Category: Public Safety

Passed CA Assembly – Peer Support and Crisis Referral Services Act

California Assembly Bill 1116, formerly called the Critical incident Stress Management Services Act, has passed the state assembly and is on its way to the Senate. If it becomes law, the act would protect the confidentiality of public safety peer support team interactions except in the case of criminal proceedings. To be covered, team members would have to have completed a peer support training course to be developed by the Office of Emergency Services, the California Firefighter Joint Apprenticeship Committee or the Commission on Correctional Peace Officer Standards and Training.

This legislation would not give the level of protection that a therapist or ordained clergy has, but it will raise the bar considerably – unlike states that have passed similar laws, peer support and CISM teams in California currently have no protection against being subpoenaed. However, in the context of non-criminal proceedings, the legal “privilege” would be the same as between a psychotherapist and patient. The only exception would be “gross negligence or intentional misconduct.”

All of the components of a CISM program along with grief support and substance abuse are named as topics the law would cover.

The bill includes the phrase “toxic stress,” which I believe we should strike from our vocabulary. Stress can be toxic, but it doesn’t have to be, and the phrase “toxic stress” carries a strong connotation that all stress is toxic. That can be a self-fulfilling expectation – if you think stress is toxic, it probably will be.

This is a great step forward for California. I would have preferred that the state also recognize ICISF-approved training, rather than only requiring new courses, but “peer support” covers more than ICISF encompasses, so it is understandable.

If you’re in California, urge your senator to vote in favor. Let’s get the law in place, develop the classes and take the training.

CISM Protection Bill Introduced in California

California may join Michigan and other states that have made CISM activities “privileged” communications, meaning they could not be subpoenaed or otherwise demanded by a court. Michigan’s legislature unanimously passed the “First Responder Privileged Communications Act” a year ago.Subpoena protection for California CISM

California will consider AB 1116, the Critical Incident Stress Management Services Act.

Here is the key provision.

Except as otherwise provided in this section, a communication made by an emergency service provider to a CISM team member while the emergency service provider receives CISM services is confidential and shall not be disclosed in a civil, criminal, or administrative proceeding. A record kept by a CISM team member relating to the provision of CISM services to an emergency service provider by the CISM team or a CISM team member is confidential and is not subject to subpoena, discovery, or introduction into evidence in a civil, criminal, or administrative proceeding.

The exceptions are not problematic – they cover referrals, events where most of us are already mandated reporters, imminent threats and waivers.

The bill was introduced last month by Assemblyman Tim Grayson, former mayor of Concord, California, who is also a Concord Police Department “Critical Response Chaplain.” He undoubtedly knows a thing or two about this issue.

In my dozen years in CISM I’ve dealt with this through our team’s policy of never keeping written records and my own lousy memory for what other people say during interventions.

Guest Post: Emotionless

This week I had a hard time deciding what I would write about. This is my 10th article, so I guess I wanted to write something special. I decided to write about police work and the toll it takes on a person’s emotions . This is not based on any science or psychological analysis but my own experience. Remember also that every person is different and other police officers might have had different experiences, but I think they will find similarities with my story.

To start off, I would like to say that when I first started out as a front line officer, I was learning a lot from more experienced officers. I would take from these officers what fit my personality and also what would work in the field when dealing with the public. I found that I was the type of person who would connect better with the public, whether complainants, victims or even suspects. I would be to get to know them better and know where they are coming from.

No, not the place they are coming from but what type of life they had and what brought them to this point…so in other words, empathize with them. Well for me to do this and for them to come and trust me, I would need to let a little bit of myself go also. Otherwise it’s one-way communication and you will never get any good rapport with anyone that way.

Then all of a sudden, the pulling and tugging stopped.

So this was the way I decided that I was going to police. It fit my values of life better and when I think about it, it saved me from a few tight situation. For example, one night I was working on the Reserve and keeping a close eye on a beer garden along with a local reserve officer. Close to midnight as we were driving in the parking lot, we were flagged down. One of the patrons was going nuts and wanted to fight everybody. My partner and I got out of our vehicle, approaching the subject of complaint and were going to arrest him then and there. Then all of a sudden, his buddies started tugging on us and we were being circled. The more we fought to arrest the subject, the more we were getting pulled and pushed away from this guy. Then all of a sudden, the pulling and tugging stopped. Well lo and behold, when I turned around, a bunch of people that I had built a rapport with in the past had formed a line and were keeping the subject of complaint’s buddies away from us.

For me to get a rapport of that kind,  I had to let a little bit of my personal past out to them as well. But what happens when you do this is that you start to connect with people and the people you connect with the most are the ones you deal with almost on a daily basis – which are the one you get to arrest on a regular basis! You start to really sympathize with most of them because you start finding out that they are the way they are today because of what happened to them in the past.

I found out that some of them had parents that were alcoholics or only one parent who was an alcoholic and sometimes would roam the streets at 2-3 o’clock in the morning at 6-7 years of age so they wouldn’t see the dad, or boyfriend beat up on their moms. Or that some of them had been sexually assaulted by a parent, an uncle or even grandparents as young as three years of age. A lot of social problems resulted in young kids growing up with having to deal with traumatic events when they were very young . I think some of them wanted a different life but growing up just didn’t know where to turn to for help.

Those became what I call today my “robot years.”

Some of these people I got to connect at a close level ended up committing suicide, including two hockey players I had coached a few years before. That really took a toll on my mental health, although I didn’t realize it at the time. Dealing with these types of situations after awhile, those became what I call today my “robot years.” I would actually go to certain calls and it would be like I was on automatic. I would not care at all about a break-and-enter with minor value stolen. I would take notes, make believe that I was concerned, and then leave and write my report and on to the next call.

I had built a wall so well that I was forgetting what it was like to live life like a regular human being.

The robot years started to carry on during my days off. I still remember my wife telling me years after how she would look at me and it would seem like I was a person that just didn’t have any emotions left. I wasn’t seeing it that way, but now that I reflect back on it, I really didn’t have any emotions left at all. Everything was on a level. No highs and no lows. Just functioning through life… like a robot. I had built a wall so well that I was forgetting what it was like to live life like a regular human being. I still feel the effects today, although I do have glimpses of feeling emotions of happiness and sadness, but not as much as before I joined law enforcement. I feel like I am empty inside. Nothing left. This was actually mirrored to me by a very good friend of mine who also worked 28 years in policing and just recently retired. He told me those exact words. That he felt like he had no emotions left inside. That he was dead inside.

I think as police officers, especially the ones who try to empathize with people that are struggling through life, we try to keep our emotions so much in check when attending calls that our mind starts to think that it is not good to have any emotions. And when you think about it, police officers do have to hold back emotions frequently. We can not start to break down and cry uncontrollably in front of the public at a serious accident scene where kids are deceased. Or in one of my cases, tell a seven-year-old that his mom would be okay and asking a firefighter to bring the kid up the embankment for me as I was with the paramedic attending the mom. Her face was a grayish pale with purple lips. I had a feeling she was badly bleeding internally and the paramedic confirmed my assumptions. She died soon after. I always felt a lot of guilt, even today for lying to that kid. But I just didn’t want him to see his mom this way.

I just want to enjoy the peacefulness that nature brings. That to me is true happiness.

I could go on and on about these types of calls that other police officers and I attended. We are to hold our emotions in on a daily basis. After awhile, you do not want to let go of all those emotions at home. Why would I burden my wife on the violence I witness during my shift? I don’t even want to remember them today. So why would I give this hell to someone I love? Doesn’t make any sense. Today, I find a lot of peacefulness and happiness just walking in the woods with my dog. Even though my wife tags along with me at times, she knows that sometimes, I just don’t want to talk. I just want to enjoy the peacefulness that nature brings. That to me is true happiness.

Thank you for those taking the time to read my articles. Please share to whomever you feel could benefit from them. I would really appreciate that. Until next week. Stay safe my friends. 🙂


Article: How One Paramedic is Recovering from PTSD

The Journal of Emergency Medical Services has published the PTSD recovery story of Benjamin Vernon, a paramedic/firefighter in San Diego. Vernon and his partner who was knifed by a bystander during an ordinary call. He describes the attack, recovery and the nightmares – a word he says isn’t strong enough – that followed. Unfortunately, the therapist he saw had never treated a firefighter or a victim of workplace violence.

“On the fifth day, I finally understood suicide,” Vernon writes.

The story ends well – he finds a competent therapist (whom he’s still seeing weekly) and receives EMDR (Eye Movement Desensitization and Reprocessing), which he describes as “the coolest Voodoo.” (It’s also sometimes called “FM” for “F%&#ing Magic.”

The danger of “nobody else can understand”

If you are in public safety or the military, as well as some other fields, you know that some people insist that there it is pointless to talk about work to any “outsider.” Often, big agencies have this attitude toward smaller, less busy, ones –  “We are the only REAL firefighters, police, medics, etc., around here.” So they close themselves off from  support by people who otherwise might be peers.

The walls even go up within agencies – specialized, elite teams form a “tribe” mentality that says if you haven’t been part of a similar unit, there’s no point in talking to you about stresses and challenges, even if do the same kind of job.

No doubt, there is some truth to this. Working at a big, busy, urban agency certainly is different from smaller ones. Combat experience absolutely has unique aspects. Being part of an elite or specialized team really is different. People who haven’t walked the walk truly cannot understand. Experience is the only instructor – words quickly fail if we were to try to fully communicate it, especially the emotions around high-stress events (which can directly impact the brain’s speech center).

For a number of years, I have suspected that organizational isolation – that’s this is about – could be as toxic as individual isolation. We know that social support is the most important factor in resilience under stress or recovery from trauma; isolation aggravates stress. In fact, almost any trauma expert will agree that people will continue to suffer as long as they remain isolated –  connections with others give us strength and healing.

I recently began reading Ellen Kirschman’s book, I Love a Fire Fighter: What the Family Needs to Know, which has been sitting on my nightstand for a while. Dr. Kirschman, a well-regarded therapist in public safety, is also regularly involved in the West Coast Post-Trauma Retreat, where I have volunteered and learned.

Here’s the light bulb that went off as I read Kirshman’s introduction – the “nobody else can understand” attitude cuts us off from our friends and family. If you are certain that even a co-worker who isn’t part of your elite unit can’t support you because “they don’t understand,” then how can your friends and family who are civilians, possibly support you?

Here’s one of Kirschman’s observations about going through a fire academy (emphasis mine).

No one acknowledged how the emotional courage fire fighter families need or the independence that is forced on them contributes to the fire service mission. This is extremely puzzling in light of the many studies that confirm how family and friends are the heart of a fire fighter’s emotional support system.

Her books (she wrote a similar one for law enforcement) are for families, but the message to public safety is just as important. Your social support outside of work is also critical to your strength and resilience in the face of occupational stresses, and recovery from critical incidents and other injuries that aren’t physical.

The following words are why it does not matter that outsiders can’t understand the job.

Empathy does not require understanding.

It’s true – if you are an outsider, you will not understand. If you’ve never been there, I can’t explain what it was like to talk to a patient one minute and then do CPR on him, unsuccessfully, the next. You won’t understand how difficult it was to walk past his wife in the ER waiting room, seeing her comforting another wife, not knowing her own husband was just pronounced dead. If you’ve never done anything like helping a family bury their dogs who couldn’t escape a wildfire, nothing I can say will make you understand. If you haven’t been part of a rescue that went all wrong and killed the victim, I don’t have words for the emotions. If you haven’t done shift work, you don’t know the toll it can take.

Even if you cannot understand, that doesn’t have to stop you from supporting a responder if you are a trusted friend – because empathy does not require understanding. They may spare you details. They probably won’t repeat the sick jokes that helps many get through the day. But if you are willing to simply walk beside them, your presence can be healing.

You don’t need to understand responder experiences to know that they are painful. You don’t have to work shifts to that it is hard to be exhausted and miss family events. Everyone has experienced pain and frustration, he stress of an event or life going out of control. Co-workers can appreciate it more than outsiders, so co-workers are an essential part of any responder’s network of social support. So are spouses, friends with completely different careers, pastors and may others.

Camaraderie is powerful. Every agency – and groups within them – benefits from friendships, mutual support and teamwork. However, the idea that only our co-workers or people like them can support us is a misguided obstacle to wellness. We should not want anyone, from new recruits to  seasoned veterans, to believe that their friends and family have little to contribute. As Ellen Kirschman says, that idea cuts t them off from the heart of their social support system.

Paramedics with social support sleep better

An article in the Journal of Occupational Health Psychology earlier this year described a one-week study of paramedics’ sleep and their social support. Those who saw themselves as having more social support reported better sleep. The researchers also observed that the sleep quality of paramedics who perceive more support isn’t as impacted by job stress.  On the other hand, they reported “Those with low levels of support displayed poor sleep quality in the face of high occupational stress.”

In recent years, it has become quite clear that good, deep sleep is vital for coping with stress – poor sleep is associated with increased risk of developing PTSD.  The correlation between social support and coping with stress has also been observed repeatedly in studies. It’s unsurprising to find a link between social support and sleep quality – this reinforces the importance of both.

How to protect sleep-deprived EMS personnel

EMS1 published an article yesterday, “How to protect sleep-deprived EMS personnel,” in which the main point is the danger of driving home while sleep deprived.

Sleep is also essential for processing traumatic incidents. REM (rapid eye movement) sleep is when our brains put them to rest. Anything that interferes – lack of sleep, alcohol, some medications, sleep apnea – makes it harder to process the day’s emotions. Poor sleep sets you up for post-traumatic stress disorder.

West Coast Post-Trauma Retreat

Next week, I will help staff the West Coast Post-Trauma Retreat. I’ve been aiming to participate for several years, but my schedule hasn’t permitted it until now. I have heard wonderful reports from people who have received care and treatment there; I also have referred first responders to the program when I could see that they were really struggling, hitting a wall of some kind.

The testimonials from attendees are phenomenal – and I’ve heard the same kinds of statements directly from some of them.

WCPR describes itself as ” for first responders whose lives have been affected by their work experience.” It is one of only two such residential treatment facilities in the world. Everyone who staffs the retreat is a volunteer – responders, clinicians and chaplains.

As a new peer supporter, I expect to mostly observe and listen – and learn a lot!

WCPR is part of the First Responder Support Network, which also offers programs for spouses and significant others of responders.