World Mental Health Day: Emergency Services Trauma

In the spirit of world mental health day I have come across an older news article I want to share. It's message is just as strong as when it was first posted and I feel its fitting to share this post today to help spread awareness of what its like to work in the emergency services.

***Trigger warning***

Discussion of intrusive memories and traumatic experiences, including death and body recovery.

Disclaimer: any words after this are not my own, but are copied from this article;

https://www.theguardian.com/public-leaders-network/2016/jan/30/mental-health-dead-people-flashbacks-emergency-services-fireighters

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I see dead people. It's normal and more people should talk about it

Rob Norman

Flashbacks and intrusive memories are part of dealing with trauma. More of us in the emergency services should be comfortable talking about mental health

This will be my 17th year in the fire and rescue service. In the course of my duties I have responded to a range of incidents including accidents on motorways, train and aircraft crashes, and the fatal fire at Atherstone-on-Stour in 2007, where four of my fellow firefighters lost their lives.

We worked for days to recover the bodies of our fallen colleagues from an unsafe structure, still in the process of collapse. Much could be written about the mental impact of this one incident alone.

It was during the critical incident debrief that followed the fire at Atherstone-on-Stour that I first became aware of intrusive thoughts. My service had contracted a counsellor to discuss the incident with all those who had been there. He explained that the brain is not able to process traumatic incidents in its usual way. Instead, it randomly accesses pieces of your memories at a later stage, which can result in intrusive memories or flashbacks. I was informed that this was normal, and that far from being an indication that my mind was out of control, it was actually essential to my mental health.

I know that I will never forget being stood to attention in a guard of honour, formed by the emergency services staff on site, as the grieving families of the deceased passed by to witness their loved ones being solemnly carried from the building to the waiting funeral cars. I will never forget how heart-wrenching it felt, and that even though I didn’t know any of them personally, they were part of what we often refer to as the 999 family. My 999 family. These are my conscious thoughts, for times of quiet reflection; they do not simply arrive uninvited, causing disruption, unlike my intrusive memories.

Sometimes I see dead people. It is perfectly normal and more people should talk about it. I was told that memories of specific incidents become less frequent as the mind puts the pieces back together and files them away. I was also told that if they don’t, or if they start to interfere with everyday life, it might be worth seeking help.

My experiences over the past 17 years have changed me. The things that I have seen, heard, and felt in that time have left me with new thoughts about life, death, and everything in between. While I don’t personally feel I have a mental health problem, perhaps without support I may have developed one. That possibility exists for any of us.

As part of its blue light programme to improve the mental health of emergency services staff, the charity Mind conducted a survey of 3,627 workers – 87.5% of whom said they had experienced stress, low mood, or poor mental health.

The support offered by my service following this incident has stayed with me, and I am thankful for it. Having been educated in the natural reaction of my mind following a traumatic incident, I am quite happy to discuss it, and this is key. But a recent YouGov poll revealed that nearly a third of us feel uncomfortable talking about mental health. And 71% of emergency services staff responding to the Mind survey felt their organisation did not encourage them to talk about mental health. As a consequence, many people suffer in silence, or turn to other coping mechanisms such as alcohol.

There will always be specific triggers for these recurring memories, such as returning to the scene of an incident. One example for me is the heartbreaking death of a father and his three-year-old son. We had been called to help with the search of a river after a boat had capsized. Two children had been rescued before we got there, and as I arrived on the river bank, the limp body of a third child was being taken from the water and frantically worked on by paramedics. As I struggled to comprehend the scene in front of me, I desperately hoped for some signs of life. There were none.

I remember helping to launch the rescue boat in the shallow water downstream, and the struggle of my teammates to get upstream, passing under a bridge, as the boat made its journey to the site where, later, we recovered the body of the children’s father.

Occasionally I drive over that bridge. Sometimes I don’t even realise I have done it, and my day continues as normal. Other days I spot the sign for the small village as I approach, and I see that father and son once again.

As cuts to the fire service continue, firefighter numbers are decreasing, meaning those that remain are likely to be exposed to critical incidents with greater frequency. The nation’s emergency services need to be talking about mental health. I am not suggesting that all emergency responders are clinging to sanity by our fingernails. Far from it. Everything I experience reminds me of what really matters in life: that in the blink of an eye, everything can change.

Even with education, intrusive memories will catch you unawares. I was recently leaving a coffee shop with my wife, and as she pulled her scarf around her neck, my mind jumped back to a middle-aged man who had taken his own life. He had hanged himself from a canal bridge, using his scarf, and had been there for several hours. After we recovered him, the police found a note in his pocket, along with a plain gold wedding band that matched the one he was wearing on his left hand.

I spared my wife the additional detail, and mentioned I had just had a flashback to an incident. She asked if I wanted to talk about it. I didn’t. It’s just my mind filing things away. I understand this.

But I do hope that by writing this, I can encourage more people to talk about mental health. Thursday 4 February is Time to Talk Day, run by Mind and Rethink Mental Illness. Everyone should join the conversations about mental illness, and help end some of the misconceptions around it.

The Blue Light Infoline, for emergency service staff, volunteers and their families, can be contacted on 0300 303 5999. It offers confidential support and advice on mental health and wellbeing. In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.

This series aims to give a voice to the staff behind the public services that are hit by mounting cuts and rising demand, and so often denigrated by the press, politicians and public. If you would like to write an article for the series, contact tamsin.rutter@theguardian.com.