Smashing the Stigma and Changing the Culture in Emergency Services

By Tania Glenn

First responders are one of our most valuable resources. Today, they are facing unprecedented levels of trauma, chaos, isolation, and violence. Now, more than ever, the mental health of our public safety members has to be a priority. First responders across the United States and around the world have been hit with significant stress, violence, and chaos. The current situation has pushed many first responders too far and with as much as they can take.

The time for change is now. This is a book about change. This is a book about caring for hearts and minds and getting it right. This book applies to everyone, from top leadership down to the front line. Agencies and first responders alike need to lean into the concept of mental health for first responders and get serious about their care. Now more than ever.

"Smashing the Stigma and Changing the Culture in Emergency Services," Tania Glenn's latest book, delivers a clear road map to assist everyone who wants to create change and bring about healing for public safety personnel.

• Language: English
• Publisher: Progressive Rising Phoenix Press, LLC
• Release date: Nov 10, 2020
• ISBN: 9781950560424

Tania Glenn

Tania was three months from completing her Master's Degree at the University of Texas when she witnessed the dramatic and violent standoff between law enforcement and the Branch Davidian Cult in Waco, Texas. At that point, she knew her calling was to work with first responders and to focus on healing these warriors from the horrors of post-traumatic stress disorder. Tania spent the first ten years of her career working in a Level Two Trauma Emergency Department on weekend nights as she built her private practice during the week. In 2002, Tania transitioned to her private practice on a full-time basis and has dedicated her entire career to working with first responders and military members. Tania assisted with the aftermath of the Oklahoma City Murrah Federal Building bombing, the 9/11 attacks on the World Trade Center, Hurricane Katrina, the Dallas Police shootings, and numerous other incidents. Tania is referred to as the "warrior healer" by her colleagues, and she is passionate about her work. Tania resides in Central Texas. Her loves include her family, her pets and fitness.

Book preview

Foreword

I met Dr. Tania Glenn in 2001 at Ground Zero during the World Trade Center recovery. She was the team clinician for one of the many Critical Incident Stress Management Teams that were sent out to NYC to volunteer their time to assist with debriefing members of the NYPD. I was an NYPD police officer at the time and had no idea just how incredible she was.

Dr. Glenn was the most dynamic person I have had the pleasure of watching during a debrief of NYPD officers, as she explained the importance of recognizing the signs and symptoms of PTSD. It was apparent that she had a knack for making people feel relaxed and open up. I still remember when we would talk after some of the debriefings; I was amazed by how much she had already done and accomplished. Dr. Glenn has worked in hospitals, crisis centers, STARFlight air rescue, and the list goes on. She was already looking into research for EMDR before it was recognized as a necessary tool for the mental health profession.

Simply put, Dr. Glenn has always been that person who has truly dedicated her life to ensuring first responders are able to get back on their feet and back to work. Whether it’s EMS, fire, police, or military, she is ready to provide the best care available. Because of her, so many people have returned to the life that trauma had taken away from them. Not just learning coping mechanisms but learning that dealing with trauma head on is the key to renewing your lease on life.

In the years that I have known Dr. Glenn, she has constantly travelled all over the United States giving seminars on resiliency, PTSD, severe trauma, EMDR, survivor’s guilt, and vicarious trauma. You name it, she teaches it.

Dr. Glenn’s love for what she does always keeps her on the go. Thanks to her life’s work, more people have been able to have a (new) normal life. She’s making the world a better place, one patient at a time.

Sergeant Robert Santiago, NYPD (Ret.)

Introduction

I am in my twenty-ninth year of caring for the hearts and minds of first responders. My journey has been filled with excitement, constant change, massive amounts of travel, victories, horrible moments, triumphs, and heartbreaks. I have made plenty of mistakes along the way, and in doing so I have learned so much. I have developed a model of caring for first responders that works. In no way am I saying that my way is the only way; whatever the process, we know that first responders across the country do reach out every day for care, advice, guidance, and direction.

After writing four books, I thought I was done. Then 2020 happened. First responders across the United States and around the world have been hit with significant stress, violence, and chaos. The current situation has pushed many first responders as far and with as much as they can take. We have absolutely reached critical mass. My biggest worry is that if departments, cities, counties, and states do not change, we will see a significantly larger number of first responders struggling with mental health issues. The worst-case scenario is the suicide rate increasing even above current levels.

The time for change is now. This is a book about change. This is a book about caring for hearts and minds and getting it right. This book applies to everyone, from top leadership down to the front line. We need to lean into the concept of mental health for first responders and get serious about their care. Now more than ever.

Chapter One

Stigma

In my headspace

I feel like I’m drowning

Am I dead weight?

Everything around me

Is so fake

I feel like I’m drowning

I’m okay, I’m okay

Headspace by Fame on Fire

The word stigma refers to a mark of disgrace associated with a particular quality, circumstance, or person. In the world of public safety, there is a long history of a very significant stigma associated with asking for or receiving any sort of mental health help. Going to therapy or treatment has been a pervasively negative concept associated with weakness and the inability to perform one’s duties.

The historical context of the stigma surrounding accessing mental health services in public safety is an easy connection to make. In the United States, decades of stigma existed in general. This came from the early days of fenced-in psychiatric facilities only treating the insane; treatment modalities including frontal lobotomies; the frequent use of extreme means to control behaviors, such as straightjackets and paralytics; and a series of toxic psychotropic medications that came with a host of side effects and physical damage to the body. American society in general viewed mental health with the stigma of being labeled crazy. The field of public safety responded to this stigma by adopting a stance that to do this work, one must be immune to stress. The stiff upper lip and walk it off mindset became the go-to mantras because there were no other options. It’s what needed to be done.

As time passed and the understanding of the human brain evolved, so did mental health diagnostics and treatment modalities. The American culture became more accepting of mental health issues and treatment. Public safety, however, did not. The mindset that if one cannot deal with the stress then they should quit their jobs remained in emergency services and still exists even today to a large extent. While it is changing slowly, numerous barriers exist for many first responders to feel comfortable getting help. The reason, however, has less to do with mental health stigma and more to do with the field of mental health failing first responders.

The ultimate threat to any first responder who considers getting help is losing their job or their license or facing some sort of fit-for-duty evaluation. Given the behaviors of some therapists, this is easy to understand. I was asked once to consult on a case where a therapist was seeing the young son of a police officer for anxiety. The therapist, upon learning that there were weapons in the home, called Child Protective Services to investigate the situation. This ignorant behavior not only jeopardized the therapeutic relationship with the child, it completely turned the officer/parent off to the field of mental health. For this officer, and every officer or first responder friend that he shared the story with, it perpetuated the stigma that mental health professionals are incompetent and clueless about public safety.

Another issue for first responders is the plethora of therapists who think they want to work with public safety and fail to do their homework. I have heard countless stories of therapists being shocked by the macabre sense of humor that first responders use to cope with stress, or therapists who begin to cry when a story of a traumatic incident is told. I ended up counseling the counselor is what many first responders have told me. Again, this perpetuates the stigma that mental health is a waste of time at best and a dangerous endeavor at worst. The stigma perpetuates itself every time stories such as these are told.

During the early years of my career, I worked weekend nights at a Level II trauma center while I built my practice for first responders on the side on the weekdays. One night we were the unfortunate recipients of an infant homicide. Because there were two of us on duty for social services, my partner told me she would remain with the patient. She knew I wanted to check on the EMS crew that transported the patient. As I walked onto the dock at the ER and toward the back of the ambulance, I heard the paramedic, who had transported the patient and was the field training officer for his rookie partner, tell the rookie that he had better not cry or express any emotions about this. He went on to tell his rookie that if this bothered him, then he was weak. He also said that if this bothered him, then he should not be in EMS. He tagged on, Don’t be a pussy for good measure.

I turned around and walked away. It was definitely not the time or place to address this. My presence would have only aggravated the situation. What I saw was a crew that needed to shake this off so they could finish their shift. I saw two human beings who just transported a baby who had been murdered, and who were having a tremendously hard time incorporating such a heinous act into their psyches. They needed the space and place to walk it off, but I knew that they would need to address this event when they were in the right space and place to do so. I also understood that the paramedic’s views and assertions were based on the pervasive stigma against psychological care passed down by many generations of first responders, as well as a lack of understanding of how the process of seeking help works.

Stigma has been the biggest uphill battle of my career. Not only have I seen it prevent first responders from reaching out when they need help, I have also witnessed the downfall of