Defeat Stigma: A New Year's Resolution for First Responders

How annual mental health check-ups can help first responders cope with the job.

Posted Dec 16, 2019

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Source: Medium Free Image

I just read this quote from a firefighter: “I wish my head could forget what my eyes have seen.”  I don’t know the man, but if I did, here’s what I’d say. “Sorry, friend, it just doesn’t happen like that. Your memories are your memories. But what can happen, if you can overcome the stigma against seeking help, you can learn how to let those disturbing memories and images come and go, like a passing cloud. But you have to talk about them. Not talking about disturbing memories or feelings is what gives them power. It's one of life's annoying paradoxes; what you resist, persists.

Talking about your troubles, especially if you’re a man, takes courage and determination. You've heard it all your life, big boys don’t cry. This is why you have to beat down stigma and shame. You need to push back against the people who tell you to man-up, joke when you’re feeling sad, pick a fight when you feel down, pretend you’re just tired when you’re feeling depressed, drink yourself to sleep, hide your nightmares, never tell anyone about your panic attacks.

Don’t let things stack up. Don’t fool yourself by thinking the job doesn’t follow you home. Don’t shame yourself into pretending things don’t bother you because you are a man, a cop, a first responder. Retired CHP officer Andy O’Hara said it this way. “Critical incidents are like Mack trucks; big catastrophic events…. [but] cumulative [stress] is like one bee sting after another…. These are the incidents that are missed by everyone, even the officer…the shame, the mistakes, the “routine” horrors, the betrayals, abuses, and the dark fears… We call them “soul woundings.”

Soul woundings, letting yourself be isolated, hiding your humanity is not healthy and may be why there is an uptick in suicide among men. Suicide is the seventh leading cause of death for males and the second most common cause of death for males ages 10-39. And while statistics are always hard to pin down, firefighters and cops, largely male populations, are twice as likely to kill themselves as they are to be killed in the line of duty. (Women also pay for expressing themselves emotionally, especially women first responders. But, generally speaking, women are more willing to talk about their feelings. Could this be why suicide does not even rank in the top ten causes of death for women?)  

Most men I know brush their teeth, go to the dentist once a year, change the oil in their vehicles regularly, go to the gym, and see their doctor when they are sick. Troubling emotions or thoughts require the same care. Think of annual mental health check-ups as “mental floss.” A time to clear out the sticky stuff that’s doing hot laps in your head. It doesn’t mean you are weak, broken, or something is wrong with you.

What exactly is an annual mental health check-up? According to the Badge of Life, who first raised the idea for law enforcement, it is a voluntary visit with a licensed mental health professional, preferably someone who understands the first responder culture and/or is trained to deal with stress and trauma. But certainly, someone with whom you feel safe and comfortable. What should you talk about? Take a look at the past year, is there anything bugging you, something you can’t let go of? Are there things you’d like to change in the future? How are you coping with life? Are you drinking more, sleeping less? What are you doing to remain resilient? How are things at home? What's going on in your personal relationships? Have you changed as a result of your work? Do you like the changes? Does your family? 

Is a check-up confidential? Licensed clinicians are required to report only if you are a danger to yourself or others, unable to care for yourself, or abusing an elder or a child. If you have been abused as a child, they are NOT required to report this unless the abuse is ongoing and children are currently at risk. Discuss confidentiality right off the bat, especially if you are using someone with a contractual relationship to your department. Going outside your department for therapy, further guarantees your privacy. 

The therapist you choose to see is not your adversary, not like the clinician who saw you for pre-employment screening or a fitness-for-duty evaluation. This therapist works for you and with you. Those other therapists work for your department.

What if you have to pay all or part of a therapist's fee? Do it. First responders often amaze me. You are willing to run into burning buildings or chase crooks down a dark alley, but risk money to help yourself? No way, if the department caused your troubles, the department should pay. 

Don't wait for your department to help. Modern thinking departments will have a well-established peer support program and/or a chaplaincy programs. These are the first people you can talk to. You should be able to confide in them and they should be able to help you find a suitable clinician. But if your department doesn't offer this kind of help or recognize the need for it, then it's on you. Don't wait around.

Make 2020 a year when you are not a statistic. Make 2020 a year when you are not part of the stigma. Make 2020 a year when you are courageous enough to listen to a buddy’s troubles even if talking about emotions makes you uncomfortable. Make 2020 a year when you encourage your buddy to seek help, maybe even go with them to their first appointment.

References

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Behind the Shield: James Geering's blog. http://www.jamesgeering.com/blog/2016/11/27-i-wish-my-head-could-forget-the-things-my-eyes-have-seen. 

The Badge of Life website: http://policesuicide.tripod.com/id65.html

Kirschman, E., Kamena, M. & Fay, J. (2014) Counseling Cops: What Clinicians Need to Know, New York, Guilford Press

Lewis Z. Schlosser and Chief Andrew A. Kudrick Jr., “ ‘You Have to See the Psych’—Reducing the Stigma of Seeking Mental Health Treatment among Police Personnel” Police Chief 86, no. 5 (May 2019): 50–56.

Friedman, M. "Bring a Buddy." https://badgeoflife.org/articles

Evans, S. (May 2018) Not Talking About Mental Health Is Literally Killing Men.https://www.menshealth.com/health/a20111514/men-mental-health-awareness-month/.