Processing the trauma of a near miss

Dozens of firefighters had a very close call on the Route Fire

Fire crews on the Route Fire entrapped
Fire crews on the Route Fire, 4:40 p.m. Sept. 11, 2021, five minutes before they were nearly entrapped. Photo by one of the firefighters.

Many of the firefighters on the Route Fire who escaped from what was close to becoming a mass casualty incident on September 11, 2021 no doubt had stress levels that were very high as it was happening, and possibly for days, weeks, or months later.

As we covered in an article on December 11, dozens of firefighters on the fire north of Los Angeles suddenly found themselves on a road with fire on all sides of them. Even though it occurred three months ago the story had not been publicly told, until yesterday. As flames closed in on them, a Captain on a US Forest Service engine took charge and organized an effort for 13 firefighters on foot with no access to their regular transportation, to take refuge in two USFS Type 3 engines, each already carrying their normal complement of 5 firefighters. Almost unbelievably, 7 crammed into one engine and 6 got in another. There were a total of 23 bodies in the two engines. Then with flames on both sides of the road, they drove through smoke to safety. Two firefighters were treated in a hospital burn unit and released.

It could have been much worse. One person thought he was going to die.

“The more experienced firefighters were more shaken up than the new guys,” a firefighter told Wildfire Today. “Firefighters on the outside looking in were pretty shaken up, but as best as I can tell I think we are all doing good.”

One person said that as they were becoming entrapped and during the escape from the nearby flames he realized later that he does not have a complete memory of the event, “My memory blacked out from time to time…It’s psychology I don’t fully understand.”

Today I found a reference by Mike Degrosky to an article in the Harvard Business Review written by Diane Musho Hamilton that might shed some light on the topic. Interestingly, at the top of the article is an old photo of a P3 air tanker dropping retardant, even though the word “fire” is not mentioned anywhere in the piece. It starts with describing the two amygdala in the brain which were characterized by Dr. Bessel Van Der Kolk, in his book The Body Keeps the Score, as the brain’s “smoke detector.” (Which may be the genesis for the photo of the air tanker.) The amygdala’s job is to detect fear and help the body prepare for an emergency response.

Here is an excerpt:

“…When we perceive a threat, the amygdala sounds an alarm, releasing a cascade of chemicals in the body. Stress hormones like adrenaline and cortisol flood our system, immediately preparing us for fight or flight. When this deeply instinctive function takes over, we call it what Daniel Goleman coined in Emotional Intelligence as “amygdala hijack.” In common psychological parlance we say, “We’ve been triggered.” We notice immediate changes like an increased heart rate or sweaty palms. Our breathing becomes more shallow and rapid as we take in more oxygen, preparing to bolt if we have to.

“The flood of stress hormones create other sensations like a quivering in our solar plexus, limbs, or our voice. We may notice heat flush our face, our throat constrict, or the back of our neck tighten and jaw set. We are in the grip of a highly efficient, but prehistoric set of physiological responses. These sensations are not exactly pleasant — they’re not meant for relaxation. They’re designed to move us to action.

“The active amygdala also immediately shuts down the neural pathway to our prefrontal cortex so we can become disoriented in a heated conversation. Complex decision-making disappears, as does our access to multiple perspectives. As our attention narrows, we find ourselves trapped in the one perspective that makes us feel the most safe: “I’m right and you’re wrong,” even though we ordinarily see more perspectives.

“And if that wasn’t enough, our memory becomes untrustworthy. Have you ever been in a fight with your partner or friend, and you literally can’t remember a positive thing about them? It’s as though the brain drops the memory function altogether in an effort to survive the threat. When our memory is compromised like this, we can’t recall something from the past that might help us calm down. In fact, we can’t remember much of anything. Instead, we’re simply filled with the flashing red light of the amygdala indicating “Danger, react. Danger, protect. Danger, attack.”

“In the throes of amygdala hijack, we can’t choose how we want to react because the old protective mechanism in the nervous system does it for us — even before we glimpse that there could be a choice.  It is ridiculous.”

The first large fire I was on, with El Cariso Hotshots, we had a near miss in Washington state, and had to escape uphill. It was a long, steep, hike out of a canyon with spot fires igniting around us. At the time I was not too concerned, in part because our Superintendent, Ron Campbell, seemed calm, as did the more experienced crew members. I was a sawyer and when another firefighter asked if I needed relief carrying the saw, I was too proud to give it up, and kept it. If I had known the true gravity of our situation I probably would have accepted his offer. As a rookie, I did not appreciate at the time how dangerous the incident was.

Five years later our Laguna Hotshot crew was directed to walk downhill on a partially completed fireline and extend it further. Two other crews were ahead of us. We only got a fairly short distance down the line when all of us were ordered out. We hiked back up to safety with no problem and later the fire ran uphill. After five years on a hotshot crew I didn’t really think too much about it, since to me it did not fall into the near miss category. It can be fairly routine to pull back when it becomes obvious nothing worthwhile can be accomplished or that it can become unsafe. However several days later after we had returned from the fire, one of the rookies quit, citing the event as the reason.

It can be impossible to predict how rookies or experienced firefighters will react to a terrifying narrow escape. It might be life-altering in a negative way, or something that is dealt with, and put away in the “slide file” of experiences to help make better, more informed decisions down the road.

I hope the firefighters on the Route Fire who were nearly entrapped, and those who witnessed it through smoke from a distance, are able to receive counseling if needed and can process what happened September 11, 2021. It’s the kind of traumatic event that can stick with a person and everyone is impacted differently.

As Sgt. Phil Esterhaus used to tell his Hill Street Blues cops as they left the briefing to begin their shift, “Hey. Let’s be careful out there.”

The awkward silence when the season ends

Lone Peak Hotshots
Lone Peak Hotshots. Screenshot from their 2020 video.

Wildland firefighters on crews that are often deployed on endless 14-day assignments far from home may become acclimated to the high energy adrenaline-fueled environment. They are part of a team working toward the same clear objective, constructing fireline, installing hose lays, or mopping up. The goal is usually very obvious, and when done they can look back and see what they accomplished while part of a group that over months together could complete each other’s sentences, know what each would do when faced with a pulse-elevating situation, or deal with boredom while waiting for a ride back to fire camp.

When the fire season is over, their environment goes through a metamorphose. Almost overnight they may find themselves with their spouse, significant other, children, parents, non-fire friends, or, alone — a completely different situation from the previous six months. Some firefighters adapt more easily than others. Those that don’t, may experience mental health issues and mild or severe depression. Spouses or children of the often-absent firefighter may also show symptoms.

In the last five years we have learned that the suicide rates of wildland firefighters is “astronomical”, according to information developed by Nelda St. Clair of the Bureau of Land Management in 2017. It is high even when compared with structural firefighters, which is also higher than the general population.

As we approach the off season for wildland firefighters who are employed less than full time, if you know someone who seems very depressed, it is OK to ask them if they are thinking about suicide. Some people think this will spur suicide attempts but that is not accurate. Encouraging them to talk could be the first step leading them to safety.

This video encourages that communication. (I’m told that some of the people in the video are YouTubers. It features Hannah Hart, Liza Koshy, Markiplier, Meredith Foster, Orion Carloto, Remi Cruz, Shannon Beveridge, Tyler Oakley, and Tyler Posey.)

Members of the military returning from deployment can also have difficulties readjusting to life back at home. A Department of Defense webpage has information on the subject that appears to be directed toward the spouse. Here is an excerpt.

“Depression and Suicide Prevention

“Depression can happen to anyone – resulting in long-term feelings that affect an individual’s mood and daily activities. Service members may be facing challenges during reintegration that seem completely overwhelming, but understanding the warning signs for depression and suicide can help you intervene and get the them the help that they need. Signs to be aware of include:

      • “A range of emotions and changes in personality, including repeated and intense feelings of sadness, anxiety, hopelessness or pessimism
      • A loss of interest in life or hobbies and prolonged periods of crying or sleeping
      • Substance abuse or withdrawal from friends and family
      • Displays of emotional distress in online activity
      • Excessive feelings of guilt, shame or a sense of failure
      • Physical symptoms like weight loss or weight gain, decreased energy, headaches, digestive issues or back pain
      • Talking about dying or seeking information about death.”

 

Help is available for those feeling really depressed or suicidal.

NWCG video about firefighter mental health

3:11 p.m. MDT Sept. 29, 2021

Firefighters crew
Still image from the NWCG video below.

The National Wildfire Coordinating Group has published a video for firefighters about about mental health. It features several former or current firefighters who have been trained as critical incident stress management peer supporters or CISM Clinicians.

@DOIWildlandFire tweeted about the video today, encouraging everyone to view it. The video was posted July 19, 2021 but as of today it has only been viewed 83 times, perhaps because it is “unlisted”.  We suggested to them that the status be changed, which should make it possible to search for it and also show up on lists of NWCG videos.

The presenters make an interesting point comparing physical fitness and mental fitness. As a firefighter you have to work at both of them, and they lay out several ways to stay mentally fit.

If you are a firefighter or the spouse or family member of one, spend 18 minutes watching this video.


UPDATE at 1:30 p.m. MDT Sept. 30, 2021: As you can see above, the video uploaded July 19, 2021 is no longer available.

At 11:56 a.m. MDT today @DOIWildlandFire posted on Twitter, “Earlier, we accidentally published a @NWCG video on supporting mental health for wildland firefighters before the video was finalized. The post has been deleted. We look forward to sharing the completed video with you soon.”

The version of the video that had been online for more than two months was excellent, and could help thousands of emergency management personnel. We hope that the NWCG can finalize it and make it available. Firefighters need this. It is a slap in the face to advertise it, then remove it. That is not the kind of setback a person suffering from mental health issues needs.

Legislation introduced in Australia and the U.S. to benefit wildland firefighters

Presumptive illnesses recognized for forest firefighters in Victoria, and in the U.S. a housing allowance and mental health program

11:51 a.m. MDT Sept. 23, 2021

firefighter Dixie Fire California
A firefighter on the Dixie Fire in Northern California. Photo by Luanne Baumann posted on InciWeb August 11, 2021.

Important legislation has been introduced in Australia and in the United States that would have a very meaningful and positive effect on wildland firefighters.

Victoria, Australia

In Victoria, Australia a bill titled “Forests Amendment (Forest Firefighters Presumptive Rights Compensation) Bill 2021” extends the presumptive disease program to forest firefighters. It also includes “surge firefighters” who are government employees normally in other roles, but who perform firefighting duties during the fire season as part of their agency’s surge capacity as needed.

The presumptive disease program ensures that if a firefighter is diagnosed with any of the 12 listed cancers, they will not have to prove that it was caused by their employment, and it will be considered an on the job injury.

The cancers covered are brain, bladder, kidney, non-Hodgkins lymphoma, leukemia, breast, testicular, multiple myeloma, prostate, ureter, colorectal, and oesophageal. The employee must have been on the job for 5 to 15 years, depending on which disease they have.

If the legislation is passed, the presumptive right will apply to individuals diagnosed on or after June 1, 2016 if the diagnosis occurs during the course of a person’s service as a firefighter or within 10 years after they have ceased to serve.

This is an important issue that should also be addressed in the United States.

Lily D’Ambrosio, the Minister for Energy, Environment and Climate Change, explained the program in detail during the second reading of the bill. Here is a link to the legislation.

United States

In the United States amendments to the National Defense Authorization Act (NDAA), if they are approved and the bill is passed, would affect wildland fire in two ways.

A housing allowance would be provided to any federal wildland firefighter hired at a location more than 50 miles from their primary residence. The amount would be based on the cost of housing in the area.

And, a mental health awareness and support program would be created for federal wildland firefighters including:

  • A mental health awareness campaign;
  • A mental health education and training program that includes an on-boarding curriculum;
  • An extensive peer-to-peer mental health support network for federal wildland firefighters and their immediate family;
  • Expanding the Critical Incident Stress Management Program through training, developing, and retaining a larger pool of qualified mental health professionals who are familiar with the experiences of the wildland firefighting workforce, and monitoring and tracking mental health in the profession to better understand the scope of the issue and develop strategies to assist; and
  • Establish and carry out a new and distinct mental health support service specific to federal wildland firefighters and their immediate family, with culturally relevant and trauma-informed mental health professionals who are readily available and not subject to any limit on the number of sessions or service provided.

In addition, each federal wildland firefighter would be entitled to 7 consecutive days of leave, without loss or reduction in pay, during each calendar year for the purposes of maintaining mental health.

Both of these, a mental health program and a housing allowance, if approved would be huge. Along with salary, these two issues have a large impact on retention. Too many federal firefighters live in their cars because the cost of housing where they are required to work is more than they can afford on the money they make. The mental health issues, including very high suicide rates, have been well documented.

If these two amendments do not end up in the final signed NDAA legislation there is a backup plan. Colorado Congressman Joe Neguse, Co-Chair of the Bipartisan Wildfire Caucus, would introduce the Housing Our Firefighters Act and the Care for Our Firefighters Act.

Mr. Neguse is also planning to introduce in the near future bills to overhaul federal firefighter pay, benefits and classification.

The Grassroots Wildland Firefighters have been instrumental in getting these issues in front of committee staffers and politicians.

Another amendment in the NDAA would require a study of the risks posed to Department of Defense infrastructure and readiness by wildfire, including interrupted training schedules, deployment of personnel and assets for fire suppression, damage to training areas, and environmental hazards such as unsafe air quality.

Wildland firefighters’ silent crisis

Bighorn Fire, night ops in Summerhaven
Bighorn Fire, night ops in Summerhaven. Coronado NF, Arizona. Photo by David Melendez, June 23, 2020.

Today The Guardian published a well-researched article written by Daliah Singer about stresses the 20,000 wildland firefighters face on the job, including mental health issues. Here is an excerpt from “Burning out: the silent crisis spreading among wildland firefighters.”


“ ‘The exposure to human suffering in the last three years is not something you’d see at a typical day of work at firefighting – entire communities destroyed, loss of human life, loss of wildlife, loss of the landscape that we treasure. That’s not what wildland firefighters signed up to do, but it’s what they’re exposed to,” says Nelda St Clair, who worked in wildland fire for 40 years and is now the national critical incident stress management program manager for the Bureau of Indian Affairs (BIA).

“Mental struggles can become more acute in the offseason, when firefighters lose their connections to their crews and transition from rigorous schedules to quieter lives.

“ ‘[Wildland firefighters] have more risk than the average firefighter because of social disconnection,” says Thomas Joiner, a psychology professor at Florida State University and one of the country’s foremost experts on suicide. A recent study by his team included a sample of wildland firefighters – just 20 individuals – and found that 55% of them reported clinically significant suicidal symptoms compared with 32% of non-wildland firefighters.

“Dr Patricia O’Brien, a clinical psychologist and former hotshot – an intensely trained firefighter working directly on fire lines – expanded those results with a survey of more than 2,500 current and former wildland firefighters. Her early data, which is not yet peer-reviewed or published, shows that rates of self-reported probable depression, generalized anxiety disorder and PTSD, as well as past-year suicidal ideation, past-month binge drinking, heavy alcohol use and smokeless tobacco use were all two to 10 times more prevalent among wildland firefighters than the general public.”

(end of excerpt)


The article refers to research conducted by former hotshot Dr. Patricia o’Brien.  Here is an excerpt from the abstract of her work.

“Wildland firefighters in the sample reported relatively high rates of probable depression (17.3%), probable generalized anxiety disorder (12.8%), probable PTSD (13.7%), past year suicidal ideation (20.1%), past-month binge drinking (57%), heavy alcohol use (22%) and smokeless tobacco use (36.9%). These rates were 2-10 times higher than rates typically seen among the general public. Further, data showed a disparity between the prevalence of depression and PTSD identified by the study screening measures and the rates at which participants reported having been diagnosed by a healthcare provider. Finally, wildland firefighters in the study reported exposures to a variety of stressful events. Results of the study provide preliminary research data suggesting that wildland firefighters may be at greater risk of developing mental health conditions than the general public, and that a significant proportion of those conditions are under-detected and under-treated. Findings highlight the need for health surveillance and evidence-based health promotion and illness/injury prevention program development for wildland firefighters, particularly in psychological and behavioral health domains.”


 

Help is available for those feeling really depressed or suicidal.

Fight fire aggressively, having provided for mental health first

American Elk prescribed fire Wind Cave National Park
A firefighter ignites the American Elk prescribed fire in Wind Cave National Park, October 20, 2010. Photo by Bill Gabbert.

By Anonymous

Note: For the purposes of this article and ease of language I will be referring to “forestry technicians” (our official job title) as “wildland firefighters.” I and many of my cohort strongly identify with the latter classification.

I am a federal wildland firefighter experiencing mental health issues. It doesn’t matter who I am, where I work, or what my demographics are because there are many like me. In the middle of my career, neither fresh nor wise, I am facing some tough questions. By explaining my perspective I hope to shed light on this worsening epidemic. Maybe my experience will encourage people to check in on their employees, peers, family or friends in fire. Perhaps with the countless other stories coming out these days policy-makers will listen and start to adjust their tactics.

There have been bad fire seasons before; I’ve worked too many hours with unpleasant people, had tyrant bosses, and experienced a smattering of sexual harassment. There was Yarnell. I’ve weathered it all not with grace but with sheer tenacity. Of course I’ve made my share of mistakes, talked back when I should have kept my mouth shut, kept my mouth shut when I should have spoken up, but I consider myself an average federal employee in this regard. I’m good at my job and maintain a high level of passion for it.

In all honesty I’ve struggled with mental health in some form most of my life. I do not believe this invalidates my experience or the responsibility of the agency to recognize its problems. Certainly the all-or-nothing seasonal nature and high levels of true stress don’t help and even augment mental health issues. Lack of commensurate pay and benefits take their toll on morale as well. A global pandemic, amplified racial tensions, and drastic climate change contribute to the daily anxiety of most people whether they are in fire or not. Our issues are not unique but they are perhaps amplified, and with more potential for danger. In any case here I am now, taking leave from a job I mostly love and mostly need to get by.

I’m convinced my first season on a hotshot crew saved my life. This occupation has provided me structure, financial stability, and camaraderie. In return it has asked of me integrity and accountability. I spent the whole winter before that first season with dark ideas permeating my thoughts. Somehow, two weeks before critical I snapped out of it enough to show up and not quit. It was a tough start but I caught up and halfway through the summer I was walking around laughing with a saw on my back.

Currently it’s as if the dark portion of my mind that usually takes up 5%-20% has almost completely taken over. This part of my brain wants to break me down, call myself an imposter, and ultimately kill me. I am in sink or swim mode; I am trying to save my own life this time. It became clear as the season drew closer that I was not mentally prepared to be the high-functioning firefighter I usually am. I chose to draw back and focus on my personal life rather than risk becoming a liability on the job.

So often we think of our “work life” and “personal life” as being distinct and separate entities. I would like to express that this mentality is highly detrimental to the lives of employees. We cannot adequately perform our duties when there is such a rift between what we ask of firefighters and what we provide to them. Keeping your personal life separate is an old-guard means of avoidance. It also denies the possibility that our two lives can actually intertwine and complement each other. If we talk about the “fire family” and supporting our people, we cannot ignore the high numbers of individuals currently struggling.

In my fight against mental illness I am extremely and perhaps rarely privileged to have a supervisor who convinced me not to resign. I am further lucky that this person’s bosses trust them to make this call. Maintaining my health insurance is proving critical to my efforts at achieving wellness. This time off is not without consequence for me. First and most obviously, I am experiencing a drastic reduction in my usual income without roughly 1000 hours of overtime to bank on. I will miss out on months of on-the-job training and the professional development and networking that happens so fluidly in the field. Thus far my fancy federal health benefits have fallen short as my insurance company keeps rejecting my doctor’s efforts to get me the treatments I need. More personally still, I carry guilt and shame from not showing up this season, including a sense of failure from not exercising my skills and attributes alongside my coworkers. 

One of my greatest fears when I consider my anticipated return to work is that people will find out. They will know I cracked. They may lose trust in my abilities; they may invalidate my strengths in light of my weaknesses. What will future potential supervisors say when they see I took an extended absence during what is sure to be a busy year in fire? I feel the weight of every destructive incident on my back, and I feel comfortable asserting that this is a common feeling. I do not however possess the mental capacity right now to worry about all that. I have made the selfish but necessary call to choose myself in this battle. 

Droughts are deepening, climates are changing, and we always seem to work short-handed. If I am not alone in my mental health crisis, which I am not, how will we continue to effectively manage increasingly larger and more disastrous fires? I would argue that we should not go another shift without providing the support our people need. We must allow our wildland firefighters to show vulnerability in the face of so much global chaos, and seek to do the actual work it takes to remedy this. Furthermore, we need to collectively fight the deep-rooted professional and cultural stigma around mental health. Just as if it were a catastrophic fire we must fight aggressively and with great urgency.


Note from Bill:

Help is available for those feeling really depressed.

  • National Suicide Prevention Lifeline: 800-273-8255. Online Chat.
  • Anonymous assistance from the Wildland Firefighter Foundation: 208-336-2996.
  • National Wildland Fire and Aviation Critical Incident Stress Management Website.
  • Code Green Campaign, a first responder oriented mental health advocacy organization.
  • A new organization, Fire Mind, will be dedicated to helping wildland firefighters and expects to be fully operational by June 30, 2021.
  • Would you rather communicate with a counselor by text? If you are feeling really depressed or suicidal, a crisis counselor will TEXT with you. The Crisis Text Line runs a free service. Just text: 741-741