Helping the helpers

By DEON LACKEY, Chronicle Staff Writer

Legend has it that the first firefighters who arrived at the scene of an accident on Norris Road back in 1991 heard the screams of victims trapped in a burning car.

Physicians at Bozeman Deaconess Hospital arranged for on-site counseling for the firefighters, law enforcement and paramedics who worked that accident.

But the horrific event prompted emergency workers to ask the question: How are we helping our front-liners cope?

"The responders just had to suck it up," said Les Anderson, Belgrade fire chaplain.

The "suck-it-up" philosophy meant people didn't stay long in emergency services. In Belgrade, with a mostly volunteer fire department, the average firefighter stayed less than three years.

"What was consistently brought up (at exit interviews) was, 'It's just not worth it,' because of what they see and go through," Anderson said.

Eighty-five percent of first-responders struggle with stress-related affects, from health problems to substance abuse. Something needed to be done.

So Gallatin County formed a Critical Incident Stress Management Team to help 911 dispatchers, EMS workers, firefighters, cops, ski patrol, search and rescue team members and emergency room personnel.

"It's only for the worst of the absolute worst. ... the 5 to 10 percent of things you never see, can't expect, can't prepare for that can overwhelm the stress mechanism," Carol Burroughs, CISM's clinical director and a local therapist, said.

Although first responders build coping mechanisms, or "trauma barriers," that allow them the detachment or callousness necessary to function through tragic events, that is often not enough for the really critical events.

The CISM team takes a three-pronged approach. First, it focuses on preparing responders for the affects of stress, things like sleeplessness, irritability, crying and losing track of time.

"It helps people to know (they) are not going crazy," said Lynnora Jetter, an emergency room nurse and peer counselor. "Whatever is happening is a normal reaction to an abnormal event."

The second prong is debriefing after a traumatic event. The team pulls everyone involved together three to 10 days after the fact and review the event, from the first call to the resolution.

Often, people struggle due to missing pieces in the story. Paramedics may not understand why a person who was stable at the scene of an accident died in surgery. Police may not know the outcome of an attempted suicide. Dispatchers only hear what goes on at the other end of a phone line.

"We send people, they go, we don't know what happens after that," said Connie Mathison, a county dispatcher. "You don't get closure."

Having all of the pieces of the puzzle can help responders come to terms with what happened.

"Part of it's acceptance (that), 'I did the best I could. We made the best decisions we could have right there,'" Burroughs said.

Finally, the team arranges a "defusing," a shorter, one-on-one, in-house session that lets a responder talk with a peer, someone who may have been through a similar situation or at least understands it better than someone outside the emergency system.

"(Peers) can provide that means of solace," said Ben Hess, Gallatin County's 911 director.

After 18 years as a dispatcher, Mathison has seen her share of tragic events and is gearing up for a bigger role with the CISM team.

"It's a necessary thing," Mathison said. "We need to look out for our people."

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