Minnesota State Fire Chiefs Association Conference

1. Minnesota State Fire Chiefs Association Conference

2. Minnesota State Fire Chiefs Association Conference 2014

3. 149 Days

4. By Paul Combs February 3, 2014 http://community.fireengineering.com/profiles/blog/show?id=1219672%3ABlogPost%3A591820

5. Minnesota State Fire Chiefs Association Conference 2014

6. Minnesota State Fire Chiefs Association Conference 2014 16 Life Safety Initiatives Define and advocate the need for a cultural change within the fire service relating to safety; incorporating leadership, management, supervision and accountability and personal responsibility Trap begins if you meld all your identities (Mom Dad,Son, Daughter,Brother,Sister,etc.) in to being a firefighter. Enhance the personal and organizational accountability for health and safety throughout the fire service.

7. Minnesota State Fire Chiefs Association Conference 2014 Focus greater attention on the integration of risk management at all levels including strategic, tactical and planning responsibilities. All firefighters must be empowered to stop unsafe practices. Develop and implement national standards for training, qualifications, and certifications (including regular recertification) that are equally applicable to all firefighters based on the duties they are expected to perform.

8. Minnesota State Fire Chiefs Association Conference 2014 Develop and implement national medical and physical fitness standards that are equally applicable to all firefighters, based on the duties they are expected to perform.

9. Minnesota State Fire Chiefs Association Conference 2014 Create a national research agenda and data collection system that relates to the initiatives. Utilize available technology wherever it can produce higher levels of health and safety Thoroughly investigate all firefighter fatalities, injuries and near misses.

10. Minnesota State Fire Chiefs Association Conference 2014 Grant programs should support the implementation of safe practices and/or mandate safe practices as an eligibility requirement. AFG Wellness and Fitness ask for “Stress First Aid for Fire and EMS personnel”. National standards for emergency response policies and procedures should be developed and championed. National protocols for response to violent incidents should be developed and championed

11. Minnesota State Fire Chiefs Association Conference 2014 Firefighters and their families must have access to counseling and psychological support. Public Education must receive more resources to be championed as a crucial fire and life safety program. Advocacy must be strengthened for the enforcement of codes and the installation of home sprinklers. Safety must be primary consideration in the design of apparatus and equipment

12. Minnesota State Fire Chiefs Association Conference 2014 May Day – When do you call for it? Feel life endangered? Save a Life? Need to expand that concept!!!! The 13th Life Safety Initiative: “ Firefighters and their families must have access to counseling and psychological Support”? What are we doing about it?

13. Minnesota State Fire Chiefs Association Conference 2014 “The Mayday Button May Actually Convince You To Buy The Kindle Fire HDX” When pressed, the Mayday button connects you via live video to a so-called "Amazon Tech Advisor" -- headset-clad and ready to answer questions or walk you through issues you may be having with your tablet.

14. Minnesota State Fire Chiefs Association Conference 2014 Some questions and certainly not all inclusive list will include:entry level? Is the concept of Mental Health in our curriculum at our academies at the entry level? Are recognition of signs and symptoms part of our Company Officer Training?

15. Minnesota State Fire Chiefs Association Conference 2014 How do volunteer/combination departments deal with this issue with no EAP? Who is your EAP and what training do they have about the fire service culture? Where do I find the resources?

16. Minnesota State Fire Chiefs Association Conference 2014 Is there a psychological/counseling component as part of the annual physical? How do we prepare to add valuable ex-military personnel to the fire service who have already been exposed to horrific situations? As we go through various situations do you see someone in the organization who fits into one of these categories? Maybe you?

17. Minnesota State Fire Chiefs Association Conference 2014 THIS IS NOT INTENDED TO BE A CISD PRESENTATION AGREE THAT MENTAL HEALTH IS A KEY COMPONENT OF OVERALL FIREFIGHTER SAFETY PTSD JUST 1 MENTAL HEALTH CHALLENGE NO ONE MAGICAL ANSWER! MANAGE VERSUS CURE SOME MATERIAL SENSITIVE: Challenge you to put away cell phones/Ipads. I can’t hide from you!

18. Minnesota State Fire Chiefs Association Conference 2014 Chief Kyle Ienn RIP

19. Minnesota State Fire Chiefs Association Conference 2014 What qualifies me to speak?

20. Minnesota State Fire Chiefs Association Conference 2014

21. Minnesota State Fire Chiefs Association Conference 2014 Post Traumatic Stress Disorder Posttraumatic stress disorder (PTSD) is an emotional illness that develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience. PTSD sufferers re-experience the traumatic event or events in some way. Don’t have to physically be present! Almost half of individuals who use outpatient mental-health services have been found to suffer from PTSD.

22. Minnesota State Fire Chiefs Association Conference 2014 Sam Kedem- Therapist World Trade Center Permanency Project “Firefighters talk with each other about everything.” • Truth: Not about their own issues! • Feelings of shock, horror, fear, or thoughts of family and death not coffee table topics (Regher 2005) Chief Buchanon example tough call on the interstate never talk about it. • The more you talk about the traumatic experience the less likely to suffer from PTSD (Cowan 2004) • WW II Vets came home as an entire company by ship that took weeks. • Vietnam Vets flown home alone. Back in US next day. • Who has higher PTSD? (Grossman 1995)

23. Minnesota State Fire Chiefs Association Conference 2014 Chicago Tribune January 23, 2012 Males 79% of all 2010 Suicides (Fire Service Make-up?) 8.3 Million U.S. adults (3.7%) reportedhaving suicidal thoughts in the past year. Nearly 1 million people attempt suicide every year. There is 1 suicide in every 25 attempts. Every 13.7 minutes someone in the U.S dies by suicide. (At least 6 will die during this talk!) Source Center for Disease Control

24. Crain’s Chicago BusinessSeptember 8, 2014 “The statistics are sobering. Each year, about 1 in 5 adults in the U.S. experiences a mental health issue, and studies show such struggles don't just happen before 9 a.m. and after 5 p.m. A 2013 Gallup-Healthways Well-Being Index found that full-time workers with depression missed, on average, four more workdays in a year than their peers and that the American economy takes a $23 billion productivity punch to the gut annually because of workers' mental health issues”. The correlation was to business owner’s responsibility for the mental health of their worker! Many turn to EAP’s but small businesses with fewer than 50 employees are not required by law to sponsor health insurance or mental health coverage. "We make sure our employees know (the EAP is) there for everything," from marriage problems to line-of-duty deaths, says Brian Adcock, training director at the Frankfort Fire Protection District.

25. Suicide Statistics Firefighter Behavioral Health Alliance 2014 Jeff Dill “ An Internal Size-Up "911, what's your emergency?"

26. Suicide Statistics Firefighter Behavioral Health Alliance 2014 Jeff Dill “An Internal Size-Up "911, what's your emergency?"

27. Minnesota State Fire Chiefs Association Conference 2014 Chicago Tribune March 12, 2014 • Suicides second leading cause of death for college students. • Up to 90% of suicide victims have a diagnosable psychiatric condition* *Dr. Schawartz, Medical Director for the Jed Foundation

28. Minnesota State Fire Chiefs Association Conference 2014 How did we really deal with it then? • Our Lady Of Angels Fire • Chicago, Illinois • December 1, 1958 • 95 Killed, 93 children • FF Richard Scheidt • 10 year old John Jankowski

29. Minnesota State Fire Chiefs Association Conference 2014 Coping Mechanisms Prevalent Today: Illegal Drugs Prescribed Medications (Pain Medicines) Alcohol Smoking Eating CAN BE COUNTERPRODUCTIVE AND MAKE US MORE REACTIVE (SENSITIVE )TO FUTURE STRESS

30. Minnesota State Fire Chiefs Association Conference 2014

31. Minnesota State Fire Chiefs Association Conference 2014 Stress Management Tools Regular Exercise Meditation or other relaxation exercises Structured “Time Outs” Learning new coping strategies “The management of stress depends mainly on the willingness of the person to make changes necessary for a healthy lifestyle.”

32. Minnesota State Fire Chiefs Association Conference 2014 “May Day” called when? 2 steps away from losing their job. About to get a divorce. You are professionally and personally lost and dying.

33. Minnesota State Fire Chiefs Association Conference Rekindle! What feeling does that evoke? Shame! • We can have emotional rekindles. • Not all grieve at the same pace or are impacted the same way so they don’t come forward. “Why is theirs out and mine is rekindling?” Simply not enough overhaul!!!

34. Minnesota State Fire Chiefs Association Conference 2014

35. Minnesota State Fire Chiefs Association Conference 2014 How do we deal with it now? Houston Fire Department 2013 Are we really any farther ahead than Our Lady Of Angels?

36. Minnesota State Fire Chiefs Association Conference 2014 “Suicide Prevention and Intervention in the Fire Service” NFA October 25-27, 2013 Leading clinicians came to share knowledge and resources along with listening to the fire and emergency services participants.

37. Behavioral Health Needs of Firefighters • Firefighters are at risk for behavioral health problems • Occupational exposure to a wide range of potentially traumatic situations is part of the job • These exposures may increase behavioral health risk • Threat of personal injury and exposure to death and injury of colleagues and associates can be strong risk factors • Erosion of positive behavioral health is demonstrated to result in negative impacts on overall health and wellness • Unmanaged behavioral health issues can limit careers and affect teamwork and morale Dr. Angie Moreland

38. Behavioral Health Needs of Firefighters • Epidemiologic estimates suggest that > 25% of firefighters need behavioral health assistance at some time in their careers • All of these behavioral health problems can be addressed with treatments that have been found to be effective • However, firefighters often do not receive these interventions when they seek treatment • Significant risk for suicide among firefighters Dr. Angie Moreland

39. Behavioral Health Needs of Firefighters • Firefighters are served by a wide range of behavioral health providers • Some are well versed in evidence based treatment • Few specialize in treating firefighters or the conditions for which they are at heightened risk • Ensuring that firefighters and their families have access to effective behavioral health treatments is one of the Firefighter Life Safety Initiatives established by NFFF. Dr. Angie Moreland

40. Break Please take 10 minutes

41. Minnesota State Fire Chiefs Association Conference 2014 CFD suicide cluster 2008. Drove research from Local 2 (Dan Degryse statistics Aug. 2011) • Preliminarily have identified 40 suicides since 1990 • Does not include Florida because they do not identify cause of death on the death certificate.  • Significant at a glance is the fact that over 50% are retired and have been in the military. • No conclusions but to create awareness and discussion.

42. Dr. Thomas Joiner “Why People Die by Suicide” His model based on 3 things must occur: Serious suicidal behavior requires desire for death. That desire composed of 2 psychological states: • “Perceived burdensomeness • “Thwarted belongingness”. If either state occurs in isolation then they alone are an insufficient trigger. If they co-occur the desire for death is produced. • Last factor then is “acquired ability to enact lethal self injury.” Capabilityis the ability to fight the most basic instinct SELF SURVIVAL.

43. The Interpersonal Theory of Suicide Joiner (2005)

44. “The truth about suicide may prove unsettling-it is not about weakness, it is about the fearless endurance of a certain type of pain.”

45. Minnesota State Fire Chiefs Association Conference 2014 May Day Examples Hinsdale FD United Kingdom

46. Minnesota State Fire Chiefs Association Conference 2014 Where do we usually turn for guidance? NFPA Standards Fire Service Organizations Training Institutions

47. Minnesota State Fire Chiefs Association Conference 2014 NFPA Standards • NFPA 1021 (Fire Officer Professional Qualifications • NFPA 1500 (Occupational Health and Safety) REVISED • NFPA 1521 (FD Safety Officer) • NFPA 1583 (Health Related Fitness Programs) • NFPA 1582 (Standard on Comprehensive Occupational Medical Program for FD’s). MENTAL HEALTH COMPONENT CURRENTLY BEING EXAMINED INCLUDING A SCREENING INSTRUMENT

48. Minnesota State Fire Chiefs Association Conference 2014 IAFC-IAFF HEALTH AND FITNEES INTIATIVE There!!! Revised 2008 CHAPTER 5 — Behavioral Health Management and Labor shall support the provision of a behavioral health plan, which may be delivered either through internal or external sources, based on specific elements.

49. Minnesota State Fire Chiefs Association Conference 2014 ISSUES?

50. Minnesota State Fire Chiefs Association Conference 2014 • COST • ACCESS • TRAINED PROFESSIONALS • CULTURAL ACCEPTANCE • INSURANCE LIMITATIONS