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Surviving the fire service (Embracing our SCARS (Mental Issues (Post…
Surviving the fire service
Preventable survivable risk factors
Assistant chief Todd Laduc
BSO Fire chief Joe Fernandez
President Torrey Fatjo
3 Legs of Health
Behavior Health
Cardiovascular Health
Cancer awareness
Dr Juan Garcia, Cardiologist
Son Ralf, was a City of Miami FF
accepted to Harvard, didn't go
dad found the acceptance letter in desk after he moved out
top of class at CSFA
Manuel Padron Award, outstanding graduate and class leader
City of Miami Fire Academy
Perfect HS GPA, Suma Cumlade
Nicknames, The Old Man, Robertico, Jimmy Neutron,The Stud
CMFD
Fire Boat
Develops symptoms
vertigo, nausea
Takes Lt exam in hospital
Touched so many lives
Cancer awareness in firefighters
Cancer initiatives
F.A.C.E
Firefighters Attacking (against) Cancer Epidemic
FL FF Safety and Health Collaborative
Keith Tyson
University of Miami Sylvester
Much work still to be done
Firefighter cancer laws
cancer presumption
PTSD
Saved 3 other lives through organ donation
changes need to be made for current and future firefighters
Leadership is doing the right thing when no-one is looking
DTRT Always
Behavioral Health
Pat Morrison IAFF
Assistant to the General President for Occupational Health and Safety
PTSD
Bringing PTSD out of the shadows
retirees
suicide
signs and symptoms,
Stigma
EAP is not used or trusted
Uninon should push it, Firefighters don't give a fuck what HR says
not integrated into the department
Many who do use it do not find it helpfull
CISM
Talk about as a crew
We don't want to show our weakness
Looks good on paper, but we don't use it
Do women get the support they need?
81% say they believe they will be seen as weak if they ask for help
1 in 5 firefighters will suffer
6x more likely to commit suicide if diagnosed with PTSD
Military has resources, but still struggle with it
Limited Mental Health Insurance Coverage
8 sessions in the EAP
Went you need it is not the time to find out you don't have coverage
Stats from behavioral health survey
3/4 of firefighters say that stress has lead to unresolved issues
sleep deprevation
77% found peer support/ peer team helpful
other services are not found to be helpful, firefighter need firefighters to feel understood
94% believe raising awareness would be helpful
Current Grant funded Behavior health programs
Resilience
Clinician training
Disaster training
Recovery Mentor Program
Online education provided by the IAFF
PTSD Presumption Laws
Meranda Jones
IAFF Center of Excellence for Behavior Health treatment and Recovery
Substance abuse
PTSD
Designed and geared for firefighters
Marbourogh, Maryland
Follow up after 3,6,12, and 18 months
Jim Brinkley, Director of Occupational Health and Safety IAFF
Peer Support
Time is Critical
Shift schedules
Available flights
bring in a team, or use resources available
Hotels gone within the hour
CISM in the fire house where members are comfortable.
Use the coping mechanisms that work for your the individual
Notice how your co-workers are responding to the CISM
Report significant changes to the support team, the member may need assistance.
Follow up for continued care for members, ongoing support
What can you do to prepare
everyday peer support
Have IAFF trained peers
List of stations and members who responded, 4 stations per day
Insurance coverage
What is covered for the members
Plan for out of pocket expenses
$4000 per member, average out of pocket
Plan for mandatory referral, and return to work policy
FDNY Frank Leto,
Frank.Leto@fdny.nyc.gov
Behavior health
Peer Support
why do we need peer support
loyalty
stoicism
Moral Code
Excellence
Selflessness
we take care of everyone else before ourselves
Evidence
Reseach shows distraction works best to prevent PTSD
Process stress when low emotions are being experienced
CISM wants people to process stress in high emotional situstions
Stigma is the silent killer of FF
FDNY program prior to 9/11
Crisis Response
Routine and requested visits
Pees support education
develop trust and reduce stigma
direct link for members
FDNY Peer Support Program Observations
Presence
Show support, be approchable
Practical Needs
Listen 2x as much and you speak
act on members needs
do not interfere with coping mechanisms
Psycho-education to reduce stigma
Referals
Range of diagnosis
be prepared to help with all types of problems
Repeated exposure trauma
Follow UP
Retirees
They don't have the kitchen table
they lose all there peer support in one day
Peer Program Development
Dont develop the program around one person
Confidentiality is the most important portion of the program
Even the illusion of broken confidentiality will destroy the program
Be cautious of social media
members should not be able to post on program pages
Fire strong
Peers provide power in healing
Table talk with peer team to develop deployment strategies.
Chaplain Program .Jeremy Hurd
Family liaison
Basic compassion training
Prepare guides for the team
Ways to help
Meals
Presence
Prayers
Follow-up
fire Dept culture
we help right away
we help all in
we don't do logistics well when it affects our fire family
We don't do compassion well when it affects our fire family
How to challenge the culture
Top Down
new officers, administration
Bottoms Up
start from the beginning with the recruits
True change comes form the middle
you must convince the middle officers who are set in their ways to be all in for their guys
Resources
CARES team
CISM
Peer Support
EAP
It's starts with you..
It All Matters
Show concern for your co-workers
Take Care of the whole person
Take care of the whole family
Fire Families
Cancer Awareness
Florida FF Safety and Health Collaborative
Gross Decon
Field Operation Guide
Decon bucket
Firefighter cancer initiative
UM research project
firefighter personal exposure reporting system
http://per.miami.edu
Clean Cab Initiative Chris Bator
Apparatus design
Anything that goes into a fire, stays out of the cab of the vehicle
Keith Tyson
74% of LODD are cancer related
Decon bucket can reduce 85% of crap on gear
New NFPA standard will recommend gear being cleaned after every fire incident
We need to start thinking differently if we want to live to or after retirement
The new NFPA 1500 requires carcinogen exposure reporting
Cardiovascular Health
Dr. Denise Smith
Cardiovascular strain in firefighting
100x more likely to suffer a cardiac event during fire suppression activities
6x more likely to suffer a cardiac event during training
Risk factors
HTN
LVH
Cardiomelegy
Sleep deprivation
smoke exposure
Behavioral factors to improve
fitness
lower CVD
lower risk of cancer
lower risk of diabetes
control weight
strengthen bones and muscles
healthy eating
The most powerful way to protect yourself from cancer and CVD is to take personal responsibility for it.
Get an annual physical
Embrace the IAFF/IAFC WFI
Pay attention to nutrition
avoid excess body fat
biggest predictor of an enlarged heart
Avoid fire ground exposures
Embracing our SCARS
Mental Issues
Post traumatic stress
Addictions
Suicide
stress
long term, cumulative
death by a thousand cuts
Acute Stress
Big Moments
we are designed to experience trauma about 5 times in out lives
What do you do with the stress
Clinical help
Peer support
Share your experience, make it real, make it safe
Mental wellness training
Dont mess with a firefighters
Pride
Passion
Purpose
The difference between hope and hopelessness, is to have someone else believe in you
REDLINE Rescue
Health and Safety Collaborative