Taking Care of Our Own 2022
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Committee on Ways and Means
U.S. House of Representatives Hearing on “America’s Mental Health Crisis”
Statement of Shawn Baird, President, American Ambulance Association
February 2, 2022
Chairman Neal, Ranking Member Brady, and members of the Committee, on behalf of the members of the American Ambulance Association (AAA), I greatly appreciate the opportunity to provide you with a written statement on America’s Mental Health Crisis. Simply put, America’s hometown heroes who provide emergency medical services and transitional care need the Congress to recognize the significant stress and trauma paramedics and emergency medical technicians (EMTs) have experienced as a result of this pandemic. The AAA urges members of Congress not to forget these heroes and to expressly include all ground ambulance service personnel in efforts to address America’s Mental Health Crisis.
Emergency medical services (EMS) professionals are ready at a moment’s notice to provide life-saving and life-sustaining treatment and medical transportation for conditions ranging from heart attack, stroke, and trauma to childbirth and overdose. These first responders proudly serve their communities with on-demand mobile healthcare around the clock. Ground ambulance service professionals have been at the forefront of our country’s response to the mental health crisis in their local communities. Often, emergency calls related to mental health services are triaged to the local ground ambulance service to address.
While paramedics and EMTs provide important emergency health care services to those individuals suffering from a mental or behavioral health crisis, these front-line workers have been struggling to access the federal assistance they need to address the mental health strain that providing 24-hour care, especially during a COVID-19 pandemic, has placed on them. We need to ensure that there is equal access to mental health funding for all EMS agencies, regardless of their form of corporate ownership so that all first responders can receive the help and support they need.
EMS’s Enhanced Role in the Pandemic
As if traditional ambulance service responsibilities were not enough, paramedics and EMTs have taken on an even greater role on the very front lines of the COVID-19 pandemic. In many areas, EMS professionals lead Coronavirus vaccination, testing, and patient navigation. As part of the federal disaster response subcontract, EMS personnel even deploy to other areas around the country to pandemic hotspots and natural disasters to bolster local healthcare resources in the face of extraordinarily challenging circumstances.
Mental & Behavioral Health Challenges Drive Staffing Shortages on the Front Line
Myriad studies show that first responders face much higher-than-average rates of post- traumatic stress disorder[1], burnout[2], and suicidal ideation[3]. These selfless professionals work in the field every day at great risk to their personal health and safety—and under extreme stress.
Ambulance service agencies and fire departments do not keep bankers’ hours. By their very nature, EMS operations do not close during pandemic lockdowns or during extreme weather emergencies. “Working from home” is not an option for paramedics and EMTs who serve at the intersection of public health and public safety. Many communities face a greater than 25% annual turnover[4] of EMS staff because of these factors. In fact, across the nation EMS agencies face a 20% staffing shortage compounded by near 20% of employees on sick leave from COVID-19. This crisis-level staffing is unsustainable and threatens the public safety net of our cities and towns.
Sadly, to date, too few resources have been allocated to support the mental and behavioral health of our hometown heroes. I write today to ask for Congressional assistance to help the helpers as they face the challenges of 2022 and beyond.
Equity for All Provider Types
Due to the inherently local nature of EMS, each American community chooses the ambulance service provider model that represents the best fit for its specific population, geography, and budget. From for-profit entities to municipally-funded fire departments to volunteer rescue squads, EMS professionals share the same duties and responsibilities regardless of their organizational tax structure. They face the same mental health challenges and should have equal access to available behavioral health programs and services.
Many current federal first responder grant programs and resources exclude the tens of thousands of paramedics and EMTs employed by for-profit entities from access. These individuals respond to the same 911 calls and provide the same interfacility mobile healthcare as their governmental brethren without receiving the same behavioral health support from
Federal agencies. To remedy this and ensure equitable mental healthcare access for all first responders, we recommend that:
The rationale for the above requests is twofold. First, ensuring the mental health and wellness of all EMS professionals—regardless of their employer’s tax status—is the right thing to do.
Second, because keeping paramedics and EMTs employed by private ambulance agencies who are on the frontlines of providing vital medical care and vaccinations during this pandemic is the smart thing to do.
Thank you for considering this request to support ALL of our nation’s frontline heroes. They are ready to answer your call for help, 24/7—two years into this devastating pandemic, will Congress answer theirs?
Please do not hesitate to contact American Ambulance Association Senior Vice President of Government Affairs, Tristan North, at tnorth@ambulance.org or 202-486-4888 should you have any questions.
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orThe National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC), is seeking public comment on current evidence-based, workplace and occupational safety and health interventions to prevent work-associated stress, support stress reduction, and foster positive mental health and well-being among the nation’s health workers, including first responders and EMS clinicians. The NHTSA Office of EMS is committed to working with our Federal partners to prioritize efforts that address the high rates of stress, burnout, depression, anxiety and suicide among members of the EMS community. This request for information is an opportunity to make sure your voice is heard.
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NIOSH invites comment on best practices, promising practices or successful programs related to providing stress prevention and mental health services to health workers, including but not limited to employee assistance programs, screenings, supervisor trainings, workplace policies, talk therapy, mindfulness, peer support and mobile apps.
Comments and responses may be submitted here through Friday, November 26, 2021.
Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the availability of an estimated $103 million in American Rescue Plan funding over a three-year period to reduce burnout and promote mental health among the health workforce. These investments, which take into particular consideration the needs of rural and medically underserved communities, will help health care organizations establish a culture of wellness among the health and public safety workforce and will support training efforts that build resiliency for those at the beginning of their health careers.
“The Biden-Harris Administration is committed to ensuring our frontline health care workers have access to the services they need to limit and prevent burnout, fatigue and stress during the COVID-19 pandemic and beyond,” said HHS Secretary Xavier Becerra. “It is essential that we provide behavioral health resources for our health care providers – from paraprofessionals to public safety officers – so that they can continue to deliver quality care to our most vulnerable communities.”
Health care providers face many challenges and stresses due to high patient volumes, long work hours and workplace demands. These challenges were amplified by the COVID-19 pandemic, and have had a disproportionate impact on communities of color and in rural communities. The programs announced today will support the implementation of evidence-informed strategies to help organizations and providers respond to stressful situations, endure hardships, avoid burnout and foster healthy workplace environments that promote mental health and resiliency.
“This funding will help advance HRSA’s mission of developing a health care workforce capable of meeting the critical needs of underserved populations,” said Acting HRSA Administrator Diana Espinosa. “These programs will help to combat occupational stress and depression among our health care workers as they continue their heroic work to defeat the pandemic.”
There are three funding opportunities that are now accepting applications:
To apply for the Provider Resiliency Workforce Training Notice of Funding Opportunities, visit Grants.gov. Applications are due August 30, 2021.
Learn more about HRSA’s funding opportunities.
Press Release
Norm Robillard
Paramedic and Public Information Officer
613-884-4544
www.firstresponderarehuman.com | Facebook Page | Twitter Hashtag
Five years ago in May 2016 a group of intrepid cyclists and support crews decided to take their message on the road “No One Should Suffer In Silence”. On May 7, 2016 they rode bicycles from Ottawa, ON to Washington, DC (“The Capital-to-Capital Mental Health Campaign and Ride”). It took 14 days for riders to cover 1,000 miles\ 1,600 kms. At many steps along that two-week journey First Responders of all stripes met these riders at their stations, firehouses, headquarters. They had conversations in an effort to break down the stigma associated with mental health, PTSD and suicide.
Five years later and after rebranding to the new First Responders Are Human these First Responders from Canada and USA are setting out on a new adventure. Between May 3-16, 2021 (and considering pandemic restrictions) they are hosting another sort of mental health campaign dubbed #MovementIsMedicine. They endeavour to be more inclusive.
First Responders, friends, coworkers and family are encouraged to register (at no cost) and be active in their own locale and to be interactive virtually with fellow participants in Canada and USA. Participants can hike, walk their dog, run, paddleboard, kayak, do yoga, stretch, they can even ride a bike.
This campaign is promoting a different resiliency skill each day. Psychotherapist, Parul Shah currently doing her PhD is leading the education piece about self-care. Participants are encouraged to try each resiliency skill and post and blog about it.
This campaign begins May 3, 2021. It coincides with the Canadian Mental Health Association Mental Health week and American Hospital Association Mental Health month.
For more information on how to register and be involved go to www.firstrespondersarehuman.com
The goal is to continue to engage First Responders all over (there are no borders) to promote #mentalhealthmatters and to support each other. Being a First Response professional is honourable. These Responders give unconditionally to strangers in need; along the way they too have to find ways to maintain a healthy lifestyle.
#FirstRespondersAreHuman hopes through its new website, various platforms, and shared goals (camaraderie) it will assist First Responders discover ways and means to lead their own self-care and a healthy lifestyle.
Published in the Journal of Affective Disorders
At a time when emergency responders are under immense stress, innovative health tech organization develops YOU | ResponderStrong wellness tool to support comprehensive well-being for at-risk group
DENVER, Aug. 27, 2020 /PRNewswire/ — Grit Digital Health LLC, a tech startup at the intersection of behavioral health, well-being and technology, has partnered with The Anschutz Foundation, Global Medical Response (GMR) and All Clear Foundation to create YOU | ResponderStrong — the world’s first personalized wellness platform for emergency responders. Emergency responders face well-being challenges (e.g. shift work, consistent exposure to trauma, and working in high risk environments) that put them at higher risk for mental health issues and suicide, yet barriers make it difficult to seek out available resources and discuss concerns, leaving many to struggle with these challenges alone.
For emergency responders, rescuing others is second nature, but the mental and physical impacts can be debilitating if left unaddressed. Studies show that first responders are more likely to die by suicide than in the line of duty, 20 to 25 percent of all first responders experience post-traumatic stress and the life expectancy of a first responder is 20 years less than average.
“Responders shouldn’t pay for their service with their lives, either in longevity or quality,” said Rhonda Kelly, founder of ResponderStrong and director of health, wellness and resilience for GMR. “Especially now when the stressors are so extreme and prolonged, burnout is on a meteoric rise. The result of our failing to meet our basic human needs, burnout is one of our biggest enemies. This tool is a tremendous aid in supporting our self-care, building our resiliency, and improving our quality of life.”
Using a human-centered research and design process, the founding partners of you.responderstrong.org brought together national leaders across various emergency responder verticals (law enforcement, EMS, fire service, dispatch and healthcare workers, etc.) to uncover the needs, motivations and challenges of these populations with respect to their mental health and well-being. The insights gathered during this process highlighted the increased pressure and new risks currently facing emergency responders across the country.
“One challenge that has been clear for first responders is figuring out the balance between being able to perform their jobs and also act in the other roles they fill as parents and spouses,” said Caleb Demers, LCSW, who works directly with emergency responders as a clinical social worker and member of the LEADER program at McLean Hospital. “Many patients we work with use a lot of energy attempting to not ‘bring the work home,’ but now that is a tangible fear with more immediate consequences. We see first responders work very hard to maintain confidence and competence in their roles, but when their supports are not as accessible, it affects their mental health.”
The solution is a digital platform, available 24/7, with hundreds of evidence-based resources and tools to support emergency responders with their personal and professional well-being. The first platform of its kind, YOU | ResponderStrong uses a tailored profile and proprietary health assessments to personalize the experience for each emergency responder that creates an account. The platform delivers customized online resources and tools across three areas of well-being: Succeed (financial and career success), Thrive (mental and physical health) and Matter (purpose and connections). The foundations of this comprehensive approach lie in Grit Digital Health’s proprietary well-being model.
“High stress work environments invariably lead to stress that carries into one’s personal life,” said Nathaan Demers, Psy.D., VP and director of clinical programs at Grit Digital Health. “It’s essential that we support the comprehensive well-being of emergency responders by decreasing the stigma and providing educational resources regarding how to support peers, as well as oneself. This is especially important in times of heightened stress, as we see now in light of COVID-19.”
The platform is built on a research-backed tool called YOU, a personalized well-being software created for college campuses and later expanded to serve rural veterans, community mental health centers, workplace wellness and now emergency responders. The platform provides an experience aligned with key research insights gathered from emergency responders: maintaining confidentiality, keeping data secure, including crisis information and providing 24/7 access to support any need any time. Data provided to tap into the platform’s personalization algorithm is completely anonymous, an essential aspect in building trust with emergency responders using the platform.
“Emergency Responders sacrifice more than most and shoulder unfathomable burdens to keep us all safe,” said Janell Farr, president of All Clear Foundation. “They are so focused on helping others that they often don’t take time to help themselves. And if they would like to, options have previously been limited. With YOU | ResponderStrong, responders can now easily assess their overall well-being and immediately access content to enhance their health, well-being and everything in-between.”
The platform is currently undergoing further testing and iteration efforts. Grit Digital Health will collaborate with the founding partner organizations to roll out a second version of the ResponderStrong wellness tool in fall 2020. The release will include learnings from testing with emergency responders and analysis of impact/engagement data. See the tool in action by visiting you.responderstrong.org.
About Grit Digital Health
Grit Digital Health develops behavioral health and well-being solutions through design and technology that envision a new way to approach mental health and well-being. The company solves complex health problems through innovation and creativity, including products that address veteran transitions to civilian life, student loneliness and well-being, employee satisfaction and the mental health of working-age men. For more information, visit www.gritdigitalhealth.com.
About All Clear Foundation
All Clear Foundation is a nonpartisan, nonprofit 501(c)3 supporting First Responders by creating, convening, amplifying and funding innovative programs to improve their life expectancy and wellbeing – as well as the wellbeing of their families. In addition to YOU | ResponderStrong, the foundation has curated a First Responder Resource Database with thousands of resources for responders and their families, and recently launched ResponderRel8, a peer-to-peer chat app that enables First Responders to connect, celebrate and commiserate with peers without fear or stigma getting in the way, and anonymously if they choose. To learn more about All Clear Foundation’s programs or to join the cause, visit AllClearFoundation.org.
About The Anschutz Foundation
Founded in 1984, The Anschutz Foundation was created by Philip F. Anschutz as a private charitable foundation. Over three decades, the foundation has given substantially to hundreds of nonprofit organizations primarily concentrated in Colorado. The Anschutz Foundation currently makes more than 500 grants annually. In 2016, The Anschutz Foundation received the Outstanding Foundation award from National Philanthropy Day in Colorado. This annual event celebrates exceptional philanthropic and volunteer contributions in Colorado. For more information, visit theanschutzfoundation.org.
About Global Medical Response (GMR)
With more than 38,000 employees, Global Medical Response teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services in the United States, the District of Columbia and around the world. GMR was formed by combining the industry leaders in air, ground, managed medical transportation, and community, industrial/specialty and wildland fire services. Each of our companies have long histories of proudly serving the communities where we live: American Medical Response (AMR), Rural Metro Fire, Air Evac Lifeteam, REACH Air Medical Services, Med-Trans Corporation, AirMed International and Guardian Flight. Combined, we completed 4.9 million patient transports last year utilizing 7,000 ground vehicles, 111 fire vehicles, 306 rotor-wing aircraft and 106 fixed-wing aircraft. We are the largest medical transport company in the world, focusing on intimate and high-service solutions at a local level. For more information, visit globalmedicalresponse.com.
SOURCE Grit Digital Health LLC
From CBS Boston
MEDFORD (CBS) – Frontline workers are now in their ninth month battling the COVID-19 pandemic. For Emergency Medical Technicians coronavirus has introduced a new kind of uncertainty to their jobs.
“You’re always thinking about COVID,” paramedic Victor Markaze told WBZ-TV. “You don’t know who’s sick and who’s not sick anymore, so now everyone is being treated as sick.”
American Ambulance Association mental and behavioral health partner the Firefighter Behavioral Health Alliance is offering two sessions of their “Saving Those Who Save Others” virtual workshop.
December 17
Afternoon Session: 14:00 ET | Register►
Evening Session: 19:00 ET | Register►
This Zoom seminar, typically $25, is free to AAA members! Please enter “AAA member” in the comment section of the registration page and you will not be charged for your attendance.
FBHA understands the stress COVID 19 has brought to fire and EMS organizations in regard to educating your members on behavioral health, PTSD and suicide awareness. To date, FBHA has cancelled over 80 workshops across the US this year. Since we are not able to travel and businesses are still on lockdown, we are offering another option.
We are excited to offer needed training virtually! We are offering our “Saving Those Who Save Others” workshop on the Zoom platform. During the workshop, we will discuss PTSD within the fire and EMS services as well as suicide awareness, plus recommendations to help yourself and your department.
Two classes will be offered on December 17, 2020. The afternoon class is at 1300 hours (CST) and the evening class is at 1900 hours (CST). The 2 hour class is $25.00.
New York City plans to test out a program where dispatchers send out emergency medical services and mental health crisis workers, instead of police officers, to mental health-related calls, making it the latest city to attempt a pivot away from policing as a cure-all.
The city’s mental health teams will work in two high-need communities starting in February. They will include health professionals and crisis workers from the fire department’s emergency medical services division. They will respond in place of the traditional police and paramedic teams, except in cases that involve a weapon or imminent danger, according to a statement from Mayor Bill de Blasio’s office this week.
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orBy Meredith M. O’Neal, MA; Simone Joannou, MA; and James Langabeer, PhD, EMT
About 30 percent of first responders develop mental health disorders, including depression, Acute Stress Disorder (ASD) and post-traumatic stress disorder (PTSD), as compared with 20 percent in the general population.3 Another common occupational risk factor includes acute and chronic exposure to both primary and secondary trauma, the latter referring to the phenomenon of emotional and moral attachment to the experience of the individuals they rescue.
These overwhelming demands from first responders can lead to compassion fatigue, a depleted capacity for empathy that results in various behavioral issues including depression and anxiety. Burnout is a similar phenomenon of exhaustion resulting from occupational strain such as overwork and lack of support from leadership. These conditions have been found to directly contribute to the more than doubled suicide rates among medics than other professionals.
From Cleveland 19 News on July 13, 2020
CLEVELAND, Ohio (WOIO) – A fight for Post Traumatic Stress Disorder coverage years in the making has ended with a win for Cleveland paramedics, EMTs and dispatchers.
A union contract for Cleveland EMS just passed, under an agreement out of court that still needs to be ratified by city council.
The agreement includes about $3.7 million in back pay for employees and mental health language, addressing PTSD.
CARE has been negotiating their contract since March of 2016.
The mental, emotional and physical impacts of emergency response work can compromise our ability to be there for our brothers and sisters in uniform, to be engaged with our families, and to protect our communities.
Founded at the National Mental Health Innovation Center of the University of Colorado Anschutz, ResponderStrong is a collaboration between emergency responders and their advocates. Its mission is to improve mental health supports for emergency responders and their families through joint focuses on intervention and prevention. Thesite serves as a resource map for responder-informed crisis and clinical services as well as easily accessible educational content and tools for responders, their families, their leaders and the clinicians who work with them. ResponderStrong has also created custom educational content regarding relationships, stress management, and resiliency in response to community needs assessments.
The role of the affective domain is well studied among other medical and public safety professions, including its impact on provider physical and mental health,
quality and patient perception of care, occupational burnout, empathy fatigue, and organizational commitment. As part of a doctoral research study, a survey has been developed and approved through an Institutional Review Board (IRB). It is hoped the information gathered in this survey will help to develop a clearer understanding of the specific difficulties and needs of EMTs and paramedics.
Participants will be entered to win one of twenty (20) $20 gift cards raffled off at the end of the study (summer of 2020). In addition, the survey results will be shared with participating EMTs and paramedics so that they can learn about our findings and better understand how their work experiences compare to those of others. The survey should take approximately 25 minutes to finish.
Administrators interested in facilitating distribution of the survey may contact researcher Emily Kaplan at Emily_Kaplan@nymc.edu
Free Webinar | Recorded June 12, 2020 at 14:00 ET
This presentation involves a careful examination of behavioral health awareness for EMS with an emphasis on understanding emotional and physical stressors. We will cover communication skills, addiction, depression, PTSD/PTSI, suicide statistics, retirement, and creating a behavioral health program. The program will:
Jeff holds a master’s degree and is a licensed counselor. He is a retired Captain from Palatine Rural Fire Protection District in Inverness, Illinois and is a member of the American Counseling Association and National Board of Certified Counselors.
FBHA’s goal is to provide behavioral health workshops to fire departments and EMS organizations across the globe, focusing on behavioral health awareness with a strong drive towards suicide prevention and promoting resources available to first responders and their families. FBHA’s goal is to promote good mental health for the men and women who serve their communities through EMS and fire protection. FBHA is also focused on training for EAP organizations, Professional Clinicians, Psychologists, Psychiatrists, Doctors, Social Workers, Marriage Counselors, Chaplains, and those dedicated to helping EMS and firefighters. FBHA is the only organization in the U.S. which tracks and validates all FF and EMS suicides.
Recorded May 18, 2020 at 14:00 ET | Free | Now On-Demand
The COVID-19 pandemic has created unprecedented challenges for healthcare workers and first responders. As this pandemic enters its third month, our employees and those leading EMS agencies are hitting a critical level of physical and emotional fatigue. While many parts of the country are starting the process of “opening back up”, we still have a very long way to go before we return to any semblance of how things looked prior to this Coronavirus outbreak.
Join AAA HR & Operations Consultant, Scott Moore and licensed Psychologist, Dr. Lau Morrison for this important webinar program. Dr. Morrison is a former EMT who currently works for the Los Angeles County, Department of Mental Health working with children who are considered high risk for severe mental health issues. In her private practice, Dr. Morrison works with EMTs and Paramedics who are struggling with PTSD and other mental health and wellness issues. Dr. Morrison and Scott will be discussing many of the challenges that faced EMS personnel in the early days of the COVID-19 response and the challenges that lie ahead in the coming months. This program will provide attendees with strategies that EMS professionals and leaders can employ to provide the greatest support to all who are impacted by the COVID-19 pandemic.
Thank you to the UK’s Dr. Alys Cole-King and Dr. Linda Dykes for putting together this resource for healthcare worker mental and behavioral health. The main document, Optimising staff preparedness, wellbeing, and functioning during the COVID-19 pandemic response, is still evolving. It will be updated and expanded in the next 10-14 days, so please check the page frequently for updated versions.