A Student Perspective: Social Work and First Responders

It may be rare for a social work student to reflect on an assignment as something inspirational rather than a stressful experience with a deadline, but at the end of  3rd year of my social work degree, one assignment was a challenge filled with hope. The assignment allowed me to contribute to a program that will give insight to other helping professionals about the mental health of first responders: police, firefighters, paramedics and others who respond to emergencies on the frontline.

The University of Newcastle has a particularly effective way of integrating workplace experience based learning with academic learning throughout the degree. The program options offered in third year which allow students to develop a program for a real agency was the most useful for me. To know your work might form a foundation for a real program in the community was a great honour and challenge to work on.

In the beginning, I was unsure of what to expect from the program development project. I was apprehensive about working with a professional capacity with a real agency, but I was excited also to learn more and try something new. There were diverse programs offered- from gardening programs to developing group projects designed for children and developing a program for professionals working with first responders.

The university gave us a chance to preference our interests and I was fortunate enough, with some other amazing women to be selected for the first responders team. The aim of our project was to put together a draft training package for helping professionals to enhance understanding of first responder mental health.

This topic drew my interest as it was beyond my scope of knowledge and I have a keen interest in mental health, so it was intriguing to me on both a personal and professional level. On starting, I very quickly became aware that I had actually put very little thought into the work first responders do in our communities to keep us all safer.

I learned just how complex the actual work of first responders can be, I learned the challenges that first responders face as a consequence of their work, the most traumatic of which is often invisible to the communities that they protect. I learned how repetitive exposure to trauma can complicate all aspects of first responder’s lives if they don’t or can’t seek or obtain support. I learned how much awareness is lacking within the multiple levels of the community, which is needed to enact change for first responders and their families.

Also, I learned the difficulties that can be faced by first responders and their families when attempting to access help. Whilst organisational supports are in place for some of the services, the stigma, shame and potential for the loss of their profession is very real. I heard stories about those medically discharged dealing with the grief and loss of their profession and identity.

My part in the group was to examine the supports already in place for first responders. I was concerned at the limited avenues for assistance and the extent of the difficulties for first responders to seek help. Besides limited services, stigma and organisational culture are barriers to effective help seeking. I found attempting to identify potential services to be frustrating, especially when looking for options within communities rather than those which are employer organisation based. My mind quickly went to how this frustration might feel for someone who was attempting the same whilst being unwell.

Gaining insight and recognition into the role first responders play, the impacts on their mental health, their relationships and all aspects of their lives and the flow on effect to their wider social ecology,  I  realised just how large the scale of first responder post-traumatic stress and other mental health consequences have on our community overall.

The hardest part of this learning experience was seeing the end of the project. The topic is so significant, it is hard to not to explore the topic further.  To me, this feels like a core social work and social justice issue, yet one which is invisible much of the time. My learning from this project has given me a totally new perspective. I have a renewed respect and a much deeper understanding of the issues faced by police, firefighters, paramedics and all others who work on the frontline in emergencies.

I know I’ve only scratched the surface of the knowledge it takes to work with first responders and enact positive change in their lives. I hope more research is completed and potentially more opportunities for training and professional development come up for social workers, whether it be integrated into core teaching within university programs or externally in workplaces.

A Qualitative Understanding of Trauma From A Helping Professional

first responders

Social Workers often work with trauma survivors and enter into the deepest parts of a victim’s psyches in an effort to help them transcend the often dark and debilitating symptoms which stem from trauma. Social Workers also experience direct and indirect trauma as part of their jobs and yet are often left out of the conversation with other first responders.

Last year, the Province of Ontario in Canada, passed The Supporting First Responders Act, which acknowledges and provides a host of benefits for the high rates of PTSD amongst Police, Fire, and Ambulance personnel. Police officers in Ontario also have the benefit of a five-year earlier retirement benefit due to the toll of their work.

I personally support all benefits for first responders, however, I remain mystified as to how social workers have been left out of this group. It almost seems absurd to have to argue the ways social workers are in fact first responders. One need only to look at the fields of crisis response, critical incident response, child protection, mental health intervention, and the like to realize that most direct practice social workers are in fact employed as first responders.

Many researchers have documented and quantified the nature and degree of trauma in the helping professions, however not as much qualitative research has been done. This is not surprising when one considers the stigma and shame associated with mental illness and especially mental illness among helping professionals.

In my twenty years of experience as a front line social worker in Child Protection, Domestic Violence Services, and School Social Work, I have observed too many times how colleagues have suffered in silence and have often been ostracized due to their struggles.

As a social worker and trauma survivor, I have worked much of my life to understand the impact of trauma on people’s functioning and I have searched far and wide for ways to ameliorate the symptoms which often erode one’s core positive beliefs about the world and about oneself. Stories and narratives about trauma are important and legitimate tools we can use to learn about the intricacies of trauma in people’s lives. As professionals, disclosing one’s story, however, is not encouraged, and helping professionals often suffer in silence.

As professionals, disclosing one’s story is often not encouraged or supported, and helping professionals tend to suffer in silence. Disclosure is scary business, and many social workers fear repercussions such as being viewed as weak, unstable, or unfit to perform our duties.

We feel the stigma that surrounds all mental illness and that serves to perpetuate silence and an ongoing lack of recognition and understanding of the cost of caring. There is a profound lack of ongoing dialogue surrounding the impact of the work we do on our own lives.

Most social workers would not trade or change their careers and lives despite the cost of caring. In fact, there is a core of altruism, dedication, ideology, and core values to improve the lives of others in this world that keeps helping professionals on the job during times of personal pain and suffering. We generally are a group that does not exercise good self-care and the organizations that employ many of us do a dismal job of protecting us and supporting our self-care.

While self-care initiatives exist, they tend to lose focus very quickly and they are not progressive in the sense of using cutting edge strategies to seriously help mitigate that stress that is inherent in our work. One need only look at the tech sector and the organizational and occupation health literature to realize that our work culture continues to be largely punitive based and continues to see employees as needing to be controlled.

Trauma refers to not only full-blown PTSD, but it is also the continuum of symptoms associated with experiencing horrific events – events that overwhelm one’s physiological stress response. A debt of gratitude is owed to the trauma sufferers who have allowed researchers to study and understand trauma which is one of the best understood mental health disorders of our time.

In particular, sexual assault survivors, natural disaster survivors, and veterans have shared their experiences over the last several decades and we must honor them continually. And, last but not least, the U.S. Department of Veterans Affairs National Center for PTSD and the PILOTS database must be acknowledged for the research, support, education, and dissemination of information about trauma.

Trauma survivors have the gift of strength and perseverance. I hope it goes without saying that living through and with trauma requires constant effort, energy, and strength. This strength leads to endless opportunities for survivors that can learn to harness their experience and strength toward future goals and achievements. While not always possible for all, finding the gifts and strengths associated with trauma is an area that does not seem to be talked about enough.

My hope is that this article can offer even glimpses of hope to those of you who have experienced trauma and for those of you who offer treatment and compassionate services to victims.

I will not give up strategizing and fighting for change in our organizational and political structures that need to recognize and provide reprieve and benefits to those in our profession who experience trauma like other first responders.

First Responder Mental Health: It’s Not All In The Mind

IN THE MIND web2

Our police, paramedics, firefighters and rescue personnel help keep our communities safe. However, the general public does not view this population group as vulnerable. While in the mental health field, doctors, psychologists and social workers are seeing a very different picture with alarming suicide rates and a high incidence of Post Traumatic Stress Disorder (PTSD). Emergency services responders are trained to look after others, but not themselves. It’s a global issue, one that is being increasingly brought to light by the courage of those who suffer and their supporters speaking out.

With many helping professionals working from a traditional medical model, mental health issues among first responders tend to be identified primarily as a response to attending traumatic incidents. Treatment is inclined to be focused on therapies such as CBT, DBT, EMDR and mindfulness. These approaches focus on individual change and evidence certainly suggests that these types of treatments are invaluable in terms of strengthening the individual’s coping and resilience skills.

However, we must be mindful how the systems in which the individual functions will also have an impact on their mental health. When working with emergency services responders and their families, it is vital that therapists and health promotion workers understand ALL the factors which impact wellbeing, not just in response to mental health issues but also in developing prevention strategies.

So, what are some of these “other” factors, or determinants warranting attention when dealing with emergency services wellbeing?

1) Emergency services culture – historically emergency services culture has fostered the ‘toughen up’ attitude, deeming the admission of mental health issues as a ‘weakness’ . Admitting this weakness not only reflects on the individual but also on the ‘brotherhood’ which values pride and strength.

2) Organisational culture- whilst changes are being made in some organisations, there are ingrained fears (real or perceived) from responders that any admission of mental health issues will either deem them unfit for work, or will stop them from getting promoted.

3) Workplace Stigma– there are real and perceived fears of work colleagues judging a responder as ‘weak’, particularly if a number of them have been to the same call outs, but only one speaks out about struggling. A lack of understanding of stress responses and the individuality of conditions such as depression, anxiety and PTSD leads to judgement and alienation of the individual affected, rather than what is needed – support.

4) Societal Expectations – Let’s face it, we all grew up thinking of police, firefighters and paramedics as heroes. They’re the people who protect us, and save our lives! We’ve been taught to listen to their instructions, trust their judgement in crisis and look to them for guidance when in danger. Somehow it doesn’t make sense to acknowledge that these ’heroes’ are human just like us!

5) Lifestyle changes Whether the responder is full time, part time or a volunteer, from the moment of recruitment personal and family lifestyle require changes. Inconvenient rosters, critical incidents, unexpected call outs and changes in household roles and routines are just some of the challenges faced by emergency services responders and their families.

6) Family Support– families of first responders have unique stresses and unique expectations. But it’s difficult to discuss these stresses and expectations outside emergency services circles. Firstly there is this feeling that the general public won’t understand. More significantly, divulging that their responder family member is suffering in some way feels like they’re breaching an unwritten ‘confidentiality code’ such as don’t embarrass the organisation, the crew or the individual by speaking about individual or family mental health issues. What happens on the job stays on the job which extends to family members. There is also the old belief that telling your family about any incidents affecting you will adversely impact that family member’s mental health. Organisational confidentiality regulations support that notion – yet talking about and processing traumatic incidents is critical in any recovery process.

7) Relevant Social Support. When responders experience work related stress, they have a number of barriers to disclosing struggles to friends who are not part of the emergency services culture. One barrier is confidentiality – they are not supposed to discuss the details of their work with anyone from the general public. Secondly, there is the notion (real or perceived) that those who haven’t done the job could not possibly understand what they’ve experienced. Thirdly, there is the reluctance to ‘burden’ civilians with the graphic details of incidents for fear they may end up suffering vicariously as a result of the disclosures.

What advice can those in the helping professions take from this?

If you treat an emergency services person with depression, anxiety or PTSD without understanding the context in which their illness or injury occurred, then you are not only doing your client a disservice, but you could in fact be damaging their potential for an effective recovery. It is vital that you have a genuine understanding of emergency services culture both today and historically.

Secondly, should we as professionals not be advocating on behalf of this group? In Australia alone there are over 400,000 paid, part time and volunteer emergency services responders – add their family members and that’s a huge population group affected by unique stresses! To advocate effectively, helping professionals need to understand the systems their lives function in, and systems which impact on wellbeing and recovery.

Thirdly, there is a strong need to focus on prevention – on a global level the media are telling us there is a “mental health crisis among emergency services workers.” We’ve seen these sorts of reports for years. What is actually happening to prevent mental health issues among emergency services responders? What sorts of consultations are happening? Who is invited to these consultations? Who is the information from these consultations being disseminated to? And what are the results of these consultations “on the frontline”?

No matter what field of practice you are in, I urge you to educate yourself on ALL the factors impacting the mental health of those who keep us, our families and our communities safe.

Reach Out Worldwide: ROWW Fulfilling the Unmet Needs of Disaster Victims

Reach Out Worldwide (ROWW)
Reach Out Worldwide (ROWW)

What started out as a group of friends traveling to exotic locales and their desire to help people struck by tragedy, Reach Out Worldwide (ROWW) was born. Founder, Paul Walker, created the organization in 2010 with the mission of providing relief to victims of natural disasters.

Two weeks after a fatal car accident, Paul Walker was laid to rest on December 15th, 2013 at Forest Lawn Memorial Park in a private ceremony with friends and family. Although Paul is no longer with us, his legacy will live on through ROWW as they continue to fulfill the unmet needs of disaster victims.

Reach Out Worldwide (ROWW) states on its website,

Natural Disasters don’t give us much warning. Our mission is simple, use our network of professionals with first responder skill-sets to fulfill the unmet need in times of chaos, tragedy, and destruction. Paving the way for long term disaster relief, leaving it better than when we got there. ~ ROWW

As a self-professed adrenaline junkie, Paul Walker was not as public about his charitable and philanthropic work with ROWW. Many people may be unaware that Paul was in the process of getting his First Responder Certification in order to be more field ready with the medical professionals on his disaster relief teams.

In a touching video recently released by ROWW, a tearful Paul Walker can be seen talking about meeting fathers holding their children asking for help to survive. As he recounts these experiences, you can see the deeply felt compassion and empathy for the hurting families they served.

If you are interested in helping  Reaching Out Worldwide continue their work, there are two ways that you can help support them. You can donate directly at www.roww.org/donate, and/or you can purchase a copy of the Fast and the Furious 6 where a portion of the proceeds will be donated to ROWW.

[youtube]http://youtu.be/FxU4kDmRzIw[/youtube]

Paul was only a couple of months older than me, and I know that feeling of not being afraid of anything. Remembering when the first Fast and the Furious came out, I was living the fast and the furious lifestyle with a 92 Honda Prelude Si. After too many brushes with death, I got scared that I was running out of chances, and the reality of my mortality set in. The Fast and the Furious franchise will never be the same, and you will truly be missed. View this fitting tribute to the life and legacy of Paul Walker.

[youtube]http://www.youtube.com/watch?v=o8UCI7r1Aqw[/youtube]

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