Working Mind First Responders program geared to helping the helpers

By Courtney Kraik

Paramedics, firefighters and police officers are often the first on scene in the event of a traumatic or medical emergency. Emotions and expectations are high as the public looks to these individuals for answers simultaneously expecting them to remain calm, professional and provide assistance in often chaotic situations.  It’s a heavy weight to carry, and left unacknowledged, may result in compassion fatigue, vicarious trauma and potentially, post-traumatic stress disorder (PTSD). Paramedics at Ornge, Ontario’s provider of air ambulance and related services, routinely transport some of the province’s sickest and most severely injured patients, and consequently often find themselves dealing with these challenges.

There has been positive change in how we view these conditions within the context of workplace injuries. Still, the barrier of the stigma remains.  Signs of deteriorating mental health include anxiety, depression and substance abuse, which can leave first responders feeling helpless, hopeless and sometimes result in the individual being sidelined indefinitely.  Training individuals to recognize such warning signs in themselves and in their peers is crucial.

The Working Mind First Responders (TWMFR) is a training and guidance module used to support the mental wellness of front line emergency responders. The course originated within the Canadian Department of Defense and among the first organizations to utilize it were the Calgary Police Service and the British Columbia Wildfire Service.

Each module for paramedics, fire and police looks a little different. The idea is to gather statistical data to measure the mental health and wellness of all first responders and what interventions, if necessary, have the most positive impact and outcome.

At Ornge, the first step to implementing the TWMFR module to support its front line employees is to train “trainers” within the organization. Thomas Walker, Ornge’s Human Factors Specialist and Dawn Gilpin, a Disability and Claims Management Officer in the human resources department at Ornge were instructed in the Primary and Leadership level courses — under the The Working Mind First Responder’s umbrella — to help facilitate the creation of a culture of sustainable mental health education.

Together they train managers at the leadership level and a network of front line peer supporters across all of Ornge’s bases. Walker and Gilpin coach these leaders and peer supporters on how to recognize when a member of their team is displaying signs of unhealthy coping mechanisms and/or mental or emotional disturbances.

“The base managers are the best point of contact with their staff because they are with them all the time,” said Gilpin. “They get to know what a normal day looks like for that individual and when that individual looks like they might be struggling.”

The three central components of the TWMFR course at any level are:

• scenario-based practical application/custom videos;
• a set of cognitive behavioural therapy-based techniques coined “The Big 4;” and
• a Mental Health Continuum Model.

These components give managers and members of the peer support network an overview of what stress looks like and how it can manifest physically.

Gilpin and Walker recognize that training people to see the signs is important, but that the stigma surrounding “mental illness” still creates a significant obstacle when it comes time for those individuals to seek help. It is common for first responders, who broadly exhibit A-type personalities, to feel concerned that once they seek help, they will be labeled as weak or ineffective at their jobs.

“I often hear ‘I can’t be unhealthy, I’m the one who fixes people’,” said Walker. To exacerbate that problem, there’s also the hesitation of peers who feel uncomfortable prodding into the private lives of their colleagues.

“It’s important for (us) to say exactly what we’re thinking,” said Walker. “We have to name it. We have to say, ‘I notice you and I notice that you don’t seem like yourself.’ We have to talk.”

Ornge, like many first response organizations, has built-in safety measures to support their staff following a traumatic event.  Ornge’s Traumatic Incident Review Process (TIRP) and Critical Incident Stress Management (CISM) briefings are the most common action plans. Operational pauses are offered to crews following high-stress calls if the crew feels it is required. However, as the industry moves in a progressive direction with regards to employee mental health and wellness, programs and modules like TWMFR gain serious traction.

Giving front line staff healthy tools that ultimately bolster their capacity for resiliency in the face of a traumatic event take priority. Tools like SMART goal setting, positive self-talk, visualization and tactical breathing are encouraged at the onset of and following stressful and disturbing incidents.

“I think a big idea we need to send home with (people) is to just take each part of what they’re going through in small chunks,” said Wayde Diamond, a Critical Care Paramedic at the Ornge Toronto Island base.  “Everything in its due time; there’s no rush.”

Ultimately, the goal of the TWMFR  is to create a space where open discussions on the fluid nature of mental health and wellness is tabled in a safe and supportive environment.

“Do I think there’s ever going to be a time when we won’t need to talk about mental health in first responders? No,” said Walker. “But I do think (maybe) there will be a time when we don’t need to teach people how to talk to each other or how to know themselves.”

The emotional and mental strain experienced by front line staff when they put on their uniform can have insidious and long lasting traumatic repercussions. Creating space and opening dialogue to begin the healing process is just as important as setting a bone or suturing a wound.

Courtney Kraik is a Communications Intern at Ornge