Increased visibility and ongoing training aim to improve mental health outcomes for first responders

Coaldale's Fire Hall

By Erika Mathieu
Sunny South News

Discussions surrounding mental health amongst first responders has improved in recent years, but training and resources must remain accessible to counter disproportionate instances of PTSD among first responders.

Fire Chief and Advanced Care Paramedic at Coaldale and District Emergency Services, Kevin McKeown, said the mainstream discourse surrounding mental health has improved greatly over the past decade.

“We, as first responders, are fortunate that there has been a lot more light shining on the mental health issues affecting emergency services over the last five to 10 years. Emergency services personnel are exposed to traumatic events repeatedly as a part of their daily jobs. If the stress from these repeated traumatic exposures doesn’t get managed, it can accumulate and lead to significant mental health disorders such as PTSD.”

The correlation between PTSD and people who work in emergency medical services and firefighting, cannot be understated. The suicide rate among firefighters is 30 per cent higher than the general population. McKeown cited the Canadian Centre for Suicide Prevention, which reports, “two per cent of Canadians will experience post-traumatic stress disorder (PTSD), while first responders experience it at double that rate. Based on this data, it is clear that our first responders’ mental health and well-being need to be taken seriously, and we must have systems in place to support them.”

McKeown said, “we know that firefighters and other first responders have a higher risk of developing mental health disorders than the general population.”

A recent study led by Dr. Nicola Cherry examined a cohort of firefighters in Fort McMurray from 2018 to 2019. 1,000 firefighters of the total cohort of 1,234 firefighters completed the Hospital Anxiety and Depression Scale (HADS), and 998 completed Post-traumatic Stress Disorder Checklist (PCL-5). Of the 1,000, 282 respondents were identified for structured clinical interviews for DSM-5 (SCID) assessment. The report concludes, “interviews were carried out with 192 (respondents). Among those assessed, 40.6 per cent met the criteria for PTSD, 30.7 per cent for an anxiety disorder, and 28.5 per cent for a depressive disorder.”

This increased visibility of the issue has facilitated additional supports and programs which consider the unique challenges, and trauma first responders face in their day-to-day assignments.

“In Coaldale, we have a Mental Health Program which aims to hit four primary areas of first responder Health and Wellness: awareness, prevention, treatment, and recovery. We conduct training and regularly speak with our firefighters about the signs and symptoms of critical incident stress and steps we can take to deal with stress as it starts to accumulate,” said McKeown.

While these frequent and open check-ins help provide awareness and healing, addressing the topic of mental health also de-stigmatizes symptoms and diagnoses, particularly amongst workers in a career with disproportionate instances of PTSD, and other mental health-related struggles.

McKeown said he is a “big proponent of the formal agreement we initiated back in 2020, which brought on a registered psychologist to support our members,” adding firefighters have access to a registered psychologist, “who has experience dealing with first responders,” and praised the efficacy of the program.

“I have been pleased with the success of that program and thank our Town of Coaldale council for continuing to support the funding for that incredibly worthwhile program. “

In addition to this, the department has incorporated, “formalized critical incident stress training that some members have taken to assist other members in a peer-support capacity,” and added firefighters in Coaldale also have access to the Town of Coaldale’s Employee and Family Assistance Program (EFAP). While working toward removing the stigma of mental health struggles continues to be a key part of empowering members to utilize available resources, McKeown said the EFAP allows for anonymity while seeking out resources. The program provides additional supports, “that our members may need, such as substance or other addiction issues, marital problems or anything else they may be dealing with in their life. Members who access the department psychologist or the EFAP remain anonymous, which is important as some people who need support don’t always want to be open and upfront about it, so it removes that barrier to care and does not deter them from reaching out for help.”

Self-reflexivity and self-monitoring are additional tools for first responders.

“I think the best thing is to be very self-aware and monitor yourself for signs and symptoms that the accumulated stress is causing,” explained McKeown.

He added people who may have observed a shift in someone’s behaviour or demeanour can extend a branch to them by gently following up with people who may be struggling.

“It’s essential to listen to your friends, spouses, family, and people that know you. Sometimes they can be the best people to let you know, ‘Hey, you’re not acting yourself lately, what’s going on? Are you OK? Do you need to talk to someone?’ If a first responder is struggling with symptoms of PTSD, the best course of action is to seek professional help. If it has gotten to that point, seeing an expert in that field, I think, is the best thing you can do,” said McKeown.

While the factors impacting first responders’ mental health and the symptoms are not something that can be controlled, McKeown said there are steps he regularly takes to keep job-related stress and trauma from compounding.

“Personally, I deal with stress primarily through exercise, having a solid support network at home, and regularly visiting a psychologist. The most important thing I think for anyone is determining what works for them to relieve stress and stick to what works. Living a healthy, active lifestyle is a key component. I exercise every day at lunch; that is my routine. On top of eating well, being active, ensuring you get enough sleep, finding something that brings you joy, whatever that may be, and doing that thing more often. First responders have to deal with a significant amount of stress from traumatic events; we devote our lives to helping others — we must not forget to take care of ourselves.”

Although first responders have a long history of being disproportionately impacted by PTSD, suicide, and other mental health struggles, the pandemic has added a new layer of strain as they navigate unprecedented concerns and constantly evolving policies including increased call volume, concerns for staff health and safety, health restrictions, and the shifting dynamics of social situations.

“Emergency Services personnel have had a difficult two years working over the pandemic,” McKeown said.

In small communities, first responders often experience close proximity to the people they serve and respond to, and this proximity can make add additional layers of grief and fatigue. McKeown explained, “In 2020, we suddenly lost two emergency services members in our community. Zsolt Varga, a local paramedic that we knew well who worked for AHS EMS, unexpectedly passed away at his home in Coaldale. We were the first ones on the scene until another EMS unit arrived. Also, later in the year, we lost one of our active long-serving fire captains, Craig Wilson, to cancer. Capt. Wilson had served our community for 30 years, and his short battle with cancer was tragic and an incredible loss for our department. In addition to all of the extra stress the pandemic brought on, losing these two local first responders was extremely difficult. Having access to our Mental Health Program was invaluable, and I am so grateful we had that in place to support our members.”

In April and May 2022, the Coaldale and Coalhurst fire departments will co-host the Individual and Group Crisis Intervention Training programs. This training will allow emergency services members and personnel from southern Alberta to participate in the training, which will, “help build capacity in peer-support mental health trained personnel in departments across Southern Alberta. Members who complete this training can also be an active peer-support members on the Alberta Critical Incident Stress Management Team, a province-wide team that departments can access should they need support from trained peer support members due to a traumatic incident.”

To access the Fort MacMurray study, you can visit, pubmed.ncbi.nlm.nih.gov/33242986/.

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