Tackling Compassion Fatigue
In October 2018, Huntington was one of nine cities to receive a
$1 million prize in Bloomberg Philanthropy’s Mayors Challenge,
a year-long competition that tasked city leaders with testing
different ideas for confronting their toughest challenges.
With the opioid epidemic at the center of Huntington’s trials,
the city presented a plan for addressing and combatting
compassion fatigue in first responders. Compassion fatigue
is a feeling of indifference or emotional strain resulting from
frequent interactions with those suffering from the effects of
trauma. Because Huntington’s first responders face 10 times
the national average of opioid overdoses, compassion fatigue
toward those suffering from substance use disorder can lead
to a lack of empathy, high job turnover and a reduced capacity
for delivering quality care.
The city’s plan includes an innovative approach to addressing
compassion fatigue by embedding certified mental health
professionals, or wellness coordinators, into its police and fire
departments. These individuals are charged with developing
and providing self-care, training and mental health resources
that will improve first responders’ personal well-being as well as
their attitudes toward substance use disorder and interactions
with overdose victims. Some of the self-care offerings include
massages; discounted getaways; and yoga, cooking and
pottery classes. While there was an initial hesitation at the
beginning, participation in these activities has tripled over the
past several months.
First responders have also been invited to share their unique
perspective in meetings between agencies working on opioid
epidemic solutions.
Health Department’s harm reduction program, providing
naloxone training and assistance with the syringe exchange
program and helping clients find housing, recovery coaches and
treatment options. Cabell County’s fatal overdose numbers in
2017 weren’t nearly as high as its non-fatal overdose numbers
due to the significant work of this program.
“We’ve saved lives with the awareness and intervention we’ve
put in place,” says Michael Kilkenny, M.D., physician director
of the Cabell-Huntington Health Department. “In 2018, we
began to see an actual reduction in the number of incidents
and feel for the first time that we have made a difference, the
interventions are working and the situation is getting better.”
One of the reasons Huntington has been able to transform
into an epicenter for solutions is the collaboration between
government, law enforcement, emergency services, education
and health care leaders. A particularly unique partnership
exists between the city’s fire and police departments and the
Cabell-Huntington Health Department.
“Both the police and fire departments were involved in the
health department’s harm reduction program from day one
and have a say in what goes on,” says Rader. “If there are any
Ashley Skeen leading yoga at the Huntington
Fire Department. Photo by Ashley Skeen.
“This structure involves embedding mental health providers
within the first responder ranks, but it also involves showing
appreciation for first responders and giving them a voice,” says
Jan Rader, chief of the Huntington Fire Department.
The wellness coordinators will use focus groups and feedback
from these programs to develop, modify and implement their
own evidence-based compassion training model, the first of
its kind.
“When there is trouble that everyone else is running away
from, there is something inside of these people that says, ‘I
am going to run into that burning building,’ or, when shots are
being fired, ‘I am going to go toward those shots,’” says Steve
Williams, the mayor of Huntington. “What our first responders
needed to hear was not just thank you. They needed to hear,
‘We value you.’ As mayor, I have one great responsibility—to
make sure these people go home at the end of each shift. I
need to give them what they need to do their work and make
sure they make it home.”
changes in the harm reduction program that cause us issues,
we ask for a meeting and talk about it. We need to stop the
spread of hepatitis and HIV and prevent outbreaks, but we
also need to keep our first responders safe, give them a voice
and share concerns. Open communication is key.”
These programs and initiatives have inspired visits from na-
tional leaders in health and policy, including Sir Kim Darroch,
British ambassador to the U.S.; Dr. Robert Redfield, director
of the Centers for Disease Control and Prevention; First Lady
Melania Trump; and U.S. Surgeon General Dr. Jerome Adams.
Adams and Redfield both spoke at the 2018 Regional Health
Summit at St. Mary’s Conference Center, and Adams praised
Huntington’s comprehensive plan as a guide that should be
emulated by the rest of the country.
“I’m very proud to be from Huntington and to be a West
Virginian because I think we’re resilient,” says Rader. “I’m
grateful for what we have done as a community and what we’ve
been able to accomplish. I think it speaks volumes about the
caliber of people who live here. We want to keep the momentum
going—we still have so much work to do.”
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