Mental Health and Wellness Training

The Missing Part of Your Annual Training Requirements

Written by Andrew Ruiz, Firefighter Paramedic

My name is Andrew Ruiz, a 20-year veteran of emergency services and a veteran of the US Marine Corps. To share my story, let me take you back to my early years in emergency services and a specific event that has left a life-long impression on me.

As a younger firefighter, I worked with a group of primarily senior, well-versed, and experienced guys who today we would consider "salty." These guys were the image and model of what a new or younger firefighter would picture. I wasn't the only younger guy in the station, and I worked with another newer firefighter who would remain anonymous. He and I became close friends while surviving the relentless onslaught of questioning and pop quizzes that the others would use to build on our knowledge base. We made each other laugh constantly and created a fun environment in the station for us both.

Routine Call – Everything but Routine

One early morning, at approximately 2:30 am, tones dropped for a response to a fire alarm at an apartment building that we often frequented for false alarms, stuck elevators, and EMS assists. Being the "frequent" alarm and half asleep, we executed the "routine," donning our gear and strolling to the apparatus. On arrival, we followed our officer up to the main entrance, and my buddy pointed to a silhouette of someone waving slowly from a 4th-floor window at us. From what I could tell, it looked like an older gentleman standing at the window with only his right arm moving at the elbow. The glow of a lamp projected from behind him. It was something that you would see in a Spirit Halloween store. We entered the lobby and checked the annunciator panel to see two activated smoke detectors in apartment 4F and the hallway. We made our way up to that floor, found smoke in the hallway, and immediately went on air. Our officer pounded on the door of 4F, and my buddy shouted through his mask, "This is the one with the guy waving." Without hesitation, the officer told us to force the door open as he returned to the stairwell, rambling instructions over the radio to the next engine crew.

We fought to maintain our fine motor skills during the instantaneous panic that overcame us, but our training and muscle memory took over, and the door was open. I don't even remember how or if we did it. I recall our entry into the room. To our left was the living room area with a recliner burning. It was the red-amber glow that I had mistaken for a lamp from the outside. Across the room, positioned by the window, was the "waving" man. An elderly gentleman in his 90s who we later determined lived alone. Somehow, this gentleman set his recliner on fire while sleeping in it. His burns covered his back, arms, and head. I quickly emptied the water can on the recliner as my buddy dragged the gentleman out, tripping over a pot on the floor that the man had filled with water and thrown onto the furniture before we arrived. As we passed the engine crew stretching handlines from the stairwell, we handed the man over to another team to take the rest of the way out of the structure. If my memory serves me correctly, he died from a post-burn infection around nine days later.

The Story Continues

In the following weeks, I relived the moment in my mind repeatedly. I realized that moments of reflection are typical after experiencing an event like that. My buddy, however, began to become withdrawn at the station and did not laugh as much as we always did. Soon after, he abruptly tells me that he's resigning. I asked why, and his response was both quick and evident. The victim of that fire had reminded him of his grandfather, who had raised him, and he could not get the images from that morning out of his mind. For him, it somehow correlated with the passing of his grandfather. I had no idea what to say to him or do. My sole expectation and thought were that the more experienced guys on the crew would talk him out of it. It wasn't too long after, and he was gone. I realized my expectations of the senior guys were wrong, and I no longer felt the job was fun. I also lost someone to relate to, share stories with, and laugh, and I ultimately left.

Looking back at it now, I wasn't leaving to join another department because "This place sucks," even though that was how I justified it to myself. I was chasing the need for people and a culture I could relate to.

Next Chapter

Organizations often rely heavily, or even solely, on Critical Incident Stress Management (CISM) teams. While post-incident services are essential, they tend to be reactive rather than proactive. In my organization, we had little to no training in mental wellness, which led to retention issues and the loss of two employees who ultimately had to be replaced. If the organization had implemented some form of training and programs focused on mental wellness, we would have had a way to support each other and ourselves.

The only training we received was task-level training, which is similar to "muscle memory" training aimed at helping and saving others. It is reasonable to assume that the current staffing crisis in the fire service is connected to a lack of proper education and training for proactively addressing these issues before stressful incidents occur.

We certainly engage in extensive training in emergency services to meet our increasing annual training requirements. Much of this training is necessary for important reasons, such as adhering to federal and state regulations, updating policies and procedures, and developing core competencies. Competency training serves two main purposes.

First, it aims to prevent the development of bad habits and complacency in skills that we frequently use. Second, it helps refresh our knowledge and rebuild the muscle memory needed for skills that we don’t use as often. For instance, many departments have annual, semi-annual, or quarterly training on egress bailouts, despite the fact that the national near-miss data indicates this skill is rarely required. We must still remember how to perform it, even if the chances of needing it are low.

Similarly, our law enforcement partners spend countless hours on the shooting range. Thankfully, many of them retire without ever having to draw their weapons.

Mental Health and Wellness Training

I think it's safe to say that if you serve any reasonable amount of time in the emergency services, you're going to eventually deal with some depression, anxiety, stress, PTSD, anger, fear, hypervigilance, or feelings of disconnection. It's almost a guarantee, but we rarely train our people how to handle it.

We should ask ourselves why we train for situations that, statistically, we are unlikely to encounter. The obvious answer is that we do it in case those situations arise. We do not want to be caught off guard and fail ourselves, our colleagues, their families, or the public because we became complacent and took uncalculated risks. But why don’t we apply the same logic to prepare for challenges we are much more likely to face?

Would you bet on something if the odds were 90% in your favor? The answer is clear! Given that stress, divorce, substance abuse, and suicide are significantly more prevalent among First Responders than in other professions, why aren’t we prioritizing the training and support they need to overcome these statistics?

Are we hesitant to discuss mental health with our colleagues out of fear of bringing up difficult issues? It is precisely at the surface level where the healing process begins. Do we simply assume everyone is fine because we haven't personally witnessed a significant incident? The inconsistent sleeping patterns among First Responders alone can negatively impact their mental well-being.

The answers are more straightforward than we think. We often need more clarity on addressing mental health and wellness and what resources are available. You do not need a PhD in psychology to implement training on identifying mental fatigue, resiliency, and stress relief techniques. Training could also identify the stressors outside the station, such as financial literacy and budgeting, nutrition, work/life balance practices, and methods for catching up on good sleep. Plenty of resources, both online and in your community, can assist.

Accept the Challenge and Be a Champion!

The challenge is real. Our goal is to equip you and your team with the skills necessary to navigate the most difficult aspects of being a First Responder, which can significantly affect mental health and wellness. Keep in mind that "what you don't know, you don't know," and that should be your first focus—seeking out those who do have the knowledge!

Some organizations possess the expertise to assist you, your team, and their families. However, if we fail to acknowledge the importance of mental wellness, we risk losing valuable individuals—something we simply cannot afford. As highlighted in previous blogs, don’t settle for a mere checkbox policy or a written program just to say you have one. Instead, strengthen that program with comprehensive training, knowledge, and reliable resources.

Become a champion for mental wellness by establishing a proactive program that prioritizes the well-being of your team and their families. You and they deserve nothing less!