Therapist Jessica Janus, right, in full firefighter gear, works the Jaws of Life on a training excersise to extricate a victim at the N.H. Fire Academy where clinicians had an opportunity to build cultural competence of fireground operations on Thursday.

Therapist Haley Davenport, left, works with Fire Academy instructor Kayleigh Eastman on a child dummy as therapist Danielle LaPlante does compression where clinicians get an opportunity to build cultural competence of fireground operations.

Therapist Jessica Janus, right, in full firefighter gear, works the Jaws of Life on a training excersise to extricate a victim at the N.H. Fire Academy where clinicians had an opportunity to build cultural competence of fireground operations on Thursday.

Therapist Haley Davenport, left, works with Fire Academy instructor Kayleigh Eastman on a child dummy as therapist Danielle LaPlante does compression where clinicians get an opportunity to build cultural competence of fireground operations.

Scott Robinson was a firefighter in Rhode Island when the Station Nightclub caught fire in 2003, killing 100 people in a matter of minutes.

The fire was caused by pyrotechnics that were set off while the band Great White was performing its first song. Within minutes, the entire venue was engulfed with thick, black smoke and entrances were blocked as people climbed on top of one another, trying to escape, suffocating and burning to death.

After the fire was put out, Robinson spent 5 hours removing melted and mutilated bodies from inside the building while friends and families droned in the background.

“I had anger problems after the fire because why did we stay so long? Why were we never relieved? Why did I have to pull five to seven bodies before I got to go back to the station?” Robinson said. “The answer was that they knew I’d be screwed up and they didn’t wanna screw anybody else up.”

Bottling up what would later be diagnosed as post-traumatic stress disorder, Robinson and his then-wife sought a therapist in 2006, three years after the fire, for marriage counseling.

“That was the first time I talked about the incident and what I experienced on the fire ground during those recoveries,” Robinson said. “By the time I was done, the therapist was crying and my wife was crying and I realized at that point that I had to put my gear back on and never share this with someone who was unable to hear it.”

As a result of that session, Robinson approached the firefighters union to create an assistance program that would train and educate clinicians and therapists on how to work with and respond to the behavioral and mental health of first responders. He later became a member of the International Association of Fire Fighters (IAFF) Behavioral Health Program.

“It’s been a passion of mine since 2006 to find clinicians that understand what we go through so we don’t feel like we have to protect the clinicians and find someone else to talk to,” Robinson said. “We see things that normal people aren’t supposed to see and I wanted to find someone that could help us [firefighters].”

The program was brought to the state of New Hampshire with the help of Justin Cutting, director of the N.H. Division of the Fire Standards and Training and Emergency Medical Services, after a colleague notified him of the IAFF program. After months of collaborating, a beta-test program was created and tested in Concord this week.

If the results are good, the program will be offered to fire services throughout the country.

“Over the last six months to a year, we’ve been discussing ways we can add value and improve the mental health for firefighters and EMS providers across the state,” Cutting said. “We are very proud to have partnered with them and host them as they deliver their program.”

On Thursday, nearly 15 years after Robinson approached the union with his idea, around 70 clinicians and fire personnel joined him at the N.H. Fire Academy in Concord this week where clinicians were led by fire personnel through four common simulations to help clinicians understand the type of stress, anxiety and pressure fire personnel endure on the job.

This week’s training was the first time this program was delivered in the country.

“There are unique considerations and special trainings that clinicians can benefit from when working with this population that copes with a lot of trauma and occupational stress,” said Candice Alizio, executive clinical director for Forge VFR, a program dedicated to assisting veterans and first responders. “We are hoping this gives clinicians a better idea of what it’s like to work in this occupation and more effective treatment and a better therapeutic alliance between firefighters and clinicians.”

“This is a resiliency-eroding profession and every time I go onto the fire ground, it eats away at my resiliency and it causes trauma to imprint faster [on me] than a civilian,” Robinson said. “They’ll [clinicians] see how heavy the gear is, what it’s like to walk on crushed stone and work over boulders, dig into a motor vehicle wreckage and how all of that impacts behavioral health.”

Clinicians and fire personnel were broken up into four groups and rotated through four different scenarios they might see in the field. The first scenario involved extricating a “person” from a motor vehicle wreckage.

“There was loud popping and glass shattering and those tools [Jaws of Life] are about 60 pounds each and I had no idea,” said Emily Barton, a licensed clinician. “My heart was racing, I was sweating. There was a lot of loud noise and they’re letting us know that there might be parents or loved ones watching in the background.”

The experience, she said, gave her a better understanding and more perspective into what firefighters experience and how clinicians can better serve them with this knowledge.

The second simulation involved an unresponsive 5-year-old “boy” in cardiac arrest that clinicians had to stabilize and perform CPR on ahead of transport to the hospital. The stabilization included clearing their airway.

“I have a small child of my own and it was anxiety-provoking to come upon a little kid,” said Danielle LaPlant, a licensed therapist. “This scenario was really interesting because we come in as a therapist and we want to be there as a support and this was support in a different way by getting into it and trying to save a life. It was very physical.”

LaPlant’s husband is a firefighter and, she said, this gave her more perspective into what he might endure daily and how it could impact him.

“When it’s a child and parents are screaming over you, ‘We can drive our kid to the hospital faster than this!’, we’re going to feel like we aren’t taking care of the kid or we aren’t doing the right thing.”

The third simulation asked clinicians to blindfold themselves and cover their faces with a mask before entering a pitch black, smoke-filled room where they were then asked to locate a body and remove it from the building.

“We couldn’t see anything, which was scary, but then we kind of had to make our way through a completely dark room and communicate with each other, find the victim and drag them as far as we could,” Alizio said. “It was pretty intense but it was a really amazing experience; it gives us the ability to empathize a little bit more.”

In the fourth and final scenario, clinicians and fire personnel worked together to put out a small fire in a building that was ignited and controlled by propane.

Agreeing that the scenarios gave them a better understanding of the constant stress, trauma and anxiety fire personnel are under while performing the job, the clinicians noted they were eager to take what they learned, apply it to their professional lives and further help EMS and firefighters.

“The more education we can give them to help them understand us and that we’re a little different, the better they can work with us,” said Bill Crews, a firefighter from Texas and member of the International Association of Firefighters Behavioral Health Program. “I’ve had 32 years in firefighting and I started in an era where we didn’t talk about behavioral health or things that bothered us. Now we are seeing men and women reaching out that wouldn’t have before.”

This article is being shared by a partner in The Granite State News Collaborative. For more information visit collaborativenh.org.

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