CLEVELAND — The everyday trauma experienced by first responders across the country and in Northeast Ohio continues to lead to growing levels of post-traumatic stress and the oftentimes life-altering side effects that come with it. In an effort to curb this trend, a coalition of researchers, experts and state officials developed a new science-based mobile app, making Ohio one of the first states with such an offering.
Called the F.I.R.S.T. Support app (First Incident Respondence Technology), the app was developed in partnership with Ohio State professor and researcher, Dr. Kenneth Yeager, and Accentus Health. Dr. Yeager leads the STAR Program (Stress, Trauma and Resilience) at OSU's Department of Psychiatry and Behavioral Health.
After an extensive beta period, the app has been released on Android and the Apple app stores. The app had a simple goal in mind: bring scalable and sustainable mental health support to high-stress, high-trauma professions like medicine and public safety. The trauma and stress from their everyday professional lives often permeates into their personal ones. Burnout, turnover, difficulties sleeping and other productivity and quality of life issues are often symptoms of a deeper issue.
"They experience vicarious trauma. They see things that nobody should ever have to see. Around those traumas that are experienced, there are patterns that emerge," Dr. Yeager said. "[The app] will lead them to the areas of focus that they need to be working in around the traumas. Maybe it's avoidance, maybe it's trust, maybe it's control. But the algorithm sorts and prioritizes."
Issues with avoidance, trust, control and hyper-vigilance root themselves in the psyche of someone suffering from some sort of post-traumatic stress, Dr. Yeager said. PTSD is not strictly curable but, instead, those that suffer from it need to build up resilience, Dr. Yeager said.
The app has been in development for three years and is driven by science, officials said. Once a user downloads the app, they complete a short, 10-minute assessment. Once the assessment is complete, scientific algorithms push content and exercises that are tailored to the user.
The app is free and users can use it anonymously. During the beta period, Dr. Yeager said peak usage occurred between midnight and 6 a.m., giving credence to the trend that a large number of those that work in public safety experience difficulties sleeping.
"The app provides some amazing resources in learning. I was reading some of my assigned readings last night just sitting on the front porch with my wife," said Steve Click, the first responder liason at the Ohio Department of Mental Health and Addiction Services.
Click, who spent 32 years at Ohio State Highway Patrol, has had his fair share of traumatic events while on the job. His trauma and stress, he said, was the byproduct of three decades worth of every day events like car crashes, death notifications and crime scenes.
A young patrolman at the time, Click, who later became a lieutenant, can still distinctly remember the sights, sounds and smell from the Lucasville prison riots in 1993, the longest prison riot in US History.
"You get there and the sirens are going off. It took a second for it to sink in how absolutely serious that situation was," Click said. "You don't get over any of the things that happen in your life or in your career. You get past, you get through, you get beyond."
The most common symptom of post-traumatic stress is sleep disturbance, Dr. Yeager said. Before developing the app, Dr. Yeager and his team surveyed firefighters across the state and discovered that nearly 70 percent of those that responded suffered from difficulties sleeping.
The symptoms also lead to higher rates of divorce among first responders. Left untreated, the stress can also turn to substance abuse, researchers said.
"If you go home and your spouse is at home and you say, 'hi there! Is everything okay?' And they say, 'it's fine.' Is it? No," Click said. "I'm not a person that believes divorce is the inevitable result of being in public safety."
Madison Township Fire Chief Tod Baker was unknowingly experiencing some of those symptoms. He only became aware of his personality changes after completing a state peer support program.
"I've been married and it will be 30 years in January. When I went home, things that impacted my wife seemed trivial to me. I didn't care," Chief Baker said. "For me, I couldn't turn the switch off and I couldn't recognize it. Now I do. If milk was spoiled in the refridgerator, that changes my wife's day. I didn't really care. I would go out and get more milk."
Chief Baker believes the public safety community has reached a critical juncture but, as a whole, the community has begun realizing the impact that the hidden hazards of the job are having on police officers, firefighters, corrections officers and paramedics alike.
Research presented at a recent first responder summit suggests that as many as 19% of law enforcement officers, 20% of EMTs or paramedics and perhaps as many as 37% of firefighters have PTSD or PTSD-related symptoms. Additionally, more firefighters and law enforcement officers commit suicide every year than the number of those killed in the line of duty.
According to the advocacy organization, Blue H.E.L.P., the suicides of more than 220 first responders had been reported to the organization in 2019, which was a significant increase over the 174 first responder suicides in 2018. The organization said the statistics may not indicate an increase in suicides but rather an increase of reporting to Blue H.E.L.P. However, researchers continue to point to the fact that more first responders take their own lives than are killed in the line of duty every year.
"We worry about physical health but we never talk about mental health," Chief Baker said. "We do preventative maintenance every year on all of our vehicles. The greatest asset that the fire service has is the people that come to work every day. We don't do enough preventative maintenance for them."
According to the Ruderman Foundation, the suicide rate among firefighters is 18 per 100,000 people and the suicide rate among police officers is 17 per 100,000. By comparison, the suicide rate for the general population is 13 per 100,000.
"The FIRST Support app is the beginning of giving everybody the tools that they need. When they do have a crisis within the department, they have a resource to use," Chief Baker said. "Just in the last week, I had somebody that is not even affiliated with my organization call me because they needed help taking care of somebody within their own department. That's the problem. We didn't have a resource to help somebody make that immediate decision."
Now they do.