Road to Mental Readiness

Metro Fire Chiefs Conference

May 2, 2015
 The Need
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 short-

term 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 REACTING INJURED ILL

Good Mental health Common, self- More severe and Diagnosable mental
Normal functioning limiting distress persistent functional illness
impairment Severe and persistent
functional
impairment

Adapted from the US Marine Corps.

 Mental Health Continuum Model

HEALTHY REACTING INJURED ILL

Normal mood fluctuations Irritable/Impatient Anger Easily enraged/aggression

Mood

Calm/confident Nervous Anxiety Excessive anxiety/panic attacks

Good sense of humour Sadness/Overwhelmed Pervasively sad/Hopeless Depressed mood/ numb

Taking things in stride Displaced sarcasm Negative attitude Non compliant

Thinking/
Attitude

In control mentally Distracted/lose focus Recurrent intrusive Cannot concentrate

Can concentrate/focus Intrusive thoughts thoughts Loss of memory/cognitive ability
Constantly distracted Suicidal thoughts/intent
Can’t focus on tasks

Normal sleep patterns Can’t fall asleep or stay asleep

Trouble sleeping Restless disturbed sleep
Few sleep difficulties Sleeping too much or too little
Lack of energy Some tiredness/fatigue
Physical

Physically well Physical illnesses

Changes in eating patterns Fluctuations in weight
Feeling energetic Constant fatigue/exhaustion
Some weight gain or loss
Maintaining a stable weight Extreme weight loss or gain

Decreased activity/socializing Avoidance Withdrawal

Performance

Physically and socially active Tardiness

Behaviour/

Procrastination Absenteeism
Performing well Regular but controlled alcohol Decreased performance Can’t perform duties/tasks
No/limited alcohol use/ use/gambling Increased alcohol use/ Alcohol or gambling addiction
gambling gambling – hard to control Other addictions
 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?