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PTSD program for first responders extended to family members

Members of the Banff Fire Department take part in a training exercise held on March 31, 2015. Fire Chief Silvio Adamo is spearheading an effort to provide grief counselling not merely to first responders, but to the families of those who experience post-traumatic stress disorder.

Chris Bolin/The Globe and Mail

The pager crackles as the call goes out to all of the town's firefighters and emergency medical technicians: "Roommate has tried to cut down the person hanging in the closet."

The message starts a cascade of questions from a little girl sitting next to her father on the couch: What does that mean?

This scenario happened to a firefighter in Banff, Alta., and it could happen to any first responder. The fight to keep work at work and insulate family members from the horrors they see is not always successful. This particular incident led Banff fire chief Silvio Adamo to take the department's mental-health program to the next level.

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The 26-year veteran created a mental-health program for its members, and is now offering services to their spouses and families.

All of Banff's firefighters and EMTs are on call 24 hours a day and carry pagers, Adamo explains. There are codes for some of the calls that come across the pagers, but details often have to be spelled out – including, for example, when a suicide victim has been cut down from the closet by a roommate. There is no code for that.

This spring, first responders who are parents will learn how to best answer tough questions from their kids, and kids will be taught how to deal with the alarming situations to which they're exposed.

"Daddy comes home from work and he smells like smoke, or mommy has been out for a couple of hours and isn't acting completely normal because they've just been at a traumatic car accident and had to deal with body parts – or whatever the case may be," Adamo says. "How can we help the kids understand without exposing them dramatically to what we do?"

Adamo called on Shawn Carr, a registered social worker and family/school liaison worker in Banff, to help after the firefighter's daughter heard his pager call about a suicide and started asking questions.

Though parents look for special words that will make a bad situation better, Carr says it doesn't work like that.

"The kids are going to be better off if the [conversation] is in the parents' own words," Carr says. "Of course you're going to try and shield them, but you can't shield them from everything."

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He says the focus should be to show the children they aren't alone and that they can always ask for help. And, he adds, "at the end of the day, they just need to know they're safe."

The emphasis on children is the newest piece of the larger health and wellness program that Adamo started about a year and a half ago.

Phase one focused on the physical health and well-being of the firefighters, getting them whipped into shape both in the gym and in the kitchen.

Their mental health was Adamo's next priority. He pursued further training on critical-incident stress management for first responders, a certified three-day program where he learned how to recognize signs of stress and how to conduct one-on-one conversations, as well as group meetings called "defusings."

"A lot of times they just have to get it out, it's important to speak about it," Adamo says. "The first step is always just listening and then being able to empathize, maybe relate, especially if it's with a peer in the same field."

The next step is discussing healthy coping mechanisms, which may mean seeking professional help.

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In a town the size of Banff (population 7,500), at least someone in the department of four career firefighters and roughly 30 on-call volunteers is likely to know the person on the other end of the 911 call, which intensifies already tragic situations.

Adamo says you always remember the incidents involving people you know – but they aren't the only ones that haunt his memories.

"I can still recall the first serious incident I ever went to," he says. "There were four fatalities and it was a really horrific accident site. A transport truck had cut this car right in half. There were body parts on the highway and we were helping put the people in body bags. Matching socks and shoes with arms and feet, to try and put all the pieces in the right bag. Still to this day, I can recall that vividly if I want to; that whole scene, what I did."

Adamo and his deputies make themselves available to the crew around the clock for support.

"That's where it comes back to us all being here for each other … if it's one of our members and they can't sleep or they can't get an image out of their head, we want them to know they can call us," Adamo says. And if they aren't comfortable talking to a co-worker, he'll find someone else they feel more at ease with.

Still, Adamo admits, sometimes you end up taking the mental baggage home with you. That is where the third part of the program came in: the partners and spouses of the firefighters.

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Katrin Middleton is one of the "rookie wives," with only two years under her belt being married to EMT and volunteer-firefighter husband J.P. Middleton.

"I was really glad to have this seminar at the fire hall," Katrin Middleton says. "If something really bad were to happen, at least I know all the other women and I can ask them, 'How did your husband deal with it?' instead of going to my friends that don't have first-responder husbands, because they wouldn't know."

She says the seminar taught the spouses how to recognize the warning signs of PTSD, including unusual bouts of anger, odd sleeping habits and drug use – and where to go for help.

"I think that it was good to bring it to our attention because a lot of us didn't even think about it, really. If the mood swings happened all of a sudden, you wouldn't necessarily connect it right away," she says. "If he told me all the things he sees, then I would worry more about how he deals with it. But for now, I know that there are people he really is comfortable with that he can go to and they already know what happened."

With high numbers of suicides in fellow first responders and military personnel, this program offers an innovative approach to giving support to people who face death and destruction on a daily basis.

"As we get more educated, there's obviously some fine-tuning to be done," Adamo says, but he thinks that it's a good starting point.

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"I wish it was in existence when I was starting out and seeing all this gore on the highway, seeing things that people shouldn't see. But back then it was, 'You're a firefighter, you can deal with anything.' Thankfully we're getting away from that now."

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