By Jimmy Nixon
Members of fire department peer support programs have an important role in the firehouse. They operate as a resource for critical incident stress, behavioral health resources, and stress management, among other things. Peer supporters also have the important task of addressing the warning signs that are exhibited by other firefighters in the firehouse that may suggest someone is struggling with post-traumatic stress disorder (PTSD) or thoughts of suicide.
- The Power of Peer Support in the Fire Service
- Commentary: The Mental Mayday
- PTSD: Don’t Move Next to an Airport and Complain About Airplane Noise
- Paul Combs Poster: Firefighter PTSD and Suicide
Awareness of the warning signs of PTSD or suicide is an important first step to addressing the topic of behavioral health in the fire service, but awareness without action isn’t any better than being unaware. As peer supporters, we must advocate for the well-being of our peers. Being an advocate must include action.
Warning Signs to What?
Warning signs are important because, as their name suggests, they are precursors to something worse—in this case, PTSD and maybe even suicide. Peer supporters should understand these warning signs and be on the lookout for them.
When a warning sign is identified, something needs to be done, and it may fall on the peer supporter to make the interaction with the individual.
How Will You Become Aware of These Individuals?
Being on the lookout for them yourself will be one way that you will find someone who may be struggling. You can find people struggling by observing their behaviors or through talk at the kitchen table. I’m not suggesting you snoop, but let’s be real—firefighters talk and sometimes the kitchen table conversations carry weight. If you overhear that someone has been acting differently or displaying some warning signs, remember to follow up with the individual.
Another way you will come across individuals who may be struggling is by people telling you about them. As your presence around the firehouse is solidified as a behavioral health advocate/peer supporter, people will trust you with these situations. Since these are difficult conversations, other members may not be comfortable initiating the conversation with the distressed firefighter, so it may eventually fall on your lap.
The Need for Action
Both of those scenarios require the peer supporter to take action. The individual who is identified either through your own awareness or from someone else could be on a lonely road headed towards dark times, perhaps even contemplating suicide. As peer supporters, your goal is to be there for people whether they come to you or you go to them. It is important to be comfortable with initiating the communication, as it may be your only option.
“This is a difficult conversation, but if they are actually struggling it must happen.”
- Firefighter Stress Resilience and Increasing Emotional Bandwidth
- Post-Traumatic Stress: Not a Life Sentence
- Help, This Job Is Killing Me!
- Calling a Mayday for Your Mind
How To Do It
Understand a couple of things before you initiate the conversation. Know that this conversation may be difficult. Know yourself and how your emotions may play a role in the conversation. It’s important to relate to peers, but you don’t want to overshadow their issues with your own. Know that the individual may get emotional. If the person hasn’t opened up to anyone and then opens up to you, emotions may get the best of them. Knowing these things beforehand can help to have a successful interaction. Following the considerations below will also help when interacting with our peers.
Timing
When you find out someone may be struggling, do not delay contacting the struggling individual. You never know how much he or she is hurting and if you wait, it may be too late. Consideration should be made to the privacy of the person. Don’t confront the individual at the kitchen table, but make sure you are prompt in your approach.
In Person vs. Text/Phone
This conversation is best to have in person, but that isn’t always possible. You may never see the individual and if the person is busy, you may not be able to arrange an in-person conversation. If in person is not possible, the next best option is a phone call (MyOnlineTherapy, 2020). Use texts as a last resort as they can be impersonal and miss the mark.
What to Say
This part is important. Don’t make it complicated but be prepared for awkwardness, both from you and the peer whom you are talking with. The important part about the conversation is that the peer knows you are willing to listen. Being direct is important, as the individual may get defensive if you are hiding your motives. Open with things such as:
- “Hey, are you okay?”
- “So-and-so asked me to check on you because you have been acting differently.”
- “That call last week was messed up wasn’t it?”
The individual may get defensive, so be prepared to meet him or her there. Remind the person that you are there for him or her and you are just making sure he or she knows they can talk to you (Dicken, 2022).
Listen
The foundation of peer support is Listen, Relate, Validate. Listening is a huge part of it. Firefighters are used to holding their feelings inside and by opening up they can feel vulnerable and uncomfortable. Actively listening to them can ease their nerves and help them open up (ACEP, 2020). If you are not giving them your full attention or you are talking over them or belittling their issues, they may never come to you again.
Listening includes your body language and keeping your mouth shut. Make eye contact with the person. Physically turn toward the individual. Add in clarifying points such as “What I’m hearing you say is…” or “It sounds like you’re feeling…”
Do not one-up the person’s story with one of your own. There is probably not a quicker way to shut down the conversation than this. Do not try to solve the problems. Try to relate to the person and validate his or her feelings. First responders respond to difficult incidents and the reactions to them, although they may not feel like it, are normal. Validate your peer’s feelings.
Finishing the Conversation
As the conversation naturally comes to a close, there are some things you will want to make sure the individual knows. Remind the person about the resources that are available should he or she want further support. Remember that peer supporters are a bridge to further support so we must know where to send struggling individuals, should they like to pursue that avenue. Do you have a list of therapists that you have vetted for your department? Is there another resource you can point them to? The Employee Assistance Program (EAP)? Other peers?
Follow Up
Consider the need to follow up with the individual. Don’t be overbearing and contact the person every day, but it may be appropriate to send a text or call in the next week to see how he or she is doing and if he or she needs anything else.
Peer support is a dynamic approach to first responder behavioral health, but if you keep these ideas in mind you will have a good shot at helping your peers.
References
ACEP. (2020). Peer Support Basics. American College of Emergency Physicians. https://www.acep.org/life-as-a-physician/peer-support-project/psp-articles/peer-support-basics/
Dicken, L., (September 2022). How To Ask Someone If They Are Ok. WiKi How. https://www.wikihow.com/Ask-Someone-if-They%27re-Okay
My Online Therapy. (October 2020). How to ask someone if they are ok. My Online Therapy. https://myonlinetherapy.com/how-to-ask-someone-if-they-are-ok-when-they-are-clearly-not/
Jimmy Nixon is a firefighter with the Streamwood (IL) Fire Department with nine years of service. He has a bachelor’s degree in psychology and is enrolled in a master’s program in counseling. He started the website firstresponderpeer.com to continue the conversation on first responder peer support.
