation about how using positive words helps create a more positive outlook. When realizing the trainees were not comfortable with the course, the rest of the classes were canceled and the team went back to the drawing board.
"We have had to do some hard pivots. There have been honest mistakes," she said. "We hear them, but sometimes our approach hasn't been right and we've been able to step back."
A firefighter's struggle
Adelle Nicholas says her husband, John, a firefighter for the city of Huntington, was among a shift of firefighters never debriefed on the Emmons Apartments fire, which killed seven people in downtown Huntington on Jan. 13, 2007. He controlled the water for his unit that day as they fought to save those trapped within the building. That was the day he started to develop signs of post-traumatic stress disorder. But it wasn't until he was attacked while responding to a call in March 2016 that his mental health began to crash, she said.
"There were two people on a truck; there should be four," she said. "They went to an abandoned building fire. John went in because he heard people inside and at this point he was jumped by an older drunk."
Nicholas, who works as a health care professional, said the attack, mixed with what she said was bad working conditions - like being understaffed along with responding to traumatic scenes - caused acute stress disorder to develop in her husband, who turned to alcohol to cope when off the clock. Adelle Nicholas said she didn't notice her husband had turned into an alcoholic until he sat on her bed and asked for help on the night of July 3, 2017. John Nicholas was sent to a behavioral health program by Chief Jan Rader, but his wife said they were not equipped to deal with trauma, especially in first responders.
Nicolas said she found a detox program for John and then he went to the IAFF Center of Excellence - a behavioral health treatment and recovery center designed for firefighters - in Marlboro, Maryland, for 50 days.
The journey to get John to the specialized facility was rough, Nicholas said. They approached the city and insurance provider seeking a worker's comp claim and in-network rate because the program was specialized and not available to that degree in the area, but they were turned down by city officials and the insurance company, she said.
John, who also served as a firefighter while serving in the Navy, has been sober for a year as of July 4 and uses woodworking and other crafts as he continues to heal.
With the city now taking on the topic of mental health, his wife is leery. While the training is a step in the right direction, she said she is afraid the resources given to firefighters might not be properly trained in trauma to deal with the firefighters' needs.
The firefighters need each other most of all, she said.
Nicholas says the firefighters had sought to bring the IAFF to Huntington to give specialized training on peer support counseling but were told there was no money to do it. Two firefighters were sent to Pittsburgh last week for the training with donations from Dels. Chad Lovejoy and Matt Rohrbach, but more need the training, she said.
Nicholas hopes it will make a nice mixture with the mental health training the firefighters have been given.
An all-inclusive wellness center would be great, she added, but it would not address the deeper issues that cause PTSD among the firefighters.
"It's pretty," she said. "It's like flowers on the street corner that makes us the most beautiful city in the world. Then you go two blocks away and they are dealing crack and dealing heroin."
Mental health game plan
In discussing the grant program, Burns said she wishes the focus on wellness would have been started earlier.
"I wish we would have known three years ago what we know now. I wish we had started this proactively rather than after the fact," she said. "It would have been nice and appreciated if we started it three years ago at the onset of the epidemic rather than now."
When approached about giving the presentation on mental health, Marshall University SBIRT Clinical Director Lyn O'Connell jumped at the chance.
"I think the grant as a whole is a really unique opportunity in that it allows innovation and creativity, which isn't something that you normally get in federal funding," she said. "So it's this idea that it's this initiative and ability to hear from the people what they want and provide it."
O'Connell sat through several focus groups with firefighters to tailor her program to their questions. As she adjusted the program, O'Connell said she found the men to be receptive of the information and interactive with the program.
O'Connell's program on mental health is geared toward talking through signs and symptoms of depression, PTSD and other diagnoses and then how to start a conversation about it. Each firefighter will receive a list of local and national resources to help with mental health issues when they arise, and it will be placed in each station, as well.
The list includes local mental health professionals who have dedicated appointment time slots each week for first responders, a way of getting them into therapy sooner.
Harless also has developed other ways for first responders to decompress, including offering to set up discounted-rate family or friend trips throughout the state for a quick getaway.
There is a fear the current services might not have the same effect on different generations. The older generation also worries about discussing negative aspects of the job because it could cause burnout in or worry the younger men, Harless said.
"Some of the older guys have just been through so much and have felt like they have not ever been offered these tools that they might be a little jaded," she said. "I think it's just going to look different as we go through the process as to how it's accepted and implemented in their own private lives. It's never too late, though."
A city employee would never lose his or her job based on a mental health issue if they remain healthy, Burns said. It is treated just as any other medical condition.
Eye on the prize
Huntington Deputy Fire Chief Rodney Wren said the training is a step in the right direction.
Wren said developing the training had improved communication skills between the HFD and city officials, and some firefighters feel like they are being heard as the city tweaks the program around their wishes and desires.
"They are listening to what the guys are saying and how that can help us, how it can be modeled and formed to help us," he said. "They have to feel like they are being heard, and this is a great program for that. We don't have anything that rivals this program now. We don't have the funding for the program."
Wren said firefighters had been developing the idea for a wellness center for years. With that goal in focus, the firefighters are starting to buy into the program, he said.
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