Episode 31 - James Boomhower on the State of Mental Heath Care for First Responders
James Boomhower, MS(c), FP-C, NR-P, C- NPT, CCISM is a critical care paramedic in Massachusetts and founder of Stay Fit 4 Duty, an organization that provides resources and training to healthcare providers and first responders. In this conversation, James discusses many aspects of mental health support for first responders, including the need to transition from term "culturally competent" to the more inclusive, "culturally informed", the challenge to provide services to retired first responders, employee assistance programs (EAP), critical incident stress management (CISM), peer support, and the difference between your identity and your profession.
James also discusses his upcoming webinar, "PTSD in the Fire Service: Signs and Solutions", hosted by Ventura Fire Foundation.
Transcript
Peter
Welcome to the Firehouse Roundtable podcast, brought to you by the Ventura Fire Foundation. I'm one of your hosts. Peter McKenzie, retired fire captain with the city of Ventura Fire Department and my co-host Jason Kay, Active Battalion Chief with the City of Ventura. Fire department. We are going to bring awareness to real issues that face firefighters and their families. We want you to feel like you have a seat at the kitchen table, which every firefighter knows is the heart of the Firehouse. Let's get right into the episode. All right, welcome. To another episode today we have James Boomhauer. James, welcome to the show.
James
Hey, thank you very much for having. Me, I appreciate it.
Peter
I was going to talk a little bit about. Your bio and I'm looking. At your your what you. Do and I'm like, oh, I'm. Going to mess that. One up, sure. So. You introduce yourself to our listeners and.
Jason
The first time it was like a deep sigh, maybe lost for words. That was good. Peter, just let let James take it over and tell.
Peter
Yeah, yeah, I would have botched it because I.
Jason
Us how so?
Peter
Was like critical care. And then I know the fit for duty and I got. Oh, forget it. Let, let's let. Him say it.
James
Appreciate it. No, no worries at all. So my, my. Formal medical title. Is a critical care transport specialist paramedic that's with Boston Medflight up here in Boston. I am also the founder of a mental health and Suicide awareness program called Stay. Fit for duty.
Peter
Awesome. Awesome. So we want to hear about all that. Obviously, we focus a lot on mental health and you know it's it's it's a pressing issue in the fire service or not just fire service. The whole first responder community and I understand you know I want to know how what, what motivates you to start the nonprofit kind of tell us what your story is. And you came highly recommended to us from. Some previous guests, and so we're excited to have you think it was a couple of people that were like, no, you need to have James on the the podcast. So so your.
Speaker
Ohh hey. I'll take that.
Peter
Here and I want to hear. Let's hear your story. Let's let's get into it. So take it. You take it from. Wherever you you want to take it.
James
That is, that is flattering at the final stop. I I hope I do it justice. Let me start with a piece in the tax man state, for for duty is. Not yet a. Nonprofit it is in the process of becoming a nonprofit, just in case that the tax man. Here's the here's the podcast. Right? But we're we're making it happen. So just a little bit about background. I've been a paramedic for just shy. I've been in EMS for just. 20 years and a paramedic for about 16 of those with 9 going on, 10 of them being in the critical care. Transport world I've. Done. Every facet of emergency medical services you. Can do I? Worked alongside police and attacked the paramedic realm. I've done municipal, I've done fire base. Done. Critical care. I've done. Fly car you have. A branch of EMS.
Speaker
I've done it.
James
And the stories are so similar, whether it's Firehouse, whether you're in a hangar, whether you're doing like concierge paramedicine just the need for not only mental health, but culturally informed mental health and mental health with the tune. Of recognizing what we do right and I I work really hard to ensure that that line is drawn at whoever helps somebody else at 3:00 in. Warning, right? It doesn't have to be just fire base doesn't have to be just. EMS doesn't have to be specific to law enforcement, right? Those those. Extra bits are. Really important, but if we say OK have you? Ever walked into someone else's home at. 3:00 in the morning to render. Aid then beautiful. You're. On this side of the line. If you haven't, you're on this side. Of the line. Just to best understand the world. You and how we all interact day-to-day and give a real sense of awareness and camaraderie when I can say I've been in your shoes and I have training to help you and you know I can point you in the direction of mental health. Services or I? Can give you those mental health services myself. So when we talk about the need for the culturally informed mental health provider, I realized that there were a few out there for sure. And there are some doing fantastic work, but that I could be one of them. I've done a ton of work in the peer support space. I've done a ton of work in the. Critical incident stress management space. I am a critical incident stress management. Instructor and I thought that was. All really impactful and. Really helpful to help. Our brothers and sisters in this space, but over the last two years, I have nearly completed my Masters in clinical psychology and AM now in my internship as a counselor so I can not only work to help my boots on the ground as it. My my professional colleagues in the medical and first response space I can take on that next level as a counselor and I can work people with some of those. Individuals and what? I really think is just as important is now. That I am. In a space where I am becoming a counselor and have the metaphorical St. cred, as it were, to sit in the space. And to do the things. I can help create more culturally informed therapists. I can be that perfect bridge. Of the guy. That's done the job for 20 years, and the guy that knows all the verbiage, at least most of the verbiage read, I'm almost done the school and can really articulate. The questions that fellow mental health professionals have, and what can they say to a fledgling month off professional that they might not have the comfortability or access to ask, certainly couldn't ask. One of their. Clients, but how can we? Help build that. Bridge and create more culturally informed councillors without. Mandating that they have a 20. Year history in the first response sector.
Peter
Gotcha. What so going through all the training on the mental health side and the professional training to you know with? The Masters degree and Psycho. You know that. What can you tell the people that are on the that are on our side where you came from? Like what? What about going through all that training was unique or did did you have any aha moments or was there anything because I think people in general aren't like super fond of psychiatrists and therapists. Right? Like, which is normal, right? Especially with the whole culturally competent thing is reducing that.
Speaker
Yeah, yeah.
Peter
That having gone through. That what's your opinion? Now that you've you've seen the the inner workings of both? Groups. Maybe. Maybe that's your question.
James
Totally. I think the profession as a whole is. Really working to change. Image right, like the the era. Of me sitting on a chair that's thin feet above you and you on a tiny little couch, things like that. There's a there's a component of that in the space, but really it's just two humans communicating with and working with one. Another and I think I. Unintentionally, one of the things that we've done on the first responders. Out of the coin, as we've put culturally competent on a pedestal, right, and you can really overanalyze that to death like sure, he's been a paramedic for 20 years, but he was never deployed. So we can't work with veterans. Oh, well, he was never a Sergeant in the police force. So he can't work with law enforcement. When if we really zoom out and say, what do we need and how can we create individuals that are aware of that within the mental health industry? We're changing the terminology of competent to informed. We're changing the definition of informed to curious. My own personal therapist is. Not an EMT, paramedic Leo. But they were one of the group of crisis responders that showed up at 9:11 and that alone, that desire to help those first responders without a ton of first response acumen under her belt was really a big push for me to give her a try, for lack of a better term and just the awareness from. A first responder sector of. I can point you to a bunch of people that might not know the difference between an EMT and a paramedic, and may not know what inch holes you're supposed to roll out at XYZ Fire, but really care about the population and really want to help the population. And I think that that's something that we should really pay more credit to those people working. Really hard to provide good care specific to us.
Peter
So maybe we're being too narrow, like we're we're putting all these guardrails on and probably excluding maybe some good people that can do some good work is.
James
Yeah, I think I think we need.
Peter
That kind of where you're going.
James
To widen our lens just a little bit and I know it's ironic, I'm going to shoot myself. In the foot here. Before I even get licensed, but I I think we went from we'll take anybody that will listen to us for five. Minutes and that's. Not good either to. You have to have a career in law enforcement. You have to do this. You have to do that or we can't trust you. There's. A beautiful middle ground somewhere in between, and I'm working really hard to. Help create what that looks like.
Peter
What made you want to become a? A therapist or a psychiatrist.
James
Perfect. Yeah, absolutely. I'll start there for sure. So a counselor or a therapist has a masters degree level of education. A psychologist holds a doctorate. A psychiatrist is a medical doctor or doctor of osteopathy, right? So some formulation of of medical physician. Who is studied in the field of psychiatry? I'm going to start as a therapist or counselor. Those those two terms are essentially used interchangeably and then. I will eventually. Go and obtain my doctorate so I will become a psychologist once it's all said and done.
Peter
Gotcha. Thanks for clarifying. Of course not. My pleasure. So what made you? What? What made you do this? Why did you want to go back to school and do this? Was it was there some sort of personal experience? Was there need you? Saw like what kind of motivated you to to go down this?
James
Tremendous self loathing and too much money in my bank account, I said I got to get rid of both of these things. I have way too much time on my hands. No, I am, as I mentioned, I did some work in the peer support space. I helped to create my agencies peer support team. I've subsequently and stay for duty has helped create a number of other peer support teams. In the first response sector, I truly love the idea up here support and think that peer support is an invaluable metric within the mental health and Wellness of the 1st. Responder it's also. Really important in times of crisis and it's like logical distress and it's it's a phenomenal tool that will never be underutilized. However, there's a cap to it, right? There's just a point where you you can only go so far. It's in the name, right, like as a peer. Supporter I can only. Get so far and. I really wanted to not only be in a position where I could oversee those peer teams with more legitimacy. But I really wanted to. Have that knowledge and do that deeper work. A singular mental health professional.
Peter
Gotcha. Gotcha. That makes sense. Yeah. I think sometimes people get curious about something and they just keep going down the rabbit hole and eventually, I mean, you're gonna you work yourself into a. Total another career which? Is, which is doesn't.
Speaker
That's it.
Peter
Do you see yourself leaving the EMS side and? Just doing the the the therapy side or? You going to continue to do both?
James
I I'd like to continue to do both for as long as my back and my brain will let me. I really, truly enjoy the work that I do on the critical care front, and I am blessed to work with world class clinicians and world class equipment and do really good work for the. People of New England. And I still truly love the job that I do. I'm also rounding 40, so I consider myself young ish in the profession. But someday I will absolutely hang up the the helmet, as it were, and put the stuff stripped down and and go full time into the mental health space. But. For now I I not. Only enjoy living. In both spaces as occasionally exhausting as it can be, but I think it still gives me a tremendous amount of validity with my peers, right? It's like, oh, no, I saw this dude on. A hook up yesterday. He still very much living both worlds and I think that gives. Me a ton of credibility.
Peter
Yeah. Awesome. Awesome.
Jason
You said you're currently a critical care paramedic, right?
James
Correct. Yep.
Jason
OK, So what does that mean in in the West Coast verbiage? Are you on an ambulance? Are. You in a hospital? What? Are what are you doing right now?
James
Awesome question. So that part of the reason the title is. So long because they didn't know what to make us. Boston Medflight operates 3 vehicles. We have our own ambulances to do ground critical care transport. We have our own helicopters to do air medical transport and we have our own fixed wing to do long distance. Traditionally less acuity but longer distance so that the entire. Verbiage of that. Sentence pays homage to the fact that we're not. Flying medics. We're not ground medic. Where or some derivation of the two, but we're always providing, or at least able to provide critical care and ICU level care medicine.
Jason
So you do currently you're kind of, I don't want to say on call, but you could get any one of those assignments any day of the week or how that works?
James
Correct. So so our our assignments are are 12 hour shifts and in a perfect world we're assigned, James is going to be on the helicopter in Bedford today. But if we're down to the weather and there's an EMT that can get us going on the ambulance, we'll hop in the ambulance. And do that so. As many of. Us can appreciate, we'll call it a fluid situation. When you're when you're on duty, but we are limited to to standard 12 hour shifts unless we're doing like an overnight transport in the fixing otherwise it's. Just 12 hour shifts from.
Jason
OK, another thing that popped my curiosity was you said you originally were CISM instructor, right?
Speaker
Yeah. Yep.
Jason
So I feel like CISM kind of evolved into peer support. Is that where you guys are? At too and and. Do you now have more peer support teams? Do they fall under CISM or how's that work?
James
So best in the fields team is a combination team. They have international critical incident, Stress foundation training. So. They are proper. Critical incident stress management and when needed can deploy critical incident stress the briefings. But a vast majority of the work we do is peer support. It's one on ones it's body checks. It is. It is much less formal. Diffusing the briefings, things of. That nature and much more of. Your support all of the teams that I had. Train fit that model as well. I think what some of us have found and and I don't want to speak for for too wide a stretch, but the the benefit of like peer support ending and then another team and polo shirts coming in to provide like the formal diffusing and the briefings I think is where some of the disconnect occurs so as. As many of our colleagues in the. Test too, we. Found like let's. Train you here. Let's get you prepared to. Do all of the things. And then if you only need to do this much, it's much less kind of this congruence when there's an. Issue One Direction or another. Because with the exception of a large event where we would also be affected as team members, it keeps it very in in the same space and working with those same people.
Jason
That's interesting you. Say that I I feel like that's kind of what we're doing as well to where we have professional therapists or psychologists that are coming to some of our quote UN quote peer support. Post incident debriefings but nobody talks about CSM anymore because they're afraid to go back to that term because originally it was so negative and it was, it was thought of as such. Just a waste of time with people who can't relate, which kind of brings me to the next thing when you're talking about culturally informed clinicians.
James
Yeah, yeah.
Jason
I feel like culturally competent was the gold standard, like less than a year ago, and now I'm seeing multiple people say just get away from that and get to this new verbiage which makes people maybe more more comfortable or more available. Different different clinicians can be more available for that and it it was just a a thought. That that's kind of. What I hear now and kind of. Where we're headed.
James
I I agree. With you, I think we we turned on a dime on that. I think the problem with culturally competent is there is a paramedic somewhere that doesn't think that I'm competent in their level of paramedicine. Right. Well, with no, you know swinging. You know what contest like, I think my CV shows that I'm a pretty good paramedic and could probably go toe. To toe with any other paramedic. By changing that to culturally informed, we widen that door and we say you don't need to have all the ribbons you haven't need to do 2 tours in Schenectady, NY, right? You could just. Be someone who's knowledgeable about the profession and works within that space.
Peter
Was there a shortage? Was that what was the problem? That there wasn't enough of these culturally competent people, or was that not?
James
You know, I and Jason can absolutely speak on the West Coast. I think on the East Coast, there were two things. There were individuals that had never been a paramedic, EMT, firefighter, what have you that felt competent in the space because they'd worked with this profession for 20 years, right. And and had really strong acting in there, but suddenly didn't feel like they could. That per say it and then you just had individuals that were just confused as to the provider they. They're getting because they just didn't know what his competency mean to you versus me. And by by changing that terminology to informed or just also allowing the dialogue to be a little smoother. Right. So you're aware of first responders you've worked with first responders rather than you've had to have been a first responder.
Jason
So do you. Have a group that that you specifically are a part of or are going to be a part of like we have. We have groups that we can reach out to. Is there a group of clinicians that you guys go to and if so, how is it that you now decide because we don't use this culturally competent purpose anymore? How is it that you decide if they're kind of able to be a part of the group to to make people comfortable who are still in the roles?
James
Totally, there is no formalized group in our neck of the woods. For example, like the first responders counseling certification right there, there's well, some individuals have taken that credential that hasn't necessarily materialized out east in the sense of like, here's our gaggle of culturally informed clinicians. I think it's really a very elaborate foam tree that I'm honored to to start to be on. We're well informed group and I think it doesn't take more than a couple of phone calls like Oh yeah, Bob's ID out in, you know, W Natick and he was in the military or he did do this or he did do that. So as far as the inclusion, exclusion criteria.
Speaker
There because there really.
James
Isn't a formalized group to be. A part of I. Don't think we have too much of that.
Jason
OK, so if there's, say, a fire department or or just because that's what we're talking about here with us and there's a, there's a call where somebody feels like, hey, we should probably get a clinician involved here or a therapist involved here. How in your neck of the woods would they go about the phone tree? And then who would they know who to get besides just word of mouth?
James
Fair. So in our neck of the woods as as the head of the peer support team, I would give them two lists I would give. Them our employee assistance program. And before everyone recoils, these are clinicians that we've already vetted to have proven to be culturally informed. So of the totality of the EAP counselor you could get. We've given you this much more narrowed down list. We also have a team psychologist who operates in our neck of the woods as that mainstay. And this is the the person who we go to when we need a clinician in our. Friend and additionally, we have probably four or five other individuals that are not formally part of our peer support team in any way shape or form, but have made themselves known on the cultural competence side of the coin. So Jason the the shortest answer would be I would help that provider kind of navigate that process and not align them with one. Of those professionals.
Jason
So you said that you have informed clinicians on your EAP that I'm just impressed. By that because.
James
Let me tell you that.
Jason
That's far from where we are out here.
James
That was what I'll say to to be kind to all involved are that made a very big spreadsheet, a very small spreadsheet. And there's a ton of pushback from the EAP itself. Who are you? Why do you want this? How dare you accuse our clinicians of not being the specialists, right? I I completely understand, especially now. As a counselor, I understand the reflexive pushback of that, but it was it was really telling to say. I don't know. We need people who identify in this space. Are they trauma informed? Have they worked with first responders? So they have a background in this. Industry and as I mentioned. It really, really narrowed the. But Jason is your .1 of the biggest things I learned from. It is you. Can do that. You're paying the AP. Maybe not you personally, right? But like as as leadership goes up, you're paying your employee assistance programs, a healthy sum of money to provide assistance for your employees, right. You are absolutely the consumer. And you absolutely have the right to at a minimum. Ask the question. And if anybody wants that like. Template that we use to start. That dialogue I'll send. It your way I have no problem with that, but I think it's important to remember that not only can you ask the leadership of the AP to say, hey this still this let's down. For me, listen to your providers and this is a huge cultural shift, right? It it involves. Talking a little bit about your experience. EAP and a friendly reminder that none. Of your employees have to if they don't want to, right?
Speaker 4
I don't want to.
James
Blur the lines of. Confidentiality. But if one of your guys comes back and said man, that's Doctor Bob was stellar. Make note right, like talk, talk to your AP. See how you can better incorporate that person into your services. And conversely, when you know Doctor Peter was awful. Strike them off the list. You know. Did you just? I don't want to say docks them, but you know you. You make sure that the AP knows that. That's not someone that your team. Wants to work with anymore and you can. Kind of run those barriers, it's. Not it's not. Easy, but it's definitely.
Peter
I'll give you an idea of where we're at with the AP. You'd be lucky to get him to answer the phone so.
James
Yeah, that's that. That is a real. As I said, I do, I do a fair bit. Of consulting with other. Programs and I never thought I would say my EAP was impressive, but they we've actually had some agencies that have. Changed their vendor. Because we did what we always do in first response, right? Everybody pardon my French. Everybody complained, right? I caught myself. Everybody complained. Everybody whined to one another. Oh, it's been 5 days. 6 days. Seven days, but nobody told leadership. And I. It was much easier for me as the consultant. If you were. But I got to go to leadership and say, listen, the lived experience out there is when you call that 100 number, it's radio. Silence for 14 days. And, understandably, thankfully, to the benefit of leadership, they said, well, that's unacceptable. And then they got to go back to my point earlier and say, listen, we're paying you guys. A healthy sum of money. What can we do to make a difference right and? Again, it's not going to change. Friday to Monday, but at a minimum it. Tells your crews that you care, right? And. Beyond that, can you start to affect change and can? You start to move in the right direction.
Speaker 4
Hi I'm Austin folk, an engineer with the Ventura City Fire Department. I'm also on the board of the Ventura Fire Foundation, an organization that supports firefighters and their families. The foundation produces this podcast as part of our mission, I worked with the foundation because I was witnessed to the help that it was able to provide. For my family, the foundation needs your help. First, please subscribe and rate this podcast on your podcast platform. This helps us get a higher ranking and more visibility for the show. Second, if you support the podcast. And the foundations work. Please consider donating. Every dollar helps us support firefighters and their families. There is a link in the show notes where you can donate through the website at www.venturafirefoundation.org. Thank you for listening.
Peter
I gotta I got. I kind of want to switch gears on you a little bit. So I was having a conversation recently and it started revolving around retired guys, right or girls or gals. And because we're giving mental health and all these issues, a lot of air time and you know some much deserved attention. And that's all good and well, but I was. I've been hearing stories like, oh, you remember so. And so he retired and he got into really bad straights and somebody some of these guys move away from the area when they retire. So they're not like shoulder to shoulder with their people anymore. And I've heard that story several times. And then when you. People talk to them. They're like, oh, yeah, I was in bad straits or people have specifically listened to the podcast and go. Yeah, I was a disaster. And I wish I would have. Known or what? What's the? What's the push for like after people leave the first responder community? Because. And then this. I'm talking a little bit from first hand experience. Like I retired like there there is a lack of connection there even though I'm still connected and we're doing this work with the foundation and whatnot. But there are other guys who are. Less connected and. I don't want to say, like maybe they don't feel like they deserve the services that the the the fire department or the agencies are offering, but it's just weird. It's a weird. Dynamic so. Yeah, I feel like. I'm really good at not asking questions after I. Talk for like 2 minutes but.
James
I got it I. Got it. I'm.
Peter
Yeah. Go for.
Speaker
Trying to answer.
Peter
It. Yeah, take it.
Speaker
It's not.
Peter
From there.
James
I think it's. Too bold, I think, and I I will credit some of the fire services out there for doing this better and and for starting to go down this pathway and some of our law enforcement agencies are doing this as well. If your program that plans to do 20 and out 25 and out. If your your plan is. To keep someone for a period of time and then allow them to retire rather than fire. Or rather than you know. Whatever HR nonsense we say to people. We have an obligation to test them a couple of years before they retire and worked them through the process of reidentifying their purpose, reidentifying their goals, making sure that we start to work with them on very much in mental health side of the coin to ensure that we understand what our next chapter is going to look like is that running a. Podcast is that. Staying within the fire. Service in some way shape or form? If so, go. But we all know, to your point, people that if they don't leave are the 6078 year old guys have a coffee at the coffee table of 600 every day because they don't know what else to. Do and I'm not throwing. Any shade at that individual in any way shape or. Form, but the idea that like this is. What I did for 20 years. Why am I not going to do it on Tuesday? So we really have to be proactive with our retirement resources for these individuals to make sure that that doesn't just feel like on Friday, I worked here Friday night, they gave me a cake and Monday I have nowhere to go and additionally absolutely. I mean, it's very verbose of me to assume that, you know, agencies can afford. That and and can. Ensure that with their. But can that be something you look into of you still very much get these services or an extension of these? Services as part of your severance as. Part of your retirement can we ensure that if? We can't keep you. In our network and our collaborate of Mozilla providers and we transition you to another if you need it and really taking more of a proactive approach. Than a reactive.
Speaker
Approach. Yeah, I don't.
Peter
I think it's great what you're saying. I don't. I don't. It's definitely not where we are. But not in our area. Anyway. There there. There's definitely a big gap between what you're describing and and what the actual experience is and I think.
James
Yeah, exactly. Yeah.
Peter
That's a that's a problem. It's a problem that. Needs to be addressed, but. We're struggling to just take care of the guys that are actually doing the job. So like the the guys that retire like the priority is not there, right? Like if you have guys that are actively in crisis mode who are on the job. It's just interesting. It's interesting that the more airtime these topics get, the more nuanced the more layers, the more. It just gets more. Complex, which is.
Jason
We're just starting to broach like the pre retirement planning and I think that's that's huge from what James is saying to like, not only do you need to plan out who you're going to be and what you're going to do, but how much of your identity is wrapped up as especially as EMS, firefighter, law enforcement, that's that's who you are to your core and a lot of these guys, that's what they live. And breathe. And when you retire. Now what and I think. That is, we're starting to. Talk about that which is. Good. Now I'll take it to the other side and go OK while. We're working here. Let's talk about some of the things that you see that we can change. So obviously there's like drinking stuff and I know how unhealthy that is and coping by drinking. But can we talk a little bit about sleep deprivation, shift work, relationships? What is it that you? See most of that you want to just strangle. People and go hey, this isn't a terrible fix. You can do this and your life is going. To get way. Better give us some of. Those golden Nuggets.
James
Yeah, all that for sure. I I think I actually recently gave a talk on real world resilience for healthcare. And it's the idea of some of the core tenants that we would tell a tax accountant are just as valuable for our fire emergency response and law enforcement personnel. We just don't think it is right. It just doesn't work for us because it's different. One of the first things that I really encourage people to do, and I struggle with this every time I have to write a bio, is over the holidays. I want you to talk about yourself for 5 minutes and not mention the Firehouse, the agency, or your job. Right. And I'm just as good. And then I went to Walgreens the other day as time 637 as my ticket, right? Like that's, that's my employee. Number what am I doing? The the idea that we can. Decouple. Who are you? I'm paramedic James Boomhauer. Shut up. Dude. You want a BBQ, right? Or your neighbor? Comes by to see how things. Are and you're like. So there we were, her. Leg was hanging off right, and that's not. That's just not how the. Rest of the world communicates. So even starting with something as simple as slowly but surely. Recognizing that your identity and your profession are not identical. And we love that. Our colleagues identify as these people, and that's a valuable tool, but it cannot be our entire lives. The the other big components are just going slow. 20 minutes more sleep is way more valuable than 20 minutes less sleep, one more meal with veggies and proteins and less carbs right is way more valuable than another bag of Cheetos, and I'm going to stay in my lane and not talk too much about nutrition. The other big thing that you can do. Today, tonight, coming from a German Irish paramedic who can never tell you to not drink unless you have, you know, some disordered relationship with alcohol is move your alcoholic beverages from one alcoholic beverage. To 1 glass of water. And if you can alternate alcohol, water, alcohol, water, you'll lower your bar tab. You keep yourself hydrated and that hydrated sleep that you get is going to let you fall into R.E.M. Sleep and R.E.M. Sleep is really where the metaphorical magic happens. When we talk about processing trauma. When we talk about excising stress, when we talk about a lot of these things, that all happens in REM sleep, and recognizing that. You can, with the exception of disorder, drinking excluded. Have your cake and eat it too. You can still go to the bar, have a couple of drinks. I just drank with a handful of buddies of mine a couple of days ago. It was a beer, a water, a whiskey, a water, a non alcoholic. Because I like the non alcoholic Guinness and then a water. Right. And you can you can do that now. We don't have to have rag on each other or bust on each other. And allowing for a little bit more moderation. All of these aspects is really how we get there and. And to your point, Jason, like. Don't forget to move your. Body the biggest thing I miss about working at. My Firehouse was the. Jim, right. And I admittedly didn't use it often while I was a firefighter paramedic there, but many of our firefighter colleagues are staring at beautiful, federally funded gyms right, that are that are collecting dust on them and you don't have to do a whole CrossFit workout. God bless you if you can, but get in. There for 10. Minutes. Watch the same show you're watching. On the treadmill, right? Can. You do small small steps to keep those habits.
Peter
So we asked most of the therapists mental health experts that come on the show the same question here. You talk, I feel like you come from a different perspective, which is good, which is encouraging. But if you could, if you had the magic wand and you could do one thing that made all of these mental health issues better, I mean. You literally could do anything you want. It doesn't have to be a mental health related thing, it could be anything you think. Would make an. Impact. What would you do?
James
Would be two things. You would be assigned a mental health professional, just like you're assigned a primary care provider, so you would just you would get one and the ability to flex if. They weren't a good fit and all that. Yes. And we would stagger our night shifts. So you are guaranteed at least 72 hours of non night shift work before you're back tonight. So I know the ruins, the 2470 twos that we. All know and. Love. But man, we know that not sleeping, just this disastrous to our. Physical and mental health and if I could. Give you a mental health clinician when you walk through the door with your polo shirt with your multi straps, with your star life. And guarantee that you had fewer night shifts or fewer 24 rotations.
Speaker
That would be it.
Peter
Yeah, that's funny. Have you thought about this before? I can tell, yeah.
James
Couple of papers. On it, yeah, yeah.
Jason
I think I think he was pretty close, Peter.
Peter
I I I.
Jason
Think that's inclusive? Of what the? Other ones I know what? You're going to say and he. Fit right in there.
Peter
Yeah, everyone usually says just work less and but essentially right, Jason, that's just a bit like.
Jason
Yeah, that's the gist of it. But I think the reason you work less is because a lot of it has to do with those night time, shoot hours and you know which, which makes you a better husband or wife or partner and have a little more patience and all that stuff all the way from top to.
Peter
Where it was. Yeah, yeah, yeah.
Jason
Bottom do you guys have? 24 You work 2470 twos. Is that what I heard you say?
James
So at midnight or 12th were were twelves.
Jason
But a lot of the people out there do.
James
Yeah, yeah. But we are we are, especially in the HEMS community, we're and I don't have the numbers in front of me, but I'd say it's probably split 50. 50 agencies that work 20 fours or 40 eighths in some, like fixing programs versus agencies that work twelves. We are simply too busy to entertain the process of 20 fours and being an aviator, I'm not the aviator but be having to fall under some aviation restrictions. Our duty time our crew. Like that? Really, really stymie our. Ability to work going for us.
Peter
That's interesting that in the aviation world they they're very strict about, like how much you can work, how much you have to rest, but you go EMS, they're like, Oh yeah, you.
James
Like it? Yeah.
Peter
Need to work seven days in a row.
James
Sorry, we've been out, but yeah.
Speaker
Like that's.
James
It man, go to work, yeah.
Peter
You need to work seven days with no sleep and drive this fire engine down the road and not kill somebody with it like no problem. Go for it. Yeah, that is wild. I do like your. Though like. Assign a mental health professional and sleep more and honestly like my whole. Career was 20. Fours and at the end we were doing 48. 96 is. And you know, in between you were working a. Bunch of days. In hindsight, I think I would have been happier on a on like a a 12 hour shift or something. And I know that some big giant fire departments have experimented with that, but obviously it's not normal. Here I don't know any fire departments that do it around here, but that sleep is so valuable it's so. Valuable and the the. You know, there's studies out there. I'm sure you've read. Them that, like the lack of they're they're starting to equate the lack of sleep with the increased cancer risk because there's there. There's other professions that have equal exposure to carcinogens who don't have the cancer rates of people who are sleep deprived, IE law enforcement, fire department, EMS stuff.
James
Yeah, exactly.
Peter
Which is crazy to me. But the other thing that's crazy to me is like, OK, so we kind of get it. It's becoming more clear and it takes time to study these things. We're not reacting fast enough, right? But it is the government for, you know, they don't do anything fast. But you think they take this information and.
Speaker
Right.
Peter
Go. Oh, this is. A problem we kind of know it's problem. OK, let's start doing something about it. But that's like, you know, dreaming for the most part. But.
Speaker
And I mean.
James
I'll be transparent because colleagues of mine and coworkers are hopefully going to. Listen to this, I love. Night shifts and I used to work 30 sixes. Right, I'd come. In Friday Day, I'd leave Saturday night a I was 25, which I think is really, really important to say out loud and B. I was this, but for the next. Day and 1/2. It worked. It was a beautiful schedule. I worked once, right? Like hear me. It worked once 136 was done for the week. What person isn't going to love that schedule? But you know, we also don't just win our beards and run into fires anymore. Like we we have to acknowledge some of the changes that we've made to better. I have to wear a helmet. And helicopter 25 years ago. After he just wore a headset. That Jason's wearing and you know for the. I mean we we we make these changes. Because we know we have to. I don't know the right. Answer don't get me wrong, I wonder if. If an easy first step is to stagger the. Length. Can we? Can we adjust those standard Kelly schedule in a way that ensures that our fire professionals and EMS professionals that follow it get more days in between that 24 hour? New order or that night rotation? I I don't. Know the right answer, as it logistically falls to different fire departments, but we know that we we at minimum have to sleep more if not work nights.
Speaker
Months. Yeah, yeah.
Peter
Let's talk about so. We have a grant that we got for the foundation and part of that grant is going to fund you to come and teach our people some stuff. So let's let's give. That a little. Look. What? What? What are what are you? Guys going to talk about what's that look like?
James
Absolutely. We're going to talk about mental health and Wellness as it relates to our agency and what does it look. Like in the. Real world. We're also going to spend a. Fair bit of time. Talking about resilience and. The difference between resilience and resistance, alongside discussing like what Jason and Peter and I started. To talk about was. How does that look in the real world? How? Do we take the tools that we?
Peter
Know are good.
James
For us to get sleep and eating them, moving our body of this, that and how do we actually make it? Tangible within our communities.
Peter
Gotcha. Gotcha. I I do also want to talk about stay fit for duty. So what exactly is it? What what are you trying to do with it? Yeah, go into that if you.
James
Absolutely. So the goal of safety for duty is to create avenues for first responders to treat their mental health with the same tenacity that they treat the individuals that they serve, right? If I told you all that there was a new fire apparatus that we had to learn. If I told you. There was a new protocol we had to learn from medication administration. We'd all be up till 2:00 in the morning. Right. We understand the importance of our job and how ready we have to be as first responders and healthcare providers to treat others. And what we do is we put ourselves on the back burner. And I'm really working. Through a number of different ways to reinforce that if we put our. Selves. Maybe not even first, but equal in importance to that, that we actually make ourselves better responders and better healthcare providers over time. We do that through engagements like this podcast, speaking things of that nature. I am very fortunate that I've done a fair bit of public speaking in the national stage on the topic to increase awareness. And to give some pearls and pitfalls, I do the system training. As Jason pointed out, when I do the the peer support team, education and creation and we hope one day to have like a home base to actually do this in the therapy and kind of spool all of this together and do all that. Work in one place and the time.
Jason
Did you start that non or soon to be nonprofit? Did you start that? Is it a conglomerate? How many? How many are on staff?
James
It is. It is me and two really good friends who volunteer to help. And as we, as we are able to incorporate and make it a nonprofit, as, as you all know, that takes a fair bit of collaboration and a fair bit of dollars behind it as we work to create that revenue and and make that a nonprofit, we'll be happy to do so and kind of activate some of the other avenues that you can take with a nonprofit.
Speaker
You can't take that just now.
Peter
Awesome. Well, this has been great. I know we're all looking forward to the the webinar that you're going to do and give our people some actionable. Things that they can do I. Mean so much of this is. I mean, this is just my opinion and as uneducated as it may be, but a lot of the. Mental health stuff is like maintenance staying on top. Of putting putting some self. Care higher priority in your life and like being aware of what's wrong going on so you don't get to the crisis times which is you know where people start thinking about suicide. And other things. Like that so. I think any training we can give our people that like just give them more tips, more tools to on things they can do in their everyday life is an immense amount of value. People just have to apply it right. That's the hard part. It's not like people don't know.
James
Yeah, that's. And we're trying to shorten that, right? We're trying to shorten the distance between that that action and that available resource. I love to just that I want. To add 1. Piece to it well, well, prevention is absolutely. It's the crux of everything, right? It's it's the best medicine. It's the best office jazz coming to see him. It's all. Professional is not reactive. Right. Finding yourself in a bad spot, finding yourself in trouble or your you got some relationship problems at home work is really struggling your guys. Are doing something different? I'm going to see him as. Well, professional he is still preventative, right? Crisis resources are still. Preventative I I don't want. Anyone to think like oh. Man, I'm a little depressed. It's now. It's too. Late I've missed this. Preventative window. It's not, it's.
Peter
Yeah, yeah.
Jason
All the.
Peter
Gotcha. Gotcha. Yeah, good point, good point. Anything else you want to get out there before we wrap this up or?
James
No, I just want to thank everybody. For the venue. Thank Audrey, Chelsea, and you guys for all your patience as we had a number of scheduling snack foods and some technical difficulties here. And please follow me on social media at stay under score. Fit for duty. Or check out my website, stay fit for. Duty.org.
Peter
Yeah, we'll make. Sure. We put the links in the show notes, Jason. How about you you got. Anything for us?
Jason
I just wanted to reiterate what James said at. The end there what I try. To tell my guys is just go one. Once to a therapist, just go once because I bet. You you're going to want. To go back, but when you? Stay at the station and just talk crap that for. Sure doesn't help so. Just go once and and see what. You think and give it a shot. And most of. The time people find a lot of value and they go. Back. So anyway, I appreciate you being on. Here also James and. I look forward to the webinar so we'll see you soon.
James
Thank you very much guys. It was my. Pleasure. Take care.
Peter
Well, that was good. Good episode. It's always good to hear from somebody who gets what we do and also is educated in the mental health world. You know, it's weird to see those two worlds like, completely crossover, but I think it was good. What?
Jason
Do you think? Yeah. I mean, he's taking it to another level with what he's doing. He saw. He saw a need. He saw what was happening in his own. History in his life and he decided to step up and and become become the person to the go to guy. One of the things he said on my take away from this is go to a BBQ or whatever it is and talk about yourself for 5 minutes without mentioning anything about where you. Work. I thought that was pretty good and I don't know of many firefighters who. Could do that so.
Peter
Well, they wouldn't they. Wouldn't have to. They wouldn't even have to open their mouth because everything on their, their T-shirt, their hat, everything would be like firefighter, everything you know.
Jaso
Yeah, I'll, I'll say I'm guilty for sure.
Peter
Hey so. Well, fun fact, James is coming back to do. This webinar for our fire family so. What's the date? You got the date? I think February 20th.
Jason
February 20th and that's thanks to Vanguard Charities. They donated to the foundation so that we could host James and he could do this webinar for us. So big thanks to Vanguard Charities you can register in the show notes below.
Peter
Yeah, it's a a series. So we're going to do 1A quarter and it was a grant that they awarded to us that's going to. Allow us to. Deliver this to our people so we're super stoked. About that, but. Anyhow, it's been. Awesome. Thanks for your time as usual. Jason and till next. Time alright.
Jason
All right. See you soon.
