A new substance abuse program designed specifically by and for firefighters and paramedics has launched through Rosecrance, a private, not-for-profit behavioral healthcare organization based in Rockford, Ill. Called Rosecrance Florian, the program essentially started as a grassroots movement, explains medical director Raymond Garcia, MD, because the people who needed it most approached the organization about developing it.
Rosecrance Florian has a dedicated eight-bed unit at the Rosecrance Harrison Campus, an adult treatment facility in Rockford, as well as an established board of advisers comprising fire chiefs and other leaders in the national fire department and paramedic community. After a soft launch and treating clients at around half capacity—mostly because the identified space was filled with other patients—the unit has now been remodeled and Rosecrance Florian is ready to roll.
Program director Dan DeGryse, BA, BS, CEAP, CADC, LAP/C, is an active member in the Chicago fire service community, currently holding the rank of Battalion Chief/Emergency Medical Technician in the city fire department. DeGryse also has served as coordinator of the Chicago firefighter’s union Local 2 Employee Assistance Program (EAP) for 14 years, worked as a peer supporter in New York after the Sept. 11, 2001 terrorist attacks, and has a clinical background in mental health and substance abuse.
Through his job with the EAP, he says a primary goal was to find local behavioral healthcare resources for union employees. Despite going to 96 firehouses over two years to let employees know what services they offered—in addition to the publications and posters they distributed and family events they planned—more was needed.
“I told my staff, ‘We have a great program and great people, but no one knows about it and we don’t know about other resources—we’re not doing our jobs,’” he says. “So I started to [research] different local treatment centers and what they provided to see if I could work with a facility on individualized treatment plans. I wanted someone to understand what we see and do and feel and experience—on the job and off the job—when they come into treatment, and nobody had that.”
DeGryse was drawn to the Rosecrance Harrison Campus because it was already a well-established treatment center.
“A lot of times you look in a facility, there’s a lot of turnover. Their leadership, staff and clinicians had all been there for a long time,” he says of Rosecrance. ”So I came to Phil Eaton, CEO of Rosecrance, and said, ‘You’ve been doing this for 43 years; I need your advice. We need a place [where] our members feel safe and feel connected.’”
The agreement was forged, and not only did DeGryse start sending people to the facility, but he also started training Rosecrance staff about firefighter culture.
Enabling the clinicians to understand what first responders deal with on a daily basis was one of the most important precursors to an individualized treatment program, DeGryse says. Members of the clinical team, including the medical director and administrator of the facility, all went through local fire training.
“I knew that I had to come in here and give the clinicians a little education on who we are and what we are about, but they were willing to feel the heat and see the smoke, put on the gear and feel what it’s like to drag a 160-pound dummy and struggle with that,” he says.
DeGryse adds, “That gave them a real, hands-on glimpse of why somebody might be holding on to something for 15, 20, 25 years from an event where they weren’t able to save somebody.”
Fire training especially helped the staff learn how to communicate with clients effectively, Garcia says.
“It helped us speak their language,” he says. “We got a bit of a crash course on how they communicate and that’s really important because that’s a big part of the culture for these professionals; that connection that they have and how much they rely on each other."
Suicides on the rise
On top of substance abuse, anger issues, marital issues and medication management problems that often plague firefighters and paramedics, a big issue in the community is suicide. DeGryse says there have been over 50 suicides in a 23-year period in the Chicago firefighting community. In 2008 and 2009, there were seven in 18 months alone. DeGryse believes that the deaths were a result of substance abuse, mental health issues, undiagnosed post-traumatic stress disorder (PTSD) and lack of treatment and education.
“It was like the 800-pound gorilla in the room that no one is talking about,” he says, adding that he decided to conduct his own study after looking online and finding nothing about behavioral health in the fire service. “It really aggravated me because fire service has been around for a long time. Why isn’t there information on this? Why isn’t someone doing something about this? People always say if somebody doesn’t do it, pick up the tools and do it yourself.”
DeGryse is a member of the International Association of Firefighters (IAFF), and after talking about the suicide problems in Chicago with members from New York, Boston, Baton Rouge and Fairfax County, Va., he found that people who had years of trauma and substance abuse were the ones choosing to end their lives.