Detective Olin Rankin could never eat in the office when he started working four years ago in the Benton County Cyber Crime Unit. The graphic images persisted in his mind through the night.
He adjusted over time, Rankin said, but he's only human. He still had to learn healthy ways to process the mental stress of the job. Sometimes he talks about it with someone or takes a day off to go fishing.
"These guys are routinely exposed to some of the worst ever," said Detective David Undiano, who is the cyber crime division lieutenant. "You can hear it, you can see it. It humanizes the situation and evokes an emotional response.
"We are talking about things that are mentally difficult to watch. If we are talking child pornography, it's images of a child. You know that's your job, and it's part of evidence and after a while, you become more calloused. But there are times the stress that's always there becomes more noticeable. You have to get up and leave for a bit. That's not just cyber, that's patrol, law enforcement in general."
The high volume of exposure to what law enforcement refers to as "critical incidents" has a cumulative effect for all officers. These cases and calls can affect police officers, firefighters, EMTs and dispatchers who respond to them.
PTSD
Post Traumatic Stress Disorder is a mental disorder in which a person has difficulty recovering after experiencing or witnessing a terrifying event. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened even when they aren’t in danger.
Source: National Institute of Mental Health
Many law enforcement and first response agencies are working to address growing mental health
concerns, according to a study by the Ruderman Family Foundation, a philanthropic organization that works for the rights of people with disabilities.
The concerns come from a high number of early retirements related to post traumatic stress disorder and suicides among first responders. First responders have PTSD and depression at a level five times that of civilians. Very little has been done to address it, even though suicide has been an ingrained issue for years, according to the Ruderman Family Foundation study.
Last year, 103 firefighters and 140 police officers across the country committed suicide compared with the 93 firefighters and 129 officers who died in the line of duty, according to the study.
Fayetteville police officers -- as well as all city employees -- have had access to an employee assistance program through Ozark Guidance for many years. Police Chief Greg Tabor, Fire Chief David Dayringer and the city human resources team sought additional resources in 2016 through UAMS and more outreach to first responders.
"We lost an officer to suicide in the last several years, and that was really devastating to members of this agency, but it brought about awareness of the need to talk about these things," said Jamie Fields, the Police Department's administrative captain. "We are all making more of an effort to talk to each other about it and seek additional resources, because we never want to experience a loss like that again."
Other Northwest Arkansas agencies also have expanded mental health services over the past few years and are continuing to work on innovative ways to reach their employees.
"If you talk to the average citizen, I think they understand that it's stressful and it's dangerous. If you say this program will benefit first responders, they get that," said officer Gene Page, Bentonville Police spokesman. "But there's also an external benefit to it as well, because there is a connection between the stress and lack of mental health resources that increases the cases of excessive force and can decrease the retention issue as well."
Some Calls Are Harder
Often calls involving the neglect, abuse or death of a child are the most difficult, several officers, firefighters and medics said.
Others said suicides or suicide attempts are difficult both because the person is taking his own life, but also because the person can be a danger to anyone who tries to stop him. Calls related to mental illness and suicide have continued to increase in Northwest Arkansas, especially in Washington County.
The county had 497 overdose and 1,214 psychiatric calls in 2017, a nearly 65 percent increase since 2013. Though these don't all indicate someone was suicidal, a large number are, said Chief Becky Stewart at Central EMS.
"Nobody is immune to the impact of these events," Stewart said. "Mental health is on the radar for everyone right now in the first responder world."
Disturbance calls can be difficult for many officers because they don't know what they are walking into, which can cause a surge of adrenaline and lead to worst-case scenario thinking, said Fayetteville officer Tiffney Lindley. Disturbances make up a large percentage of calls police departments receive and often are in regards to fights, assaults, threatening or other disorderly conduct, police said. Fayetteville received 1,000 calls of disturbance in 2017, according to the department call log.
Lindley returned to duty in 2011 on the day doctors removed the staples from injuries she got when a man attacked her on the job. However, her co-workers saw she wasn't quite herself, she said. The personality changes persisted, and about six months later she was called to the chief's office. Tabor said he could either fill out paperwork to mandate she see a counselor or she could go on her own.
"I think some people would have been pissed off at that, but I took it for what it was worth: People who care about me saw and he cares enough to bring me in and talk about it," Lindley said.
Officers who have been injured on the job or observed traumatic scenes recall those events every time they go on a potentially similar call, she said.
"You go through those scenarios again," she said. "It's self-preservation. But can you imagine, let's say, five times a day you have to prep yourself for the worst situation imaginable? That's a lot of stress to be under."
"After you have been here for a while, you learn how to control it and not let it get to an anxiety point," Lindley said.
Mental Wellness
Employee assistance programs, often offered through the city, allow officers or other first responders to request counseling services anonymously. Many departments also offer counseling to an employee's family. Each department has a cap on how many sessions are provided, usually about five per year.
Dayringer said his department has had several firefighters who had to quit or retire early over the years because of post traumatic stress disorder.
"It's the car wrecks, the burned bodies, the helplessness of not getting there soon enough to help someone. The helplessness is tough. Some of those stay with you," he said. "So it's common. A lot more common than some may think. It's not an 18-month deployment. It's 20 or more years on edge."
Other first responders said they have also experienced that feeling of helplessness. Dispatchers are usually the first to interact with someone in crisis, but they are in a room all day, unable to see the situation or directly help.
"You are on the phone and just waiting for the other shoe to drop. We don't always know the final outcome," said Beverly Luper, who has worked as a Rogers dispatcher for more than five years.
Luper's supervisors encourage dispatchers to know what they can handle. If a call affected them, they can walk out to calm down, talk to a colleague or access available outside employee assistance programs, she said.
Dayringer said firefighters are fortunate because shifts are like families who live together and go out on calls together, which not all police officers have. Firefighters can come back to the station to formally debrief and talk about what happened after a traumatic incident.
"I think that helps in a big way," he said. "I always tell my guys after an action review, 'Let's stay focused on the next call. That one is behind us.'"
Firefighters also have access to an employee assistance program for counseling and a chaplain and have an annual class led by a social worker to get a mental health refresher.
Dayringer and his staff saw the need for an additional tool to help those who may begin suffering from PTSD. The department launched a fatality and traumatic event, or FATE, log in 2016. This log keeps track of how many such events each individual employee has worked. It began with the idea of helping firefighters get their pension when retiring early because of mental health issues from chronic exposure to traumatic events.
Dayringer said he wants to experiment with using the log for annual mental health checks. The idea is the department would send an employee to talk with someone as standard procedure if that person reached a certain number of incidents in the FATE log, he said.
"If you get early treatment for these things that build up in the FATE log, you end up working longer, and being a more productive member longer, and you won't have to retire with a disability," he said. "So, I think, it's about prevention and preservation of quality of life."
Dayringer said this is the first year the log is fully up and running, so he is still waiting for the data to build up to see the results.
Different Approaches
The Benton County Sheriff's Office is taking a more individual approach to mental health. Officers at the department said the biggest help has been their superiors listening to their schedule requests along with the standard assistance program.
The Cyber Crime Unit in Benton County added a required meeting with a counselor to talk about work, personal life or anything else, Rankin said.
"It worked out," he said.
Rankin spoke to the counselor about how changing from a standard five-day week to a four-day, 10-hour schedule would help him get back to normal, he said. The office made that schedule change available for everyone on the unit.
"That's one day less a week that I'm exposed to child pornography," he said. "With that third day, I can use it to decompress. If I want to go fishing, I can go fishing."
Many departments choose to rotate officers in and out of special units, such as cyber crimes, in five-year details. They added mandatory counseling and changed the schedule because they didn't want to follow that model, Undiano said. It can take five years to get someone completely trained and educated to be able to do the job well, he said.
Bentonville Police along with social worker Mary Schuz started the nonprofit group Heroes of NWA. It's designed to be a hub for all mental health related services, professional or personal. Schuz started the first leg of the nonprofit group, a resource advocacy program, in November and Heroes was officially certified a nonprofit group March 14.
They have plans to expand both in terms of what they offer and who they offer it to, she said.
Page said officers have already taken advantage of the advocacy program.
Schuz said she's there as a personal, trusted resource, not to be someone's counselor, though she can connect them to one if they need. Often, her job can be as simple as informing an officer who they need to call and what to say.
"Going from call to call to call, I want to know what I can take off their plate so they can put one call behind them and go to the next," Schuz said. "On the personal side, I can tell them about what their insurance covers and connect them to additional resources if they need that."
It's also a way to get the help they need without the concerns they may have of talking to someone within the department, she said.
"There is such a stigma with mental health, but I've always looked at it as your brain is just another organ you have to take care of. You have to exercise it and keep it healthy. When you have to get help, it's not a sign of weakness," Schuz said.
Page added, "we don't chastise people for going to the gym, why should we do it for mental health?"
Overused Strength
Resources are available, but often employees won't access them, Dayringer and others said.
"We're too tough. A show of emotion is a sign of weakness. So we are going to have to change our culture, and we are trying to do that," he said.
The culture of officers and first responders is one focused on bravery and strength, said Samara Duckworth, program director at Arkansas Employee Assistance through UAMS, which serves many first responder agencies throughout the state.
"It's a catch-22, because on one hand this culture keeps things bottled up and can make problems worse, but on the other hand, it's also a coping mechanism that they have to have. If you are going to run out to horrible situations every day, you kind of have to put your emotions back," Duckworth said.
Many worry they will be labeled with a mental illness, but Duckworth said the employee assistance consultants don't diagnose. The consultants are there to listen and help with any sources of stress someone is having on or off the job.
"We don't want to strip away what they use to cope, but we want to help them with what they've experienced. One way to look at it is weaknesses are just strengths we've used too much. One way of handling things doesn't work all of the time."
The most emotionally difficult times sometimes come when first responders aren't on a call, many said. Sometimes, It's sitting in the office after the adrenaline has left from a call and, "you have to write up the report, reliving every detail of the incident," said Michael Downing, Central EMS paramedic.
Sometimes, the stress of the job doesn't hit until the officer walks through his front door at home -- after eight hours of watching children being horribly mistreated -- and "gets in trouble for not having your happy face on," Rankin said.
First responders said while it's important to share some things with family, it's good to have other people in the field to talk to and hang out with outside of work.
"But if you went home and told them step by step everything that happened today, you're probably going to find that your significant other is disconnected, doesn't understand a lot about it," Undiano said.
Downing has made strides to address the possible mental health concerns of his coworkers and break the silence by creating a presentation he gave at a meeting last month. Stewart said it went over well with the crew.
"We are normal people in abnormal situations. We see more in one day than some do in their lifetime," said Tammy East, CEMS quality improvement coordinator. "It's about getting rid of the stigma. It's necessary that you need to talk, which is internally motivated."
Lindley said it's taken some time to learn what strategies for dealing with stress work best for her, but sometimes it's the simple ones.
"For me, what I learned is the moment I walk through my front door, work is not there. It's gone," she said. "I won't wear my uniform home. If you do the physical symbolization of it, the mental part will come.
NW News on 05/29/2018