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Sponsored Content by the First Responder Behavioral Health Institute
By: Robert Avsec, Executive Fire Officer
When I retired from the Chesterfield (Va.) Fire and EMS Department as a battalion chief/paramedic in December 2007, neither firefighter cancer nor firefighter mental health were on the fire service’s “radar.” In the ensuing 17 years cancer became a recognized hazard in the early 2000s, and much work has gone into informing and educating firefighters about their increased risk, along with policies and procedures for reducing that risk.
The mental and behavioral health risks for firefighters began to gain recognition with the publication of studies in the late 1990s and early 2000s that highlighted the psychological impact of firefighting, including higher rates of PTSD, depression, and suicide among firefighters compared to the general population. Though happening at relatively the same time, the development of strategies and programs to aid firefighters with their mental health issues has lagged behind that for firefighter cancer. In this article, we’ll look at one program that’s having a positive impact on closing that gap.
Introduction
The First Responder Behavioral Health Institute (FRBHI) is a pioneering organization dedicated to addressing the mental health needs of first responders. Established in 2022 by Joseph Brigandi, a retired fire captain/paramedic who became a licensed professional counselor and psychotherapistat the Counseling Center of Texas, FRBHI aims to provide education, training, and support to ensure the psychological well-being of first responders, be they law enforcement officers, firefighters, or EMS personnel. Today, Brigandi serves as the Clinical Program Director for FRBHI.
Why First Responders Need FRBHI
First responders, including police officers, firefighters, and EMS personnel, face unique and often traumatic challenges in the line of duty. Cumulative stress and exposure to critical incidents can lead to a variety of mental health issues such as PTSD, depression, anxiety, and suicide. Unfortunately, too many first responders do not receive adequate mental health support, resulting in poor job performance, increased absences from the job, family strife at home, leaving the job entirely, or in worst case scenarios, taking their own life.
For those first responders who do seek professional help with a mental health issue (e.g., through their EAP or private practice) there’s a lack of mental health professionals who understand the unique cultures of law enforcement, fire departments, and EMS agencies. This can lead to frustration for the individual and cause them to avoid further assistance. It can also lead to the individual sharing their frustrations with their colleagues, “Don’t bother with them because they don’t understand us.”
Mission and Vision
FRBHI’s mission is to develop a common platform worldwide to facilitate open dialog, discussion, research, and education into behavioral health from the first responder perspective. The institute aims to create a comprehensive program leading to certification as a Behavioral Health First Responder, providing continuing education and tailored training programs.
Programs and Services
In a short four years, FRBHI has grown into an organization that offers a range of programs and services specifically designed to support first responders. These include but are not limited to:
- Providing Critical Incident Stress Debriefings (CISD) that give immediate support to first responders following traumatic incidents.
- Delivering education and training with course offerings on resilience, stress management, and mental health first aid.
- Collaborating with agencies and governments to develop workplace standards and mental health leave policies.
- Conducting research to improve workplace environments and advocating for meaningful evidence-based standards of care.
Success Stories
The following two stories highlight the positive impact FRBHI’s programs can have on first responders, helping them navigate the mental health challenges associated with their demanding roles.
Success Story 1: Critical Incident Stress Debriefing
A fire department in Texas faced a devastating wildfire that resulted in significant loss of property and emotional trauma for the firefighters involved. FRBHI provided immediate Critical Incident Stress Debriefings (CISD) to the members of that department, helping them to process the traumatic event and offering coping strategies. The debriefings were instrumental in preventing long-term psychological issues, and the firefighters reported feeling more supported and resilient in the aftermath.
Success Story 2: Resilience Training Program
A police department in Texas implemented FRBHI’s resilience training program for its officers. The program focused on stress management, mindfulness, and mental health first aid. As a result, officers reported a significant decrease in stress levels and an increase in job satisfaction. The department also saw a reduction in absenteeism and an improvement in overall mental well-being among its personnel.
Impact and Importance
The establishment of FRBHI was a crucial step in addressing the mental health crisis among first responders. By providing specialized training and support, the institute helps to reduce the stigma associated with mental health issues and encourages first responders to seek help when needed. This, in turn, leads to healthier, more resilient individuals who are better equipped to serve their communities.
The path to FRBHI began in 2015. “FRBHI is an outgrowth of my duties as an EMS Captain, EMS Coordinator, and Crisis Response Team leader for a fire department in Texas,” said Brigandi.
According to Brigandi, “It was the first fire department in Collin County Texas to have a clinically directed crisis response and peer support team for first responders. It eventually became The Counseling Center of Texas Crisis Response Team. Subsequently, in 2022 we moved the Crisis Response team to FRBHI. Today, FRBHI has dozens of first responder instructors who are also licensed in some behavioral health discipline.”
“I’ve been a training officer for many years,” said Brigandi, “And many of the available courses you see now on our website now are programs that I began writing while still in the fire service years ago.”
Once Brigandi received his counseling licenses, he moved over to the Clinical Director role for that team for another five years. “We went from serving two counties to providing mutual aid responses for over a dozen police and fire departments statewide in Texas,” said Brigandi. “When I left public service, and went into private practice, the team found itself without a qualified leader.”
Brigandi credits the fire department that supported him in taking the crisis response team with him. “We had more of a statewide mutual aid responses in so many cities other than our own,” Brigandi said. The team has grown into a multistate network with dozens of mental health clinicians in four states—Texas, Washington, Oregon, and California—working in collaboration with the primary response team during multistate critical incidents and emergencies across the region.
FRBHI has two ER doctors who teach for the institute and advise the institute’s staff. “We have a Medical Director over the crisis response team,” said Brigandi. “We also have nine Ph.Ds. on faculty and eleven clinical mental health therapists on the faculty as well.”
For those desiring to work for FRBHI, you must be a first responder, a mental health clinician, or a first responder clinician. “We are a platform to bring together a common voice among experts in the field and a place to take some amazing course offerings with experts in the field,” said Brigandi. And if you should decide to commit to FRBHI, you can get certified as a behavioral health first responder or clinical responder, or both, once you have over three years with FRBHI and 600 hours of coursework.”
Brigandi, who’s taught college courses for years, along with training programs for first responders and therapists, was moved in 2020 to found FRBHI and the First Responder Behavioral Health Foundation (FRBHF) in 2022.
