In a small-town hall Saturday morning, Rep. Suhas Subramanyam (D-VA-10) heard concerns surrounding available resources to address mental health injuries from Loudoun firefighters and shared legislation that he is working on to provide more support for first responders.
Attendees told Subramanyam that a common challenge they face when looking for mental health treatment is finding practitioners who are experienced working with firefighters and EMTs. Loudoun County Fire and Rescue Assistant Chief Travis Preau said because of a lack in supply for those types of clinicians, first responders are often treated by counselors outside of the industry.
“They [go see] a regular counselor and they’re like, ‘wow, I am not prepared to deal with some of the things that you’re unpacking here today,’” Preau said. “Because I think this first respondercommunity needs kind of a niche set of clinicians that understands what we do, but there tends to be a really big deficit in the number of providers that are either specially, clinically or exposed to what first responders are.”
That concern was reiterated by others in the room.
“There is a void right there, and we aren’t pumping out enough clinicians with this knowledge to serve the number of first responders in the communities who are taking on the toll of a career in this field,” Behavioral Health Coordinator Lynn Gray said. “Because these guys don’t bounce jobs. They stay. This is their chosen profession. This is their commitment, this is their passion, and they stay. So, we have todo something to match and meet that and take care of them so that when they leave here, they can go enjoy their life.”
That experience is not just needed on the counselor’s side to provide adequate treatment, but it also builds trust with the first responder, which is vital to identifying the illness in the first place.
“Firefighters, EMTs, first responders are not going to divulge to somebody they don’t trust. And I can read you and read the room real quick, and if I don’t trust you, I ain’t saying nothing. Right?So, where’s the benefit to the person that needs the service?” one firefighter said.
LCFR Behavioral Health Coordinator Kristina Moore said while peer to peer support is important and long-term inpatient facilities are also critical, there is often no “middle level” support for first responders.
“We do try our best to network with the community and get community providers that are culturally competent in working with first responders,” she said.
Members of the general community can access intensive outpatient programs that look like three hours of treatment three days a week.
“But for first responders, our levels go from here, to a therapist one hour once a week, to inpatient for 30 to 45 days,” Moore said. “Which if somebody needs that level, absolutely, but we don’t have any other levels in between.”
There are often very few training opportunities for clinicians treating first responders.
“We’re going to attend a national conference in June, and one of the things we recognize is there are no classes for clinicians serving first responders. That’s a travesty. That is ridiculous and on a national scale,” Gray said.
How can the federal government incentivize schools and clinicians to train and educate themselves in this area, she asked.
Another firefighter said it’s easy to fill out paperwork and find treatment for physical injuries sustained on the job, but that it’s harder for mental injures.
“A lot of that falls back primarily on us as individuals,” he said. “There’s not lifetime mental health coverage. We’re responsible for our co pays, our medications. … We’re sometimes doing one or two [traumatic calls] a day, and that just overall breaks you down and wears you down. And then, secondary to that, I’m using my vacation time to go to speak to a therapist for 45 minutes.”
Subramanyam said he was glad for the feedback and to hear about the challenges facing the industry.
“Now we have some work we need to do the social work level, and we have create an ecosystem of people that you can turn to, that you can trust, that understand what you’re going through. I think that is the key to helping resolve a lot of this,” he said.
Subramanyam introduced two pieces of legislation last week that he is hoping will provide some additional support to the industry.
The Peer Support for Our First Responders Act is focused on enhancing and streamlining peer-to-peer work for law enforcement officers and first responders’ behavioral and mental health. The bill would bring together experts, law enforcement officers, firefighters, first responders, and stakeholders by establishing an interagency working group which would review best practices and issue updated recommendations to Congress on ways to improve behavioral and mental health outcomes.
“The evidence we’ve seen is that peer to peer mental health services work really well. People want to talk to someone who’s had their experience, understands where they’re coming from, and that has worked. So, let’s invest in stuff that works,” Subramanyam said.
The Public Safety UAS Readiness Act, also introduce by Subramanyam last week would establish a $10 million per year grant program to support the creation and development of dronepilot training for fire departments, emergency medical service providers, and law enforcement agencies.
Subramanyam said other efforts he is pursuing include grants to make access turnout gear that is free from forever chemicals easier to achieve, establishing a cancer registry to better track health impacts from the industry and a national suicide database for first responders.
His efforts were praised by LCFR Chief James Williams, who especially noted the absence of a comprehensive suicide database. The importance of behavioral health treatment has been a cornerstone of Williams’ work during his decades with Loudoun’s fire and rescue and he said he’s seen many changes over the years.
“It is amazingly important to me in so many ways. Through our own tragedies, and the tragedies that we’ve seen and were part of, legislation to support our first responders, is so important,” he said.