By Taylor Blatchford
The Seattle Times
EVERETT< Wash. 鈥� A new University of Washington center is seeking to fill a training void for frontline responders in fire departments, better equipping them to respond to mental health and substance use calls.
(BHCore), run by the UW School of Social Work, held its first training Friday for firefighters and emergency medical services staff from nine fire departments across the state.
Mental health and substance use calls have become a large portion of fire departments鈥� work. Many cities and counties across Washington are also growing alternative response programs that send mental health professionals to respond to mental health crises with, or instead of, first responders.
But those programs are significantly smaller than the existing infrastructure of police, fire and emergency medical services, and many don鈥檛 operate 24/7. Particularly in rural areas, traditional first response systems are often the only option for mental health and substance use calls.
鈥淚t鈥檚 really important that we prepare them to do the work and that they feel good about it, because otherwise they don鈥檛 feel like they can handle the call,鈥� said Jennifer Stuber, BHCore executive director. 鈥淭hat鈥檚 going to also lead to their sense of burnout and compassion fatigue.鈥�
The center launched last year with funding from the state Legislature that鈥檚 managed by the state Health Care Authority. Last year, nine fire departments received grants to help them with efforts like building crisis response teams and administering medications for opioid use disorder.
鈥淲e鈥檙e really set up for everything else we do: heart attacks, car accidents, rescues,鈥� said South County Fire & Rescue assistant chief Shaughn Maxwell, who helped develop the training. 鈥淚 think this is filling a need: This is now equipping us for mental health.鈥�
Inside the training
In a large conference room in Everett on Friday morning, more than 50 firefighters and emergency medical services personnel contemplated a question: Are they wearing any 鈥淪AD HATS?鈥�
The acronym 鈥� which stands for 鈥渟ick, alcohol, drugs, hungry, anxious, tired, stressed鈥� 鈥� is meant to help first responders evaluate factors that might affect them as they respond to a crisis call.
One person shared they hadn鈥檛 slept well because they had been worried about waking up and getting to the training on time. Another said they were tired from recently starting a new, challenging workout routine.
In the first training session, attendees examined these factors and discussed emotional triggers 鈥� types of calls that might be particularly hard for them based on past experiences. Later sessions focused on concrete skills when responding to crises: evaluating a scene, medical assessment, active listening, connecting with community resources.
These trainings will fill a void for first responders who haven鈥檛 always felt equipped to respond to mental health and substance use calls, Maxwell said.
鈥淔irefighters and paramedics get into this business to help people, and it鈥檚 actually really hard on them when they鈥檙e not helping people,鈥� he said. 鈥淲hen you call 911, you want your problem fixed, and we didn鈥檛 have the tools to do it. This is helping with those tools.鈥�
Substance use was also a focus of the training. Anne Raven from the Spokane Fire Department led a session on responding to opioid overdoses and walked attendees through administering buprenorphine, which can treat severe opioid withdrawals after an overdose is reversed with naloxone.
鈥淚s this going to change the city of Spokane? I don鈥檛 know,鈥� Raven, the department鈥檚 integrated medical services manager, said of buprenorphine. 鈥淚t would be great if it did. But just giving Narcan isn鈥檛 working, so we鈥檝e got to try something else.鈥�
Recognizing mental health
Responding to emergencies can take a toll on first responders鈥� own mental health. First responders of all kinds have higher suicide risks compared to the general population, research has found.
Frontline responders can experience acute post-traumatic injury from seeing the aftermath of events like a really bad car accident, Maxwell said. But mental health and substance use calls, particularly overdoses, can cause more of a chronic post-traumatic injury.
Repeated overdose calls in particular can have a cumulative toll on first responders鈥� mental health, 鈥渓ike an IV drip,鈥� Capt. Nicole Picknell of South County Fire said.
Friday鈥檚 training included specific resources for first responders鈥� mental health, including specific crisis lines tailored to their roles. A future training from the center will focus on suicide prevention within the law enforcement community, Stuber said.
鈥淥ften they don鈥檛 get the support they need to really process through those events, and they have a cumulative toll,鈥� Stuber said. 鈥淒espite the fact that people come into this work to help people, they often get so overwhelmed with the amount of negative, traumatic experiences that are on them. If they don鈥檛 know how to cope with them, and you don鈥檛 know how to prepare for them, then it鈥檚 going to get increasingly harder and harder.鈥�
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