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First responders heal with peer support

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Local Network Delivers “No-Strings Attached” Mental Health and Wellness

By Mark Maynard

Just off busy Liberty Street near the core of Reno’s downtown sits a nondescript two-story building. Upstairs, facing away from traffic, is a quiet room with a large window that lets in natural sunlight; overstuffed mauve-colored chairs and bright green houseplants invite one into the space. A box of Kleenex sits on a glass-topped coffee table. 

This is The Ewald Room, named in remembrance of Tyler Ewald, a second-generation firefighter for Truckee Meadows Fire and Rescue who died by suicide in 2019 at the age of 32. Ewald was well-known in the northern Nevada fire community; he’d been a Bureau of Land Management Hot Shot wildland firefighter, completed his paramedic training at REMSA, and fought fires for the Carson City Fire Department before serving with Truckee Meadows Fire and Rescue.

The road to burnout

For many, the initial appeal of firefighting comes from popular culture and stories of brave men and women risking their lives to save people from fires and other critical emergencies. In reality, the majority of calls firefighters respond to are medical calls. 

In 2021, only 3.5% of the Reno Fire Department’s calls were for fires. By comparison, 4.5% were false alarms and over 65% were for emergency medical services. 

“People were lured into this job thinking that they were going to save people from the grips of death,” said Adam Heinz, executive director of integrated healthcare for the Regional Emergency Medical Services Authority (REMSA). Heinz estimates that in his 21-year career treating thousands of patients in emergency medical situations, he’s saved fewer than 20 lives.

Heinz said society sensationalizes the job, creating what he calls “toxic heroism” that can lead to disenchantment. He said emergency responders might realize: “‘I did not sign up to go to somebody’s house at 2 o’clock in the morning who fell out of bed, defecated on themselves – I have to clean them up, pick them up and make them a cheese sandwich.’” 

First responders tend to be naturally altruistic, Heinz said, but the volume of non-critical calls can eventually lead to burnout. 

Firefighters will go on thousands of calls over the course of a career, and in addition to the physical dangers they can face, there are also long-term mental and emotional tolls.

“I always called it a gut-punch. You don’t really know what is going to affect you until you see it,” said Derek Reid, battalion chief at Truckee Meadows Fire and Rescue. “I did CPR on a young kid, and he looked like my son, and I’ll tell you what, the pool parties we went to thereafter, I didn’t take my eye off him.” 

Reid said the job can also produce moral injuries where something witnessed on the job challenges one’s sense of right and wrong. “If you’re helping somebody that was brutally raped and beaten, these things are really heavy.”

Derek Reid at the Nevada Peer Support Network. Image: Mark Maynard
Derek Reid at the Nevada Peer Support Network. Image: Mark Maynard

Acknowledging the problem

Chaz Blackburn has seen what emergency-response stress can do first hand. He is the community service coordinator for the Great Basin Chaplain Corps, a group of licensed, trained, and culturally competent chaplains serving first responders. 

Cultural competency is a deep experience-based affinity for the linguistic, professional, and lifestyle needs of first responders and is achieved through a combination of on-the-job experience and specific training. Blackburn said it can take chaplains years to develop the trust of first responders, and that chaplains must be up to the professional standards and understand their role is one of support, not evangelism.

“We have to acknowledge that there is a problem,” in the first responder community, said Blackburn. “Suicide rates nationally are going up, especially through the pandemic and isolation,” and unhealthy coping mechanisms such as substance abuse are also on the rise for police and firefighters. Blackburn said that fatigue affects the performance of first responders, and the length of their careers.

“What I’ve been seeing is burnout. People are retiring early, unfortunately, because they are so stressed, and spread thin, and frustrated,” he said.

“Suicides have outpaced line-of-duty deaths in a very high-risk occupation,” said Truckee Meadows Battalion Chief Derek Reid, founder and president of the Northern Nevada Peer Support Network. “It shows that we’re potentially more dangerous to ourselves than our jobs are,” said Reid.

The reality of suicide has directly affected the close-knit local first responder community over the last several years. 

“Recently our organization experienced the loss of an employee to suicide,” said REMSA’s Heinz. “It is obviously very close, and something in which our team continues to grieve. This is a hard job.”

While data shows that firefighter and police suicides occur at a rate higher than line-of-duty deaths, is difficult to ascertain as it is limited to voluntary submissions by fire departments, and is likely underreported. 

The causes are rarely simply attributable to overwork, or even post-traumatic stress disorder (PTSD), both of which may be contributing factors. Reid added, “What we’ve been able to gather, where the wheels come off, is when those most important relationships start to struggle. It’s the personal relationships that show as the number one cause of suicide in that first responder group.”

This can include strained relationships or an inability to feel understood by spouses, children, and others closest to the responder. And this stress between trying to find balance between the job and life outside the job can put great strain on marriages and other close relationships.

“We plan for vacations like everybody else. When you call the wife and say ‘I just got mando-ed, I’m not coming home today.’ You want to see some upset significant others? That’s the way to do it,” said Reid. The level of stress the schedule – including mandatory overtime also called the “mando train” – can put on a relationship has even led people to leave the fire service entirely. 

Inside the Ewald Room at the Nevada Peer Support Network. Image: Mark Maynard
Inside the Ewald Room at the Nevada Peer Support Network. Image: Mark Maynard

A safe place for first responders

“Anybody who’s been in fire service for more than 12 months would agree that it is a calling for them,” said Dr. Steve Nicholas, a counselor and clinician at Truckee Meadows Fire and Rescue. “On a personal level, on a vocational level, you have your brother and sister’s back.” 

Both Nicholas and Reid talk about “residual stress”: things that accumulate in the bodies, hearts, and minds of first responders. One of the most effective ways to deal with this is to be able to share it in a safe, neutral space surrounded by understanding peers. This is one of the reasons why Reid founded the Nevada Peer Support Network

Originally created as a mental health wellness program through Truckee Meadows Fire and Rescue, it has now grown into an active, coordinated resource network that supports local first responders including firefighters, police officers, and other public safety and military service members. The network is housed in a dedicated facility at 330 E. Liberty St., where it shares space with Specialty Health, a contracted wellness provider for first responders. 

The upstairs space resembles a large break room like one might find in an office or fire house. There is an emphasis on communal space and food – there is a large kitchen area with numerous bar-height tables, a well-stocked fridge, and a full coffee service. There are dedicated counseling offices for affiliated mental health practitioners who are trained in cultural competency. The entrances to these offices are screened from view to maintain privacy and confidentiality – there is still a stigma about seeking out mental health services in the first-responder field. 

The facility provides what Reid describes as “no strings attached” services. “It has to be Switzerland,” he says, so that the clients don’t have to use their department’s employee assistance programs. 

Nicholas explains the importance of this. “We do not go and tell mom and dad what’s going on with you. We’re here to actually help you. Nevada Peer Support Network also has no financial strings attached, so we will not bill insurance, because insurance is connected with a medical file, which is connected to a diagnosis.” 

This allows first responders to be more vulnerable with their concerns as they don’t have to worry that a diagnosis might lead to them being declared unfit for duty, Nicholas said. 

The space also offers an Alcoholics Anonymous group, yoga classes, meditation, and other wellness activities. The larger main room allows first responders to informally gather over coffee and tell stories, or solve problems. 

While Tyler Ewald’s name, and those of his brothers and sisters that served as emergency responders, might not be featured on official memorials alongside those that “died in the line of duty,” at the Nevada Peer Support Network, the sacrifices small and large made by first responders are never far from mind.

“We forgot to talk to Humpty Dumpty while he was still on the wall,” said Nicholas. He explained that educators, first responders, and others are trained to recognize suicidal ideations and behaviors – one of which can be an inability to focus on future plans – but that they aren’t consistently training for what he calls a “living ideation.”

Nicholas explained that practicing a living ideation encourages peers to focus on what someone wants to do in the near future, emphasizing a desire to want to live another day. Nicholas gave an example: “Man, it seems like the weather’s going to be pretty awesome. I remember you telling me that you got that ski pass to [Mt.] Rose and Rose is opening today!”

He hopes that the growing network of first responders seeking to help one another can develop a model to promote strength and health and ability. “That ultimately outcompetes debilitation and pain.”

If you are in distress, call the Suicide and Crisis Lifeline 24 hours a day at 988, or visit 988lifeline.org for more resources.

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