he tells them to save their careers and save their marriage. “It’s important to
appreciate what you have and not focus on what you don’t have,” he says.
Now in retirement, Raclaw jokes that his greatest challenge is deciding what
to make his children for lunch. Still, he says he misses the adrenaline rush
that goes with the job. “I would love to be working,” he says. “I had to leave a
career that I loved. But no one ever says, ‘I spent too much time with my kids.’”
Seeking treatment for behavioral health doesn’t have to be a career ender. In
some cases, treatment can help preserve a career. Following his treatment,
Kovalsky returned to the firehouse. After hearing about his struggles with PTSD,
his fellow firefighters tell him it’s like reading their own life story.
Being open about his own experiences with mental illness also allows him to
set an example for new recruits. His message to new firefighters coming on the
job differs markedly from the speech he heard decades ago.
“I tell them, you will see bad stuff, but don’t take it home. Talk with somebody
when you need to and ask for help.”
The IAFF thanks these members who gave us permission to share their stories
in the hopes of helping others who are struggling with similar behavioral
health issues.
PEER SUPPORT
The first step is asking for help. The second step is knowing
what resources are available for counseling and treatment. In 2003, when a fire at the Station nightclub in West Warwick, R.I., killed 100 and injured
300 others, members of Cranston Local 1363 were among those who responded. A band
performing at the venue had used a fuel-based foam that triggered the fire.
The stresses faced by IAFF members throughout the course of their
careers—multiple casualty events, violence, injury to children and the
inherent dangers of firefighting—can have a cumulative impact on
mental health and well-being. Scott Robinson, vice president of Cranston Local 1363, recalls fighting the fire from
11:30 p.m. until 2:30 a.m. with body recovery continuing until 7 a.m. In the aftermath,
he and other firefighters struggled to cope with the incident. Some were even terminated
because of job-related stress.
Research shows that peer support programs are an effective method
for providing support to occupational groups, including firefighters.
The IAFF Peer Support Training program, initiated in 2016, teaches
members about common behavioral health problems that impact
the fire service, how to provide one-on-one peer support and how to
develop or enhance a peer support program.
The program was designed to develop a cadre of peers who can
identify with the professional struggles firefighters and paramedics
face following traumatic events and to connect the distressed member
to appropriate services, when needed.
“Firefighters are often reluctant to seek mental health treatment,”
says General President Harold Schaitberger, “and are hesitant to talk
with behavioral health professionals who are unfamiliar with the fire
service. Our members are more comfortable talking to another brother
or sister. Our Peer Support program helps meet this need.”
After completing the IAFF training, trained peers have the knowledge
and skills to provide support to their peers, serve as a bridge to
behavioral health services and community resources, and help build
or enhance other peer support programs.
THE TREATMENT JOURNEY
The training includes a two-hour online behavioral health awareness
course, which is a prerequisite for the two-day onsite training. Each
training session typically accommodates 30 students. Additional
courses tied to peer support are under development, including a
resiliency course, a recovery mentor course, a disaster response
course and a clinicians course.
STEP 1: CONTACT
A prospective client, family member, local member or department member can reach
out to the Center of Excellence admissions department, which operates 24/7 with
dedicated intake coordinators trained specifically to address IAFF members’ needs
and guide them through the admissions process.
To date, more than 2,500 IAFF members in the United States and
Canada have received the IAFF Peer Support Training.
STEP 2: INSURANCE VERIFICATION
The intake team obtains a prospective client’s insurance information to verify benefits
and determine insurance coverage for services at the Center of Excellence. If desired,
the intake team can also provide a summary of benefits for an entire department’s
insurance policy, which can be useful if other members are interested in treatment at
a later date. The center strives to make treatment as accessible as possible and has
in-network agreements with several commercial insurance providers, including Cigna,
Aetna, Humana, Multiplan, Healthcare Solutions, United Healthcare, First Health and
Medical Mutual of Ohio. Accredited by the Joint Commission, the COE can also accept
individuals whose insurance allows them to use out-of-network benefits or those look-
ing to pay privately for treatment.
STEP 3: PRE-ASSESSMENT
The admissions team conducts an individual pre-assessment by phone, which gener-
ally takes 15-20 minutes. This information is used by the clinical team to screen for
existing substance abuse and mental health issues, other medical conditions and any
relevant family history. While the actual diagnostic assessment cannot occur until
the member arrives at the Center of Excellence and is evaluated by clinical staff,
pre-assessment information is used to determine if the Center of Excellence will be an
appropriate fit for treatment and to obtain initial insurance pre-authorization.
STEP 4: COSTS
Intake staff will review insurance coverage and projected costs of treatment with the
member. While the exact cost of treatment cannot be determined prior to admission,
members are informed of daily copays, deductibles and out-of-pocket maximums per
their plan. Every member’s treatment experience is different, including the length of
stay, level of care and potential additional costs, such as prescription needs. Incre-
mental payment plans are available.
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FIREWIRE • FALL 2018
CRANSTON LOCAL 1363
When Robinson visited a clinician to talk about the incident, he realized that even trained
mental health professionals weren’t prepared to address the horrific trauma firefighters
witness on the job. “There were no mental health resources for our members,” he recalls.
Today, Robinson says the IAFF Peer Support program is one of the union’s greatest
benefits for members.
Now, when new recruits enter the fire service, he says the Cranston peer support team
meets with them to educate them on behavioral health issues and make sure they are
aware of the resources available for getting help.
“It has to start with a phone number and set of members who are trained to help,”
Robinson says.
GREENSBORO LOCAL 947
Greensboro, N.C., Local 947 was one of the first locals to host an IAFF Peer Support
training class in March 2016. A small peer network was already in place, but with 570
members, the 10-member team was just a start.
The need for peer support occurred in May 2018 after five children died in a Greensboro
house fire, to which more than 40 Local 947 firefighters had responded. Rather than wait
for members to ask for help, Local 947 Vice President and IAFF Peer Support Instructor
Justin Price made calls to his brothers and sisters in the first week after the fire.
“We explain that we’re not clinicians,” Price says. “We can give advice on a certain level,
but our main role is to listen, refer and follow up.”
There is no question that the peer support program is needed. Price says, “There has
been a culture shift in the 18 years that I’ve been in the fire service. Twenty years ago,
this would have fallen on deaf ears, and I might even have questioned it.”
Since then, he has learned a lot about post-traumatic stress and how other behavioral
health issues pose a major threat to firefighters.
STEP 5: ADMISSION
The Center will work with members to determine the best method of arrival to the facil-
ity, whether by plane, train or car. A center staff member will meet the member at the
airport or train station and transport them to the center. After arrival, clients meet with
a member of the nursing team, a general physician, psychiatrist and financial counselor.
STEP 6: TREATMENT
Within the first few days, clients meet with their assigned primary therapist for a di-
agnostic assessment to evaluate their treatment needs and develop a treatment plan
to support their path to recovery. After the initial assessment, the client is placed into
the appropriate level of care, depending on diagnosed primary and co-occurring condi-
tions. During their stay, clients participate in both individual therapy, group therapy and
psychoeducational group sessions. Treatment levels range from acute medical detox
to intensive outpatient treatment. Clients reside in one of four station houses on the
Center of Excellence campus.
STEP 7: DISCHARGE
Discharge planning begins at the start of the treatment stay to ensure success through-
out the client’s recovery journey at the Center and beyond. Upon discharge from the
Center, a client will have an appointment to continue local behavioral health treatment
within seven days, in addition to a follow-up appointment with a primary care doctor.
The recovery process does not end upon leaving the Center of Excellence. The Center is
focused on creating sustainable, long-term success.
“I think every member is hurting at some point,” he says.
Greensboro Local 947 now has 35 IAFF trained peer support members.
SURREY LOCAL 1271
Surrey, B.C., Local 1271 has one of the oldest peer support teams in Canada, dating
back to 1990. But Local 1271 member David Burns, an IAFF Peer Support training
instructor, notes it was not called peer support back then.
The program began partly in response to two members’ suicides and another who was
killed in a motorcycle accident. Today, 40 Local 1271 members have completed the IAFF
Peer Support Training program. The local holds a training session every three months.
“When members say, ‘I have this problem, what do I do?’ you realize how much you need
the program,” says Burns.
Local 1271’s peer support program includes a long list of resources,
such as financial help, anger management, marital counseling and
suicide prevention.
“Confidentiality is the number-one priority,” says Burns. “If you don’t
have that, then the program has no credibility.”
FALL 2018 • FIREWIRE
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