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IPSA's Public Safety Column
The IPSA's Public Safety Column is an opportunity for our members and corporate sponsors to provide thought leadership articles about all topics facing public safety.
The articles we publish are not necessarily the views of the IPSA, rather they are opinions shared by each contributor.
By Jessica Dockstader, IPSA Mental Health Committee Member
Police officers experience traumatic events throughout their career called critical incidents. A study conducted by Chopko, Palmieri and Adams (2015) found that on average, law enforcement officers experience 188 critical incidents in the course of their career. In response to critical incidents, officers can develop negative coping mechanisms, experience symptoms of and/or develop post-traumatic stress disorder (PTSD), and develop other co-occurring psychopathological disorders. Additionally, factors such as organizational stress, stigma surrounding mental health within the department, a lack of mental health literacy on the part of the officer, and a lack of leadership surrounding mental health in the department can also lead to an officer developing PTSD and/or using poor coping mechanisms.
Officers suffering from PTSD or PTSD-like symptoms have a higher likelihood of exhibiting violent tendencies towards the community and themselves; this is in part due to patterns such as “death imprint” and “desensitization” commonly displayed by individuals suffering from PTSD (James & Gilliland, 2017). Furthermore, the characteristics of PTSD such as hypervigilance and reliving memories can cause officers to become violent towards themselves and the community. Law enforcement departments must adopt best practices and policies relating to officer mental health to in turn address police violence—thereby reducing officer suicides and preventing traumatized officers from causing harm to the communities they serve.
Trauma and policing
Police violence in the United States may be significantly influenced by unaddressed trauma. Police officers experience trauma on a daily basis during critical incidents which “frequently involve perceptions of death, threat to life, or involve bodily injury” (Digliani, 2012). In addition, studies have found that law enforcement officers under-utilize available psychological services (Spence, 2017). As a result, officers’ ability to distinguish real from perceived threats may be impaired, causing an overreaction in situations involving threat (Lancaster, Cobb, Telch & Lee. 2016). Officers may legitimately “fear for their lives”, as they often assert after a use of force, but their fear response may originate from a history of untreated trauma related to cumulative post-traumatic stress disorder, and lack of coping skills rather than an actual threat (Beshears, 2017).
The trauma that police officers face on a daily basis during critical incidents, coupled with their lack of or under utility of mental and emotional health training leads officers to be less efficient (Spence, 2017) and have high rates of suicide (Heyman, Dill & Douglas, 2018). One historical reason for the under usage of job-related psychological services by law enforcement officers of all ranks is fear of reprisal and creating barriers to promotion (Spence, 2017). Studies have illustrated that individuals struggling with psychological trauma and post-traumatic stress symptoms are more prone to violence (Gillikin, Habib, Evces, Bradley, Ressler & Sanders, 2016; Kivisto, Moore, Elkins & Rhatigan, 2009; Heyman et al. 2018). Therefore, a lack of adequate care and training leads to a more violence-prone police force patrolling our streets.
Ignorance and dismissal
Factors contributing to the ignorance and dismissal of the mental health crisis in law enforcement stems from mental health stigmas held across the United States and within the law enforcement community (Spence, 2017). Other contributing factors are the unwillingness to establish a mental health baseline in currently operating officers based on the fear that some of them are unfit to serve and the polarization between the police and the community which leads each side unwilling to admit any fault.
The challenge lies in establishing that police officers are, like all human beings, in fact affected by trauma without implying they are unable to do their jobs. It is imperative to impress upon the law enforcement community that their officers might be suffering from post-traumatic stress which in turn impacts the way they do their job. This impairment is a public health concern to the officers and the communities they serve.
In the current age of polarization, many officers are apprehensive that community members will point to the proven trauma an officer experiences as a reason they either should not be on the job, or why the community member should receive compensation in a civil suit as a form of justice. Fear is present among both sides of this equation, with the officers and the community, leaving the problem of trauma-impaired law enforcement officers to be relatively unexplored. Researchers must determine if prolonged exposure to traumatic events throughout a law enforcement professional’s career, which is proven to increase aggression and violence, can be offset by mental and emotional health training at the beginning and throughout said law enforcement professional’s career.
Below are key recommendations for law enforcement agencies and researchers.
Law enforcement recommendations
Centralize Mental Health Resources: Develop an area within the department where all resources available for officer mental health and wellness are centralized and can be easily accessed. This will simultaneously accomplish two goals: reducing the stigma of receiving help and ensuring every officer knows where to go if and when they are seeking out help.
Partner with Mental Health Organizations: Partner with mental health organizations such as the National Alliance on Mental Illness, and/or former law enforcement officers who have experienced and overcome mental health issues to deliver presentations to officers on how to recognize signs of mental illness within themselves.
Collect Data on Officer Suicides: Begin to collect data on the suicide rate of officers from the department, and contribute to the new data platform, a partnership between the Department of Justice’s Bureau of Justice Assistance and the National Action Alliance for Suicide Prevention.
Prepare Lateral Transfers for Critical Incidents: Lateral transfers coming from a smaller department to a larger one may be more severely impacted by critical incidents (Chopko et al. 2015). Ensure these officers are receiving appropriate training and assistance as they integrate into the department.
Recognize the Impacts of Understaffing on Officers: During the ongoing nationwide staffing shortage, it is important to emphasize mental health awareness and self-care for officers. Copenhaver and Tewksbury (2018) found that officers were 28.4% more likely to seek help for symptoms related to mental illness when they had received an extra hour of sleep; thus, it is imperative to better understand the impact of shift work and sleep deprivation on officers.
Improve the Organizational Culture: Research has shown that organizational stressors have an equal or greater impact on law enforcement officers than critical incidents (Shane, 2010). Bring in an organizational consultant to assess and address issues which could be negatively impacting the department.
Establish Partnerships with Research Organizations: Partner with local and/or national research organizations to integrate evidence-based practices in the department. Without coordinating these partnerships, the department, officers, and communities you serve have the potential to be negatively impacted.
Conduct Research inside Departments: Develop relationships with law enforcement departments, so as to conduct research with their officers to determine their level of mental health literacy, attitudes towards mental health treatment, and to begin to determine how many officers are struggling with PTSD and PTSD related symptoms.
Develop Safety Protocols for Officers: Law enforcement officers have a large fear of being “de-gunned”. At the same time, having their weapon can be a risk to them while suffering from PTSD. Researchers and counselors must work with law enforcement departments to create special safety plans to address an officer’s access to lethal means while placating their fear of not being able to work.
Educate Departments on Evidence-Based Practices: Law enforcement departments have been utilizing Critical Incident Stress Debriefing (CISD) despite the fact that it has not been found to accomplish what it claims to (Mitchell, n.d.). Researchers must develop partnerships with law enforcement departments to routinely update them on the latest evidence-based practices, to ensure a robust flow of knowledge surrounding best practices in the field of law enforcement.
About the Author
Jessica Dockstader is an M.A. Candidate at the University of San Diego, and earned her B.A. in Human Development with a concentration in Counseling Services from California State University San Marcos. She is currently completing her Master’s capstone on mental health in law enforcement, and has worked in the field of police-community relations in San Diego for a year and a half. She also serves as a member of the IPSA Mental Health Committee. email@example.com
By Kevin Aries, Leader, Product Management, Product Success
Public and private organizations that operate fleets are facing growing challenges, from regulatory compliance to rising fuel consumption and a burgeoning driver shortage. Vehicle-dependent agencies are trying to identify technologies to address these roadblocks and streamline operations as budget constraints add stress on their resources.
Due to the sheer number of vehicles at their disposal and the number of citizens they serve, public safety fleets, in particular, will see the coming years bring with them a number of challenges that only modern technology can help them overcome. Some of these include:
A scalable and robust fleet management technology can help public safety fleets of any size rise to these challenges and also help them prepare for future issues.
GPS tracking helps keep your fleet journey smooth
Government Fleet’s 2018 benchmarking report shows that advanced technology ranks second among respondents’ top concerns, and about three-quarters have implemented telematics in at least some of their vehicles. Training needs, an aged fleet/replacement budgeting, recruitment, and data management round out the rest of the top five concerns.
A comprehensive GPS fleet management solution with a centralized dashboard can help public safety fleets address these top concerns as well as increase asset visibility for improved utilization and greater overall productivity, such as:
From smart dashboards to driver education tools, GPS tracking can dramatically improve fleet management and ROI. Public safety officials can use smart dashboards and driver education tools available through GPS tracking solutions to address the issues that are most critical to efficient and successful fleet operations.
Preventative maintenance. According to Government Fleet’s report, “vehicle age has increased across every class compared to statistics from last year (which averaged 2014–2016 data).” In addition, maintenance cost per mile has gone up for almost all vehicle types part of their survey. The ability to proactively schedule preventative maintenance will be key in making advances in reducing vehicle downtime (especially unexpected), including vehicle alerts and insight into vehicle diagnostics (odometer mileage, engine miles and diagnostic codes).
Vehicle Utilization. Forty-four percent of respondents to the Government Fleet survey indicated flat or reduced budgets, despite cost increases in fuel, pars and oil, and technology. For these fleets, the ability to do more with the vehicles and assets already owned will be critical. GPS tracking provides data visibility into vehicles status and availability to help managers identify underused vehicles and reallocate them accordingly.
Mitigate liability claims. OSHA’s Guidelines for Employers to Reduce Motor Vehicle Crashes, an on-the-job crash resulting in employee injury costs an average of $74,000 to the employer. In addition to providing historical data for use in the case of litigation, GPS tracking can provide data on driving behavior and vehicle use to help negotiate reduced premiums or discounts with insurance companies. Telematics provides access to data to verify vehicle location and speed and in turn mitigate the potential of costly claims.
Safe driving behavior. Training is the top concern for Government Fleet’s survey respondents, and encouraging safe driving behavior is a part of that challenge. Though GPS tracking cannot automate and ensure safety, the data it provides can equip you to more effectively coach your employees for increased chances of improvement. Administrators and management can use reports and alerts on vehicle speed and harsh driving events to coach drivers on safe driving behaviors.
Idling. Idling is a major source of fuel waste, leading to wasted money. The U.S. Department of Energy estimates that 6 billion gallons of diesel fuel and gasoline are wasted by idling vehicles. The few minutes an engine is left running, whether during a lunch break or for a “quick” task is being completed, add up to significant costs for fleets. Fuel is one of the most tangible and fast areas to see the financial benefits of improved habits, and with GPS tracking, managers can take steps toward reducing idle time and understand idling patterns in order to reduce those costs.
Routing. In addition to reducing idling, optimized routes using a GPS tracking solution is a key area where fuel waste can be addressed for a reduction in expenses. Another valuable use for the routing capability is the ability to know vehicle locations and efficiently deploy vehicles in an emergency or time-sensitive circumstance.
Case Study: Snohomish County Improves Officer Safety
Law enforcement comes with inherent risks. Officers face a lot of different dangers while on the job, but statistics show that the majority of officer fatalities (over 35%) are caused by car accidents, and almost half involved unbelted officers.
A major aim of the Snohomish County, WA, Below 100 Program is to address these and other leading causes of officer deaths. The program focuses on five tenets that promote key ways to encourage officer safety, two of which relate particularly to safe driving and can be managed using Verizon Connect telematics software:
The Under 100 Program took on special meaning for Undersheriff Rob Beidler of the Snohomish County Sheriff's Office while undertaking specialized training at the FBI's National Academy in Quantico, VA. A presentation by Kim Schlau, a mother of two daughters killed by a state trooper's reckless driving, really made an impact, underscoring the importance of actively managing office safety behind the wheel.
“I realized that my positional authority as Snohomish County's under- sheriff obligated me to ensure that my people make it home every night. Safety is paramount,” he said.
In addition to cost savings in several obvious areas, including fuel and maintenance, the county was able to see a reduction in expenses resulting from collisions and litigation. Vehicle collisions during 2015 cost the county $151,171 in medical and legal expenses and lost work hours and wages plus $2.3 million in litigation expenses. "We'd like to use those extra funds to hire more deputies," said Undersheriff Beidler.
Watch their story at verizonconnect.com.
Kevin Aries leads Global Product Success for Verizon Connect, helping build software solutions that optimize the way people, vehicles and things move through the world. Working predominantly with field service businesses, Kevin spends his time understanding the problems and solutions of the service industry to improve customer experience.
How tech can empower next-gen police fleets
By Kevin Aries, Leader, Product Management, Product Success
Police fleets—and the officers behind the wheel of patrol vehicles—often face a level of danger that goes above and beyond that of the average motorist. Technology and data play an important role in both modernizing police fleets and helping keep officers (and citizens) safer. Knowing this, here are some of the current trends and challenges in the police fleet space, and a look at how the right next-generation GPS tracking technology can help.
For police fleets, driving safety takes priority
The nature of their work means officers can face situations that require them to drive more aggressively than others on the road, whether accelerating to catch up to a speeding motorist, responding to reports of a fleeing felon or urgently trying to reach the scene of an emergency (car accident, fire, public disturbance, etc.).
An added risk is that being behind the wheel of a police vehicle inherently means having to multitask. Answering dispatcher calls, typing names, license plate numbers or other search queries on dash- or front-seat-mounted laptops and keeping track of speeding vehicles or other disturbances in their vicinity are just a few of the responsibilities police officers must contend with in addition to the “usual” responsibilities of driving their vehicle.
Due to the increased wear and tear from increased driving hours and aggressive driving, vehicle maintenance plays a crucial role in fleet – and driver – safety. Budget-strapped police forces must get the maximum number of miles and service out of each patrol car, but it shouldn’t be at the expense of those operating the vehicles (often at high speeds). Police cars must be safe to operate, and that’s where diagnostics comes in. The ability to proactively keep track of both routine maintenance and unexpected issues help ensure that trouble codes associated with each vehicle are addressed.
Integrating the right GPS tracking system – with features that include everything from vehicle diagnostics and maintenance schedule adherence to keeping track of crime within a certain geographic area – can help take the burden off police officers. 1 And the benefits of integrating fleet tracking software into patrol cars and other police vehicles don’t stop there. This technology can also help:
A connected network of police cars
Police fleet vehicles are essentially standard consumer trucks and cars customized to handle the demands of police work – and the enhanced connectivity hitting mass market vehicles has likewise made its way to police transports. With built-in WiFi (4G and even 5G) set to become standard on most cars and trucks in the next few years, increasingly, vehicles will act workplaces and mobile hotspots on wheels as well as modes of transportation.
This is a great development for police fleets, as officers can connect in-vehicle systems with other agencies to simplify data access and promote near real-time data review and exchange. In addition, having a connected in-vehicle network enables the ability to build displays right into the car, which connect to a computer in the trunk, versus having a standalone laptop take up space in the front seat, distracting drivers and becoming a potential danger/projectile should the vehicle be involved in an accident.
Future-focused fleet features
Looking to the future, there are a number of ongoing tech-enabled improvements on the horizon for patrol cars and police fleets, including:
Learn more about how your organization can safeguard the brave men and women who put their lives on the line for our communities now and well into the future by visiting verizonconnect.com.
Kevin Aries leads Global Product Success for Verizon Connect, helping build software solutions that optimize the way people, vehicles and things move through the world. Working predominantly with field service businesses, Kevin spends his time understanding the problems and solutions of the service industry to improve customer experience.
Public safety fleets must prepare for a digital future
By Lieutenant Joseph “Paul” Manley, IPSA Board Member, IPSA Memorial Committee Vice-Chair
Ensuring that first responders return home safely at the end of each shift is a paramount concern for all public safety leaders. The IPSA is committed to honoring fallen first responders while also raising awareness about line-of-duty deaths. As of April 30, 2019, the IPSA reported 67 first responder fatalities and nearly one-third of them were vehicle related.
Surviving a vehicle
On Saturday, April 13, 2019, a Georgia firefighter was struck by a vehicle while directing traffic in a school zone. On Saturday, March 30, 2019, police officers were at a residence serving an arrest warrant when the suspect arrived home, he fled the scene and in doing so he struck a police officer with his vehicle. On Saturday March 9, 2019, a California paramedic was assisting the driver of a car that had gone over the side of the freeway when a tractor-trailer hit both the ambulance and the fire engine at the scene before going over the side of the highway, as well. On Monday, February 4, 2019, a Massachusetts State Police trooper and a tow truck driver were struck while assisting the driver of a disabled car on Interstate 95.
These are just a handful examples of first responders being struck by vehicles reported in 2019. Fortunately, all survived. However, in such incidents, fatalities are common. According to the National Fire Protection Association and Officer Down Memorial Page 8, police officers and 11 firefighters died after being struck by passing vehicles in 2018.
“Move Over” laws
In response to increasing roadside fatalities in the line of duty, the United States and Canada have passed “Move Over” laws which require motorists to “Move Over” and change lanes to give safe clearance to emergency responders working along the roadsides. The law identifies emergency responders as law enforcement officers, firefighters, ambulances, utility workers, and in some cases, tow-truck drivers.
In the past, Canada and United States have used this term to apply to two different concepts; however, this is beginning to change as Canadian provinces have begun expanding the scope of their “Move Over” laws. This legislation currently exists in six Canadian provinces (British Columbia, Alberta, Saskatchewan, Ontario, Manitoba and Quebec). Currently in the United States, only Washington, D.C. does not have the “Move Over” law.
Reducing vehicle-related tragediesIn order to reduce the number of injuries and deaths to first responder personnel due to vehicle collisions and being struck while operating in the roadway, all parties involved must take responsibility for addressing and solving the problem. This includes agency administrations, labor organizations and individual members. If any one of the links in this chain fails, the likelihood of unnecessary injuries or deaths increases. While the service that each provide are obviously different, the responsibilities associated with managing the hazards and reducing risks associated with vehicle response and roadway scene safety are generally similar.
Below are four recommendations to reduce vehicle-related LODDs:
Motor vehicle line of duty deaths are preventable. It’s important to remember that when operating a motor vehicle, first responders do so at speeds that are reasonable and prudent for the existing conditions. It is always important to wear seatbelts. Operating at the scene of an emergency, placing your vehicle strategically to maximize accessibility, utilization, safety and egress is extremely important in making an operation run smoothly.
Lt. Manley is a 30+ year law enforcement professional and adjunct faculty member at North Shore Community College, Danvers, MA. Paul is the Founder of Risk Mitigation Technologies, LLC and currently serves as the Executive Officer for the Nahant Massachusetts Police Department. Paul has a master’s degree in Criminal Justice Administration from Anna Maria College, and a Bachelor’s Degree in Criminal Justice from American International College. Paul is honored to be a Board Member of the IPSA and Vice Chair its Memorial Committee.
International Public Safety Association InfoBrief: First Responder Line of Duty Death Causes and Prevention Strategies
International Public Safety Association InfoBrief: Assaults Against First Responders
International Public Safety Association InfoBrief: Fitness, Nutrition and Wellness Tips for Public Safety
By Chief Robert A. Mitchell, Ret., CFO, CEMSO, PSC, FPEM
There were 54 first responder fatalities during the first quarter of 2019 (January – March). The three most common causes include gunfire-related (n=18), vehicular related (n=16), and medical emergencies (n=9). Sadly, these types of deaths are recurring in the public safety profession.
Gunfire-related. The 18 gunfire-related fatalities in Q1 2019 include three K9s and 15 officers. Gunfire-related fatalities occurred during arrest warrants, vehicle pursuit, investigations, accidental ambush attacks, domestic call, barricaded subjects and traffic stops.
Historically, law enforcement officers were not shot for stopping a driver with a tail light out. They were simply trying to enforce laws to make the roads safer for other drivers, and this is still an officer’s intent – safety. Given that times have changed, officers and departments need to assess if they are doing everything possible to prevent gunfire-related deaths. Before duty, officers need to ask themselves:
While these questions may seem like rookie stuff, the seasoned professional tends to get complacent about details over time. An officer can never let their guard down, no matter how routine an encounter may seem.
Below are some recommendations from the International Public Safety Association InfoBrief: First Responder Line of Duty Death Causes and Prevention Strategies:
Vehicle related (assault, struck by a vehicle crash/accident). There were 16 vehicle-related fatalities in Q1 2019. This includes vehicle crashes/accidents, assault and being struck by a vehicle. No other group in the world multitasks like a first responder: lights and sirens; navigating traffic; clearing intersections; operating a two-way radio; getting updates from a mobile data terminal; receiving calls from dispatch on a cell phone with that one more piece of information. However, emergency drivers must start putting things down. It’s life dependent.
When reviewing data from third party sources, there is very little information cited to explain the crash (e.g. excessive speed, distracted driver or medical emergency). Further, there is no consistent data whether the occupants were wearing seat belts, whether the airbags deployed or did materials and equipment dislodged that may have caused a fatality.
Medical emergencies. There were nine line of duty deaths in Q1 2019 from cardiac arrest and medical emergencies. While the job of a first responder is inherently stressful, being in good health is part of the job. This is probably the thing that can be most controlled by an individual. Below are four tips for first responders to adopt:
All first responders age, and with age the body changes and health or medical issues surface. It is imperative to get an annual physical exam.
According to the International Public Safety Association InfoBrief: First Responder Line of Duty Death Causes and Prevention Strategies, "Beyond an annual physical, agencies have developed policies that require wellness exams based upon certain circumstances as officer involved shootings, major fire or rescue emergencies and mass casualty events. This medical surveillance program is mandatory, conducted by the department safety officer or other dedicated medical resources, and the first responder may not return to duty until the examination or observation is complete. Included in these programs is healthy diet education, teaching the firehouse cooks how to prepare healthy meals, how to teach patrol officers to avoid fast food, and how to teach EMS personnel foods to avoid. It is a combination of these initiatives that will or have, over time, created a healthier workforce."
First responder line of duty deaths will continue to occur, but there is an opportunity to reduce the number of fatalities. Avoid distracted driving. Wear a seatbelt. Go to work with the right mental frame of mind. Talk to a clinician. Get an annual physical. Be health conscious. Maintain situational awareness. Learn what is causing line of duty deaths to prevent them from happening.
Chief Mitchell is a retired Chief Fire Officer, Chief EMS Officer and Professional Emergency Manager. During his 40-year career, he has worked in law enforcement, fire service, EMS and emergency management. He now consults and teaches around the country. You can reach Chief Mitchell at firstname.lastname@example.org.
Scene Safety Infographic
Internal Situational Awareness Infographic
Editor’s Note: Article reprinted from EMS Week 2019 publication. Please find out more about EMS Week at emsstrong.org
To handle the stress associated with working in EMS, paramedics and EMTs benefit from good physical, mental and emotional health.
The greatest asset of any EMS agency is its people—the EMS practitioners and other personnel who are there for members of the community during their worst moments, and who ensure their patients receive high-quality, compassionate and lifesaving care.
However, “being there” for patients and their family members and friends during medical emergencies is inherently stressful. EMS practitioners often work in harsh environments; under difficult, unpredictable circumstances; with limited information, assistance and resources. They may be exposed to risks such as infectious disease, physical violence, occupational injury, vehicle crashes and death. They may be called on to help victims of traumatic events, which can leave scars on the responders who bear witness.
To effectively handle the stress associated with working in EMS, EMTs and paramedics benefit from having good physical, mental and emotional health. Research shows that mental and emotional well-being lowers the risk of developing chronic physical conditions, while keeping healthy physically can help ward off conditions such as depression, anxiety and stress-related disorders. Resilience is also protective—responders who are resilient can bounce back more easily from adverse events and more readily adapt to change.
Yet research also shows that some members of the EMS workforce face ongoing challenges in maintaining their mental, emotional and physical health—and that many EMS practitioners believe there is more that EMS agencies can do to help.
A 2015 survey of EMTs and paramedics published in the Journal of Emergency Medical Services (JEMS) found a high rate of suicidal thoughts among EMS practitioners. The survey found that 37 percent reported having contemplated suicide, nearly 10 times the rate of American adults.
In 2016, NAEMT’s National Survey on EMS Mental Health Services found that 37 percent of EMS agencies provided no mental health support for EMS practitioners, and 42 percent provided no health and wellness services. Even among those whose agencies provided counseling or resources such as employee assistance programs (EAPs), many EMS practitioners were reluctant to share their struggles for fear of being seen as weak.
A 2017 survey by the University of Phoenix of 2,000 U.S. adults employed as first responders, including firefighters, police officers, EMTs, paramedics and nurses, found 84 percent of first responders had experienced a traumatic event on the job and 34 percent had received a formal diagnosis of a mental health disorder such as depression or PTSD. For those diagnosed with depression, nearly half cited incidents at work as a contributing cause.
Getting started: Building a culture of wellness and resiliency
A culture of wellness and resiliency begins with an awareness of healthy lifestyles in the workplace. EMS agencies can help their personnel achieve this by providing educational opportunities, programs and hands-on experiences to address a large array of health and wellness-related topics for employees.
Attributes of a workplace that supports wellness and resilience include:
Defining wellness and resilience
What is Wellness?
Wellness is an active process of becoming aware of and learning to make healthy choices, according to the National Wellness Institute. Wellness means more than simply not being ill; it focuses on keeping your body in good condition to prevent certain chronic diseases. True wellness is proactive and recognizes that each individual has mental, physical and social needs that must be fulfilled to maintain optimal health.
What is Resilience?
Resilience is the ability to cope with stress and adversity without suffering lasting physical or psychological harm. Resilient people bounce back from setbacks. Resilience also provides protection from PTSD. When faced with a traumatic or stressful situation, resilient people are able to move past what occurred and resume their lives.
Factors associated with resilience include: optimism, the ability to stay balanced and manage strong or difficult emotions, a sense of safety and a strong social support system. Some people are naturally more resilient than others. But research shows that resilience isn’t a fixed trait. Resilience is a set of skills that can be taught and learned—and EMS agencies play a role in this.
Helping EMS agencies help the EMS workforce
To assist EMS agencies in developing programs that help EMS personnel maintain their physical, mental and emotional wellbeing, NAEMT has developed a Guide to Building an Effective EMS Wellness and Resiliency Program. The guide presents:
Editor's Note: Reprinted with permission from the author, Dr. Robert T. Muller. Originally published with Psychology Today.
In February 2016, Gail—a 911 dispatcher with Toronto Paramedic Services—found herself in tears at work. She had just received a call about Wallace Passos, a three-year-old boy from Toronto, who fell from a 17-story apartment building to his death.
At age 57, Gail has been working as an Emergency Medical Dispatcher for 15 years. Taking calls from around the city, she dispatches the closest ambulance. All dispatchers are expected to work 12-hour shifts, at times with only one colleague on duty.
This past year, Gail’s job became especially difficult for her when she was diagnosed with Post Traumatic Stress Disorder (PTSD). Gail recently spoke with the Trauma and Mental Health Report to discuss the experience that led to the diagnosis:
“I’m still haunted by the sounds of the family crying on the phone after the three-year-old fell off the building. I imagine the boy in pain, and it’s just awful.”
Gail is not the first emergency dispatcher to experience PTSD symptoms. A study conducted by researchers at Northern Illinois University described how 911 dispatchers are exposed to duty-related trauma, which is defined as an indirect exposure to someone else’s traumatic experience. Duty-related trauma puts dispatchers at risk for developing PTSD. Participants in the study reported experiencing fear, helplessness, and horror in reaction to various calls they received.
Along with the stress of being on the receiving end of difficult calls, emergency dispatchers also deal with the pressure and demand of following protocol, despite variability in situations.
Toronto Paramedic Services follows specific protocols set by The National Academy of Dispatch. The system was developed at Salt Lake City, Utah in 1988 and incorporates a set of 33 protocols for those answering 911 emergency phone calls. On a call, everyone is treated equally and is asked the same basic investigative questions. These questions are then used to give priority to life-threatening situations and provide guidance to first responders like firefighters, paramedics, and police officers on the scene.
While the protocols can be useful for guiding dispatchers through stressful situations, in other circumstances, they can cause pain and discomfort when a dispatcher can tell that a situation is hopeless. Dispatchers are not trained to deal with each unique case differently; they are expected to follow through with the routine questions regardless of circumstances.
In the case of Wallace Passos, Gail had to give instructions for CPR despite knowing that the child was already dead.
“It’s not just that the little boy died, but I feel that I traumatized the people that were trying to help him because I was required, in my position as a dispatcher, to tell them what to do to try and save him. And I knew from their description that he was dead. But we have to follow the procedure; we have to try.”
This predicament is further compounded by the blame placed on dispatchers for negative outcomes. Gail explains:
“People curse us and call us names just because we’re doing our jobs.”
Before her diagnosis, Gail often found herself crying at work without reason; she would take a call regarding a minor injury and become emotional. Her supervisor eventually gave her permission to take a leave of absence.
Over the past few months she has had disruptive sleep, nightmares, headaches, and unexplainable muscle spasms:
“I am hyper-vigilant, especially when I hear sirens. And it doesn’t have to be an ambulance; it could be a police car or fire truck. I hear the sirens and I start tensing up and looking all around me.”
Gail has been on a year-long search for proper psychological support for her PTSD. Unfortunately, there are few mental health benefits offered to dispatchers. Gail sought help from doctors, counselors, and social workers, most of whom referred her to other mental healthcare workers without providing much support.
But there is reason to be optimistic. The Ontario government passed legislation in February 2016 for better mental health support and benefits for first responders with PTSD, including 911 dispatchers.
“It made me sad that no one was stepping up and taking care of us. I want my peers to understand what it’s like to have PTSD after doing this job because I felt so alone when it happened to me. But this new legislation is huge. I think it’s very important because it’s raising awareness around this concern.”
Afifa Mahboob, Contributing Writer.
Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.
Copyright Robert T. Muller.
Robert T. Muller, Ph.D. trained at Harvard, was on faculty at the University of Massachusetts, and is currently at York University in Toronto. Dr. Muller was recently honored as a Fellow of the International Society for the Study of Trauma & Dissociation (ISSTD) for his work on trauma treatment. And his bestseller, "Trauma and the Avoidant Client," is in its third printing, has been translated, and won the 2011 ISSTD award for the year's best written work on trauma. As lead investigator on several multi-site programs to treat interpersonal trauma, Dr. Muller has lectured internationally (Australia, Europe, U.S.), and has been the keynote speaker at mental health conferences in New Zealand and Canada. He founded an online magazine, "The Trauma & Mental Health Report," that is now visited by over 100,000 readers a year. With over 20 years in the field, he practices in Toronto.
By Dave Weiner, IPSA Mental Health Committee Member
In March of 2018, I had the fortunate experience to be part of the Mayors Challenge team. The Mayors Challenge is a great partnership between the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Department of Veterans Affairs.
The overarching goal of the Mayor’s Challenge is to reduce suicides among service members, Veterans and their families using a public health approach to suicide prevention. The multi-disciplinary team from Los Angeles consisted of members from the City of Los Angeles Mayors Office, Los Angeles County Department of Mental Health, Didi Hirsch, 211 LA, U.S. Army Suicide Prevention Office, Los Angeles County Sheriff’s Department Mental Evaluation Team (MET), Los Angeles Police Department Mental Evaluation Unit (MEU), Greater Los Angeles VA Suicide Prevention Office and I attended to represent VA Police from our region.
This entire program was funded by SAMHSA and the eight city teams met in Washington D.C. from March 2018 to develop a comprehensive framework for a strategic action plan that would be a benefit Veterans in the County and City of Los Angeles.
Veteran suicide rates
In July 2016, the VA conducted an analysis of veteran suicide rates. They reviewed 55 million Veteran records from 1979 to 2014, from every state in the United States. The data revealed that roughly 20 veterans died by suicide per day.
While the VA has made great strides in working to reduce the number of veteran suicides through the development of the Veterans Crisis Hotline, expanding capacity for same-day mental health appointments and hiring additional clinicians to address these critical issues, one element had been overlooked. This was the proactive outreach to Veterans in crisis like how both LAPD and LASD do proactive outreach to non-Veteran citizens in crisis in their respective communities.
Making a change locally
After working with the Mayors Challenge team in D.C., it was apparent there was an opportunity to do more for our Veterans locally. This led to the creation of the VA Police Veteran Mental Health Evaluation Team at the VA Long Beach healthcare system facility in August 2018. Like the MET and MEU teams at LASD and LAPD respectively, this new element is the proactive utilization of VA Police Department officers in conjunction with VA mental health clinicians to conduct outreach contacts and follow-up on cases of Veterans experiencing mental health issues/crises.
Building the program
Developing this program took a lot of internal and external coordination. Nothing like this had been attempted before. To the VA’s credit, they do have a program that pairs a VA Police Officer and clinician to teach first responders how to interact with Veterans in the field but that’s where it stops. The VMET team is a natural extension of that program and puts boots on the ground to interact directly with Veterans and provide the care and resources at the point of crisis.
It was critical to get buy-in from a plethora of people internal to the VA and support from law enforcement counterpart. It was equally important to connect with key stakeholders in the mental health field, social work services and the executive leadership of these groups.
VMET pilot program
The VMET pilot program went live on August 20, 2018. In just six months, it went from concept to reality. The team performs a version of case management to ensure when they get a Veteran back to the medical center for care, that they are routing the Veteran to appropriate services. The team does periodic follow up to ensure the Veteran is staying on the right path and moving toward recovery.
This case management component is important. It shows that the team cares about the outcome and that they are partners in the Veteran’s success in recovery. The response to this service has been overwhelmingly positive and has garnered media attention of the team.
The team is a force multiplier in the fight against Veteran suicide. They can bring the resources the VA has to bear on an issue a Veteran has. This pro-active outreach, co-response model has changed the course in several Veterans’ lives.
It took a monument of effort to get this program operationalized. Below are some tips, ideas and strategies to replicate a program like this in another community:
To date of this article, the VMET team has responded to well over 400 calls for service involving Veterans in crisis to include necessary follow ups and case management.
Two media articles below highlight the team and their effectiveness.
Dave Weiner is the founder and CEO of Secure Measures, LLC, a risk management consulting firm that provides protection solutions for the global ecosystem. Prior to founding his company, Weiner’s 26-year public safety career included roles in corporate security, training, K-9, SRT, community policing, investigations and culminated in retiring as Regional Chief of Police and Emergency Management.
By Jennifer Stewart, Communications Supervisor, Charlotte-Mecklenburg Police Department Communications Division, IPSA Board Vice-Chair
Everyday day thousands of people dial 911. They hear a voice come on the line that asks if they need police, fire or medic. The telecommunicator will then ask the most important question while they have you on the phone – what your address is. Depending on what type of emergency response is needed the telecommunicator will ask more clarifying questions and then both parties disconnect.
If most 911 calls were that easy we would be living in a perfect world. However, no 911 call is the same. A 911 operator goes from one emergency call to the next and does not get any closure. Each accident, domestic, suspicious person or a noise complaint calls are all different. And then there’s that one call that occurs sometime during a 911 operator’s career that is never forgotten.
Working in an emergency operations environment
The job of a 911 operator is not easy. People do not call just to say hello, it is because they have an emergency.
Sometimes a 911 operator is yelled or cussed at because the caller is frustrated by all the questions. While being chastised, we have a duty to remain professional and maintain a calm voice. Being a 911 operator is not a thankless job because even if you helped just one person it is worth it.
Most people can never say they have met a 911 operator so the next time you do meet one tell them thank you. They are often the first voice you hear when you need help.
Jennifer Stewart is a 15-year veteran with the Charlotte-Mecklenburg Police Department Communications Division. She is the Vice-Chair of the IPSA's Board of Directors.
Editor's note: This article is from the International Public Safety Association’s UAS eBook
By Mark Wesley, Member of IPSA’s UAS Committee
University and college campuses have traditionally been venues used by students and others to protest, demonstrate and engage in other activities under their First Amendment rights. Managing the security and safety during these large gatherings is primarily a function of law enforcement officers and campus public safety personnel. However, these events can quickly evolve, the size of the crowd can increase rapidly, and the peaceful mood can swing to civil disturbance, which will ultimately stress the limited resources available to most campus public safety departments.
UAS offers a cost-effective and safe force multiplier. A bird’s eye view live stream of the situation can quickly provide information on crowd size, movement, access path, and other elements that can assist campus public safety make decisions on how to manage the event.
Mass gatherings and UAS
UAS are deployed at many events to help with security and management. The 2018 Coachella Music Festival organizers and local law enforcement utilized surveillance UAS as part of the security measures for the event. Indio, California police officers used the UAS to monitor security and traffic.
Following the Route 91 Harvest Music festival shooting in October 2017, Las Vegas police used UAS to monitor crowds, identify suspicious packages and track any unusual activity on the Strip during New Year’s Eve celebrations.
The Air Support Unit of the Contra Costa County Sheriff’s Department used UAS to monitor an immigrant rights rally at the Contra County West County Detention Facility.
While UAS may seem an efficient and easy application, there are many considerations that need to be addressed prior to flight operations in support of law enforcement. A few of these basic considerations include regulatory compliance, integration with incident command, and privacy issues.
Campus law enforcement needs to be familiar with applicable federal, state and local laws and policies to determine if UAS can be used. Has the agency met FAA requirements for operation under a Certificate of Waiver/Authorization (COA) or under Part 107?
According to the FAA, federal, state and local government offices can fly UAS to support specific missions, under either the FAA’s Part 107 rule or by obtaining a COA. Be aware that some states have legislation restricting the use of UAS by law enforcement agencies. Can the operation be warrantless?
Before any deployment, agency leadership needs to decide if the use of UAS is the best way to fulfill the mission. If the decision is to use UAS to support the mission, then the specific details of the operation need to be identified prior to deployment and captured in an incident action plan. Adherence to incident command protocols is essential for successful UAS flight operations during events. Setting the conditions for flight operations, establishing the chain of command for authorization of flights and ensuring notification to ground elements of the operation are just some of the elements that need to be planned out prior to deployment.
UAS operation can also impact the campus community’s perception of the agency’s transparency and trust. Some people will view the use of UAS as a violation of their privacy and a restriction on their First Amendment rights. The agency needs to be prepared to proactively explain the need for improved safety and why UAS supports that effort. One way to accomplish this is to engage the campus community in the process as the program is being developed and to publicize the agency’s policies regarding UAS use, collection and storage of information. It will be an on-going debate over when and how law enforcement uses UAS.
However, UAS can be an incredibly effective tool in conducting situational assessment and proving valuable information to help protect both law enforcement personnel and participants during mass gathering events.
Mark Wesley has more than 30 years of progressive experience as an emergency management professional, with a focus on program development, policy analysis, training and exercises. He is currently the Emergency Management Director at Eastern Michigan University and previously spent 22 years with the Michigan State Police Emergency Management and Homeland Security Division. He is the principal manager of MHW Consulting LLC, founded in 2011, a veteran-owned consultancy company that provides comprehensive emergency management services.
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How public safety agencies leveraged UAS during recent natural disasters
What to consider before starting a new public safety UAS program
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