After nearly 15 years of responding to traumatic calls as a firefighter and paramedic in Cowlitz County, Stacie Poff noticed she would sometimes feel angry and agitated at nothing in particular. At home, the activities that used to bring her joy did little to lighten her mood, she said.
Those were the first symptoms of the post traumatic stress disorder (PTSD) she developed on the job, said Poff, who works with Cowlitz County Fire District 6 in Castle Rock.
“I was anxious, and I lost my confidence in the field. I know a lot of my closest peers and family members noticed it the most,” Poff said of her initial PTSD symptoms in 2015. “I did a lot of second-guessing, and I just wasn’t comfortable in my own skin anymore.”
With the help of her husband, Poff sought counseling and treatment. Today she says she’s “doing well” managing her triggers and symptoms — and her “lengthy battle” with PTSD has inspired her to help others.
Poff and her Cowlitz 6 colleagues have launched a campaign to shed light on the mental health problems first responders face and encourage them to seek help when they need it. The department is wearing specially designed T-shirts in June for PTSD Awareness Month. The campaign even is catching on nationally.
“In order for us to go out and do our jobs effectively, we have to be able to take care of ourselves. We can’t have people be afraid to ask for help, or to try and do their job when they are hurting and anxious,” Poff said.
“The overall goal is to get people to know it’s OK to not be OK,” said Andy Ogden, assistant fire chief at the district. “It’s OK to ask for help.”
In 2017 more first responders died of suicide than in the line of duty, according to the Ruderman Family Foundation, an international philanthropic group that supports persons with disabilities. A study by the foundation found that frequent and long-term exposure to traumatic situations causes a higher rate of mental illnesses like PTSD and depression for first responders, which in turn causes them to commit suicide at a considerably higher rate than the general population.
Ogden developed PTSD after almost 20 years working as a volunteer firefighter. He said his symptoms were triggered by a series of calls in 2017, though past experiences played a role in his trauma.
“The call that gets you doesn’t have to be a major one. It’s just something inside triggers (trauma) from way back,” Ogden said.
An employee with the county roads crew, Ogden said driving by places where tragedies have occurred often led to flashbacks and reminders of traumatic experiences.
“Everywhere I go, there was a fatality here or a house burnt down there. There was no escape, and without knowing it, it just kept boiling,” Ogden said. “Over the course of time, you see a lot of stuff. I’ve put friends in ambulances. I’ve put friends in helicopters. And I’ve put friends in the back of the coroner’s van. It finally just gets to a breaking point,” Ogden said.
For many first responders, the expectation is to “just fight through it,” Ogden said. Firefighters and other emergency personnel are expected to “be the tough ones. It isn’t alright to hurt or show weakness” because of the negative stigma surrounding mental health, Ogden said.
A 2015 article by the American Addiction Centers said first responders often recognize that the job puts them at higher risk of developing a mental illness, but it is “not always readily acceptable to discuss it or openly admit the need to talk to someone about it on the therapeutic level.” Some first responders fear they will lose their job or credibility with the community if they open up about their mental health needs, the article says.
Ogden said he was fortunate to know Poff and others at the local department who were open about their personal struggles with PTSD. His colleagues recognized his symptoms and suggested he look into treatment, he said.
Since then, he’s learned coping mechanisms to help him manage his PTSD, he said.
“Just the other day we were in a spot where we had a double fatality, and instead of reliving the accident, I remembered the things we were doing right before the accident. We all happened to be down here having dinner .... It doesn’t just center on the actual event,” Ogden said.
The T-shirt campaign is intended to make it easier for first responders to ask for help and to “normalize” mental health troubles, Poff said. At its heart, the campaign is about breaking the “us against the stigma” mentality that often stops first responders from seeking mental health treatment, Poff said.
“We go and rescue people all the time. Let’s try to rescue ourselves here,” Poff said. “We want to bring a little more awareness to not only ourselves, but our other extended family (of first responders) like law enforcement and dispatchers.”
The shirts have succeeded in sparking positive conversations among local responders and citizens, Poff said.
“We’ve had a few people comment that they like them. They ask us about some of our experiences. We’ve gotten a lot of thank yous,” Poff said. With first responders, “We’ve had more people in the last month come forward and ask about resources,” she said.
The Castle Rock-based campaign has attracted attention from other departments who have donned their own versions of the shirt, Poff said. Cowlitz 6 was joined locally by Cowlitz 2 Fire and Rescue, Cowlitz County American Medical Response and the state Department of Natural Resources, though emergency departments as far away as Snohomish County and the state of Florida have joined the effort, Poff said.
Cowlitz 6 plans to make the campaign an annual event.
“It’s not a new thing. (Mental health) has been a problem in the first responders field for years, we just haven’t been open like this,” Poff said.
Ogden added that if the campaign makes it easier for just one person to ask for help, then “it’s all worth it. That’s the goal.”