Mental health – yours and theirs!

By Chief Sam DiGiovanna

World Mental Health Day is on October 10 and as our understanding of mental health grows, we grow along with it. Mental health has become a growing issue for both the general public and first responders. It is important to take a look at ourselves so we can be “mentally fit for duty” and to understand and be able to help those we respond to with mental health issues.

So, let’s start with,

Yours: All of us at some point and time deal with mental health issues. They come in various degrees. Like incidents we respond to, some are easy to manage, some are complex and need additional support. On working incidents, we get “kudos” for calling in special resources or that “second or third alarm.”  So why don’t first responders ask for help when they need it? They do not want to appear weak. There is fear of judgement, and fear of retaliation. Many feel they are the only one needing help, but that is not true. We are seeing more members in public safety committing suicide than line of duty death.

We respond to incidents every day. Adverse mental health and wellness in the minds of first responders are becoming an incident internally and growing every day. Like fires and medical incidents, we need to have resources and qualified personnel in place to help deal with mental issues. Remember, one small crack does not mean that you are broken

First Responders have the most stressful and high-risk job in the United States. Traumatic events such as active shooters, civil unrest, physical assault, wildfires, pandemics, political issues, domestic violence calls to name a few are dramatically on the rise.

This is a good time to take a look at your agency’s wellness program and re-evaluate its effectiveness. Just because you have one, does not mean it is the right one. Your Peer Support members and wellness committee members should meet and make sure it is of quality, confidential and accessible. Cordico can help you and your agency, along with family members find solutions

So, now we had our turn, let’s look at,

Theirs: Considerations for First Responders Dealing with someone with Mental Health Issues:

  1. Approach individuals in a calm, non-threatening, reassuring manner. Introduce yourself with your name, rank, and agency. Make the individual feel that he or she is in control.
  2. Determine whether the individual has a family member or caregiver you can contact. Be aware that this person may be the offender or may try to protect the individual.
  3. Avoid the following conduct in your actions and behavior with individuals:
    1. Circling, surrounding, closing in on, or standing too close to the individual
    2. Concealing your hands
    3. Sudden movements or rapid instructions and questioning
    4. Whispering, joking, or laughing
    5. Direct, continuous eye contact; forced conversation; or signs of impatience
    6. Any touching
    7. Challenges to or agreement with an individual's hallucinations or paranoia
    8. Inappropriate language, such as "crazy," "psycho," or "nuts
  4. Interview individuals in a quiet, distraction-free setting and ask simple and brief questions. Understand that a logical discussion may not be possible on some or all topics.
  5. Back off and allow individuals time to calm down before intervening if they are acting excited or dangerous but there is no immediate threat to anyone's safety. Outbursts are usually short.
  6. To bring compulsive talking under control, break the speech pattern of individuals with simple questions such as their birth date or full name.
  7. Empathize with individuals and understand that their hallucinations are frighteningly real.
  8. Be aware of non-verbal responses if someone is unresponsive. Do not ignore him or her or assume that he or she cannot hear you.
  9. Be honest. Getting caught in a well-intentioned untruth will increase suspicion and fear of you.
  10. Assess the individual's emotional state continuously for any indications that he or she may be a danger to him or herself or others.
  11. Do not overreact to offensive language or sexual, racial, or ethnic slurs directed at you.
  12. Do not order, command, warn, or threaten.
  13. Do not moralize, preach, or judge.

Source: United States Department of Justice (2010)

It is important we raise our awareness of this growing concern. We all experience difficult times and stress in our lives, and no one should feel ashamed in seeking help to manage those times.

Sam DiGiovanna is a 40-year fire service veteran. He started with the Los Angeles County Fire Department, served as Fire Chief at the Monrovia Fire Department, and currently serves as Chief at the Verdugo Fire Academy in Glendale, Calif. He also is a consultant for Lexipol Fire Services.