Psychological problems and suicides of people in firefighting and rescue services are a topic that is not discussed very much and above all openly. Jeff Dill does just that. The 58-year-old American from Chicago worked as a fire captain and paramedic for 26 years. Parallel to his work, he has continued his education, obtained a Master's degree and has become a licensed counselor. He is founder and CEO of the Firefighter Behavioral Health Alliance, which he will present at INTERSCHUTZ.
24 Jul. 2019
Jeff Dill, let's start in person. Who are you? And what led you to form the Firefighter Behavioral Health Alliance?
Hurricane Katrina was the catalyst for the beginning of my work with our brothers and sisters. I saw a need for counselors to help those who responded to New Orleans in 2005. In 2009, I founded Counseling Services for Fire Fighters. This was to train and educate counselors and chaplains about our world as 1st responders. In 2010, I began to receive emails from across the world asking if we did anything about firefighter suicides.
I never knew there was a problem. In fact, no one did. After many phone calls and much research, I found that no organization was tracking these tragic events.
In 2011, I founded Firefighter Behavioral Health Alliance (FBHA) to bring awareness and education about posttraumatic stress disorder (PTSD) and suicide in the fire and emergency medical services (EMS) world.
Please describe briefly what the Firefighter Behavioral Health Alliance is and what it is working on with how many people.
We are still the only organization in the U.S. that tracks and validates firefighter, EMS and dispatcher suicides. We do this to remember our brothers and sisters and then understand why.
We use all the data and interviews to bring this education through the seven different workshops we offer. I have traveled close to three quarter of a million miles across the States and Canada. We have yet called upon departments to try and promote our workshops. Fire and EMS organizations hear about us and they bring us in to teach. FBHA has two other instructors besides myself. My wife, Karen, is the backbone behind FBHA. She volunteers over 30 hours a week to keep us running. Without her FBHA doesn’t exist.
How does the FBHA investigate firefighter/rescue and suicide issues? How do you collect data?
FBHA has a confidential reporting system found on our website at www.ffbha.org. People fill out the report and then submit it. When we receive it the email is scrubbed so I have no way of knowing who sent the report. I then contact the department chief to follow up. We never use names or departments in our released data unless families call us to say it is okay.
As of this date, June 24, 2019, FBHA has validated 1,325 losses. We estimate a 50 per cent reporting to FBHA. I have personally spoken to over 1,270 chiefs and family members to gain the information. We collect items like state, year, age, active/retired/resigned/fired/on duty injury, rank, gender, department, name, method, and reason why, if known. The data shows and tells us so much.
Suicide is a taboo subject anyway. Is it even more taboo in the fire and rescue sector? What is the mentality behind it?
Suicide in society is taboo but when we started tracking and validating in 2011, we met a lot of resistance. Many thought we were crazy, making up the numbers or would not discuss the issue of firefighters and EMS taking their lives. FBHA talks a lot about Cultural Brainwashing. Simply it means, we put this uniform on and this is how we are expected to act.
Strong, brave, courageous, show no weakness, don’t ask for help and we can handle our issues on our own. Who expects this? Our brothers and sisters, the community we serve plus the traditions of the EMS and fire service. This becomes a difficult task when you see the things we see, plus add our job issues and our personal life issues. Trying to handle all of these issues alone becomes impossible. So we hid, struggle, turn to addictions, suffer from PTSD and/or take our lives.
Do members of the fire brigade and rescue service generally need support in their everyday lives or only after traumatizing events such as Hurricane Katrina?
By traveling across the States it is amazing how many of our brothers and sisters are struggling. From the major cities to the rural departments.
There is no discrimination. FBHA believes every organization should have a behavioral health program. FBHA consults with many departments about this issue. For FBHA, there are twelve points to address for their members. It starts in the academies until long after retirement.
From your point of view, what exactly do firefighters and aid organisations have to deal with the most?
I believe the biggest issue we face is the expectations on how we are supposed to act both on and off the job. We can’t show weakness in the face of difficult calls and then we can’t show weakness to our loved ones.
So we struggle and suffer to some degree. It is different for every first responder. The effects those usually play out at home through our behaviors such as isolation, anger, addictions, lack of communications, hypervigilance, and our relationships with our loved ones and children.
What is part of "healthy behaviour" after a mission?
FBHA believes each responder is different in their behavior process. Some like to talk while others still take time to process on what they just saw or did. Either way the department should have resources available such as peer support teams, qualified trained counselors/chaplains available to talk to either that day or for several days afterwards.
I am a firm believer resiliency begins by talking about issues. I am a firm believer in pet therapy. Is there a dog the department can bring in to help our members?
What would be ideal structures and offers to absorb stress before it becomes a health threat?
The idea structure would be a behavioral health program, officer training on how to spot members struggling, on how to listen and direct them to the proper resources. Having qualified counselors/chaplains who know about our culture is imperative. For individuals I believe they need to talk plus have some form of self-care they need to use every day. This can be working out, walking, reading, journaling, working with pets-whatever allows you to take a few moments each day to get away from stress.
What should relatives and colleagues pay attention to? What are warning signs of imminent mental illness or even suicide?
FBHA asks over 500 members struggling with PTSD or suicidal ideations. There are so many warning signs and it is different for so many but here are the top five we found. In fact, we hand out a tip card with them on it. We will be bringing them to IINTERSCHUTZ.
Loss of confidence in skills
You offer your support not only in the USA, but worldwide. To what extent are the situations similar in an international comparison? Where are the differences?
I have spoken to our brothers and sisters in Australia, England and Sweden. I have found the differences are very minor. This issue of behavioral health, PTSD and suicide are a global issue. FBHA is looking forward to travel internationally to discuss all we have learned these past 10 years from our brothers and sisters.
What is your experience in working with people from fire brigades and rescue services? Do you encounter them openly or are there fears of contact?
FBHA has three points we believe in. 1. Be Direct 2. Challenge with Compassion 3. Perform and Internal Size-up on your emotions daily. I truly follow the Be Direct in my life when talking to my brothers and sisters. One reason I get positive responses is because I am one of them I have done the job and have struggled with a main issue in my life from a family incident.
Because of this I am accepted, receive weekly calls from our brothers and sisters who are struggling and looking for help. It is a difficult task what FBHA does but our FBHA people truly love helping others.
Are you in contact with German or European associations and institutions? Is there any cooperation here?
I have not been in contact with any German or European departments but would love to build a relationship, to share what FBHA has to offer. Then, maybe why we are there in Germany next year we can present workshops to fire and EMS departments/brigades.
Our goal is to meet my brothers and sisters from around the globe. To hear what issues they face in regard to behavioral health, PTSD and suicide. I would like to share the wealth of information we have to offer, through talks and workshops. Like I said, this is a global issue, not just a U.S.A. issue. I believe Interschutz gives us the greatest opportunity to accomplish these goals.
According to the Association for the Promotion of German Fire Protection (vfdb), there is no central institution in Germany that deals with the subject of suicide. When it comes to psychosocial support (in German: PSU), the main work is done by local fire brigades and aid organisations. So-called PSU helpers and assistants are available in the fire brigades as general contact persons who initiate ad hoc measures and, if necessary, pass on their colleagues to competent bodies. They are also trained to address colleagues directly in the event of anomalies.
Foundation "Help for Helpers"
For the German Fire Services Association (DFV) it was clear at the latest after the train accident in Eschede in 1998 that emergency care activities were an important offer for emergency forces. The DFV's "Help for Helpers" foundation exists since 2000. It promotes suitable preventive measures as well as short and long-term aftercare services that also take into account the social environment of the emergency service people. The "Help for Helpers" foundation will be presenting itself at the DFV booth during INTERSCHUTZ.