‘Your outlook on life changes’

Chatham first responders talk about work’s impact on their mental health

Posted 9/6/19

Nearly 30 years in any profession gives someone stories they can tell. Law enforcement, according to Mike Wagner, is no different.

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‘Your outlook on life changes’

Chatham first responders talk about work’s impact on their mental health

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SILER CITY — Nearly 30 years in any profession gives someone stories they can tell. Law enforcement, according to Mike Wagner, is no different.

Wagner was part of responding to 26 traffic fatalities in one year while working in Albemarle County, Virginia. Now the chief of the Siler City Police Department, Wagner said responding to an accident scene can be a harrowing experience in many ways.

“You see young, old, kids, mothers, fathers, grandmothers,” he said. “It’s about them, but then you have to deliver that message to the extended family. It’s really hard. You deliver that message 26 times, it’s tough. You live through it because you have to process the scene, you have to see the fatality itself.”

Seeing some of these things, he said, makes it understandable that first responders and law enforcement community members deal with mental health conditions at a higher rate than the general population. Thankfully, as Wagner and others attest, the conversation around mental health in these professions is changing, but it hasn’t always been that way.

A shifting dynamic

Gary Blankenship was the chief deputy at the Chatham County Sheriff’s Office from 2002 to 2013. He had served in the department from 1984 to1999 and spent a few years with the Carrboro Police Department before returning to Chatham.

Now a criminal justice instructor at Central Carolina Community College, Blankenship said he had to learn “early on” that it was best to “withdraw my emotions from the scene” of a particularly gruesome crime.

“Sometimes you could have a scene and you can relate to maybe the victims,” he said. “Maybe they were the age of your children or they look like a family member or they experienced something maybe a family member of yours experienced. I realize I could not connect myself to that if I was going to be able to survive and do what I was expected to do.”

First responders — whether they be police officers, firefighters, Emergency Medical Services personnel or others — are on the front lines of responding to some of society’s most violent and devastating incidents: murder, rape, child abuse, horrific car crashes among them. Matthew Harmody, who is the medical director for FirstHealth EMS, which serves Chatham County, said his paramedics “see people at their worst, both from a medical standpoint and often from a traumatic standpoint.”

Robert Powell, the head instructor of the Basic Law Enforcement Training program at CCCC, talked about one incident from his career. A child choked on a hot dog in a Shoney’s, and one of Powell’s co-workers “tried everything” to help the child, but it didn’t work.

“In all these professions, you sign up because you want to help people,” Powell said. “That’s your ultimate goal. But at the end of the day sometimes, you feel like if that child died in your arms, I didn’t help that child. I didn’t stop that husband from killing that wife. And you wear it. You feel responsible for it, even though it’s not your fault.”

For a long time, people like Powell and Blankenship say, helping officers deal with these traumatic experiences was rare. Blankenship said that with his generation, “reaching out for help was a negative thing.”

“They looked at it as a weakness,” he said. “It was kind of an unspoken thing.”

Powell, Blankenship, Harmody and Wagner each cited the mostly-masculine nature of first responder professions. According to the Federal Bureau of Investigation, 73.4 percent of all law enforcement employees and 88.4 percent of all officers were male in 2013. The National Fire Protection Association said earlier this year that around 93 percent of firefighters in 2017 were men, and the Census Bureau reported in 2017 that 66.3 percent of emergency medical technicians and paramedics were male.

In professions with a majority male population like law enforcement, Wagner said, the older generation was less likely to be willing to talk about mental health stress.

“When I first started, if I had come to my superior or one of my supervisors with, ‘Man, I really feel bad,’ they’d say, ‘Suck it up. Let’s get on with the work,’” he said. “After that, I would never say anything again. I’d have to work it out on my own.”

The scope of the issue

The combination of forces have led to some staggering numbers, according to current and former officers, on mental health. A few statistics:

• 30 percent of first responders develop behavioral health conditions, including, but not limited to, depression and posttraumatic stress disorder, as compared with 20 percent in the general population, according to the Substance Abuse and Mental Health Services Administration

• Firefighters have higher suicide attempt and ideation rates than the general population, according to SAMHSA

• 108 police officers committed suicide in 2016, compared to 97 killed in traffic accidents or by gunfire, according to Badge of Life, a police suicide prevention program

• 105 firefighters committed suicide in 2014, according to the Firefighter Behavioral Health Alliance, and alcohol abuse among firefighters is more than twice the rate of the general public, according to the U.S. Firefighters Association

People like Powell and Wagner have seen those effects first-hand. Powell said a lieutenant on one of his shifts was an alcoholic and committed suicide, a best friend he went through the academy with killed himself and a sergeant he knew committed suicide. One of Wagner’s best friends in law enforcement, whom he said had “a great life,” also killed himself.

Harmody said EMTs who see some of the most gruesome and grievous things have both access to medication and knowledge of how to commit suicide, and added that the profession can lead to an increased use of alcohol.

“That certainly increases one’s risk when you’re around medications that you could take or you see it on a regular basis in caring for your patients,” he said. “We know that that increases our first responders and medical providers with response to suicide. A lot of them for sure have PTSD. A lot of them have probably not been evaluated for it or diagnosed for it.”

Harmody works in an emergency room, meaning he doesn’t go out to calls, but he has seen some harrowing things while treating patients coming to the ER. In March 2009, a man came into a nursing home in Carthage and shot nine people, killing eight. Harmody, who operates out of Moore County, was on duty that day when several of the victims came into the ER. He also referenced the opioid overdoses that have grown in prevalence in recent years.

“We see a lot more young people dying from overdose,” he said. “You can’t ever become numb to it because you stop caring and you should probably get out of the medical field. But it’s tough when you repeatedly hear or see that happening to people from overdoses.”

Even with these horrible things, these men and women first responders have to put on a brace face and sometimes even, as Harmody says, “have that difficult conversation with family at the scene.”

“It’s still emotional and tearful,” he said. “Sometimes I’ve got to walk out of the room, collect myself, and I’ve been doing this for 20 years.”

A sea change

While several years ago mental health may not have been as much of a priority, those working in the field now say there’s been a shift and that mental health-related conversations are more prevalent.

Powell said he teaches a section in BLET training about “crisis and incident management.” Those who graduate from CCCC, he says, will see things “they’re not going to be able to unsee,” so giving them that heads-up is critical.

“Their psychology is going to change,” he said. “At this stage, when I have them, it’s to warn them. That’s the extent that it goes to.”

It’s up to the individual departments to provide consistent support.

While Blankenship was with the sheriff’s office, he said they went through training from Kevin Gilmartin, a behavioral sciences and management consultant specializing in law enforcement and public safety, and his book “Emotional Survival for Law Enforcement.”

“He tries to tell officers, ‘You need to recognize some signs where it gets to a point where it’s almost irreversible,’” Blankenship said. “It was training I wish I had as a young officer.”

FirstHealth EMS works with organizations to provide critical incident response teams, particularly to “grievous events” and those that involve children, Harmody said. Specific to Chatham County, these teams will come whenever there’s a child drowning at Jordan Lake or a similar event.

“It’s a small group, it’s open, people can share their feelings,” he said. “It’s a non-accusatory type of environment. We try to do that very close to an event like that.”

Harmody and Wagner said an individual’s faith can play a role in helping them process incidents, and Wagner said he is in the process of selecting a non-denominational department chaplain to serve that role for the Siler City PD. Wagner’s plan is for the chaplain to be on-hand at the police station to provide a listening ear for officers to share what’s on their mind, whether it’s something on the job or something at home.

“I believe that’s where you start,” he said. “Even if it’s just him walking the halls, being available to us, a phone call away, that’s a big deal. If you don’t have any of those resources available, you’re telling your officers that mental health is not important. I think it is.”

Blankenship said the change starts and continues by individuals coming forward and being open about their struggles. He added that he thinks the growing presence of females within law enforcement has helped.

“When I was young, I thought law enforcement was a man’s thing,” Blankenship said. “Women are just as good if not better than men in dealing with these types of issues. Just them being there breaking down walls of this masculinity and this sort of thing.”

It’s always there

The last traffic fatality that Wagner went to in Albemarle County — he got the Siler City chief job this June — was a vehicular suicide. A mother of two children just drove off the road.

“It racks your brain to think, ‘What would drive a person to do that?’ On the surface, everything looks great. And that’s the scary part about suicide is that we just don’t know. Sometimes we don’t get those indicators. It just happens. And you feel guilty.”

He referenced his close friend who took his own life.

“With the close friend, I felt guilty,” Wagner said. “It lingers with me today.”

Those things stay. They’re always there. Seeing child sex crimes, horrific murders, devastating vehicle accidents — it changes you.

“It becomes such a mental state of seeing children injured and taking advantage of and exploited that it wears on your brain and your heart,” Wagner said. “Your outlook on life changes. If you don’t take care of your own, take care of yourself, you’re surely not going to be able to take care of others.”

Harmody said people in his profession are “more willing and able to talk” about mental health now than they were even 10-20 years ago, and that it’s a good “first step in solving and improving a situation.” Blankenship and Powell, both long-time law enforcement members themselves, said things are much better now, but even new challenges present themselves. Both men referenced increased pressure on police officers due to viral videos and police-involved shootings.

“There’s a lot of civil unrest and there’s not as much pride,” Powell said. “You’re being embattled from so many directions now, whereas we just jumped out of the car and dealt with crime and injuries. And now they’re worried about crime and death and injuries and lawsuits. That’s just more a pressure cooker that they’re dealing with day-by-day.”

Blankenship said there’s still some of the “macho-ism” and “I’m all good” attitude, but not as much as before.

“I think you’re starting to see a change where you’re starting to see some officers step forward and say, ‘Hey, I’d like to go speak to someone about this,’” he said. “There’s day-to-day stuff that you see that I as an administrator may not realize what they’re seeing and how what they see impacts them. You’re seeing a change some.”

Reporter Zachary Horner can be reached at zhorner@chathamnr.com or on Twitter at @ZachHornerCNR.

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