PORTLAND, Maine — Firefighters are trained to show up to calls, assess the situation, and quickly help those in trouble, all while putting aside any feelings about what they see or experience.
But it's not just fires they respond to; it's suicides, child abuse cases, shootings, overdoses, and fatal crashes, to name a few. Long after the emergency is over, firefighters themselves are sometimes the ones who are in need of "rescue."
NEWS CENTER Maine reporter Hannah Yechivi spent time with the department to get an up close and personal look at how the Portland Fire Department is leading the way not only in Maine but in the nation regarding changing the culture around talking and dealing with mental health and trauma.
Portland's Fire Department receives the highest volume of calls in Maine, answering about 19,000 emergency calls every year.
Mental health has become a priority at the department, including an active peer-support team. In addition, new firefighters are getting mental health training at their training academy. Most recently there's one effort only a handful of fire departments in the entire country have, a full-time mental health counselor.
Portland Fire Chief Keith Gautreau said it has made a huge difference for many.
One example is Portland firefighter Nick Jewett. He said his passion in this line of work started as a kid. He lived right in front of a fire station, watching and listening as the men and women responded to calls.
"I just remember seeing those guys go out and the trucks and the lights, and I was so excited," he said. "One of my teachers, her son was on the volunteer department there, and she knew I was really excited. She hooked me up with him during a parade, and I got to ride in a fire truck. And it was just a great and funny story. I now work with him."
Jewett said he didn't think he could make a career out of fighting fires, so he went to college. But the interest was always there.
"I went down, put in my papers, and I fell in love," he said. "After playing college sports, having that team aspect, that's what the fire service kind of brought to me. I like the EMS side a lot. You really get some instant satisfaction, like you are truly helping somebody right then, and you can see the things you did make a difference in improving their day."
It's the main reason first responders like Jewett get into this field, to help others on their worst days.
"But we can't help people if we don't come to work; we can't help people if our mind is not right," Gautreau said.
Gautreau said he had noticed a lot of his own peers struggling when he was side by side, answering calls as a firefighter, a reason why he knew exactly what to do when he got the chief position—provide firefighters with the right resources.
"In the past, we've relied on focusing on the physical things. OK, let's provide new fire trucks, let's provide gear, PPE, fire stations. We've always focused on the physical things, but now we know traumatic stress disorder is a real thing," Gautreau added.
"We didn't talk about mental health around the table. You knew it was there, you knew guys had hard times, but you kind of kept quiet about it, you gave them a lot of space," Jewett expressed.
The example of the overflowing cup helps illustrate the strain. Think about the space a cup has. Each drop is a traumatic call. For decades, the culture was one of silence when it came to the topic of mental health. At some point, though, the cup overflows.
"To not get in too much detail ... but we had a car crash in the neighborhood that I lived in, the child transported was my son's age. He rode in the school bus with her, so that just brought it home, and I ran by this every day. It was my running route. It wasn't so much the call being there and working it. I'm a professional. There are certain things we do, and we do it. It was the coming home, seeing my own children, seeing my wife, kind of brought everything back to, like, 'Wow, things snap real fast, and that happened in my own community.' I'm already seeing enough of it at home, but to actually go to this call in my own town that I live in, it was really hard to process," Jewett said.
Jewett said it got to the point that he had witnessed and experienced so much trauma that he practically didn't know what to do. He said he was anxious all the time, aggressive, didn't sleep well, and had several panic attacks, among other things.
"I wasn't able to truly engage in what I was doing, which then alarmed me that this isn't safe," he said. "I'm not being safe to myself, to the guys I'm working with, because I'm disassociated with everything that's going on. My body is telling me that you've overloaded yourself, and that's when I decided to get help."
With no clear path in sight, Jewett ended up in the emergency room. He shared that after six months of not getting the right help, Jewett heard through his union that the Center of Excellence in Maryland, is an inpatient mental health facility just to assist firefighters with PTSD, trauma, and mental health struggles.
"With encouragement from my family, I went. What a great place. I found a place where I met people who were a lot like me," Jewett said.
Dr. Abby Morris is the medical director of the center. She said firefighters typically spend a month there.
"They want to feel better, and they want to go back to work, because to be a firefighter or dispatcher or EMT or paramedic is the world to them. That's what they know. That's who they are. That's what they want. That's their identity. And that's what brings them so much pleasure: serving their community," Morris said.
Gautreau has sent more than 10 of his own firefighters away to the center in Maryland and another mental health facility in Brattleboro, Vermont.
"And it can be up to a month, three months, six months of people being out. We've had people out for over a year," Gautreau said.
"It's so hard to teach people that on an airplane when they say if in the event of that pressure changes and an oxygen mask falls, that you have to put your own mask first. You can't help anybody else if you are not well, and that concept is so hard for them, that they feel if they are not well, they must have failed somehow," Morris said.
"And you'd hear things like, 'This is the job. You knew what you signed up for. Deal with it.' That's certainly changing, I think it's changing, because guys are talking about it," Jewett said.
Gautreau said with support from city officials and from their union (Portland Professional Firefighters AIFF Local 740), they all acted to find a way to professionally help his own locally.
"We've decided to move forward, and we've hired a mental health coordinator. That's Oliver. He comes with us with experience. He's a licensed professional. And he is solely dedicated just to the firefighters in Portland, and that's his only job," Gautreau said.
"Where we work on things like anxiety, depression, post-traumatic stress, substance use disorder, things like that," Oliver Bradeen, employee assistance program coordinator for the Portland Fire Department, said.
Bradeen was hired two years ago and has been so busy providing services, as more firefighters are recognizing it's OK to be open to counseling.
"Several people have been coming proactively which is an approach we are trying to take where people aren't waiting until they are having their worst day ever. They are coming kind of like, 'I'm not sure if I have to be here, but I just wanted to talk and make sure I'm doing OK.' And that's what we are trying to push. Let's not wait until it's a problem; let's try to keep you sort of as healthy and well as we can," Bradeen said.
To give you an example of just how much any department can accomplish with effort and a fraction of money, with approval from the union, the fire department has spent more than $300,000 in mental health efforts in the past two years after hiring Bradeen. That equals $150,000 per year, which for them is just 1 percent of their annual $30 million budget, which includes salary, rent, training, overtime, and administrative costs.
The Division Chief for Emergency Medical Services and Training, Sean Donaghue, said the department has seen more than an 80 percent drop in their members seeking out-of-state, in-patient assistance since Bradeen began working in the department.
"The program is successful because it is a system, not just one person in an office. PFD has had a robust peer support system for over a decade, which enables it to engage with the member's mental health actively and in an ongoing way," Donaghue said.
"Peers, both trained and informal, are the vanguard of mental health within the department. Oliver credits his success to the support of peers taking care of each other in the department and being able to encourage higher level care like visits with Oliver when the situation exceeds peer support capability," Donaghue said. "While the program is 100 percent confidential, clients of Oliver are free to share their own experiences with their peers, and many do as a way to encourage usage of the service."
Donaghue added other key components of the program:
- No insurance billing to see Oliver Bradeen
- No payment out of pocket for members
- Rapid access model: everyone gets in within two weeks of request, often within the same week
- Session times are dictated by treatment best practices and client needs, often 90 minutes, instead of the traditional "50-minute hour"
- EMDR has been incredibly successful for members (it's the Eye Movement Desensitization and Reprocessing there
- Success is seen in the use of the Acute Stress Adaptive Protocol (ASAP) for critical incidents
"This is something else that we are providing them as a resource so that they can get through their long career. Twenty-five years is a long time to see these types of emergencies," Gautreau said.
"You can't train too much for a job that can kill you. True? But if more guys are killing themselves then getting killed, are we really training in the right places?" Portland Fire Deputy Chief Kevin McGuire said.
Another resource implemented is mental health training and resiliency for the new firefighters joining the rescue team, which is taught by McGuire.
McGuire himself went to Maryland to the Center of Excellence after dealing with his own mental health struggles. Now he is teaching the topic and the importance of being open about it to the younger generations joining fire stations across Portland.
"A bunch of us were struggling and honestly got tired of having no help to go to, myself as well as a lot of members from this department. It doesn't have the stigma to it that you are weak or you are failing just because something is bothering you, and I really hope that's what we instill in these new guys so that as this continues on. That's just the new way we do things," Mcguire said.
Striving for happy, healthy employees as they continue to be asked to do a lot more than what's expected out in the streets.
"If we don't take care of them, we might as well be out of business," Gautreau said.
"I know for me admitting that I needed help meant, I feared I wouldn't be able to continue this job. I feared that I would lose part of my identity," Jewett said.
Jewett is back with the department full time, mentoring others who are struggling, visiting Bradeen, and has even been promoted to lieutenant in his unit, making sure his brothers and sisters are not masking their mental health challenges.
"I think that's been some of the things I want to do, is to help those who need someone to talk to, and I've gotten feedback from guys who have gone to Oliver. I think they are feeling that door is open at least with me that they can say, 'Hey, what do you think about this?' [or] 'I'm going to see Oliver. He wants to try this with me,'" Jewett said.
Bradeen helps them diffuse and debrief some of the most difficult 9-1-1 calls, sits with them to chat, and has private and confidential free sessions with any of the 220 uniformed firefighters.
Bradeen said he knows what he is doing matters because firefighters are getting better.
"I think it's a real privilege to have this position. I'm hopeful that there will be a movement of creating these types of positions in the state of Maine or nationally because there really needs to be a sense of trust built for the first responders, to come to a position like this, and so that's why it's slowly building," Bradeen said.
Gautreau said it's a needed move, after seeing so many firefighters struggling and preventing them from going out of state and being out of work for a long period of time.
"He's really the last piece of this comprehensive program that we've put together. We are like one of a handful of fire departments in the country that has their own dedicated mental health person. I am just so proud that we are kind of leading the charge here, not only in Maine but New England and the country," Gautreau said.
"It's OK. We are still good people. We are still good firefighters. We are still good EMTs," Jewett added.
And as cliche as it sounds, they're finding out they are not alone.
"I wish I had it. I totally wish I had this when I got hired. It would make me, probably, a different person. In my heart I know we are doing the right thing. I know we are," Gautreau said with joy.
Jewett has developed the self-love he lacked. And when this bell goes off signaling a call, he is one of the first ones to hop on this truck, now with the same excitement he did when he was just a kid.
"I love this job. I mean, there is something about it that I truly love doing. I do like helping people. I do like going to medical calls. I love going to a fire and making it stop before it ruins a home, and I'm passionate about it. And I came to the realization that it's about building resiliency, and it's about having the right mechanisms," Jewett said.
According to the Firefighter Behavioral Health Alliance, more firefighters die by suicide each year than in the line of duty. So another big goal is, of course, to avoid suicidal ideation or thoughts.
Gautreau said he's had other fire chiefs in Maine showing interest in mimicking their program. He said the fact that those conversations have started, is a huge step in the right direction, and that it comes down to money and the right support.
If you or someone you know is experiencing suicidal thoughts, there are resources right here in Maine that can help navigate through those thoughts and find a path to hope.
Maine Crisis Hotline: 1-888-568-1112
Maine teen text support
This peer support text line is for Maine youth 13 to 24 years old and is staffed by individuals 18 to 24. Talk about your feelings and get support from another young person. Daily from noon to 10 p.m. EST at 207-515-8398.