Road to Mental Readiness

Metro Fire Chiefs Conference May 2, 2015

The Need• 7% of adult Canadians have been diagnosed

with a mental illness• 6% are experiencing symptoms but have not

been diagnosed(Lim, K.L., Jacobs, P., Ohinmaa, A. et al., 2008)

• in any given year, 1 in 5 Canadians experiences a mental health or addiction problem

(Centre for Addiction and Mental Health)

The Need

First Responders

Israeli study of active firefighters:

• 24% showed full PTSD• 67% showed partial symptoms• 9% showed no symptoms

(Science Daily, 2012)

First Responders

American Study:Protective services workers exposed to multiple traumatic events are at increased risk of developing new mental disorders, especially in the early stages of their careers.

(Kaufman, Rutkow, Spira & Mojtabi, 2013)

First Responder Suicide

Canada:• April – Dec. 2014 – 27 first responders• Jan. – March 2015 – 6 first responders

(Tema Conter Memorial Trust)

United States:• 2014 – 103 firefighters• Jan. – March 2015 – 23 firefighters

(Firefighter Behavioral Alliance, 2015)

Canadian survey:

• 54% of employees said that disclosing their mental illness to management would jeopardize their chances for promotion

• 26% of employees felt that their supervisor effectively manages mental health issues

(Conference Board of Canada, 2011)

Perceptions of Mental Illness

Ontario survey:

• 39% of workers said that they would not tell their managers if they were experiencing a mental health problem

• 64% of workers would be concerned about how work would be affected if a colleague had a mental illness

(Dewa, 2014)

Perceptions of Mental Illness

Financial Cost

• Estimated cost of lost labour-market participation due to poor mental health in the workplace: $20.7 billion.

(Conference Board of Canada, 2012)

• Mental illness is second-leading cause of short-term disability ($18,000 per leave), double the average cost of all other causes.

(Dewa, Chau & Dermer, 2010)

• annually 3% of workers are on short-term disability related to mental illness

(Dewa, 2014)

• 2020 - expected that mental illness will be the second-leading cause of all disability globally (after heart disease)

(World Health Organization, 2001)

Financial Cost

• Post-incident (Peer Support, CISM)

• Diakonos Workshops for Couples (through Local 255)

• Missing: tool to build resiliency skills across career path

Calgary Fire Department Resources

• Developed by Canadian Forces to increase resiliency and mental health of soldiers

• Adapted by Mental Health Commission of Canada and New Brunswick RCMP for police services

• CFD first to adapt for fire service

Road to Mental Readiness

Objectives - Frontline

• Improve short-term performance and

long-term mental health outcomes

• Reduce stigma and other barriers and encourage early access to help

Objectives - Leadership

• Provide tools/resources to manage and support employees who may be experiencing a mental health problem or illness

• Assist supervisors in maintaining their own mental health and promote positive mental health in their employees

Main Components

• Anti-stigma

• Skills development:• goal setting • mental rehearsal (visualization) • positive self-talk • tactical (diaphragmatic) breathing

• Mental Health Continuum

Mental Health Continuum Model

HEALTHY REACTING INJURED ILL

Good Mental healthNormal functioning

Common, self-limiting distress

More severe and persistent functional

impairment

Diagnosable mental illness

Severe and persistent functional

impairment

Adapted from the US Marine Corps.

Mental Health Continuum Model

HEALTHY REACTING INJURED ILL

Normal mood fluctuationsCalm/confidentGood sense of humour

Taking things in strideIn control mentallyCan concentrate/focus

Normal sleep patterns Few sleep difficultiesPhysically wellFeeling energeticMaintaining a stable weight

Physically and socially activePerforming wellNo/limited alcohol use/ gambling

Irritable/ImpatientNervousSadness/Overwhelmed

Displaced sarcasmDistracted/lose focusIntrusive thoughts

Trouble sleepingLack of energyChanges in eating patternsSome weight gain or loss

Decreased activity/socializingProcrastinationRegular but controlled alcohol use/gambling

AngerAnxietyPervasively sad/Hopeless

Negative attitudeRecurrent intrusive thoughtsConstantly distracted Can’t focus on tasks

Restless disturbed sleepSome tiredness/fatigueFluctuations in weight

AvoidanceTardinessDecreased performanceIncreased alcohol use/ gambling – hard to control

Easily enraged/aggressionExcessive anxiety/panic attacksDepressed mood/ numb

Non compliantCannot concentrateLoss of memory/cognitive abilitySuicidal thoughts/intent

Can’t fall asleep or stay asleepSleeping too much or too littlePhysical illnessesConstant fatigue/exhaustionExtreme weight loss or gain

WithdrawalAbsenteeismCan’t perform duties/tasksAlcohol or gambling addictionOther addictions

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Delivery Model

• In-class group program

• Wallet cards (Mental Health Continuum)

• Aide Memoire

Three Versions of R2MR

Primary– for everyone - 4 hours

Leadership– supervisors – 8 hours

Train-the-Trainer – 5 days

Evaluation

• Initial evaluation by MHCC using questionnaires (immediate pre- and post-session and 3-month follow-up)

• Long-term tracking using CFD Wellness data

CFD Timeline

2015 Q1/Q2 • adaptation of course materials• engagement of leadership, peer support team• beginning messaging to the floor

2015 Q2• initial testing• training the trainers • continued engagement and communication

CFD Timeline

2015 Q3/4• pilot and evaluation of program• ongoing communication

2016 Q1• additional revisions

2016 Q2• beginning of full roll-out

Questions?