What are the best practices for addressing mental health stigma among first responders?

Our department has evolved over the last decade, and now fully supports CISM and other programs to facilitate officer's mental health and wellness. Having been personally involved in multiple critical incidents over the course of my career, I can certainly say it was a relief to have the CISM program available for some of these incidents. We recently lost an officer on psychological disability after experiencing a short span period of incidents involving the deaths of several young children. CISM was instrumental in helping other responders to these incidents to reduce their trauma load, and continue peer support treatment.

It starts at the top, senior leadership must embrace preventative and supportive programming. A pre-employment screening is also developing. An anxiety disorder maybe should exclude first responders? A comprehensive program of peer support, front line supervisors willing to engage and qualified counselors to see first responders is a must. Take care of your people they will take care of the public.

I was a CISM Peer for over 15 years in the military and am a staunch proponent of the program. In my own opinion, CISM is a peer driven system in which the emotional and physical effects of a tragic incident are mitigated by providing an environment of open and non-judgmental dialogue to assist in the realization that the participants are having normal reactions to an abnormal situation.

Avoiding stigma is a serious problem. An effective way to address the problem is to accept the fact that stigma is a mental health behavioral problem and that if persons in leadership accept the idea that mental health modalities e.g., interventions and preventive methods are forms of the mental mitigation process there will be more positive outcomes. First responders hiding and avoiding the ugliness of stigmatization will follow the example of Flag officers/Generals, Battalion Chief, CEOs and other leaders of paramilitary organizations who accept mental health as a integrative CULTURAL positive tool and only then will we will see changes with decreases in shaming while experiencing increases in mental health treatment participation.

The biggest problem is we are almost solely reactionary. Without proper, continued support, cumulative PTSD is almost equally overwhelming. A consistent, career long, mandated mental health regiment almost seems necessary.

One of the best methods I have found to reduce stigma within my organization is to proudly share my journey with counseling. Attending counseling exponentially changed my life for the better, and saved my career. I am not afraid to share that vulnerability with my officers or peers. As a leader, coach and mentor, I want to see those people that I influence succeed. Openly discussing how counseling changed my life is a perfect method to highlight the positive aspects of seeking help. If sharing my past and present truths can assist one person from ruining their life or career, I have accomplished my mission.

I have found that the best way to reduce stigma is to just talk about it. I used to keep everything to myself but now I openly talk about therapy and how it has helped me work through trauma. One reason is so that others know it isn’t something shameful to talk about and maybe someone who needs help will reach out.

The authenticity and integrity of any peer support team is crucial in terms of hearts, minds, and stigma reduction. Open and honest conversations about lived experience, especially from leaders, is essential. I don’t think the role of supervisory leaders can be overstated - they need to create psychologically safe environments through living empathy and again, authenticity.

Allow first responders to speak to other first responders. Some of the most powerful lessons I've learned come from people working the front line, who may or may not have received mental health care, and learning how that impacted their lives. Allow veterans of response to speak in trainings or seminars, address signs of trauma, and how that trauma can resurface years later. Only by speaking about mental health care can we remove the stigma atta hed to it.

I have championed responder mental health and fought to reduce the stigma by openly sharing my journey. I have struggled with depression, suicidal ideation and post trauma stress. Two years ago I was just finishing inpatient treatment at the IAFF Center of Excellence. I have since shared all of my journey with the services I provide CME education to. I really look at and talk about this issue as I would a diabetic whose pancreas is not functioning properly. I and anyone with mental health issues have an organ that isn’t functioning properly. Maybe it’s medications that are needed, maybe it’s inpatient intensive treatment like the hospital admission and maybe its therapy, no different than physical therapy to condition the body.

I find this to be a very difficult question. Promoting self-care among people who are working 100 hours a week in the frontline of an emergency can come across as being completely disconnected from reality - and worse, can make first line responders feel guilty that they are not able to take care of themselves. Much better to have generous rest and recuperation patterns that are strictly enforced. It is unrealistic to believe that humanitarian workers at the frontline of an emergency will be able to have work-life balance - and we should be ready to slapped when we tell them to use deep breathing.

Promote self-care by encouraging regular exercise, adequate sleep, healthy eating, and relaxation techniques like meditation or mindfulness. Emphasize the importance of setting boundaries, seeking support when needed, and practicing self-compassion. Provide resources and opportunities for self-care activities, such as workshops, wellness programs, and designated break times. Encourage individuals to prioritize their mental and physical well-being as a fundamental aspect of overall health and resilience.

A few things that I would consider is having a healthy diet. A healthy diet will at least have a positive impact on your day to day routine. Alcohol intake is the biggest obstacle for law enforcement officers statistically. There has to be another way to relieve stress such as working out, reading, meditating, etc. that will be beneficial a lot longer than consuming alcohol.

The gym has always been my first spot to go in order to burn off extra energy, stress, and promote a healthier lifestyle. Furthermore, I quit drinking and added more hobbies to my off days! Got back into golf as well so the boys and I can just go blow off steam.

Reducing the stigma around mental health for first responders is vital for their well-being. Strategies include education, open communication, confidential support services, normalizing help-seeking, and implementing supportive workplace policies. By combining these efforts, a culture valuing mental health can be established, encouraging responders to prioritize their well-being and seek necessary support.

Physical exercise, proper nutrition and a full life outside of the job is critical to resiliency. WE all need a reality check from people who cam speak truth to our lives and who have our best interest at heart.

Getting rid of TOXIC leaders. Presence of toxic leadership can severely impede operational and mental effectiveness during emergencies, undermining team cohesion and morale. Cultivating a positive working environment is particularly vital in emergency management, where collaboration and mental resilience are key. Especially when you working together 12 hour shifts. Therefore, any form of toxic leadership must be rejected to ensure a supportive, productive, and psychologically safe workplace for all members.

As a senior enlisted leader in the military and a first responder, nurturing resilience is crucial. We achieve this by tapping into your inherent strengths, instilling a profound sense of purpose, boosting confidence, fostering optimism, and promoting continuous learning and growth. Recognizing and leveraging your personal and professional resources is key, acknowledging the significant contributions you make. Empowering you to take charge of your well-being, pursue goals, and reflect on experiences ensures a resilient mindset in the face of challenges.

Peer support programs: Building peer support networks can foster a sense of camaraderie and understanding, allowing first responders to share experiences and support each other. Mentorship programs: Connecting experienced first responders with those new to the field can provide valuable guidance and support for navigating challenging situations.

In my experience I embrace change and accept things I cannot change. Accept that nothing stays the same because change is part of our day to day life. Embraces mistakes, theirs, yours. Find ways to embraces and help others. Never set goals so high that they may not be obtainable in the workplace. Lastly pay attention to the workplace not everyone handle stress the same. Most professionals you can see it on their faces or in their body language. The workplace should be an environment to grow and promote positive change.

Avoid providing empty advice to make yourself feel good. It’s highly unlikely that first line responders at the onset of a crisis will be able to keep work-life balance, to breathe deeply or to exercise. Don’t add to their burden by making them responsible for self-care they cannot realistically exercise but do provide opportunities for real breaks, don’t have them on call during their breaks and make it clear that taking time for breaks and for listening to others are skills that are highly valued.

As a former law enforcement officer, I have unfortunately been on the opposite side of the psychological effects of the role. The constant stress, hostile conditions, and incidents involved all leading to an issue of mental health is a real and true concern. My perspective is to open the door to help by senior leadership. The term lead by example is an excellent motivation to mid and junior officers to seek help if they believe it is safe to do so.

One thing I've found useful is to help a friend! We are more than willing to help someone else - so if we have a peer who is struggling with drinking, offer to join them at an AA meeting! Had a really bad call? Invite someone that was on that call to join you at a debriefing or in talking with the department Chaplin or other professional. Or do something as simple as challenge them to a weight loss/improved diet/better sleeping habits contest. Any of these things will help them and it's our job to take care of each other! (psssst, want to know a secret? It'll help you, too!)

With over 30 years as a first responder, I've come to realize that 50 percent of the stress I faced originated within my own agency. While I acknowledged that I could not control this internal stress, I learned to manage myself by discerning what aspects of my job I can and cannot control. This includes being mentally prepared for the challenges I may encounter on the streets as part of my duty.

One simple thing to help with resilience is, have a hobby. I dont mean this in a joking way either. We need to be able to disconnect form our stressful jobs. So find a hobby that has nothing to do with your job. Ive found lately that, hobbies that are not only removed from my job, but seemingly out of character for me as well, help me destress. They also foster resilience, because I am more likely to fail early on in that hobby, and any victory is amplified!