Episode 82| Live at 5x5: Why Wellness?

Narrator: You're listening to Public Safety First, a podcast to help you learn about the First Responder Network Authority and how you can be part of the future of public safety technology.

And now, your host.

Jordan Skolnitsky: Welcome to the Public Safety First Podcast. I’m Jordan Skolnitsky, director of human resources at the First Responder Network Authority. The podcast you’re about to hear was recorded Live at 5x5: The Public Safety Innovation Summit. I was joined by Dr. Kristen Wheldon, President and Founder at the Fire Service Psychology Association; Patrick Fale, assistant chief for the Tualatin Valley Fire Rescue in Oregon, and Sylvia Moir, Undersheriff in Marin County, California. We had the opportunity to discuss the importance of wellness for first responders. It was an honor to moderate this panel on such a sensitive but critical topic. I hope you enjoy this episode.

Jordan Skolnitsky: Well, good afternoon, everyone, and welcome to the Why Wellness panel. My name is Jordan Skolnitsky, and I am the director of Human Resources for FirstNet Authority. I am joined by three incredible panel members on stage who are going to introduce themselves in just a second. So, we know there's been a lot of discussion in the public safety community and in the world about wellness.  Though wellness is seemingly everywhere, it does not take away the importance of the actual subject matter or the critical nature that we should continue to discuss it. Wellness, if you Google it, there's a lot of definitions out there, but the one I'm going to share today; "wellness is defined as a holistic integration of physical, mental, and spiritual well-being fueling the body, engaging the mind, and nurturing the spirit." so the FirstNet Authority, where I work, has started to really embrace the concept of wellness, recognizing the importance to our own workforce, which includes retired and active volunteer first responders, as well as professional staff such as myself. And we also recognize the importance to our public safety stakeholders. The Ruderman Family Foundation's white paper on mental health and suicide of first responders found that first responders suffer from depression and post-traumatic stress disorder at a rate up to five times higher than non-frontline response workers in the general public. So, with this panel, we're going to explore the conditions and situations driving first responders to face these challenges, and we'll discuss early intervention solutions. So now I'm going to give each of these esteemed panelists an opportunity to introduce themselves and provide some insight into a specific early intervention solution that is top of mind for them. And Doctor Wheldon, I'm going to start with you.

Kristen Wheldon: Well, thank you. My name is Dr. Kristen Weldon. I am a clinical forensic psychologist, meaning much of my work was established in patient care. And I also have worked in the forensic setting, which is essentially anything that has to do with the government. So, corrections, law enforcement, fire service, military. And in my experiences over the years, I've learned quite a few things about how different organizational systems manage occupational exposures, specific risks to those groups, populations. And one of the things that has really kind of stood out in my mind was the use of the military trying to manage post-traumatic stress disorder. That's been a goal since World War One, when they really started using psychologists to do assessments and things like that. And so, there's been the concept of psychological first aid throughout many, many years trying to basically get a handle on PTSD [post-traumatic stress disorder] specifically, although it was called many other things before it was called that.

So, there are some psychologists that were working with the Royal Marines, in the UK, who basically developed a system called Trauma Risk Management. And this system basically follows the trajectory of PTSD, which is essentially we know that if someone's exposed to a traumatic incident, eight out of ten people will naturally recover. Two out of ten are going to need clinical support. So, your job organizationally is to find your two without pathologizing your eight. Well, how do you do that? Right? So, what they did was they trained the peer support team to do risk assessment. And this risk assessment was looking at specific acute stress symptoms. And they would give them the risk assessment at 96 hours after exposure, which is a baseline. And then follow up in 30 days, and then follow up again in 60 days using the same metric. And what they were able to find is that there are four different trajectories that someone's going to follow. There's going to be the person who has symptoms the whole time. That person would be considered chronic in their presentation. There's the person who has no symptoms the whole time. They call that the resilient trajectory. And then there are the people who are going to have symptoms initially, but then they'll drop off at the 30-day mark. And that's going to be your natural recovery group.

And then the last group that we don't often talk about is the delayed presentation. This is someone who is not having acute symptoms up front. They're not having at 30 days, but at 60 days they've had a chance to really kind of noodle on whatever that traumatic incident was for them, and oftentimes it's tied to a moral injury. And then they have symptoms. So, if you followed that organizationally as a model and had that ongoing into your system, what you would be able to do again is identify your two without pathologizing your eight. And this is really tricky, I think for organizations to kind of manage what might be traumatic for me might not be traumatic for you. And that's because of your own psychology, your own unique, navigation strategy through life. So essentially, if organizations can follow that methodology and essentially look at science, use data to essentially identify and mitigate risk, we might be able to not only predict these cases of PTSD, but get people into true early intervention. And early intervention starts at 30 days. It doesn't start before then because you could really be thwarting natural recovery, right? If someone's having nightmares after they saw something that was really, unfortunate, that could be your brain trying to make sense of something that it hadn't really wrapped its, you haven't had it wrapped around, right? So, there's a lot of things in the science of PTSD and our organizational commitments to managing these things that I think we, we can evolve in, and we can do a really good job of supporting our people with the right resources and support. And so that's a little bit about me and that's a little bit about trauma risk management. And I'm going to hand it off to my esteemed colleague here and take it away.

Patrick Fale:  Hello, everyone. My name is Patrick Fale, assistant chief for Tualatin Valley Fire and Rescue.  My background certainly isn't, nearly as clinical as Doctor Weldon, or as in depth as maybe some of the other panel members. But I have noticed patterns in a 26-year career, and I have a deep passion for the care of the men and women that we ask to do really tough jobs down on the street, day in and day out. I'm fortunate enough to work for an organization that is well funded. We have on staff, clinicians, robust peer support teams and a really robust chaplains group that's a part of an overall integrated care team that's on staff 24 hours a day. They're available all the time. We're really lucky, but we still have troops that are struggling. We still have command staff, and this is something that I don't think we talk about often that is struggling. And we really started to ask ourselves why? And then through our relationship with FirstNet, long standing relationship, we helped a company, or a group really understand how to scale and culturally scale into the fire service, and that was Boulder Crest. they bring science out of Walter Reed and John Hopkins that really takes a different path approach, with post-traumatic stress and kind of flips the script to post-traumatic growth. I know for myself; I was really struggling several years ago. Our order backs were through the roof. Political decisiveness in our stations was rampant. Our culture seemed like it was crumbling beneath us. Violence against our responders was going through the roof. I'm negotiating a labor contract during this time. Like, I just kind of a hot mess, but I didn't really know that I could ask for help. And through FirstNet, I was asked by Chief Johnson to help this group kind of scale, and through the course of that, somebody noticed, "Hey, you're not doing well." And so, I went through the whole program, and now I'm so grateful because I can lead the entire organization. You know, it's easier to say, hey, the assistant chief, the number two of the organization needed some help, and I could see that you all needed some help. So, let's go there together. So, we've had that program for a while at our organization, I can honestly look everyone in the eye and say it is changing our culture. So, we're on to something and we're so grateful to have that partnership. So, thank you.

Jordan Skolnitsky: Thank you, Chief Fale. And last but not least, Undersheriff Moir, you want to go?

Sylvia Moir: Thanks, Jordan. I have 36 years in the biz of frontline law enforcement in Sacramento, mostly in California. I retired there as a police chief after doing some really cool stuff. I was in Tempe, Arizona, for a handful of years. Then, I retired and went over to Napa, and Napa just needed an interim police chief for a minute. So, I served there and retired again. And now I serve as the undersheriff in Marin County , which is really, really cool because I get to take all the texture and experience of being a chief executive and get stuff done for my sheriff, and influence strategy and policy and culture and climate in the organization to do things, love people big, love the profession of policing without being the one in charge, which is really cool.

So, my path really started with I wondered why? I wondered why, with the amount of acute, chronic, and cumulative toxicity and suffering in municipal policing, that I was firsthand witness to, why I was not on my knees, why I was not more devastated by it? And I didn't have an answer to that, except that I'm the product of incredible parenting, where my father is an engineer and United States Marine. Basically, the motto was suck it up and drive on. You're a Moir. Act like it. And so, I didn't really know what that meant, but I knew that that coupled with this intellectual curiosity, and this incredible nurturing and loving of my mom, and the way we were raised, really created some adaptations in me that served me well when I became a cop. When I became a police chief, I knew that I had the position that I could be authentically me, to find out more about what to do, to dive into the research, and then to make actionable the things that that the research was informing and dove into a mindfulness practice. Meditation practice as a pathway of mindfulness, really interpreting what this world was giving, and this resilience body of work to know that every life has some degree of suffering, so now what? So, I dove in and really wanted to know more and then bring that to my organization and then broadly let it permeate policing. Now let me tell you something, the resistance was real.

Well, it's taken hold now and I was okay meeting the resistance and just doing. We'll talk a little bit about what that looked like, but really it was about the organizational climate that would then further the culture and the climate about, like this pliable way that we speak to each other, how we engage the language we use, the actions we take, how we invite diverse inputs to the table to get this richness of this human endeavor that is policing. I will say that with 36 years in the biz, I've seen some incredible growth. But even as we sit here today together and in this position of, policing, policing has unique authorities that no other profession enjoys. Those authorities are, they have government authority to deprive someone of their freedom. In policing, we have government authority to use deadly force. Those unique authorities have incredible and significant consequence, and they have to be respected. And because of that and the staggering, the corrosive drip of policing, every event, every event, a drip on her soul, there has to be something that we do to mitigate harm, to mitigate it boring a hole in our soul. These unique authorities and the suffering that we bear firsthand witness to, we have unique coping mechanisms. And, if we use the same things that we used before we're going to have the same result. And this adaptation that our beleaguered nervous system needs, we need a varied approach. My approach was meditation. My approach was to just, to dive in fully, to lead the charge and then start instituting some human performance advancement that addressed the entire human being. So, what you get from me today is just a raw perspective as a practitioner and an openness to dive into this thing and hope, and hope is not a strategy, I get it, but a hope that you maybe get one thing so you serve yourself and can be greater, of greater service to others, and maybe take some action that might look and feel differently for yourself and those that you interact with broadly. So that's what you get from this side of the intellectual table here.

Jordan Skolnitsky: I really appreciate those opening remarks. I have a few questions. Chief Fale, I'm going to start with you. Why did your organization start exploring the concepts of post-traumatic growth?

Patrick Fale: Yeah, we have tremendous resources where I work and, in the metro area surrounding us, but we, our troops are still hurting. And what we had wasn't working. It was often reactionary. We didn't really have anything to prepare them for the life they were going to lead on the ground. And that's really when we started to look at these concepts that prepare them to understand that they are going to live a life of struggle as all human beings do. And we have a choice in that struggle. And we can either choose, to have it dominate us, or we can choose to tap into it as tremendous strength. So, we went down a path of asking ourselves, well, what does that look like? And what does that training look like? For us, it's not therapy, it is training. It's training before the event, we've instituted where it's ongoing and it's infused into our developmental processes from lieutenant to captain to battalion chief, all at a higher escalating level. So, they have a deeper understanding of it, and we're seeing results. Simple answer, we really didn't have anything on the front end to truly prepare them to do the job that we were going to ask them to do and do it and do it in a healthy way.

Jordan Skolnitsky: All right, Undersheriff Moir, I'm going to come to you.  I'm hoping that you can speak a little bit to some of the programs you've helped implement over your years of experience.  

Sylvia Moir: You bet, Jordan. So, my approach was really to dive into the science, the neuroscience and then found some remarkable stuff out in the environment. We invited a number of our folks to take part in a three-day immersion training where we dove into the science, we dove into the practices, and we began as an organization, a culture around meditation, as a pathway to mindfulness, as a pathway to resilience and all of the connections. And with some remarkable results. I took that to Tempe, Arizona. With the difficulty and the struggle there, my approach was refined based on my initial experience. Right. So what I did was, I got our tactical guys, and I said, fellas, what if I told you that there was a three-day training that I could send you to, that you would emerge on the other side with greater situational awareness, with a different response to all the stimulus out there that you could reset between calls for service, that it might just refine your officer safety, you might be more tactically sound and you might just be a different fella as you went home each night, they said, "Yeah!" And I sent them to a mindfulness retreat, and sure enough, they came back and reported that they were different people.

And we kept that going. And they became the champions, advisors, advocates from the bottom, the incredible champions. And then I did it from the top, and we merged in the middle, and it permeated the organization. And what they reported was stunning. The ability to reset between traumatic calls for service, imagine a cop going to 15 calls for service in one day. These are people. This may be the only time in their life they interact with a cop. It might be a death. It might be a missing person. It might be a struggling parent with dementia. It might be fill in the blank. The ability to reset between those calls for service and reset before they walk in the door at home. They reported that it changed the way they show up in this one precious life that we have.

We‘re replicating that in Marin County to be more holistic, to really address the whole human, those stressors that are common finance, the psychological, all, all of those things that we can imagine. And simply it's just, it's an urging to do what's courageous instead of comfortable. So, my approach was to encourage them and to change the climate the way we speak. and we can expand from there. But I think that was, that was the approach, and it's showing some real promise in how folks are addressing the difficulties where they are. I have to say one other thing. I needed it more as a chief executive, with the staggering suffering of shouldering the burden of all of our people in this conflict of being a chief where I'm simultaneously sending people into harm's way and then caring for them in a way that they deserve. And to use the techniques, and to address the stimulus, and this freedom that exists, before a response was never more necessary with the consequential actions that come from being a police chief.

Jordan Skolnitsky: Thank you. So, Doctor Wheldon, I'm going to come over to you next. Can you share a little bit about how traumatic experiences affect people differently?

Kristen Wheldon: Yeah, absolutely, absolutely. So, there's some different schools of thought about what comes first, your emotions or your thoughts, right? And I'm kind of under the impression that our emotions came first because babies can't talk, right? So, you have these emotional experiences even in utero. Your parents are, you know, making noise. Things are going on, and you're becoming a human through all of these experiences that you have. When you're born, obviously you're born into a certain area, with certain parents, with certain circumstances, finances, you know, maybe exposure to substances or even abuse or these different things. And so, what you do psychologically is you start organizing the world almost like a navigation strategy, right? So, when I'm talking to people in therapy, I'm professionally curious, why does this make sense to you? Because no one errors on purpose. So, what makes some things traumatic for some people and not for others? It really has to do with your worldview, right? At the core of the human experience, we're asking ourselves two questions, "Who am I, and who am I in relevance to others?" And I would say we spend our entire lives trying to answer that question. We do it through our work. We do it through our intimate relationships. We do it through our parenting. So, your worldview is your navigation strategy. When you're confronted with something that does not fit in the navigation strategy, I think of it like grinding gears. So, trauma is a situation that brings you to a point where you need to reorganize. And what's going to bring you to that point is not going to be the same as it is for me, right?

People will say trauma is trauma. Why should we specifically focus on populations? We should absolutely focus on populations because the context of their trauma, which is essentially the meaning they make of those unique exposures, has to be understood in order for you to help them reorganize.

So, I think we have created all of these cultural judgments about your response. Is it the right response? Is it the wrong response? I think that's the wrong question. We have to say, hey, we're all going to be affected by something at some point. If you live long enough and you're going to be confronted with that moment where you have to make meaning and you have to make peace with something. And if you didn't get those skills growing up, we have to learn those things and then we have the obligation, or at least in my opinion, the responsibility to impart that onto the generation that's coming up. So, the fact that, you know, we're in 2024 and wellness is being embraced, I would say, by the first responder community is really encouraging.

Jordan Skolnitsky: So, one final question, and it's for all three of you. if you had any advice for leaders looking to improve their organizations through wellness initiatives, what would it be? And Undersheriff Moir, I'm going to come to you first.

Sylvia Moir: Sure. My mom used to say, you know, being selfish and, and our understanding is to serve self at the deprivation of others. She said there's a second kind of definition. It's to serve self, to be of greater service to others. I would encourage you to start with self. Start with self. Start a practice. Perhaps that will then permeate the way you interact with folks and may just permeate your organization. So, serve self and it may make you of greater service to others. And that's a super meaningful, awesome thing.  

Jordan Skolnitsky: Thank you. Chief Fale?

Patrick Fale: I think along the same lines, same theme is I know there's high level leaders in this room, and I can imagine the stress and strain that you're under, and you have a choice whether to navigate that well and take pride in how you're navigating that, or to continue down the path that you've always continued through your normal coping mechanisms that you've gained over time. I'd ask that if you're a high-level leader, ask yourself if those coping mechanisms are serving you? If they're not serving, you've made it this far in your career, in your life, to high level leadership. and you've had to make choices. We'll make some choices for yourself that can even enhance your leadership even more. For me, it's transcendental meditation. It's been a huge part of my life, a major impact to my leadership and being able to center myself. And the second thing I'd say is be bold in your leadership. It's scary to get up in front of people and say, "Hey I'm not perfect. I'm not doing that well." But you'll be shocked at the response that you'll have from your people. They're hungry for somebody to be honest and authentic with them, to be human and vulnerable. Please take the chance on yourself and take the chance on your people and be bold.

Jordan Skolnitsky: Thank you. Dr. Wheldon?

Kristen Wheldon: All right. Well, that was wonderful. We have both of you guys. So, I'm going to echo what they said, but I'm going to package it in a very small package. All right. You can't give somebody something you don't have. So, take care of yourself.

Jordan Skolnitsky: Well, thank you everyone for joining us for the Why Wellness panel. But, safe travels home, everyone, and thanks again.

If you are struggling or in crisis, remember that there is hope and there are steps you can take to seek help and support. Call or text 988. 988 serves as a universal entry point so that no matter where you live in the United States, you can reach a trained crisis counselor who can help.

Narrator: Thanks for listening today. We're excited to have you join our podcast community. Make sure to subscribe on iTunes, SoundCloud, and YouTube. You can learn more about the First Responder Network Authority at FirstNet.gov and learn about FirstNet products and services at FirstNet.com.