Mental health support has become important factor of public safety jobs

23/11/2023

REGION — “I don’t remember a day … since I started doing this (30 years ago) when first responders from all three towns were that taxed, it was very unique,” said Paris Police Chief Mike Dailey of July 7.

Oxford Police Officer Andre Chasse carries a dog – who was in an outside enclosure – away from the burning Ox-Bow Dog Grooming business on Roller Rink Road, in Oxford on July 7. The fire killed two dogs and a cat, according to officials. Submitted photo

Public safety workers throughout Maine have been understaffed and under pressure since before the pandemic hit in early 2020. It has not gotten any easier. The line of available volunteer firefighters is thin and fraying.

Police recruitment is wavering and retention a never-ending challenge. Police officers and EMS personnel may face more mental health and substance use disorder crises than crimes and health emergencies during their shift. And then there is the toll of a local workday like July 7.

July 7

A string of tragedies began around noon that day, with dispatch calling law enforcement and rescue to a “1048 possible H” on Greenwood Road in Norway. H stands for homicide and 1048 stands for unattended death. PACE, Norway fire personnel and law enforcement from myriad agencies responded.

At 3 p.m. a 911 call came into Oxford’s fire department: a home and pet grooming business on Roller Rink Road was on fire. While three occupants escaped safely, two dogs and a cat did not and were lost. By 5:30 p.m. first responders were on the scene of a two-car crash on Route 26 near the area of 935 Park Street in Paris.

Three occupants of one vehicle were killed and another victim was transported to Stephens Memorial Hospital in Norway. That same afternoon in Oxford a vehicle fire at Walmart and elsewhere a suicide were reported and a female inmate, who had been arrested two days earlier at the hospital, died at the Oxford County Jail. It is probably impossible to accurately estimate how many first responders and health care workers from Oxford Hills, SMH, PACE, and beyond were associated with those multiple tragedies.

At the core were law enforcement departments from Norway, Oxford, Paris, the Oxford County Sheriff’s Office and Maine State Police and fire and rescue from Norway, Paris and Oxford.

In addition to local departments, the Oxford fires saw ripple effects extend to Auburn, New Gloucester, Otisfield, Mechanic Falls, Casco and Poland, whose departments provided assistance on-scene, or with mutual aid to each other. “I didn’t have time to decompress from one scene to another,” said Dailey. “I didn’t have any down time in between. Eventually you have to have some way to deal with it.”

“We went from one major event to another in an hour,” said Oxford Police Chief Rickie Jack. Oxford Police Department held a debriefing, according to Jack. “The town manager came right down and offered [us] any services we might need. The three officers [who had responded to the homicide and fire] met with him and debriefed.

“The fire, in a way, helped us come down from the more stressful homicide,” said Oxford Officer Andre Chasse. But, “then a suicide…I knew the person and had a twinge in my heart for the family,” added Jack.

Emotional Impacts Behavioral health intervention and self-care are relatively new concepts in the field of public safety.

Veterans of 15 years or more recall the days when the day after working a gruesome crime scene or tragic emergency was treated as no different than the day before. Police and fire department employees whose tenures date back 10 or so years were among the first to benefit from the emergence of mental health support as an important factor of extremely stressful jobs. Known as Critical Incident Stress Debriefing (CISD), the process is now part of public safety agencies’ standard operating procedures.

Programming varies from city to city, but the main elements of debriefing include pre-incident preparation, crisis intervention, incident debriefing, follow-up support, organizational support and resilience-building. Generally speaking, a debriefing is conducted in small groups of peers following tragic and traumatic situations. The Maine Warden Service was the first public safety agency in the state to establish a peer support model for debriefing according to Kate Braestrup, its chaplain for the last 22 years.

Her experience with trauma goes back further than that and it is deeply personal; in 1996 her first husband, State Police Trooper James Griffith, died in a vehicle crash while in the line of duty, leaving her a widow with four children.

Braestrup has been a driving force of peer support from its early days to the present. She provides support training to all of Maine’s public safety agencies and the Maine State Police Academy, facilitates sessions for multiple agencies, as well as providing comfort to civilians involved in critical incidents and their families. “A debriefing will be facilitated by trained peers,” she said. “They do the same work, they understand what the others are talking about.

And they [facilitator] have not been personally involved with that critical incident. Those involved get to tell their story of the event, and their response to it. After, the peer supporter, having listened carefully, will provide pretty simple behavioral material to them.”

If a person has trouble sleeping or eating, or some other response in the aftermath of a critical incident, the peer supporter can advise on ways to help them recognize if their body isn’t recovering completely, as well as where to get more help. “Chemicals released in the body during a stressful or traumatic event is natural, and it is useful to people who experience it in the line of duty,” she said. “But the body is not meant to be engaged so repeatedly. It is taxing on the body.”

What Braestrup described is the mental and physical overload that officers and firefighters across Oxford Hills may have experienced July 7 as one tragedy after another struck Norway, Oxford and Paris. “These are extremely healthy people with unusually good coping skills, but they are asked to do extraordinary things,” she said. Debriefings can be a defense against developing post-traumatic stress and deflecting accumulated build up of stress.

“It gives the crews involved with the incident a chance to talk,” former Oxford Fire and Rescue Chief Paul Hewey told the Advertiser Democrat following the July 7 maelstrom. “We will bring in crisis outside teams if necessary from Maine EMS or Tri-county Mental Health.

These are private sessions and stay within the room.” Some more urban departments and agencies have dedicated behavioral health staff to provide CISD assistance. In smaller rural towns, chiefs rely on organizations like Tri-County Mental Health or Maine EMS.

CISD intervention can be a one-time session or be held as many times as an individual or group may benefit. Hewey said in Oxford all crew associated with traumatic events are encouraged to participate, but it is not mandatory. Dailey said prior to the July 7 vehicle accident, the most recent debriefing Paris police went through was two-and-a-half years ago, following a fatal house fire in November 2021.

For Norway police they say it was the double murder in Paris a couple of years ago. “Debriefings definitely help,” Dailey said. “They aren’t done enough, they should probably be done on any manner critical incident. On those not necessarily in the public eye.”

After the 2021 fire, the debriefing was large scale.

“We had the hospital, many more resources who [had been involved] participated,” he said. “Those that were there were part of it.” Dailey said that conducting them as closed meetings with peers is what makes debriefings effective. They continue in more casual settings too, whether on a coffee break at Dunkin’ or riding a patrol shift.

“When people see police [at Dunkin’ for example] …. they’re not just hanging out,” he continued. “They’re networking, they’re accomplishing stuff, they’re destressing.” A huge challenge for public safety officials is to leave the job at the time clock. This is where the CISD tools are applied to self-care, and it’s as learned a skill as any.

Part of self-care, though, is looking out for co-workers. “What doesn’t affect me, I don’t know if it affects somebody else,” Dailey said. “They may not show it. We [may see] someone not acting like themself.

We have had to ask why.” “You compartmentalize stuff,” said Chasse. “I never leave the office without talking to someone…that’s what has allowed me to handle it. You need to recognize when something is bothering you.”

According to Hannah Longley, Sr.

Clinical Director Community Programs for NAMI Maine, “Compartmentalizing during the incident … such as putting everything in a bucket (from the incident) but the bucket then needs to be emptied and peer support helps with that.” “If this is going to be my career I have to learn how to deal with it,” Jack noted. “Substances [alcohol/drugs] are the wrong way to handle it. I can tell if something is bothering my guys.

“No one really sees us [cops] in a positive light…no one likes getting a ticket, having paperwork served or being arrested,” contemplated Jack. “It wears on you and builds up …It gets so you just want some time not dealing with anything or anyone. We’re all human beings so when they [officers] need time off, they get it.” Officer Breagh Pyburn came to the Paris PD from Scarborough.

There, the department had an on-staff social worker. She hopes to bring a similar position to the department through a COPS Grant from the federal Department of Justice. The grant covers the position for two years.

In addition to facilitating internal debriefings, a social worker would handle welfare checks or be a liaison to concerned citizens who call police for assistance with mental health situations. The benefits extend from supporting the department following traumatic calls to alleviating workloads and lessening broader work stress.

You don’t forget “I had a young child more than 20 years ago and that child stuck with me to this day,” Jack said of a critical incident. “Children always stick with me …

I do deep thinking, deep swallowing. “We are now a lot more aware of mental health issues.” “I’ve been in law enforcement for five years,” Officer Andre Chasse said. “The [Maine Criminal Justice] Academy addresses (critical incident trauma).

I’ve never had a child but I remember a crash I responded to where the victim was still alive even though their face was crushed they were spitting out teeth and bits of their mouth – that really stuck with me.” “I remember my first fatal,” Jack continued. “A passenger on leave from the Army, it was a head on collision and the victim had a ski pole in his head … I looked in his eyes …

I remember his eyes, I’ll remember forever … he was alive and then he wasn’t.” Jack added, “Animals upset me for the family … my animals are part of my family. I have been with OPD for 27 years and there’s not many in town that I don’t know so I know people who have bad things happen.

Once a year I really start to think about stuff I’ve seen … what keeps me going is my family … home and family.”

Norway K9 Unit Officer John Lewis recalled an incident that has stayed with him. “A long time ago I assisted in a drowning [bringing the victim to surface] … I still see it.” Norway Police Chief Jeff Campbell said, “Process what happened, self-evaluate … everybody has those calls you realize at the time it was a [terrible] call.”

He said that they don’t get debriefs for suicides though. Norway School Resource Officer Holly Pullen added, “I still see a suicide I responded to where the victim had shot off half their face but was still alive… .” Lewis said his coping skill is to strictly direct his focus. “I know enough about myself to not need to be close to the victim and as few times as I can manage to look [at the victim] I have fewer pictures in my brain … if I keep my mind engaged it won’t [affect] me as much down the road …

There’s a lot of other stuff going on to focus on.” Peer support

“Key to what we do is peer support,” explained Maine State Police Sgt. Dan Hanson. “We have training in how to actively listen and communicate in those situations.

In groups or one-on-one. You meet, see where they’re at. If they’ve recently experienced something, we want to meet with them and check on how their day-to-day is going.

“We do a general overview of how we think they are. Similar to what we would do for friends going through a tough situation.” “It’s hard to find trained people to run [debriefings] and you have to get a large number of parts together [multiple departments] to run a helpful debrief,” said Lewis. “Small departments struggle with coverage if personnel need to go debrief.”

Braestrup leads peer support training not just in Maine but for agencies out of state. While debriefings are voluntary for Oxford Hills’ agencies, participation is mandatory for the Maine Warden Service. To assist smaller departments that may struggle to hold debriefings, she is working on programs that lend trained supporters from agencies with established procedures, as well as establish regional teams to collaborate on debriefings and develop multi-agency support sessions.

Braestrup noted that multiple departments involved with one particularly difficult case – the April, 2018 manhunt for the killer of Somerset County Sheriff’s Corporal Eugene Cole – gathered for a joint debriefing facilitated by peer supporters from different agencies. “As an FTO (Field Training Officer) I have my trainee read On Combat … I require it… ,” said Norway Investigator Jeremy Pyburn.

The book looks at what happens to the human body under the stresses of deadly battle and the impact on the nervous system, heart, breathing, visual and auditory perception, memory – then discusses new research findings as to what measure warriors can take to prevent such debilitation so they can stay in the fight, survive, and win.

It looks at the critical importance of debriefings as well. “How it works for us, if you think about the military and you think how they’ve evolved in taking care of their soldiers,” Hanson said. “When you have a soldier … and they want to talk about their experience, is it easier to talk with someone that’s been there and seen it than to talk to someone that read about it in a book and knows nothing of the physical facts of being in that situation – that’s where peer support comes in. “You’re talking with someone who has been there and experienced that type of situation, and has that understanding of when someone is explaining how they reacted to something you can relate to them in a way that someone who hasn’t done it cannot.”

“You don’t truly know until the moment arises where you need to step up and do something [if you can do it],” said Trooper Jason Wing. “People in law enforcement, they feel like they have that ability. Rise to the occasion when necessary. “Take 9/11.

How many people today can raise their hand to say they will run in a burning building, a horrifying, chaotic situation. How many would run in? But people sign up for this job knowing this is an expectation,” Wing continued. “That’s the thing … it seems abnormal to want to do that.

But thankfully there are people in society who are willing to do that.” Post training simulation reactions include “adrenaline is huge, absolutely,” described Hanson. “You have that, cortisol, elevated heart rate, sweating… .”

“You can see how they [trainees] react,” added Wing. “It’s not always 100%, but you can see how they react and how you need to move them through their training, and maybe make the [decision] whether they can do the job or not.” “You want to give as much experience of things they could possibly encounter,” said Hanson. “There’s a shock factor coming into contact with something you’ve never seen before.

They need to see these scenarios and we need to prepare them. To have seen it before and responded before. “It’s not a perfect world but it helps.”

[Afterwards] “taking the time to do something that takes you away from the stress [is important]” added Hanson. “Everyone has a different way. For me, it’s working out. I like to sweat it out.

But sometimes it’s just focusing your mind on mundane things, to give yourself time to reset.” “I deal with it at that time,” said Wing. “Then I box, I do jiu jitsu. “To go to a homicide and see all that chaos.

Four hours later you’re going to be sitting down with a coffee, with each other. And start to debrief. Most people in the general public wouldn’t get that.

We can go from a homicide scene to a domestic, back to a homicide, to a workplace harassment complaint.

“We have to be able to compartmentalize what happens so we can go on to the next situation. A clinician doesn’t understand that environment,” Wing concluded. Hanson noted that the critical incidents that stick with them usually involve children.

“Kids, things with kids more than anything else,” he said. “When we look at the children, they are the true victims. They’re the ones who are supposed to be taken care of, especially by their parents. “As a police officer doing your job, you have to examine the body of a two-and-a-half-year-old.

For me, anything involving children. In car crashes, been killed or different incidents. Infant deaths.

They’re so traumatic. Those are the things [where] you really rely on stress management. Keep your head up and get rid of all those chemicals you get when exposed to those situations.

You never forget them, and people assume it’s only violence. But you’re exposed to so much and it releases stress chemicals. “When you’re exposed to a child’s death, there are going to be chemicals in response with that and you have to do the work to get rid of that stress.

It doesn’t have to be chaotic or violent, but those exposures in tough situations, you have to manage that.” While actively dealing with such situations Hanson said he has to “remind myself I have to do my job. Especially when I’m dealing with victims associated with fatal crashes or incidents like that, my focus is to do the best job I can to ensure the story of that victim is properly told.

That is what the family will want.

“If I allow my emotions to get involved, it is going to affect my ability to properly do this investigation.” Under fire Law enforcement sometimes have critical incidents when they are under fire.

“You hope you don’t get hit,” said Wing. “You’re waiting for it. I’ve been shot at,” added Hanson. “And that aspect of it is so unique.

You know it’s coming but you don’t know when. When you hear the bang, that’s when it’s too late. “I’m going to feel it before I hear it.

There’s no way to stop it. That aspect, of being involved when there are shots being fired, you’re just waiting for it. I had a chase with a murder suspect years ago.

We’re chasing him down the highway and the lead unit called out ‘shots fired’ and his vehicle crashed. We’re seeing smoke rolling out of the car and I need to position around it. We’re waiting for the back window to blow out.

I’m trying to get in position to cover for him and I’m thinking that if shots come out, how am I going to prepare for this?

“I remember, just waiting for, with the fear that it was going to happen. There’s chaos when that happens. It’s gone off and you hear that one and wonder when is the next one coming?

There’s a lot of anticipation, stress.” “For me, I’m experienced with military training,” Wing countered. “I’ve been deployed to Iraq and Afghanistan. I have a different perspective.

It doesn’t really bother me. I don’t want to get shot – I prefer to not get shot. But I don’t get worked up.

“A junior officer just coming out who’s in a chase, you’ll hear they’re a little hot on the radio,” Hanson continued. “You can hear it in their voice. They’re getting that chemical dump and their body is reacting to it. That jitteriness, the adrenaline.

Over time you do get used to it. “Twenty years on, you’re in that same type of chase. The chemicals are the same but you don’t respond the same way.

You’re acclimated to it and able to work in it different. Like the first time you have a cup of coffee and the 1,000 time. Now, you’re used to it and the caffeine doesn’t hit your system the same way.

You function different. “Because of Wing’s military experience, it helps coming into the law enforcement world. For people like me, I came into law enforcement green.

I had to learn all of that, working in the law enforcement environment and no prior military experience. I had to develop my stress management skills on the job.” Statistics

“The most recent study in 2021 found law enforcement is 54% more likely to die of suicide than individuals in the general population,” said Longley. “There was an additional study that was released that found that the higher an officer goes in rank, the more at risk they become.

“We lose more responders to suicide in Maine and nationwide than line of duty death. “I connect (first responders) with resources and training about their own health and well-being,” she explained. “Most of us will experience two to three critical or traumatic incidents in our lifetime.

“First responders will experience 170-180 through their career plus the two to three in their personal life.” A critical incident could be a car crash, fire, significant loss in our lives such as an unexpected death through suicide, homicide, fire, or car crash, Longley explained.

“Each critical incident has a cumulative effect on a person’s health. For example, increased risk of cardio vascular issues.

Increased risk of physiological effect such as a significantly higher risk of anxiety, post traumatic stress and suicide.” She cites the HERO Act or Helping Emergency Responders Overcome Act. “In Maine, this Legislative session, death by suicide is now considered death in the line of duty,” she said. “They respond to a car crash (where maybe a child has died) then go home to their own family, their own kids,” she explained. “We ask them to go against the way the brain is wired … they run into the danger, not away from.

“We all have coping skills that get us through our day to day and jobs. There is now a greater understanding, acknowledgement and ability to talk about it (the trauma/stress) … it is no longer stigmatized. “Twenty percent of first responders meet criteria for Post Traumatic Stress Injury which is significantly higher than the general population and there is a presumption of eligibility for first responders to qualify for workman’s comp.

How to help

So what can the community do to help its law enforcement officers? “People can help by going to select board meetings and supporting the department,” said Jack. And “Withholding judgement until they have the full story …”

“That’s what I think about,” said Wing. “Individual people talking to their reps about funding, about training, through bills, that support us.” “I would go a different route,” countered Hanson. “Just say ‘thank you’. We were at lunch the other day after court.

A mom came over with her little boy and he wanted to say hi. Simple little things like that recharge you. We have a … very difficult …

Job in a difficult environment. “It’s rare to make it through my shift without someone flipping me off driving down the road. They don’t know me.

Just because of the job that I do, they immediately are against me. That hurts. It’s pretty rude.

Simple little things like someone saying ‘thank you’, that means a lot. “When I’m pumping gas and someone at the other pump who looks over and says ‘good morning, how’re you doing? Thank you for what you do.’ Simple little things like that do mean a lot to us.”

Hanson describes an protest a number of years ago in Portland where the State Police were sent to keep order.

“These people were getting right in my face, hollering horrible things,” described Hanson. “They don’t know me. They don’t know anything about me. And they’re judging me based on the profession I do and the role I have to play.

That is hard. I know it’s a small group of people that do not support [us]. “We have to recognize that the majority in our state, as Jason pointed out, does support us.

“But when that group gets in our face and is yelling and screaming at us, that’s what we see. We may have majority support, but they aren’t in our face saying they support us. “That a person [is] yelling at me and hates me, who wants to harm me.

That’s what’s so difficult. It’s like when Jason says, ‘stand up and speak for us’.” Dailey noted that the public might be more aware.

“You don’t think you take it home or with you on the job but your family may say you’re really grumpy today … that’s the mental side of it that people may not know,” he explained. “Such as a traffic stop where you are ‘grumpy’ well they don’t know you just came from a critical scene.” “A lot of people, the next day, thanked us for the [awful] day we had … it’s nice to hear,” Lewis said. Editor’s Note: Since that day in July, Maine and especially Lewiston, experienced the horrific mass shooting on October 25 when 40-year-old Robert Card fatally shot 18 people and injured 13 others during a shooting spree at two locations.

The trauma of this event went far beyond first responders. Anyone who watched TV, worked at CMMC and other hospitals, reported on the events, responded to the events, as well as those who survived, their friends and families of both survivors and deceased, were severely traumatized. The “debriefing” that first responders do would work for all of us.

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