Sarah Bernes, MPH, LMSW, MBA is a Behavioral Health Specialist at the International Association of Fire Fighters.

Lieutenant Jeff Campbell of Tualatin Valley Fire and Rescue Local 1660 and Fire Fighter/Paramedic Heith Good of Norwich Township Fire Department Local 1723. Jeff and Heith have a combined 41 years of experience in the fire service. Both play an integral role in their local peer support team and serve as IAFF Peer Support instructors.

Webinars:

• Understanding Peer Support in the Fire Service
• Work Life Balance in the Fire Service

Articles:

• Coronavirus Guidance for Peer Support
• How Peer Support Can Combat Addiction and PTSD
• After the Chaos: The Power of Peer Support
• 5 Statements to Avoid When Comforting a Crew Member

Kelly:

Welcome to our Community Education Series, hosted by the IAFF Center of Excellence for Behavioral Health Treatment and Recovery. My name is Kelly Savage. I am one of our outreach directors for the IAFF Center of Excellence for Behavioral Health Treatment and Recovery. I’m joined by my co-director Myrrhanda Jones in the red, and we are going to give you a brief introduction and cover some housekeeping for this presentation focused on IAFF, peer support and program development as we go ahead and get started in the program. There are a few capabilities down at the bottom of your screen that you’ll see. First is the question and answer. We would love to take questions; we do have a block of time at the end to try to cover as many questions as we can. So if you have a question as we go along, please drop it in the Q&A — we will absolutely get to it towards the end once we try to get through most of the information and see if we cover a lot of those questions. But we are excited to have some engagement, and if you have a question specifically in terms of developing your own peer team or a peer program and want to have one of our instructors weigh in, we would love to do that for you. So please drop those questions in the Q&A box. 

We also have the chat feature. You’ll see that down on the bottom of your screen as well. We would love to know if you’re comfortable sharing who you are and where you’re coming to us from. On last week’s webinar, we had individuals from Florida, Canada, Africa, Alaska, and everywhere in between. So it’s really neat to see where everyone is coming from and what your role is. We’re also going to be doing some polls in this presentation, so get ready to vote in those polls, but you’ll also be telling us what your role within your department — or really, the world — is. So we are looking forward to hearing a little bit more about that. 

We’re going to jump right in, firstly, by covering a little bit of information about the IAFF Center of Excellence. This is part of one of our initiatives, as we’ve kind of had to pivot to a virtual world to provide as much education as we can to fire service members, first responders, community mental health partners, those in health care and clinical partners. Part of that is educating the community at large about the Center of Excellence and the services we offer. So I’m going to go ahead and turn this over to Myrrhanda to discuss some of these details, and we will get the show on the road. 

Myrrhanda:

Thank you so much, Kelly. I appreciate it. So, just talking a little bit more about what the IAFF Center of Excellence is and how all of this started. This is a partnership between the International Association of Fire Fighters and Advanced Recovery Systems. Advanced Recovery Systems is a pretty large behavioral health care company that has treatment facilities all across the country, everywhere from Washington state, Ohio, Colorado, Florida, soon to be in New Jersey, along with our IAFF Center of Excellence. So really, the thing that makes this program different than any of our other programs is that we are dually licensed at this campus, and we exclusively treat IAFF union members — both active and retirees. On campus, we’ve got about 15 acres located in upper Marlboro, Maryland, which we lovingly refer to as the D.C. metro area, but I will tell you it’s pretty rural for D.C. So out there in upper Marlboro, Maryland, like I said, we’ve got 15 acres of campus exclusively for IAFF union members. There’s no other people on campus; there’s not a general population track on campus. It’s exclusively for the brotherhood and sisterhood that is the IAFF. We do have 64 beds on campus, Currently, due to COVID, we’re operating a 48-bed census, but we’re excited to see that continue to grow as travel restrictions and things like that start to lift across the country. 

We are in network with most major insurers across the country. We’re in network with Cigna, Hana, MultiPlan, HealthCare Solutions, United, Blue Cross Blue Shield. If you do want to go get more information about what your insurance is and whether or not we accept your insurance, for members seeking campus, please feel free to reach out to Kelly or myself. We will gladly run your insurance benefits so it has no issue with your plan. It’s just what we run to be able to verify what the cost to your members would be. Especially as peer support trainers across the country, it’s incredibly important to know what the financial responsibility for your member would be if they did come to treatment with us. So feel free to do that. We would love to be able to get that information over to you all. I’m sure we’ll drop our information into the chat in a little bit, and I know it’s at the end as well.

From that point, average length of stay for members that come and seek treatment on campus is around 30 to 45 days — so about four to five weeks. But that definitely differs patient to patient. The patients really are able to sit down with our entire medical staff, nursing staff and clinical team to decide what best fits for them. After that, 30 to 45 days is a small blip on the timeline of a member’s life and — what we are hoping — for a lifelong version of recovery in their lives. So what our promise is to all of you is that there’s an 18-month long aftercare plan that every person that leaves the Center of Excellence is going to connect with our staff once a month for the first six months, then again at three-month spans, all the way up until 18 months. The purpose for this is to ensure the best patient care. We want to make sure that the clinicians that we’re referring people back out to and communities are the ones that they want to go and see — the ones that really fit for them and are the best versions of clinicians for themselves. This is why we’re doing these webinars: to be able to really cultivate both the clinical side of things and for all the fire fighters. 

After that, on campus, one of the great things is that it feels kind of like a firehouse. We’ve got station house one, two, three and four, which is our residences, and they’re bunk-style where there’s four to a room. We wanted to ensure that that community that you all have in your everyday work lives is also something that’s supported on campus. Staff ratios are incredibly important for the fact that we want to make sure that each individual isn’t just getting a cookie-cutter, set program — they’re getting something that’s truly molded for themselves. So, just numbers up to date: As of last week, overall we’ve had 1,338 members seeking treatment on campus with us. 570 were primary mental health diagnoses. What that means is, like I touched on, we are dually licensed. We operate both a primary substance abuse and a primary mental health license. So someone doesn’t just have to come in with a substance abuse issue needing detox; they can, but they also can come in with a PTSD diagnosis with anything else that falls underneath that mental health realm. So whether or not that’s depression, anxiety — we see a lot of OCD — we see a lot of other issues that members are coming in with, and our job is to treat the entire person, not just one primary thing. 

So, currently in treatment. I was just going to touch on currently in treatment: We’ve got 63 members that are utilizing our services right now. We’ve got 39 inpatient on campus and 24 outpatient utilizing our telehealth services. If you’re in the DMV area, the Maryland, Virginia or District of Columbia area, we have telehealth services that are available to you through our providers on campus. So feel free to reach out about that and utilize our outpatient services as well. Now I’m going to turn it back over to Kelly to talk a little bit more about the resources that we have for you all. 

Kelly:

Thanks, Myrrhanda. We have prepared a cadre of helpful resources related to the Center of Excellence and behavioral health in general. One of these resources is the IAFF YouTube channel. We have a number of videos that feature alumni testimonials on the Center of Excellence. We have a great virtual tour, and I’m not just saying that because I organized it. We have some information and a presentation from our medical director, Dr. Morris, who should actually be joining us as a webinar presenter next month. But yeah, I encourage you: If you haven’t seen the Center of Excellence or really gotten to know a little bit more about it, please do check out the YouTube channel. You can see the link there to get more familiar with the program and how it might be able to assist a colleague, friend or fellow member of yours.

If we have any clinicians on or those that are familiar or looking for more information regarding our clinical modalities on campus, we do have a clinical program overview available. I think Myrrhanda is going to be kind enough to drop it in the chat, but it is on our resources page if you go to IAFFrecoverycenter.com/resources. This covers a little bit about what a clinician would want to know regarding what type of program this is and what we offer on campus. So it does review our evidence-based modalities like cognitive behavioral therapy, cognitive processing therapy, EMDR, that are utilized on campus, hits on individual family and group therapy and a number of other clinical practices utilized on campus. It does touch upon making referrals as well as some information regarding our medical director, Dr. Morris, as well as our executive director on campus, Mark Radigan. So I do encourage you to check that out. We just dropped it in the chat below, actually. Myrrhanda, it’s being shared with panelists at the moment. If you’ll share it with all attendees, that’d be great. And I do encourage you to check that out. 

Now, getting into today’s presentation on peer support program development, I am so pleased to be able to have our speakers on. They are a wealth of information, so knowledgeable about all of these — about building your peer team — and have the experience to share with you and take those questions. So, we’ve got Sarah Bernes; she’s one of the behavioral health specialists at the IAFF headquarters. Hi, Sarah — joining us from her virtual conference room. 

Sarah:

Hi everyone. 

Kelly:

We’ve got Jeff Campbell, a lieutenant for the Tualatin Valley Fire Rescue in their TVFR Local 1660, and he’s one of our master peer support instructors as well. And Heath Good, a fire fighter in Norwich Township, Ohio, who is also one of our master peer support instructors and I know leads the way over in Ohio on peer support program development. We’re going to turn it over to them. I know they’ve got a lot of awesome information to share, but please, as you have any questions that come up or things that come to mind, drop them in that Q&A so we can get to them towards the end. Please do not drop them in the chat because they may get lost, and we want to make sure we get to all your questions. So, we’ll turn it over to you guys.

Sarah: 

Thanks, Kelly. Thanks, Myrrhanda, for telling us a little more about the IAFF Center of Excellence and for giving us the opportunity to present this afternoon. We only have a few slides and then we’re going to have our other two speakers share their video, and we’ll do this more as a discussion. The learning objectives for today — we have three of them — by the end of this presentation, we hope you’ll be able to discuss the rationale for peer support and why it’s important in the fire service, describe a 10-step model to build a peer support program and then list available IAFF resources for peer support. We have developed many things over the last several years, some of which we’ll tell you about, and many of them will also be linked in the chat.

If you’re not an IAFF member — maybe you’re a clinician or you’re otherwise interested in the fire service — we wanted to tell you a little bit about who we are. The International Association of Fire Fighters represents more than 320,000 full-time professional fire fighters and paramedics across the United States and Canada. We’re organized into more than 3,500 affiliates. We also have two headquarters in Washington D.C. and in Ottawa, Ontario. We’re very proud of all of the work our members do every day, and especially during the COVID-19 pandemic. Our IAFF members protect more than 85% of the population in communities throughout the U.S. and Canada.

In a few minutes, I’m going to have our other panelists introduce themselves, but for the moment, I’d like to learn a little bit more about you today. So Kelly, if you could cue up the first poll question, please? We’re interested. Let us know what your primary role is — as you can see, a lot of options on the screen here. We have four poll questions. This is the first one — hoping that this will give our speakers a little bit more background information to customize the information they share based on who the majority of our participants are. And feel free to select the other category as well. I tried to come up with a comprehensive list of who you all might be, but I recognize this might not cover everybody who’s listening. So Kelly, let me know when we have a critical mass of people who’ve answered this first poll question. Share the results when you’re ready. 

Alright, so if we look at the results here, it seems like the vast majority of you on this webinar today are fire fighter or EMS professionals. About 54%. We also have a good number of chief officers, mental health clinicians, retirees, which is great to see, and then a fewer number of chaplains, other health care providers and law enforcement. That’s great. Thank you all for joining us today. 

So let’s go to our second of the four poll questions. If you’re in the fire service, does your department where you’re local have an established behavioral health or wellness program?

We hope everybody does, but we know it’s a lot of work to get these programs off the ground. So feel free to be honest; it’ll help us present more relevant information throughout the rest of the webinar.

Alright, thank you for that — sharing the results, Kelly. It looks like about 65% of people who this question was relevant for did say yes, which left about 28% saying no and then a small number of people also said they didn’t know. Oh, wow. I encourage you, after this webinar is over, to look into that. My guess is if you don’t know about it, maybe you don’t have one or they might need to be doing a better job of promoting that they exist and that they’re available to help members. 

A slightly more specific question now — poll number three. Within a larger behavioral health and wellness program, peer support is only one component. Does your department or your local have an established peer support team? Kelly will let us know when most of you have answered the poll and share the results in just a second. Alright, this is great. I know the IAFF has put in a lot of effort over the last several years on peer support and helping our affiliates develop peer support teams, and I think that’s reflected in these results. About 70% of you do have a peer support team within your local or your department. That’s awesome.

Final poll question for today. Question four: Have you attended the IAFF peer support training, yes or no? If you have not, we’ll be sharing information about that training later on in the webinar. Alright, it looks like about 36% of you have attended the IAFF peer support training and the other balance, 64%, have not. We’re happy to have you back if you’ve attended the training, and we hope by the end of this webinar — if you haven’t — I will definitely share some information about how you can host that training within your local or get access to it in some other way. Thank you all for participating in the poll questions; it gives our speakers some good background information. 

So, just wanted to reiterate that peer support is only one component of a comprehensive behavioral health program. You can see there are many others listed on the screen here. This list comes from the Fire Service Joint Labor Management Wellness-Fitness Initiative, or the WFA. That’s the fourth edition. You can see the hyperlink there on the slide. Just wanted to point that out — developing a comprehensive behavioral health program is a massive undertaking, and today we’re just talking about the peer support component. Not that the other components aren’t important — there’s just so much to cover

So today’s presentation is going to follow this model. The IAFF has created a 10-step handout for how to build a peer support program. These are the 10 steps, and I believe Kelly or Myrrhanda is going to help us out and drop a link to that full handout in the chat, but this is the overall roadmap for our presentation today. With that, I’m going to stop sharing my slides here and ask our panelists, Jeff Campbell and Heath Good, to start their video. First, I’d like to start with some expanded introductions. I always find it’s useful to have panelists introduce themselves, so Jeff, why don’t we start with you? I know you’re a master peer support instructor with the IAFF — very involved with creating a peer support team in your area. Tell us a little bit about your background and your experience. 

Jeff:

Alright, my name’s Jeff Campbell. I am a lieutenant paramedic with Tualatin Valley Fire and Rescue in Oregon, Local 1660. I’ve been on the job for 18 years and I’ve been a member of our peer support team for 10 years. Currently, I serve as the team coordinator for Tualatin Valley Fire and Rescue as well as the Local 1660 peer support network. And as Sarah mentioned, I am a master peer support instructor with the IAFF and was appointed in 2019.

Sarah:

Thanks for that introduction, Jeff. Heath, I’m not sure if you’re able to share your video, or Kelly — if you can give Heath that ability. Heath, I think we’ve got you on audio, so why don’t you introduce yourself next? 

Heath:

Good afternoon, good morning — wherever you’re at. So my name is Heath Good, and I am a fire fighter paramedic with the Norwich Township Fire Department in Hilliard, Ohio. Those of you that are not familiar with Hilliard, it is the westside of Columbus, Ohio. I’ve been serving as a fire fighter paramedic for 22 years and serve as a peer lead for three different teams that I’ll speak of today. And I’m also just excited to be here. I serve as a master instructor with the IAFF with peer support and am just excited to talk about peer support today. 

Sarah:

Great, thanks both for those introductions. Let’s just get started into our discussion here, and Heath, I’m going to start with you. For our listeners or watchers who aren’t familiar with peer support, what is it? What is peer support? 

Heath:

One of the things about peer support — it’s a continued process. When one fire service member talks to another fire service member, that chat serves as a bridge or a link. Just to talk about — maybe they’re struggling about a particular run, maybe they’re struggling about a particular conflict at home or just life in general. But really, it’s a fire service member connecting with another fire service member, not offering counseling or anything like that but just lending a helping hand.

Sarah:

And Jeff, this one’s for you. So Heath told us what peer support is. Why is it important, specifically in the fire service? 

Jeff:

I think we have a strong fire service culture, and part of that culture is a stigma that goes along with it. We’re strong, we like to help people, we hold stuff in and we get through tough times. I think our culture is changing and we need to reduce the stigma, and the peer team is here to help educate people that it’s okay to talk to problems. It’s okay to reach out for help. As a brother from Local 1363 and a master instructor, Scott Robinson says, “fire fighters can help other fire fighters better than anybody else.” So, that’s why I think it’s important as we have shared experience and we have trust, and the big thing that the peer team can offer is confidentiality.

Sarah:

Great. So thank you, Kelly, for putting a link to that 10-step handout about how to build your peer support team in the chat. Within those 10 steps, the first of the 10 is to obtain buy-in. So Heath, whose support do you need to get a peer team off the ground?

Heath:

Just for clarification: When I speak throughout the day, know that I serve on different types of teams and I’ll be happy to chat about them, but I serve on my local fire department team and kind of a metro-type team — Central Ohio team — and then also through OAPFF, which is a state team. And the first person that we need buy-in is our members, our people — there’s no one more important than our people. To lend that helping hand to our members, it’s our biggest asset. So we need to have those conversations with our administration, our chief officers, and they understand that. It starts there, and the union leadership — getting those involved — but if that effort is done together for the good of the members and the people that we serve with, that’s the biggest buy-in that we need, and I think it’s a collaborative effort.

Sarah:

Jeff would like to add to that and maybe tell us a little more about how our members out there could make the case if they don’t have a peer support team, that they need one. 

Jeff:

Yeah, I reiterate everything that Heath said. The people are number one, our line personnel are the ones we’re here for, and obviously having buy-in from our local leadership and our department leadership is so important. And really, it’s a relationship and it’s cooperation. It shouldn’t be dominated; it should be working together. And that’s pretty well spelled out in the WFA of how we can do this collaboratively. Also, I think you need to get the buy-in from your clinicians that you’re going to be working with so that they understand what we as fire fighters face and that we are like society, but we’re also a little different. Getting them to understand that is important. And I’m a big “why” guy, so explain to the members why we’re here and then, of course, that goes into how we do it and what we can offer. So take the time to really explore why you’re doing it and what your goals are, and I think that will really help get the buy-in you need. 

Sarah:

So step two on this 10-step handout is to identify a peer support team leader. We recommend that every team, no matter what level — as Heath mentioned, whether it’s a local level or department, whether it’s a regional or a statewide or even a multi-state effort — you really need someone to coordinate and make sure everything’s running smoothly. I know both of you are serving or have served as leaders of your peer support team, so I’d like to ask both of you: What attributes should a peer support team leader have? What are the characteristics of this person and the function that they’re going to serve? Jeff, let’s start with you this time.

Jeff:

Well, I think first and foremost you have to have a passion for this type of work and a passion to help your brothers and sisters. Having time to be able to commit to develop this program in your team is important, and it takes a lot of time and effort. Some other things probably are having a vision for your program; having some background in mental health issues could help, but it’s not necessarily a requirement ‘cause you can always learn. I think also being organized because there’s a lot that goes to this, as Sarah has mentioned, as well as having really good communication skills. When you have your team up and running, a lot happens, and sometimes a lot happens at one time. So being able to communicate effectively is really important.

Sarah:

Heath, what would you like to add? 

Heath:

The one thing, Jeff — I think you’ve spoken well, but I think those leaders need to love people, number one, and having the ability to communicate is effective. A lot of times when we’re talking with our fire fighter peers, maybe rank gets involved and title gets involved, and that could get a little sticky. I understand that depending on where you are in the country, that that could maybe create barriers. But one of the things is it’s always people before titles, and as a leader, you need to understand that. I say love people and have a willingness to listen to people. As fire fighters, we’re quick to want to take care of the call or take care of the run or take care of the person, but the peer work is we need to be slow and methodical and listen, and I think that’s one of the biggest things as a leader that you need.

Sarah:

I think that’s one major challenge for people when they become peer supporters — I think that the natural inclination of somebody who’s in the fire service is to fix the problem immediately. Jump in and solve the problem, put out the fire, start CPR, and with peer support, it’s a little more slow than that. It’s relationship building. It’s a process and it’s listening, like you mentioned. Communication. Making people feel like they’re heard. 

The third step on the 10-step handout of how to build a peer support team is to recruit members. You need more than just the team leader; you need a group of members who are committed to this. Heath, I know you’re on a couple of different teams, like you mentioned. Give us some ideas or suggestions. How have your teams recruited new members, either at the beginning when they’re just starting out or over time to maintain the team?

Heath:

So obviously, many hands make light work, and this is something that you need people. Every organization has those people — you just need to identify them and find out who they are. I think about: Who are the people that your organization already goes to? The kind of “go-to guys” that people respect, that people pour their heart into or share struggles with already — identify those individuals. As a department or as a peer team, you can establish application processes, you can establish interviews. I think that’s a good thing to do. And I think it’s important that you incorporate leadership, whether that be union leadership, department leadership, chief officers. That’s important, again, that you do this collaborative as a group, whatever that group may be — a department, a union, a state, whatever. But find out who your people are you already know, and if they have the passion and a passion for people, you just need to connect with them and go get them. 

Jeff:

I’d second that, and I’d also say, specifically, the way that you can do this is to send out an anonymous poll. I’m using SurveyMonkey, and what we have done is asked for, like, “Give us your top three people that you would go to when you need help,” and it gives us a good, good snapshot of who we can recruit. I think it’s very, very important to be diverse and try to touch every corner of your organization and your local, as well as reflect the people that you’re serving. So take into account race, ethnicity, gender — don’t forget the retirees. They’re our legacy, and usually when they retire, they’re forgotten. I think a big effort needs to be made to bring them back into the fold. I think that’s really one of the most important things that we can do right now, especially given the times that we’re in unity and trying to reflect who you are as an organization with your peer team.

Sarah:

Some great suggestions about how to find the natural peer supporters within your department that already exists. We talked a little bit earlier about the characteristics of a peer team leader — that they need to have a passion for this, they need to have the time to be able to put into coordinating a team. Could you expand, Heath, a little bit about what qualities should peer supporters have if there’s anything different than what a team leader might need? 

Heath:

I think it’s similar. I already said love people, passionate for people, want to help and good listeners. I think that kind of overflows, and whether you’re the leader of your peer team or you’re just a member, it kind of goes hand in hand. But one of the other things I think — and as a peer support person, we talk about the backpack or we talk about the cup and as a peer supporter, you’re a leader or a team member or whatever — I think it’s important to know your mental health condition yourself and be able to share that with your peers. That you’re aware if your cup’s too full, your backpack’s too heavy and you’re not able to intentionally take care of people in the best way possible. It’s okay to take a step back. That’s important of the leader to be able to identify when his peer team members are struggling. Just to say, “Hey, you need to take a break and step back.” But I think they’re both the same — trustworthy people is who you want on your team, and people that want to serve others is a big thing. So I think they go hand in hand. Jeff, what do you think?

Jeff:

I agree. I think we all experience different phases of life, and there’s times when people are just doing other things and need to focus on promotion, maybe. Or maybe there’s a new baby and they just don’t have time to provide care and service to our brothers and sisters, and it’s okay to take a step back. I also think that it’s the peer members — you can also structure your teams so that you’re not doing this alone. You can coordinate the team and also make leads for your team, whether that’s by shift or on a monthly rotation so that you don’t have to shoulder the burden of coordinating everything. You can work through other leaders on your team, which will help develop your team and make it a last longer into the future.

Sarah:

It looks like we got a question in the Q&A about how do you choose or identify personnel to be peer support team members? We’ve talked a little bit about that. Consider using an anonymous poll. Some places do an open call where they just ask all members if they’re interested, although some of the challenge with that might be someone might be interested but might not have the natural characteristics of a listener or a peer supporter or somebody who can keep confidentiality, which as Jeff mentioned, is really important for a peer support program. So there’s a lot of different ways that this can be done. The IAFF also has a guide on recruiting members for your peer team — that’s a PDF that can be downloaded for free, so I think Kelly and Myrrhanda can put that in the chat for us. 

One of the things that we’ll get into a little bit later in the discussion is about the role of a mental health clinician for a peer support team and the different things that they can assist with. One potential role for a team clinician: One is to provide support for the peer supporters. But two, they can serve like in an annual function where some peer support teams require members once a year to go get a behavioral health check, just to make sure they’re doing okay and that it’s still the right time for them to participate — that they’re not dealing with too many things in their own lives. And that clinician could also be utilized to help with some mental health screenings as somebody who’s joining the team there. I dunno, Heath or Jeff, if either of your teams do that or if you’ve talked with other locals around the U.S. and Canada that do those sorts of functions.

Jeff:

We have talked about doing like an annual checkup with our behavioral health clinician and our advisor to the team, and really, it’s kind of ongoing. That happens a lot where we just talk all the time, so he or she has a pretty good sense of where we’re at. But I think a more formal approach of just checking in and spending one-on-one time would be good, especially now. I think we’re all dealing with a lot of issues and there’s a lot of mental health issues and stress that we all face. It’s important for us to talk about that and make sure that we are still capable of providing peer support. 

Heath:

Yeah. I think as I reflect, when I first got into the fire service, we didn’t do it. Obviously, mental health 22 years ago was not talked about in the fire service. And I believe now, the new Academy hiring and getting jobs across the United States. I believe they are meeting with behavioral health specialists prior to their appointment to their department — I think that’s an excellent idea. How do current fire fighters that have been on the job for many years, what do they do? I think it’s an excellent thing to discuss and look into. What better way to take care of your people than to make sure that everything’s good. You know, we’re good. Sarah, you talked about the big step process and physical fitness and health and eating diet exercise, and all that stuff is great. The mental health is another facet of that — quite frankly, for me personally, I think it’s probably the most important thing, as far as we need, to make us right.

Sarah:

One other thing that we recommend that you discuss with your team clinician is how to accommodate team members who are in recovery from a mental health or substance use disorder. Folks who’ve had those own lived experiences make excellent peers, but while somebody is early on in recovery or is actively in their own treatment for an acute mental health issue might not be the right time for them to serve on the team. You gotta just — like when we get on an airplane — you gotta put your own mask on if the oxygen levels drop before you help others. So I think when we’re recruiting members and maintaining the team, we can create a culture where it’s okay, like Jeff said, for people to take a step back when they need to focus on themselves and their families, and then have them rejoin the team and be more active later down the line.

Let’s move on into the fourth step of our layout that we’re following today. So we’ve gotten buy-in from a peer support team. You’ve got a peer support team coordinator. You’ve recruited a bunch of members for your peer support team. You also have to develop your team a little bit further. The team needs more than just members — it needs definition about how to operate, whether that’s SOPs or SOGs. Heath alluded that there are a lot of different models for peer support teams, whether it’s based in the local or a department or regional, or a combination with law enforcement and other agencies. So Heath, could you tell us a little bit about how the different models work in your area?

Heath:

So as I stated earlier at the beginning, I serve on different teams and all of them have advantages and they have disadvantages and all help people. I like that, but with that being said, I’ve been fortunate to serve in each one of those, whether it’s my department at Norwich Township, the metro team or the state team, I serve under great leadership — chief officers that have allowed me and my teams to not have much red tape. And I’m probably not the best one to answer this question because I look at it as I understand fire service, and I understand the importance of SOGs, SOPs, GRGs — call them whatever you want, but personally, I look at it as a mutual aid call. If the call comes in today in your firehouse — in anywhere across the country — you would take the call without not having it GRG or SOG. You would take the call and figure it out. 

I look at peer support sometimes a little bit like that. I understand we need to make sure that we’re doing what we need to do, but the more barriers you put up — the more policy and procedures surrounding peer support — I think it creates difficulties for your teams. I think trust your people, trust your leadership and allow them to take care of people. That’s what it needs to be. There’s plenty of great examples of peer support teams, firefightermentalhealth.org is the OAPFF website that has lots of resources. There’s lots of resources out there that can help you develop those GRGs, SOGs, but be cautious, be hesitant — not hesitant, but just understand what it could create for you. Jeff? 

Jeff:

Yeah, I think it really depends where you’re at. From region to region, we do this differently. In Oregon — I live up near the Portland area, which is the metro area and southern and eastern Oregon or different places of Oregon — there’s a different way of doing peer support there, and that’s fine. The big thing to me is that when something happens, can we work together and can we work together effectively? So the collaboration, whether you’re a union-based team or department-based team or both, it really comes to just that cooperation and being able to handle the task at hand. I think what’s really good about training is, like, what the IAFF offers is a great baseline to start your team and you can take it wherever you want to from that point. You can get more training, you can do IAFF training, you can do anything. 

There’s a ton of stuff out there to develop your team. I have found that SOGs are important, especially when you’re trying to operate within your department or your fire district ‘cause it just creates the framework of how things should work and it allows the contacts to be made. Otherwise, if things get a little messy and a little lost, people don’t know who to call. So I see the SOGs as a framework. I also see there’s handbooks that are out there; I see those as being more of the framework for your team. So given a certain incident, it’s something for them to review and look over so that they can effectively do their job as a peer — because there’s a lot of different things that we do. It’s not just mental health. I mean, we do deal with financial problems and marital problems and childcare issues, and “my house burned down” problems, so how do we help our members? And the handbook is a good way to give that information to your team. 

Sarah:

So having a peer support team handbook or SOPs or SOGs or whatever you want to call your written documents that really guide how your peer support team functions. I’ll give a couple of examples of things that we would suggest are in your written guidance, and then I’ll throw it back to Heath and Jeff to add some additional detail. So, things that you probably want to have included are how you recruit members. We talked about that — you should have a defined way that that happens, how you onboard and train new members. We’ll get into training your peer support team a little bit later in the presentation. How is your peer support team dispatched after a potentially traumatic event? How do they know that a child drowning occurred? That might be something that the team should stop by and do some education about common reactions after. So, Heath or Jeff, what else should be included? One other thing is the confidentiality agreement: Each member of your peer support team should have to sign a confidentiality agreement, and the text of that agreement can be within that handbook. So, Heath or Jeff. 

Heath:

I have assisted other places across the United States in just the development of their program, or even those surrounding this SOPs and SOGs thing, and oftentimes, departments want to list criteria as to when peer support is activated. I think it’s on the individual peer teams, maybe when they do station visits. We’ll talk about this down the road about outreach and getting into stations and letting your crews know who you are and what you do. But I think it’s important to make sure the leadership that’s leading the departments know that it may not fall in this criteria to activate a peer team — but it’s okay if it doesn’t. Call us. If it doesn’t feel right with you and you just don’t know who else to reach out to, chances are that the temperature is right. The feeling that you may be feeling is right, and we’re just a phone call away oftentimes. It’s okay to allow us to help you triage that situation. It may not be peer support team activation, but at least we can help you triage it, I think. 

Jeff:

Yeah. I agree with that 100%. I think the team having the awareness of what’s going on is the biggest deal. So if we have an awareness, we can plan on the back end for something bigger that we may need to do as a team. We may not need to do it, but at least we have the awareness and we can be proactive instead of reactive. Another thing about confidentiality, Sarah, that you mentioned also — knowing when to break confidentiality. There are times when, as a peer, we are required to break confidentiality. Having a clear understanding of that and letting your membership know and your leadership know when you can say something — when you will say something and when you won’t — those lines need to be very clear.

Sarah:

One last example, before you move on to the next step of something that you would want to have in your SOPs or SOGs, is what’s the procedure if a member needs to take leave to get mental health treatment? Or is at risk while they’re at work and needs to be taken off the apparatus they’re on for that day? And how will that work? Really clear guidelines to protect confidentiality as much as possible, but also make sure that that member gets the help that they need. 

So let’s move on to step five in our model for today. The IAFF 10-step handout offers how to build a peer support team, and step five is identifying a behavioral health clinician who can provide clinical oversight to your peer support team. I can see we had a question in the question and answer. Is it required to have a mental health clinician on the peer support team? Required is a strong word. The IAFF provides initial peer support training that’s available and also does educational events like this. How you set up your peer support team and how it operates after that point is up to you. We strongly recommend that every peer support team have a mental health clinician involved; they can play a lot of different roles. So Jeff, why don’t we start with you on this one? What are some of the reasons why we suggest that so strongly? What are the things that a clinician can help your team with?

Jeff:

I view the clinician and the oversight that they provide to the team very much like our medical control for EMS. So we have our doctors that provide protocols and standing orders for us to operate as EMGs and paramedics. I see the same thing with the peer clinician. So really, that should be a very close relationship — with the team and the clinician — where we can consult with them when we need to talk about issues. We can refer to them if need be, and we’ll get into this a little later about a referral network, but it could be a starting point. I also think identifying them — it’s important that they understand our culture in the fire service and that we are like a society, as I said, but we also are not. 

And the culture of us in the fire service of holding onto issues — and the key term we use is “suck it up buttercup” — well, those days are over. It’s time that they understand what we face, what we see, and are able to address those issues and understand where we’re coming from. The big thing also — Heath had mentioned this — you can always teach these clinicians about our culture. It’s a little hard right now with the coronavirus and COVID-19, visiting stations, doing ride-alongs, but we’ll get back to that time and how we can share the culture with these clinicians. But the big thing is they’re a good person. I think people gravitate towards good people. So if you can identify a very good clinician who’s a good person and cares about people, that’s the number one thing you need to look for. 

Heath:

Jeff hit it on the head. I think we all can relate with our medical directors for our EMS departments. And I think that’s a great way to put it, you know. Another thing I think about is being accessible to your team and the members is a big thing. And like Jeff talked about, COVID has really hampered the way that we do business in the fire service, but it is absolutely critical that your clinicians understand fire fighters. They understand fire table humor, they understand apparatus bay humor, because you want your clinicians to be part of your group. 

Maybe they come to pizza night, maybe they come to chicken wing night, whatever that is, and they do ride-alongs, like Jeff said. But they provide that overall direction; they can do screening. I think the biggest thing for us — a lot of times when I think about some of our clinicians — is they help us vet other clinicians. Because again, peer support is made up of a bunch of fire fighters. We’re not professional counselors. We’re not physicians. And oftentimes, it’s good to have a professional licensed clinician help us understand other professional licensed clinicians. I think that relationship is great to help us for the betterment of our team.

Sarah:

Absolutely. So, recapping some of the things that Jeff and Heath’s mentioned here. A team clinician would give ongoing supervision to the peer supporters on the team. Jeff mentioned confidentiality is important, but there are some scenarios where trained peers would need to break confidentiality. If a peer needs to consult on a situation where a member is a danger to themselves or others, who is that person that they’re going to consult with? It should be a mental health clinician. Clinicians can also provide ongoing education. We’ll get into training your peer support team next. Like Heath said, they can help you with relationships with other clinicians that members can be referred to for treatment or other types of issues. They can help build a network of vetted providers, and they can also help in reviewing your standard operating procedures to make sure that, clinically, everything looks solid, just like a medical director would do for EMS like they mentioned. 

Let’s talk about training your peer support team. Training is obviously an ongoing process when you’re talking about anything in the fire service. I’ll tell you a little bit about the IAFF peer support training program, and then we’ll turn it back to Heath and Jeff for some additional information. So the IAFF peer support training program covers several different topics: active listening, confidentiality, general assessment, suicide assessment, crisis intervention, action planning, education and outreach, self-care, which is often overlooked but very important, and more expanded content on how to build an effective peer support team. 

The IAFF launched this training program in 2016. Since then we’ve held over 240 different trainings across Canada and the United States, and in those trainings, we’ve trained over 6,140 people in peer support. Traditionally, the IAFF peer support training has been delivered in person in a classroom setting — 16 hours split over two days. Due to the COVID-19 global pandemic, we are adapting the curriculum to be taught online. I know that was a question that somebody typed in the Q&A, so I’m happy to announce that we’ve been working very hard on that. The online version is going to take place over three consecutive days because eight hours is a long time to sit in front of a computer every day. So to really teach the information effectively and keep the training exciting and interesting and interactive, it’ll be shorter days but three instead of two. We will also be increasing the number of instructors. Normally, the training has two instructors; the online version will have three. Then to ensure a quality educational experience, we’re also going to reduce the number of students that are allowed in each online training to really make sure that we maintain the opportunities to practice, the role plays and the discussion that really makes the training what it is. 

So that’s a little bit about the IAFF peer support training. Kelly can put this link in the chat for us for information about the IAFF peer support training; she’ll put that link in the chat. We do not have a known launch date for the first online delivery of the IAFF peer support program, but if you go to the link that’s in the chat — Kelly will place it there in just a second. For the IAFF peer support training, there’s a navigation on that page for how you find a peer support training to attend. And on that page, there is a mailing list you can sign up for, and we’ll let everybody know who signs up for that mailing list when the online version becomes available. It’s going to be delivered in two different models. One is just like the regular IAFF in-person peer support training; your local can request it and then fill all of the seats with members of your choosing at the discretion of the local president. The other model is going to be that the IAFF will host a training and open registration across the U.S. and Canada, so we have members from all over the place that will be able to join those trainings. 

We really believe that offering it in those two models is important because we know that many of our smaller locals, or locals who are in more rural areas, just don’t have the ability at this time to host a full peer support training and fill all of the training seats. This online delivery model will allow them to still have access to this information and better care for their members. So that’s a little bit about the IAFF peer support training, but I mentioned that training is an ongoing process. Both Jeff and Heath are master peer support instructors with the IAFF. Honestly, they can definitely talk about that program. But my question, Heath, for you is how does your team keep members up to date with training and education after they’ve taken the initial training and they’re a member of the team? What does that look like? 

Heath:

Team meetings can serve as trainings. I think there are great opportunities to gather people together, and anytime you can get a group of people together, you need to make it meaningful. So I think those can serve as opportunities to have training. Now obviously with COVID, we need to get creative. However, that is a Zoom call — there are lots of opportunities, especially now in 2020 with webinars and WebExes and different types of virtual trainings that are out there. Be creative, get out their search stuff. There’s lots of stuff all over the country. Invite clinicians. There’s lots of clinicians that are posting opportunities to learn things. We send stuff to our members and say, “Hey, check this out,” and that serves as training. Anything that can enhance your ability to help another individual and make the impact bigger. 

Just as any type of tool bag that you use — whether you’re an engine guy, ladder guy, rescue guy, those of you that decide to be a peer person — you’re just trying to make your tools bigger. So I think being current with what’s going on, not only in your region, your state, your products, whatever it may be. Across the country is important because, just as Jeff said earlier in another question, what happens in Ohio or what happens on the East Coast is not what happens on the West Coast. It just doesn’t happen that way, and that’s okay. But I think it’s one of the things that I’ve enjoyed being with the IAFF is understanding different ways to do peer support. Jeff and I have had many conversations and it’s great! Network with people — that’s important. 

Jeff:

Yeah, I’d say it’s really important to be good at the basics, and the IAFF training is really good at teaching the basics. If your team is an IAFF team, revisit those skills that you learned about active listening, developing a plan, confidentiality and practice. Trainings that we do include scenario-based trainings where we put our team members in a position and give them a scenario to run, just like an EMS scenario, then we critique it and then we talk about it. That gives you an opportunity to bring up the resources that you have available and make them start thinking about: “Where can I go? What’s my plan? Who can I talk to?” We try to do things quarterly here at TVF&R and Local 1660, and we do have somewhat of a — like, there’s a rule that you have to make like three of the four to stay on the team, but that’s up to individuals. 

There’s a lot going on. Mental health is a huge issue in the country, in the world and in the fire service. So there’s conferences you can attend; you can talk to clinicians privately just to get ideas for how you can train. Think about joint training. In the area that I’m at, there’s a lot of other teams around TVF&R Local 1660. So I can train with Portland Fire, Local 43, ‘cause we’re all doing the same thing and our teams, our members, actually live in Portland. So maybe they don’t want to talk to someone from TVF&R, and so if we’re all speaking the same language, that would help. And I can’t agree more with Heath — just stay current on what’s going on in your organization and in the world. Especially now, a great phrase I’ve heard is that “We are all in the same storm, but we are all on different boats.” So we’re all dealing with coronavirus right now but everyone’s dealing with it differently, and having that understanding of what’s going on and what people are facing is going to help guide your training and help you be in a more effective team. 

Heath:

It’s ironic. Jeff and I were chatting earlier today about Jeff being in Oregon and myself in Ohio, and that analogy you said about the same storm but different boats — that’s just so true. And, you know, reach out. Education is important, but there’s lots of people around you that are probably doing the same game that you’re trying to do. If you can kind of gather all those people in and somehow work together, that’s important. I know it’s tough. I speak it now, but as I think about it, there’s lots of people out there just in Central Ohio that are doing peer support, and it’s a struggle to kind of “let’s all work together to help people.” But you’re right, Jeff. I like that analogy. 

Sarah:

So we need to have a plan for ongoing training. whether it’s a certain number of trainings per year or you have to attend a certain number of team meetings. We can utilize team clinicians to provide training on topics that are relevant and timely for the membership, or you can train across departments with other peer support teams to pool resources there. A couple other great resources, actually for people who’ve already taken the IAFF peer support training. The IAFF is developing advanced peer support training courses that are available online, free of charge if you’ve already taken the IAFF peer support training. One of them launched several months ago and is available now. It’s a disaster response peer support training, and then in the next several months, we will also be launching a suicide intervention training. That is based on the safety planning intervention, which is an evidence-based intervention to reduce suicide risk. Kelly will place a link to the advanced peer support training page in the chat, and I’m going to move us along to the next topic. 

Jeff, this question is for you. So step seven is developing a referral network. You talked about how important it is to vet mental health clinicians and how you do that. If a peer can’t provide the assistance that a member needs, peers are supposed to serve as bridges to other resources. If it’s beyond the scope of a peer supporter’s training, they need to refer to somebody else. So Jeff, in your area, how do you vet these types of resources and how do you keep track of them all? 

Jeff:

The vetting is having conversations, and it goes back to, like, identifying your behavioral health clinician. It could be identify your financial advisor, identify your childcare provider, so that they understand our culture and our shift schedule and the things that we face. So when you’re developing these networks, be broad; think big picture of what your members may be facing. It could be mental health — think of substance abuse specialists, other peer support teams. Are they qualified? Can they help out your members that you can call on them? I know one of my members is traveling to Ohio and they have a problem. I can call Heath because we have a network. Look at your support groups available. EAPs, and I asked our members to be really savvy with the EAP so they understand what it can offer and what it can’t. Know the insurance, how that works — and the big thing is reviewing this constantly. I’d say six months to a year, review your network to make sure that everything is still relevant, the same people are still working in your area or in your network and are still available to help.

Sarah:

A lot of work goes in. We’ve covered seven of the steps in the 10-step model so far. The IAFF also has a handout of seven questions to ask to find the right clinician — that we can drop in the chat — that peers can use when they’re vetting resources or members can use even if they don’t want to connect with the peer support team. If they want to find a mental health clinician through some other means. So if you’ve gone through all this work so far, you’ve set up a peer support team, you have a coordinator, you have SOP, you have training, you have a mental health clinician and you have vetted all of these other resources for your members to utilize if they need to. If you build it, will they come? Heath, for step eight in this model, it’s “conduct regular outreach.” How do you let members know that all of these great resources exist and provide them some education around common topics? 

Heath:

The first thing I think about is don’t wait and say, “Okay, let’s make sure we have everything in place before we decide to start on a team because I would hate for something to happen.” And you say, “Well, we have all these great people and these great things we want to help.” So start now. Start today and work on your plan. Work on all these steps that we’re talking about. There are postings on the stations, on the refrigerators, on the bulletin boards, station visits, text messaging, and just letting them know, “Hey, I care. I care about you. I care about what’s going on. I heard you had a tough call. Anything going on?” Be intentional rather than reacting, waiting for the storm to happen. Just letting your people know that you’re there for them — that you care for them. Oftentimes, it doesn’t have to be me or Jeff or anyone on our teams, but maybe it’s someone else on our teams that members can talk to. That’s the great thing about surrounding yourself with great individuals that make up your team. 

Jeff:

Heath mentioned flyers or postings — make your roster available with phone numbers, how to contact you, what shift you’re on, what station you work at. ‘Cause people just don’t know where to go, and that’s often the hardest step. When someone needs help, can you quickly and easily give them the information they need to make the call they need to make? Talking about station visits, be creative there. You don’t have to just go as the peer team and talk about mental health. You could roll in with a peer fitness trainer and talk about exercise and diet and mental health and really a more well-rounded presentation that might be better received because of the stigma that we’ve talked about. 

Sarah:

So there’s two IAFF resources I want to highlight here that we can put in the chat. One is when the COVID-19 pandemic started, the IAFF developed guidance for peer support teams about how to check in with members during the pandemic, especially if they’re placed in quarantine or isolation. So that’s a great time-specific resource to check out, and the IAFF also has a variety of handouts on a lot of different behavioral health topics that could be used during station visits, placed on bulletin boards, all sorts of other things, distributed at family nights. However, your peer support team wants to do outreach and education, so we just put those links in the chat for you.

We’re nearing the end of our 10-step; we’re onto step nine. Step nine in how to build a peer support team is maintain the team. Now you’ve done all of this work up to now to get it set up and running, but the work isn’t done. This kind of work really doesn’t end — it’s never over. Leaders and team members need to be actively involved in sustaining the team. So Jeff, what does that look like for your team? 

Jeff:

Well, the big thing that I’ve learned since becoming an instructor with the IAFF is self-care. So that’s how we maintain, that is your baseline. If you can’t take care of yourself and you’re struggling, then you’re not going to be able to take care of others, so we start there. We also evaluate our SOG to make sure it’s still relevant, that the process is working the way it should. I’ll talk about the next step about evaluating the impact, but develop some sort of tracking of your contacts that can help you maintain the team. If you do it correctly, you can blind it and you can kind of see what you’re doing with your personnel. Then, maybe you can go back and target your outreach to address issues that the members are facing. Other than that, Heath, what do you think? 

Heath:

I think you said it: The self-care is important. Encourage self-care with your team members, temperature checks, you know, “How are guys and gals on my team doing?” If they’re at their max, let them know, “Hey, take a break for a little bit,” and that’s okay. So yeah, divide the workload up. We talked about “many hands make light work.” So self-care, dividing the workload up, it’s important. Back to you, Sarah.

Sarah:

Jeff alluded to our next step here. The last step in this particular model of this handout is evaluate your impact. So the first step, you need to get buy-in. You need to continue to maintain buy-in as long as you’re going to have a peer support team. Collecting data helps you understand how your peer support team is working, if it’s being utilized, around what issues are people needing some assistance with. It also lets you demonstrate your impact to the administration back to your members — to other stakeholders. Heath, how does your team do this? 

Heath:

Yeah, this is for myself. I sometimes neglect this, but it is an important thing because our leadership that we serve under needs to know what we’re doing, and it adds value to the stakeholders that they answer to. So when you ask for conference money or you ask for training or you ask for anything, ‘cause oftentimes, there’s people that are not in the battle with you and the peer support world. They don’t know, and when you can show them, “Hey, we went on a hundred visits in the last six months,” or whatever that magic number is, it’s good information. And sharing the success stories; I think that’s important, and sharing those with your crews because it shows, “Wow, our teams are making a difference. We are helping, and that’s important.” So, Jeff?

Jeff:

If people you’ve helped are willing, you could have testimonials by them of what happened, what they went through and how they got through it with the help of the peer support team. Surveys to the line about how can we get better? What do you need from this team? I mean, ask the question: What do you need? ‘Cause that’s what we’re here for. So ask your people what they need, and then tracking — I mean, data at least. I think it’s everywhere, but here, especially where I work at TVF&R, data drives budget. If you can prove that your team is relevant and it’s making a difference, you will get the money you need to continue. We use TargetSolutions, which I think is a nationwide training platform, and everything’s blinded. So there’s no names — just what day, what we talked about, we used the DSM-5, the categories to kind of delineate what we’re dealing with, and then we put the date. It’s not even hours; it’s just contacts. This was one of the biggest things that people don’t do — enter their contacts. So as a coordinator or a lead with your team, make sure that you’re constantly telling people to track their contacts. Because it will affect the outcome for your team. You’ll show a greater impact.

Sarah:

We’ve reached the end of our 10 steps. We’ve had a lot of great questions that have come in. In just a second, Kelly is going to cue up some of these questions for us. But before she does that, Heath and Jeff, I’ll ask both of you for your final words of wisdom or advice for others who are embarking on this process. So Heath, let’s start with your final word. 

Heath:

Reach out. We’re a phone call away and email away. We may not have all the answers; we have resources and are willing to help you navigate through it. Thank you. 

Jeff:

Thanks for having us and thanks for coming to listen. This is a good fight. Fight the good fight and reach out. If you need help, we’re all here. I know Sarah has a list of people that can help, and don’t give up, ‘cause it can be hard and daunting, but it’s worth it. 

Sarah:

Thank you, Kelly. Back to you. 

Kelly:

We’ve got a lot of good questions, so hopefully we can get through them in the next 13 or so minutes. But we’re going to start — and I think you have touched upon some of this stuff — the questions. Some of them are from earlier, so you might revisit a previous answer, but wanting to make sure they were all covered. In regards to individuals who are in recovery joining a peer team, we have a question regarding how long since treatment is it okay to ask to be a part of a team in general?

Sarah:

This is an excellent question and you’re not going to like my answer. That I can’t — none of us can give you a “wait X number of days, weeks, months, years since an experience.” It depends on what the person’s recovery or lived experience was, how they’re doing, how they’re maintaining that. I wish that there were a really cut-and-dry answer. There’s not; that’s why we say a team clinician is so important. Because it’s really about having an honest, open conversation with that person about if now is really the right time for them to be serving others, or do they need to be spending any more time focusing on themselves?

Kelly:

Thanks, Sarah. Speaking of team clinicians, we have a question regarding who does the vetting process for clinicians for teams, and are most clinicians paid or volunteer? I’m going to give you one piece of information and then I’m gonna let everybody else chime in. Our clinical coordinator, Molly Jones — she’s a licensed social worker — she’s been leading some of our webinar initiatives. She is doing a lot of vetting of clinicians across communities. So we have some peer teams that have sought our assistance in trying to identify and vet clinicians. We have others that have their own vetted team clinicians. Vetting is gonna look different for every agency. What your requirements are, or preferences, are going to differ from the agency next door, but we can assist with that. We have contact information up at the end if you would like our assistance with that and to connect with Molly on that. 

We’ve also had a question from a clinician asking how they get involved with a local in their area. We can help bridge the gap and connect you with a local in your area, too. So if you are a fire agency looking for clinicians in your area, reach out; we may have some individuals to point you in the direction of to then do your own assessment as to whether or not they’d be a good fit. Likewise, if you’re a clinician looking for an IAFF local that may have a peer team, we can connect you with those individuals, too. But I think my counterparts may have some of their own insight into how and who does this vetting for their teams.

Sarah:

I’ll just say one thing and then throw it to Heath or Jeff. The IAFF is working on developing a cultural competency training program for mental health clinicians who want to work with the fire service. It’s not a training about how to be a mental health clinician for a peer support team. It’s really about what would you need to know to provide quality treatment to the members of the fire service. When that program launches in 2021, that would be a great opportunity. My colleague Lauren Kosc, who’s the other behavioral health specialist at the IAFF, gave a great webinar last week providing a little bit of education to mental health clinicians about what their role would be if they were involved in a peer support team. We can link in the chat — and I’m sure we will for this webinar and for that last one last week — where those recordings can be accessed. So, Heath or Jeff, why don’t I have you also give an answer to this one?

Heath:

Yeah, I think it’s absolutely a critical step and it’s a time-consuming step. We talked about that, but I think it’s one of those things that is certainly ongoing. It could be your team lead, it could be your team members, but we have to be cautious about the clinical people that are out there because there’s lots of behavioral health professionals that want to help fire fighters and first responders. If we just accept their card and put it in our phone and send our people to them, it’s not the right thing to do. So we need to make sure that we vet and visit them, talk to them, chat with them and really dig into what they do, because it’s important.

Jeff:

I agree with that, and I think that when you look at bringing on clinicians for your team, there’s a lot of questions that go into that. So is it union-based, is it department-based, you need buy-in from both sides? Or one side or the other; depending on where the clinician is offering or how your team is structured, they have to have the time and accessibility. So as a peer, when you call this clinician for a referral or a consult, they need to answer the phone and they also need to see your members in a timely manner. For me, and that could be for me, it’s 72 hours. I mean, we’re not talking a month — I have an appointment in a month. That’s not going to work for our people. There’s a lot of ways that they can understand our culture. So there’s FIRE OPS 101, which the IAFF offers, and you’d have to work through your local to get that set up. That is like putting them in the boots, literally, of a fire fighter so they can understand our job. 

I think there was a question about compensation, and it depends. Some departments and some locals hire their own clinicians and there is some sort of monetary arrangement. I don’t know what that would be, and then I think it would vary from place to place. Some departments have their own built-in behavioral health specialist or clinician on staff, so it really varies from region to region. I’d say talk to the teams around you; you have joint clinicians for multiple teams. I mean, there’s ways to make that work. Hopefully that answered the question.

Kelly:

Yeah, I think so. Thank you to everyone that contributed to that from our fire fighters’ perspective. This clinician has asked — and I know I touched upon our team being able to connect them — but if they were wanting to reach out to someone at the firehouse to build rapport, especially in times of COVID where maybe that’s via email right now, who would be the person to reach out to?

Sarah:

In the interest of time, why don’t one of you take this question? I don’t know which one of you wants to do that. 

Jeff:

Let me go. I contact the local, the union, local leadership. Let them know that you are interested, and contact the leadership of your department to have access. The cold calling — especially now, just calling up a station — that’s not working. It’s not going to work for us ‘cause we’re not letting anybody in, and it can get very territorial. So just work through the proper channels, and try to connect with the peer support team lead or coordinator or any sort of behavioral health program manager at a department.

Sarah:

Most of our IAFF local affiliates do have a website that includes the local leadership listed with contact information. So if you Google the name of your city or town and then fire department local or IAFF local, that might be one quick way for you to find out who that is in your area, and you can also contact us. We’ll put up our contact information in just a couple of minutes. 

Kelly:

Great. Thank you everyone. We’ve gotten a few questions regarding the online peer support class that you spoke about and regarding its costs. 

Sarah:

Great question; we knew this one would come up. The in-person IAFF peer support training is $9,000 for 30 students. The pricing for the online version of the peer support training has not been finalized yet, so unfortunately, I cannot share that. But I can share that it will be lower in terms of total cost and per-student cost. So if you’d like more information when those details are available, sign up on your support page under the “find a training to attend,” and we’ll be sure to email everybody on the list when we are making those announcements about final pricing details and how you can host or attend training. 

Kelly:

Thanks, Sarah. Similar vein: How does one inquire or become a master trainer? 

Sarah:

Excellent question. So right now at the IAFF, we have 40 master peer support instructors across the U.S. and Canada. If you’re interested in applying, visit that peer support training page on the website; there is a navigation on the left-hand side for “become an instructor.” The application process is competitive and all final decisions are made by IAFF General President Harold Schaitberger, but the application process includes three different letters of recommendation, a cover letter, a resume and a sample video of you teaching. We do accept applications on a rolling basis, although we do not expand our instructor cadre every year. It’s really based on the demand for the training program. 

Kelly:

Thank you. Do you recommend spouses become trained members of a peer support team? 

Sarah:

Heath, why don’t you take this one. 

Heath:

So we want to make sure we understand what peer support is — a fire fighter talking to another fire fighter. So I would say if the spouse is a fire fighter, then absolutely. I wouldn’t see a problem with that. But if the spouse is not a fire fighter — hopefully I’m answering this correctly — I would say no. But I think it’s important: One of the things we did locally, and I’ll try to wrap this up real quick, but one of the family nights, if you will, is a wife night. I think one of the best things we did as a peer support team was we did a wife’s night, and we had excellent feedback and we provided education. It really was just a nice night, and we pampered our wives and it was a great thing. So I think that to help them understand peer support — help them understand the effects of being a fire fighter — is a good opportunity. 

Sarah:

One other thing you might consider is do you have a separate, smaller team of spouses and family members? You wouldn’t, like Heath said, if the way we’ve defined peer support is truly a peer. So you need someone who understands your job and your occupation. If one of our family members needs support, it would make sense for someone to be available to support them who understands what it’s like — be married to a fire fighter, be the child of a fire fighter, those sorts of things. 

Kelly:

Absolutely. We have a few more questions; I’m going to try to hit as many as we can in the next three minutes. Is there a model that you might recommend for smaller volunteer departments or regional fire fighter associations? I know Oregon and Ohio both have a large number of volunteer and small agencies. I don’t know who wants to jump in here.

Jeff:

I would say yes. Having access to the IAFF training, that would be like Sarah had mentioned: It’s up to the local president and who you’re bringing in. But it is a baseline, and yes, it would be great for volunteer fire fighters. The concepts are the same, so there is no delineation between paid or volunteer here. As far as a regional team goes, I know at least in Oregon, it is easier to respond to a bigger incident with multiple teams when you’re all kind of speaking the same language. What the IAFF provides is just a baseline of, “Okay, we all kind of understand the basics of this,” and then things can change as things progress. But it’s a good baseline, and yes, I think it would be good if for any peer team.

Sarah:

In terms of a model for organizing a pure team, whether it’s department-based or local-based or regional or statewide, I think the best model is the one that works, and different things work in different places. So if you’re smaller and don’t have as many resources, partner. Do something regionally so that when a big incident or something really massive happens in your area, you have neighbors, whether they’re affiliates or other departments to call on. I don’t think there’s one model that’s better than the rest. I think they all have pros and cons. 

Kelly:

I think we have time for maybe one more question. Would you be willing to put up our contact information as we wrap up so that anyone who’s interested can get in touch with us to follow up if they have additional questions? That will be helpful. I will hit on this just briefly. Next week, we’re going to be hosting a webinar on building cultural competency for clinicians. This is a great introductory webinar for those looking to get involved with treating fire service members and an introduction to some cultural norms — things that we’ve mentioned today, like apparatus, rank, scheduling, things like that — that give you more of a familiarity with the fire service. 

That’ll be able to be registered for right now on our community education page. Whether you’re a clinician or fire service member, we encourage you to take part. You can reach any of us here at this contact information should you have further questions or any needs we can assist you with. I know I’ve mentioned benefits — if you are a fire service member and want to check your benefits with the Center of Excellence to make sure you’re in network and become aware of what those costs would be to your members, we would love to help you with that. We’d like to keep that information refreshed and make sure everyone’s aware. So please, either call or email Myrrhanda or I, or both of us, and we’ll be able to take care of you with that. 

I’d like to answer one more of these questions. We’re not going to be able to get to all of them, but for the 8% of fire service members that are retired, could you guys — as very young fire service members — contribute any suggestions on ways for retirees to approach the new generation of team members to stay engaged?

Jeff:

There’s value; the retirees bring value to a team. They bring perspective and the tradition, and I think probably just — the question’s kind of confusing. I’d say just get involved and see what you can bring to the table, and be there for your other retirees. Because often when we retire from this job, we’re just gone and forgotten about. And that’s the big thing: maintaining connection. 

Kelly:

Okay, excellent. Well, if we didn’t get to your question, like I said, please shoot one of us an email and we will be sure to either get it to the right person or answer that question for you. Please reach out to us about benefits if that’s of interest to you. Okay. Next week, we have Molly speaking on cultural competence for treating fire service members, and then our events for September are up on the community education page as well. We look forward to seeing many of you there.

Thank you so much for being with us; you’ve been a great audience and great participants in the polls and the Q&A. We’re so appreciative of everything you do, and we hope to see you in the future. Thanks so much. Have a great afternoon.

Thank you for joining us. Please visit our website, IAFFRecoveryCenter.com, for future training opportunities and recorded webinars. Thank you for all you do.