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After the Plan- Don’t Forget Everything Else

Last week, I had the honor and privilege of attending the Mental Health First Aid for Firefighters on the first day of the Rosecrance Florian Symposium.  Firefighters from Los Angeles County, Florida, Alaska, Oregon, Illinois, Toronto and others- participated in an informative discussion about topics that are prevalent within our profession.  The curriculum included issues such as: anxiety, depression, suicide, psychosis, and substance abuse and was well received by all attendees.

The recurring theme for each behavioral health issue was the following Mental Health First Aid Action Plan:

Action A: Assess for risk of suicide or harm

Action L: Listen nonjudgmentally

Action G: Give reassurance and information

Action E: Encourage appropriate professional help

Action E: Encourage self-help and other support strategies

Each module included a description of an issue followed by a discussion on how to implement a plan of action using case scenarios.  During the course of the day, the subject of department policy was examined as to how it fit into the intervention strategies as described above.  There was no definitive answer to this question as each department/city/state has its own guidelines with which to follow.  It was recommended that any policy set regarding behavioral health should be followed, especially if the assessment of risk for suicide or harm is high.

Towards the end of the day a most enlightening monologue was given by Lieutenant Graham of the Rockford Fire Department.   He stated that once the department guidelines are followed for the protection of the individual as well as the crew/shift- “Don’t forget everything else.”  What the good LT was referring to was the human side of the equation.  Yes, we must take the immediate step to mitigate the situation (standard SOG response), but then we must have the honest conversation to attempt and uncover the underlying cause.

LT Graham used the example of a career firefighter who starts showing up to work under the influence of alcohol- something that is out of character for this individual.  First, we must not cover this person’s tracks as this will only compound the problem.  Implement Action A and follow department policy.  After that, LT. Graham said an after-care conversation should be initiated.  For example, this discussion can begin something like “I have noticed that you are acting out of character lately and it’s not like you . . . what’s going on?

LT Graham further related that by “making it safe” (as Matt always says) we may just find out that this person is having financial and/or marital issues or a health crisis involving an immediate family member- which has led to said drinking.  This is what peer support is all about my friends- reaching out, caring, and sharing the human experience with our brothers and sisters.  Should we be so fortunate to have the peer divulge sensitive information, this will help provide a solid foundation for after-care activities.

As peer supporters, it is not our job to diagnose or treat behavioral health emergencies.  Our mission is to provide an environment that a peer feels safe to discuss issues well before they spiral into the Action A Zone.  Always remember to “not forget everything else.”  My sincerest thanks goes to LT. Graham for sharing his wisdom.  Until next time-

Be well and stay safe,


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