Texas LODD Task Force

Constructing Levels of Care

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Each agency needs to determine what resources are available to them in order to provide the right type and level of support and and assistance to their members.  A rural volunteer fire department's needs will look very different for a large urban police agency, which will look very different for a mid-sized non-profit EMS provider.  While a larger department may have access to EAP programs and a smaller department may only have access to a chaplain, there are still several ways to optimize the best support services for your agency.  Providing mental health services is like an onion, there are many layers of care that you can offer.  Here are some basic suggestions for you to consider.

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Start At The Ground Level

• Shift commanders, officers, and co-workers are going to know their co-workers.  Start by training all officers, and other personnel in how to spot mental health issues, suicide awareness, and personal crisis management.  All officers should know what to look for and how to respond to first responder in crisis.  It's also key to have other individuals on a shift or in a department that are trusted and respected by their peers to be trained as well.  These individuals tend to be the first person a fellow co-worker might go to when dealing with stress or other types of mental health crisis.  They should be trained in how to help and refer.  The Stress First Aid course presented by the National Fallen Firefighters Foundation is a great training that any emergency services personnel (fire, police, EMS) can take. Plus you can do it online.  Also, check out other peer support training programs through credible organizations.  Psychological First Aid through Johns Hopkins is a great alternative for those who would like to take an online course.  Peer support training is one of the most important steps that you can take in putting together a first responder care program in your department.
   

• Find an experienced chaplain, or start training one!  Chaplains are individuals that provide non-denominational pastoral counseling and care.  Because first responders can struggle with spiritual and faith issues, especially after difficult calls, chaplains are trained to provide an element of spiritual care to those who request such services.  They are also trained to just listen or offer advisement.  Chaplains can be first responders who have been trained in chaplaincy care or they can be local pastors who have been trained on the intricacies of the emergency service providers they have been called to serve. The Federation of Fire Chaplains offers excellent training for fire and EMS chaplains on a national level.  They were the first organization in the nation to offer such training and services to individuals interested in chaplaincy.  The International Conference of Police Chaplains trains individuals to serve as police chaplains and has excellent training on a national and local level.  The Texas Corps of Fire Chaplains is a Texas based group of fire and EMS chaplains that offers training, response, and networking.  Chaplains are a vital member of your agency and can provide ground level, confidential care.
   

• Provide easily accessible information on issues that first responders face.  This information can be in a pamphlet format or built into a website.  Links to information on topics such as post traumatic stress, complex grief, compassion fatigue, addictions, etc. is a great way for personnel to learn more about the issues they face in the privacy of their own home.The City of Rockville Police Department Wellness Program is an outstanding example of this type of program.

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Build Out

• CISM Teams- Critical Incident Management Teams are made up of peers and clinicians that come in after a traumatic event to facilitate discussions and to educate members on stress responses. While some individuals might not want to participate in a group discussion, the option should be available.  Plus many teams have individuals that are trained in one-on-one debriefings.  If you are a larger department and have the capabilities to construct an internal team, you might want to consider training interested personnel.  If you do not have the personnel or the resources to put together an internal team, know who your local team is.  You can find a list of teams on the Texas Department of Health website or call 512-206-5555.  If you are unable to reach a team by calling that number please call Jennifer Reid, LSMW at 512-206-4840.
   

• EAP- An Employee Assistance Program (EAP) is a voluntary, work-based program that offers free and confidential assessments, short-term counseling, referrals, and follow-up services to employees who have personal and/or work-related problems.  EAPs address a broad and complex body of issues affecting mental and emotional well-being, such as alcohol and other substance abuse, stress, grief, family problems, and psychological disorders.  EAP counselors also work in a consultative role with managers and supervisors to address employee and organizational challenges and needs.  Many EAPs are active in helping organizations prevent and cope with workplace violence, trauma, and other emergency response situations.  

  • How To Set Up An EAP ​

  • EAP Costs

  • Top 20 EAP Providers
     

• If you are a smaller agency or a volunteer department that cannot affords the costs of an EAP program, you can research local therapists in your community that provides counseling on a sliding scale fee.  It's important to find a therapist that is experienced in dealing with trauma intervention, grief, PTSD, and has experience with the first responder community.  In very small communities, look for therapist that have experience with members of the military.  Because individuals in the military and individuals in the emergency services community suffer with similar mental health issues, someone who is experienced in military care will most likely be a suitable match for first responder care. Need help finding a provider?  Check out our referral services page.

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The Big Picture

• ​Sometimes a person may not feel comfortable with reaching out to an EAP program, or you may not have an EAP program.  It's important to know who in your community can provide counseling services, or specialized mental health care to first responders.  Most individuals who have health care, should have access to mental health care benefits.  They can easily find out who their mental health care provider is by looking on the back of their insurance card or by looking at their policy.  Many therapists either accept a wide range of insurance or offer sliding scale fees.  Know who is available and provide easy access to that list.  Send the list out periodically in a department email.  Post the list in a password protected site on your website.  Tack it on the bulletin board at the station.  We can help your agency find a provider.
   

• Sometimes an individual needs a residential treatment facility.  Programs such as Warriors Heart provides a private healing center for first responders struggling with PTSD, chemical dependancy, and family crisis situations.  When choosing a residential treatment facility, choose facilities that offer care specifically to emergency services personnel.  The IAFF Center for Excellence is another option for IAFF members.
   

• E-Counseling is an option for individuals that prefer the comfort of their own couch.  E-Counseling can be done through text, Skype, or over the phone.  Many e-counseling providers offer counseling sessions at a greatly reduced rate.  E-counseling can also ease worry about stigmas associated with speaking to a counselor in-person near you.  To learn more about e-counseling, or to get matched to a provider, check out Better Help.

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