| | | | In the Wake of the Pandemic Peer Support Programs Thrive Written by: Carolyn V. Coarsey. Ph.D. | | | |
The Foundation's series awareness@work intends to shed light on the growth of consciousness in how business organizations respond to traumatic losses in their workplace. Be it one person (customer, employee, family member) or a group of people experiencing trauma; many organizations are initiating changes in how they support people in times of distress. Awareness of how best to meet distressed people's needs is rising dramatically with the evolution of Care and Special Assistance Teams. Once cautioned against approaching a distressed survivor due to liability concerns, many companies today encourage employees to contact them without fear, expressing sorrow, and showing genuine compassion toward the impacted individual. This month's article highlights improvements that are taking place in mental health support for employees exposed to trauma as a regular part of their work. Specifically, this article looks at how the emotional impact of the coronavirus pandemic led to improvements in mental health services and peer support programs offered emergency medical technicians (EMT's), paramedics, and other first responders. _______________________________________________________________
The New York Fire department is now providing enhanced training to its peer support team leaders. The newly-designed approach follows a triage model where the peer leaders are trained to recognize when a responder would benefit by seeing a trained counseling professional. - New York Daily News March 13, 2021
Most first responders were immersed so quickly in dealing with COVID-19 calls, that these seemed to be all they were handling. A good friend of mine, a Captain of an Engine Company in the South Bronx, told me that during a twenty-four-hour shift they responded to 8 cardiac arrest calls—back-to-back. All of the patients were pronounced dead on arrival. He knew something was wrong when in the evening, during downtime, the firefighters were all quiet and somewhat withdrawn. Knowing he didn’t want them to deal with the trauma at home, he called them together to speak about the day’s events. Early into the pandemic, the Counseling Services Unit (CSU) Peer Support Team members couldn't be in the field as most are retired and vulnerable due to their ages or pre-existing medical conditions. Unable to access the support units for assistance at the end of a shift, leaders would have breakfast with the oncoming crew and brief them on the past days’ event. My friend said there were some pretty somber moments. - Charles “Charlie” Fraser Retired, FDNY Thirty-two-years, Fire and Medical Services
An article in the New York Daily News on March 13, 2021, echoed the experienced responder's comments described by Charlie. The coronavirus pandemic tested the FDNY (the Fire Department of New York City) emergency medical technicians and paramedics as nothing had before. One paramedic reported that while most calls last around an hour, COVID was one big call that went on for weeks. It was more death than many responders had seen in their entire careers.
There was a 25% jump in use of counseling services over the same time the year before. Between March 19 and May 29, FDNY members took part in 3,077 counseling sessions with a licensed therapist, a 25% jump from the same time the year before. Additionally, the peer support program consisting of EMTs and paramedics went from station-to-station, offering an ear to anyone who wanted to talk.
Three EMS members died by suicide during this time period. Despite the wide use of the support offered, three EMS members died by suicide during this time period. While no one can say for sure the cause of the suicides, there is little question that the stress from the pandemic was a contributing factor. It is harkening to note that many women and men chose to access support offered by their leadership, and yet all agree that one suicide of a fellow-employee is too many.
Peer Support Programs Originally Met with Challenges Use of peer support models in emergency medical services has a long history as an intervention for alleviating responder stress. Initially, peer support programs were met with significant challenges and mixed reviews. The following comments from another retired public safety professional provides insight into challenges faced in the early days of the peer support programs.
My public safety career began in 1976, providing EMS in the City of Newark, NJ. The city was still trying to heal from the riots, and EMS was making a transition from swoop and scoop to EMTs providing pre-hospital medical care. In those days, we self-medicated after a tough shift with some heavy drinking and uncontrolled humor. You can imagine how this played out at home for some of the senior members. Unfortunately, some of my colleagues transitioned to drug use or leaving the service due to burnout.
Sometime around 1989, our fire union trained some members to conduct a debriefing following a traumatic loss during my fire service career. These debriefings would follow a significant civilian or member of service loss. A single team would travel around the state following your shift. The problem with a single unit was the team was not readily available to respond, so we would often wait a few hours following our shift to wait for the team. So, the guys would sit around drinking much more coffee than usual, waiting for the team. Once they arrived, we spent an hour or two reliving the incident. This was done as a group, and no one would say a word. The team did provide contact information for one-on-one counseling, but peer pressure discouraged anyone from participating. -Joseph Houck Retired, Emergency Services, Newark, NJ
The examples provided by the responders in this article mirror those from other front line health care workers. No one can deny the extreme distress associated with responding to patients during the pandemic. Nor the problems organizations face in finding solutions with a workforce who are not open to discussing their feelings. However, the unprecedented stressors associated with the pandemic have caused even the most skeptical to see a need for accessible, reliable mental health resources for everyone exposed to the trauma--perhaps the only good thing we can say about this horrific tragedy.
Workplace Suicide Prevention-The Workforce Task Force “Because many adults spend a substantial amount of their time at work, the workplace is an important but underutilized location for suicide prevention. Workplaces could potentially benefit from suicide prevention activities.” See https://www.cdc.gov/mmwr/volumes/67/wr/mm6745a1.htm In the February 17, 2021 awareness@work, we described how the COVID crisis brought much-needed attention to the subject of crew member suicides onboard cruise ships. While death by suicide is rare among cruise ship employees, due to denial of the subject of suicide among cruise line leaders, the tragic issue received little, if any attention. With the onset of the pandemic, things changed. When the pandemic first began, hundreds of crew members were quarantined—and several suicides occurred within a few short months. A news article exposed the tragic events to the press, and the subject is finally being addressed. One major international cruise line is requiring every crew member to participate in a computer-based training module on suicide prevention. Its focus is on caring for self and looking after peers. Like the improvements made in the programs of the FDNY, addressing issues of employee peer support and self-care in the cruise line industry is a direct result of the pandemic.
The suicide rate among the US working-age population increased 34% between 2000-2016. Employee wellness is a top priority with the new Workplace Suicide Prevention program. These efforts grew out of a Center for Disease Control (CDC) report issued in June 2018 revealing a 30% increase in suicides in half the states, and more than half of those did not have a known mental health condition. In November 2018, the CDC issued a second report which showed the suicide rate among the US working-age population increased 34% between 2000-2016.
If workplaces believe that the mental health symptoms and suicide crises are only due to untreated or misread mental illnesses, they may be engaging in a "state of denial" about their own systemic contribution to the problem. -Workplace Suicide Prevention-The Workforce Task Force The Workforce Task Force was adopted by the American Association of Suicidology and became the Workplace Suicide Prevention and Postvention Committee. The improvements in workplace programs for employees discussed in this article directly match the recommendations made by the Workplace Suicide Prevention group. (Click here for more information)
Final Thoughts In closing, it is important to offer our sincerest condolences to those who lost family, friends, and co-workers as a result of the pandemic. At the Foundation, we also want to express gratitude to the men and women who so bravely face the threat of the coronavirus head on. We also thank the leaders of the NYFD, and all public safety and medical groups for their fortitude in continuing their peer support and other mental health programs, despite lack of buy-in from those who do not understand the need for these services. As retired fire fighter, Charlie said in his interview, “One of the biggest challenges facing first responders and health care providers is ensuring the mental health of their employees is addressed so as not to allow this stress to effect critical thinking when performing lifesaving skills.” At the Foundation, we see the need for creating a healthy, safe working environment for all employees. We understand that traumatic experiences are part of life. It is when trauma remains unresolved that problems occur—thus the need for peer and employee support programs. For more about the Foundation and our programs, please contact Cheri Johnson, cheri.johnson@fafonline.org or visit us at fafonline.org.
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