Road to Mental Readiness Metro Fire Chiefs Conference

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)

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)

Perceptions of Mental Illness 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)

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 shortterm disability ($18, 000 per leave), double the average cost of all other causes. (Dewa, Chau & Dermer, 2010)

Financial Cost • 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)

Calgary Fire Department Resources • Post-incident (Peer Support, CISM) • Diakonos Workshops for Couples (through Local 255) • Missing: tool to build resiliency skills across career path

Road to Mental Readiness • 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

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 Good Mental health Normal functioning REACTING INJURED ILL Common, selflimiting 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 Behaviour/ Performance Physical Thinking/ Attitude Mood HEALTHY REACTING INJURED ILL Normal mood fluctuations Calm/confident Good sense of humour Irritable/Impatient Nervous Sadness/Overwhelmed Anger Anxiety Pervasively sad/Hopeless Easily enraged/aggression Excessive anxiety/panic attacks Depressed mood/ numb Taking things in stride In control mentally Can concentrate/focus Displaced sarcasm Distracted/lose focus Intrusive thoughts Negative attitude Recurrent intrusive thoughts Constantly distracted Can’t focus on tasks Non compliant Cannot concentrate Loss of memory/cognitive ability Suicidal thoughts/intent Normal sleep patterns Few sleep difficulties Physically well Feeling energetic Maintaining a stable weight Trouble sleeping Lack of energy Changes in eating patterns Some weight gain or loss Restless disturbed sleep Some tiredness/fatigue Fluctuations in weight Physically and socially active Performing well No/limited alcohol use/ gambling Decreased activity/socializing Procrastination Regular but controlled alcohol use/gambling Avoidance Tardiness Decreased performance Increased alcohol use/ gambling – hard to control Can’t fall asleep or stay asleep Sleeping too much or too little Physical illnesses Constant fatigue/exhaustion Extreme weight loss or gain Withdrawal Absenteeism Can’t perform duties/tasks Alcohol or gambling addiction Other addictions

Delivery Model • In-class group program • Wallet cards (Mental Health Continuum) • Aide Memoire

Three Versions of R 2 MR 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 Q 1/Q 2 • adaptation of course materials • engagement of leadership, peer support team • beginning messaging to the floor 2015 Q 2 • initial testing • training the trainers • continued engagement and communication

CFD Timeline 2015 Q 3/4 • pilot and evaluation of program • ongoing communication 2016 Q 1 • additional revisions 2016 Q 2 • beginning of full roll-out

Questions?