By Dan DeGryse
Those of us in the fire service encounter traumatic events in the line of duty every day. Days become years, and those years become a career that spans decades. To deal with the stress of the job and sometimes injuries from the job, some of us turn to alcohol and other drugs to cope. Our mental health suffers, harming job performance and family life. Ask yourself, “What’s the toll on your body, your mind, and your emotions after 30 years on the job?”
As firefighters and EMTs, we’re very pragmatic. We see a problem, and we correct it. But we’re never really taught or trained how to feel about it. The reality is, we’re human and we do feel. What we find out many times is that we don’t like those thoughts and feelings, so we anesthetize them.
We need to overcome the macho image of how we’re supposed to be and realize we’re human beings who are affected by years of trauma, whether we have personal trauma from losing a brother or sister in the fire service or we have secondary/vicarious trauma from the injuries and bad things we see every day.
Rosecrance, a leading provider of behavioral health services based in Rockford, Illinois, launched the Florian Program this year in hopes of providing a haven for the fire service. It’s the first program in the country dedicated to serving firefighters and paramedics who need substance abuse treatment but who also need care for job-related post-traumatic stress disorder (PTSD), anxiety, depression, and other mental health issues.
I’ve been in the counseling field for 28 years and have referred firefighters and paramedics to Rosecrance for the past 14 years. I approached Rosecrance President/CEO Philip Eaton last year about tailoring a program specifically for the fire service, and he welcomed the challenge.
The program was developed with the help of Dr. Raymond Garcia, medical director at the Rosecrance Harrison Campus, where the Florian Program is located. We gathered a 12-member panel of experienced firefighters and fire personnel from across the country to advise us and started treating clients in the fall.
“The nature of being a firefighter or paramedic is to always be ready for anything, to expect anything that can happen,” Dr. Garcia said. “It’s being ready for the unpredictable, and the unpredictable can be fairly traumatic.”
A Specialized Program
The Florian Program, named for the patron saint of firefighters, is based at the 97-bed Harrison Campus in Rockford. The campus has detoxification services and a full spectrum of inpatient treatment and outpatient programs for adults.
Florian clients have their own coed 1,800-square-foot, eight-bed unit that was recently repainted and remodeled to include firefighter memorabilia. Staff such as Dr. Garcia, a board-certified psychiatrist and addictionologist, has treated firefighters and paramedics for many years.
Participants interact with other inpatient clients and have access to the same fitness, art, and music therapies Rosecrance offers. But Florian clients also have programming tailored specifically to them.
Peer support from active and retired fire service personnel is a key element of the program. Men and women also can relate to each other’s experiences while staying on the same unit together.
The program also has spiritual support from people such as the Rev. Jim Swarthout, Rosecrance’s clergy community relations coordinator, who has experience as a fire chaplain.
“My role is just to be present. Firefighters and emergency medical technicians (EMTs), they have experienced trauma, and they’re trying to breathe life into others, and sometimes life goes out inside of them,” Father Jim said. “Our role is to help them realize they have life inside of themselves again.”
It’s important for counselors to understand what firefighters do to connect with us during treatment. Derek Bergsten, fire chief for the Rockford Fire Department, is a member of our advisory panel, and he helped us arrange an opportunity to do that. Nine Rosecrance staff members trained with the Rockford Fire Department in October to get a better understanding of some of our responsibilities. They suited up in full firefighter gear and took turns extinguishing a car fire; climbing a 100-foot aerial ladder; navigating a confidence course with various obstacles; and performing a search and rescue evolution, rescuing a 160-pound dummy.
You could watch all the fire TV shows and movies in the world, but to truly connect with somebody is so important. Our employees can now connect, not only mentally, but also physically, to some of what we are dealing with. When we talk about an incident, we naturally go back and have memories. And now our employees can remember the training; and when they talk to someone, they can say, “I get it now.” Experience, memory, and connecting are huge for a counselor and an organization.
Helping the Helpers
As firefighters and paramedics, we have different needs and respond to different therapeutic strategies than the general population or other first responders. “A big difference about this population is that they have to go back to work in most instances,” Dr. Garcia said. “Most firefighters and paramedics are going to go back into the same environment, so they’re going to be facing the same stressors. Our program has been designed to help them learn coping skills and develop ways to reduce stress on a daily basis so they have a better ability to handle those triggers when they come up on the job day to day.”
Resiliency is an important lesson, but so is accepting help and not feeling weak or ashamed by doing so. It can be difficult for the average person to ask for help, but we’re trained to be the helpers.
Patrick Kenny, fire chief in Western Springs, Illinois, and a member of the Florian advisory panel, calls it the “cape syndrome.”
“When you’re sworn in as a firefighter, whether you’re a volunteer or a career member, and you take that oath, they hand you a cape,” Kenny said. “You don’t actually see it, but you get it. And your job is to go out and save the day, to do the things that other people can’t do; and, unfortunately, you can’t always save the day. “You kind of get locked in that phone booth, and there’s a feeling of dismay:
‘What’s wrong? I should be able to do this.’ And you don’t share that because you’re not supposed to have any of those feelings, so you begin to self-medicate. We see a lot of our firefighters dealing with PTSD that self-medicate, so all of a sudden they have an anxiety or depression disorder, and then they’re drinking too much or they’re starting to use drugs, and their life begins to spiral. And they don’t usually ask for help–because we are the helpers–until they’re so far down the road that they’re in so much trouble, in their marriage, their job, or both, that they become right on that edge of are we going to lose them to the point of committing suicide.”
Dr. Garcia dispelled any fear of coming to treatment in the Florian Program:
“I think what (firefighters and paramedics) will find when they come to this program is that there will be people who will be able to understand what they’re going through, amongst their peers and other people who are here seeking help and amongst the treatment team who are providing help.” I think they’ll be more comfortable and be better able to let their guard down a little bit so they can be assessed and the needs that they present with can be addressed.”
Recognizing the Signs
While the centerpiece of the Florian Program is the inpatient unit in Rockford, training fire personnel across the county to recognize and act on the signs and symptoms of substance abuse and mental health issues is also crucial.
Some fire departments may be fortunate enough to have active employee assistance programs (EAPs) and/or proactive human resources departments that offer some education on addiction and mental health disorders. But there are 35,000 fire departments out there, both full-time and volunteer, and many don’t have the resources for this type of training. I believe it’s imperative to address these issues. There has to be a movement. We need more people on board to tackle behavioral health challenges for the fire service so we don’t pass along things like addiction to the next generation.
In the same way we “read smoke” when we approach a fire, supervisors and employee assistance professionals need to reach out when one of their own needs help. “Reading smoke to me means that you can look at a situation and assess fairly quickly where there’s really a problem and what you need to do as quickly as possible. Because, as in firefighting, in treatment, time can be of the essence. And something that’s smoldering can combust and become really dangerous and lethal at any time.” said Dr. Margot Jacquot, a licensed clinical psychologist who treats firefighters and is a board-certified traumatic stress expert. “So being able to read those signs and symptoms and reach out to another firefighter before his life combusts can make all the difference in the world.”
My good friend Tim Gibbons, a retired battalion chief with 35 years of experience with the Chicago Fire Department, entered the fire service in his early 20s. By age 23, Tim had developed a pattern of drinking and drug use that was problematic in his life.
“Drinking was a big social outlet in the fire service, even more so than today,” he said. “If we had a tough night, we might go out after work, which for us was 8 a.m. My drinking was beginning to push all the parameters, though.”
Tim sought help from a treatment center and, today, has nearly 30 years of continuous sobriety.
I’ve known Tim most of my 25-year career. We studied together for two promotional exams, both of which resulted in our promotions. Then we worked on neighboring fire companies on Chicago’s west side—I was on Truck 35 and he was on Squad 2. He was also one of my go-to guys to help others who were struggling with alcohol and drug problems because of his 12-step expertise.
He’s been by my side as a peer supporter for active and retired fire personnel since we started that arm of our EAP program. He supports the Florian Program because it’s geared specifically toward firefighters and paramedics.
“I’m very excited to hear about the Rosecrance Florian Program because I know the critical people that are behind it and putting it together. I know what their motivations are. I’ve served in the fire service and in the mental health world of recovery alongside these people,” Tim said. “I know their intentions are true, I know confidentialities are always upheld, and I know that they get it, based on their own experiences in life, that they’re bringing a lot more than intellectual knowledge to an individual’s recovery. They’re bringing experiential knowledge. And in my opinion, that’s the best way.”
A Necessary Step
The Florian Program breaks new ground by offering us a safe place specifically designed for fire personnel to start down the road toward recovery.
“The Rosecrance program and what Dan is doing are going to give people the tools and knowledge so that they can go and get healthy and stay healthy,” said Bobby Halton, editor in chief of Fire Engineering magazine, FDIC International education director, and a Florian advisory panel member. “Because getting help isn’t about being weak–it’s about being strong–you have to be courageous to ask for help. Any coward can hide in a bottle or hide behind drugs. It doesn’t take any bit of character to hide your pain. But we were trained to do that, and we were trained wrong.”
Florian comes at a time when people such as Jeff Dill, another advisory panel member, are speaking out about firefighter trauma and treatment. Jeff is a captain with the Palatine (IL) Rural Fire Protection District and founder of Counseling Services for Firefighters and the Firefighter Behavioral Health Alliance, which educates firefighters and EMTs about suicide prevention and awareness.
“I think a program like Florian is needed because I travel across the United States, and I’ve talked to and seen thousands of firefighters, and we are now desperately standing up and saying, ‘Yes, we need some help,’ ” Jeff said. “Well, where are we sending them? We need qualified programs like the Florian Program that are dedicated to firefighters and EMTs so they understand that it’s safe to say, ‘I need some help,’ because the program is run by firefighters and counselors who understand the culture. And that’s so very important for firefighters because we like that validity that ‘they understand who we are.’
Jim Purl, a Chicago Fire Department special operations battalion chief and a Florian advisory panel member, said the Florian Program will help not only firefighters but also their families.
I’ve worked on and off the job with Jim for many years, and he was instrumental in encouraging me to develop our union’s peer support network called the “Gatekeepers,” which he is part of.
“I think education is the biggest thing now. The more we educate and the more we get the word out, the more people will end up using the program,” Jim said. “There’s more opportunity for spouses to recognize a problem. Maybe they’ll be able to help recognize that their loved one is in need of some type of help, and the person can get the help prior to feeling like they’re failing.
There needs to be education for everyone around, even for people who are in command, to start recognizing that this is a different type of era where people need to deal with their feelings.”
It will take prominent people in the fire service, much like the people whose statements you’ve read in this article, to start this movement. And if you’re looking for more people to get involved, look in the mirror. We need you to voice your concerns and get involved. That’s what we at the Florian Program are trying to do. We want to treat the problems and also educate people so the problems don’t continue and identify issues such as alcoholism, PTSD, and anxiety before it’s too late.
While I was editing this article, a friend and coworker of mine on and off the job committed suicide on Nov. 22. This shocks and frustrates me – and angers me at the same time. Neither I nor other close friends of his had any idea he was thinking about ending his life. We need to do more, and we can do that only through help and more education/awareness. It’s about being proactive. We need to have short-term and long-term plans. In Chicago, we saw 50 firefighter suicides in 23 years, and many of them were attributable to substance abuse and mental health issues. I don’t want that to continue in Chicago or in any other fire department, paid or volunteer. But if we maintain the status quo, then we’re doing the same things but expecting different results. We must be more proactive than reactive.
Visit rosecrance.org to learn more about the Florian Program. Scroll down and click the Florian banner on the right side of the home page to view a video about the program and read biographies of our advisory panel members.
Dan DeGryse has worked 25 years for the Chicago (IL) Fire Department. He has served as an officer for 19 years and currently holds the rank of battalion chief/EMT. He was the coordinator of the Chicago Firefighters Union Local 2 Employee Assistance Program for 14 years, and he remains a member of the International Association of Fire Fighters Standing Committee on Labor/EAPs. He has been the director of the Rosecrance new Florian Program since June. He is a certified employee assistance professional, a certified labor assistance professional, a certified alcohol and drug abuse counselor, and has advanced training in critical incident stress management. He earned a bachelor’s degree in fire science management from Southern Illinois University and a bachelor’s degree in psychology from Wabash College. He has written articles, given speeches, and collaborated with others on the behavioral health of fire service members. He worked as a peer supporter in New York after the terrorist attacks on Sept. 11, 2001, and in Chicago following the E-2 nightclub disaster. He also worked six years as a counselor at a private hospital.