Behavioral Health and Wellness Program 2018

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The city of Goodyear is one of the fastest growing cities in the United States with a population of over 80,000 citizens. The city of Goodyear Fire Department employs over 100 employees, 93 of which are sworn. The Goodyear Fire Department is an "all-hazard" emergency response agency. Our members are trained and equipped to provide medical services, fire, hazardous materials mitigation, community education, and emergency management. The department participates in the Metro Phoenix Automatic Aid Regional Response System and deploys two paramedics assigned to each fire crew per shift. Clinical oversight is provided through the department along with a base hospital and an administrative medical director.

The behavioral needs of the Goodyear community is an ever-growing issue and represents one of our many challenges to the fire department’s response capability. However, over the last few years we have noticed an increase in behavioral health needs by the firefighters. The correlation between an increased number of behavioral crisis calls in the community and the increased number of Goodyear Firefighters exhibiting behavioral health problems cannot be ignored. During a 3 year analysis period, over ten percent of the department had been impacted by behavioral health issues that do not appear to trend in a specific causal category. Initial strategies to address these issues, including the implementation of a web based behavioral health program called Firestrong and the Employee Assistance Program did not have the desired results.

Command staff realizes this is a silent crisis. In addition to Firestrong, Goodyear Fire has a volunteer Chaplain who has been involved with command staff to address some of the behaviors observed by crews that appear to be unusual, including isolation, mood shifts and poor eating/sleeping habits. The command staff recently concluded that some of these individuals do not want to seek out the Chaplain because they think that the assistance offered will be religious in nature. While Firestrong has beneficial resources, we recognized that it is a stop gap solution; not a comprehensive solution. We also looked at the number of sick days used and the increased number of firefighters requesting leave due to stressful calls. If anything, the number of requests for information from firefighters to the Firestrong website was a clear illustration of the need for a behavioral assessment of the entire fire department.

On the opposite side of the spectrum, the city of Phoenix, which far surpasses the city of Goodyear in size and population, experienced four firefighter suicides within a seven month span in 2010. Phoenix created a Crisis Services Unit with programs to assist firefighters with the issues Goodyear is facing. Without the financial resources Phoenix has, Goodyear is unable to create that model. In consultation with the head of Crisis Services in Phoenix, it is clear that the fire department needs a better understanding of where to start in order to address these new issues. The long-term solution would be to identify the magnitude of the city’s needs and then provide sufficient resources.

For firefighters that needed weeks or months to deal with their total wellness, the department has to use overtime to ensure full staffing. Every year when the budget is developed, the overtime budget estimate is based on infrequent absences and known events. However, behavioral illnesses often results in long term absenteeism. The first type of overtime is Fair Labor Standards Act (FLSA) or scheduled OT, in which firefighters assigned to shift receive overtime pay (1.5/hour) for any hours worked over 106 hours in a pay period. The second type of overtime is Constant Staffing (CS) which is used to cover vacancies in a shift due to illness, injury, special event, or vacation. The Goodyear Fire Department budget for FY2015-16 was $1.8M. Overtime accounts for 15% of the personnel budget excluding FLSA or 18%, including FLSA. For the current fiscal year, the fire department has spent over half of their overtime in the first quarter of the fiscal year. The overtime spent to date accounts for both constant staffing and FLSA. In terms of constant staffing costs alone, not associated with FLSA, they have expended $1,200,000 or 64% of their budget to date. 

In 2016, the fire department put forward a plan to pilot an on-site behavioral health program which would provide training and site visits by a licensed mental health professional. We submitted a 2016 Assistance to Firefighters Grant application and were awarded $36,000 to pilot the program. We posted a solicitation for qualifications to meet the needs of the department and eventually the pilot program was awarded to Dr. Tania Glenn and Associates. During the pilot program Dr. Glenn agreed to be “on-site” with the department for a minimum of five weeks during the performance period of the project. Dr. Glenn agreed to provide stress resiliency training to all personnel in large group settings, train a peer support team and offer one on one clinical hours for those that voluntarily agreed to sign up for her services. The program had very positive feedback after the first week and continued to have positive feedback for the entire performance period. We had close to 40% of the department visit Dr. Glenn during the performance period and many reported that they felt much better after talking with her. We continue to stress the importance of the Employee Assistance Program, our Chaplain and the Firestrong program. At the end of the performance period, the department felt so strongly about the program that we sought permission from City Council to make this an on-going budget supported program. In 2017, the program was approved and supported by City Council and the City Manager and is now part of the fire department budget.

Since July 2017, Dr. Glenn has been visiting the fire department, 4-5 weeks per fiscal year. Dr. Glenn is also available by phone 24/7 during high stress incidents and she will typically triage the calls from the peer support team or the Fire Chief to better understand if she needs to be on-site for the employee. This played out during the December holidays when the crews went to a particularly disturbing call involving an infant. We quickly deployed the peer support team, however it was a couple weeks later when the peer support team realized that two crew members were displaying behaviors consistent with Post Traumatic Stress Disorder (PTSD). Dr. Glenn consulted with the Fire Chief and was brought on-site to deal with two crew members and both reported feeling much better after visiting with Dr. Glenn. We continue to build our stress resiliency through training and one on one clinical visits. Dr. Glenn is also working to continue to develop our peer support team, which has been deployed multiple times for high stress incidents. We are also working on developing a family support program, which will be operational at the end of the 2018 calendar. The idea for the family support program is that they could be voluntarily activated after high stress incidents to ensure that the employee and their family have the mental health support that they need.

The Goodyear Fire Department has an exceptional tradition of delivering outstanding customer service. Some of the most talented individuals in the fire service work here. Members of the department spend hundreds of hours every year learning the latest response technology and honing their technical skills in training sessions. It is our obligation to seek out the most appropriate resources to help our coworkers cope with the traumas and stressors that are part of the work they do every day to ensure they can respond to the needs of our citizens in a professional and expeditious manner. Every member of this department is dedicated to service. If they need additional support to continue their mission, the City is committed to getting it for them.