Many surviving members of the FDNY were left traumatized after the terrorist attacks on Sept. 11, 2001. The director of the FDNY Counseling Service Unit (CSU), Malachy Corrigan, along with the unit’s deputy director, Capt. Frank Leto, and others, realized that the CSU’s staff of 12 wasn’t enough to handle the mental health ramifications of 9/11 on the department’s members. So, city and state mental health agencies were enlisted to train FDNY peers (and EMS peers) on various mental health topics (depression, anxiety, marital problems, substance abuse, post-traumatic stress disorder [PTSD] and suicide) to discuss with members of the department. Daily meetings were set up in the CSU’s Manhattan office. Peers themselves met with a clinician on a monthly basis to see how they were dealing with their feelings.
After the Happy Land Social Club arson fire in March 1990, which resulted in the death of 87 civilians, the CSU started a program to train active and retired members of the FDNY to become peers. That peer model was modified slightly after 9/11: One peer would go with a civilian clinician to one of the 61 firehouses that lost one or more firefighters in the World Trade Center. Usually, the peer would know some of the members, and that made for a cordial introduction. (Some of the clinicians were a bit reluctant to go to the firehouse, because they weren’t familiar with the culture. On the other hand, the firefighters were concerned about the stigma that was associated with mental health issues.) The peer introduced the mental health topics that the clinician would discuss. This fostered a situation whereby members could begin to try to make sense of what was going on in their life and identify possible solutions. Sometimes the clinician and the peer would get a group together around the kitchen table in the firehouse and get a dialog going, talking about members’ feelings.
After the introductory meeting, the peer stepped aside, and the clinician made the return visit to the firehouse alone. (A clinician would be assigned exclusively to one firehouse.) It took time, but gradually, the process began to be accepted.
Included among the reasons for the slow progress was that so much was going on at the moment for clinicians, including taking care of deceased members’ families, working the pile and attending funerals as well as taking the time that was necessary to care for their own family.
Also, when you think about the number of firefighter and EMS family members in addition to the firefighters and EMS providers themselves, it’s comparable to the population of a medium-size city.
Furthermore, firefighters had to learn how to take care of themselves during this time of a new normal. A brochure that was created by the department listed items that might cause stress problems that were affecting members and the families. As more and more members read the brochure and recognized several items that were bothering them, the willingness to talk to a professional—the clinician—grew.
Over the long months of recovery, post-traumatic stress disorder became post-traumatic stress recovery. Firefighters would set up lists of chores to be performed for families of deceased members. These lists included cutting the grass, helping children do homework and driving them to the dentist, and even babysitting.
One peer, Firefighter Ralph Esposito, babysat a deceased member’s four children for a weekend. He still is in contact with the family to this day. The two boys in that family now are FDNY firefighters.
FDNY Clinician Kim Ahearn Young started a program that provided such activities as camping trips, rock climbing, gymnastics, ice skating and skiing. CSU Peer Phil Duncan and his wife, Ginger, worked with Ahearn Young to help children to cope with problems that were caused by the loss of their firefighter parent. To this day, the Duncans keep in touch with many of those children, who now are adults.
Eighteen months after 9/11, clinicians discontinued their firehouse visits. Peers still are regularly available to members.
Peers at Surfside
Terry Coyle, who is a firefighter-turned-peer-turned-licensed FDNY clinician, recently went with peer teams to the Surfside, FL, condominium building collapse. Coyle, Leto, the team of peers and clinicians talked to firefighters and rescue workers from all over the world. Coyle noticed similarities to the World Trade Center that brought him right back to 9/11: the pile, the sounds, the smells.
While working one night at the collapse site, Coyle observed the eagerness of firefighters and rescue workers to talk to a mental health provider who was a firefighter. It was a welcome demonstration of the changing acceptance that members have toward mental health issues.
FDNY Lt. Dan Bellew, who is a peer, also talked to rescue workers in Surfside. The January 2005 Bronx tenement fire that’s known as The Black Sunday Fire came up. (Six firefighters were trapped on the floor above the fire and were forced to jump out of fourth-floor windows. Two were killed; others were injured severely. One who was killed was Bellew’s brother.) As a peer, Bellew tells firefighters not to wait to ask for help. He recognizes the difficulty of this for some firefighters. After all, firefighters are in the business of helping others.
A very difficult situation for firefighters is the death of a child in a fire or accident, similar to what went on in Surfside. It can be a trauma that gets locked up in an individual’s brain. To free it and get back to normal, the individual needs professional mental health counseling.
Time is important, and trauma should be addressed as soon as possible. Waiting to see how you feel in a few weeks or months can compound the problem. Trauma delay can come back to haunt a person weeks or months later or even beyond that. It’s very cunning and baffling.
A new day
In the old days, when it came to trauma of the type that’s described above, we would stuff it, ignore it or anesthetize it with alcohol and believe that it would go away. Now we know that it can come back to haunt a person years down the road, but an individual might not realize it in his/her own situation. Other people might see it, but we might not see it. Connecting the dots between personality change and unresolved trauma can be challenging. That’s why it’s so important to “get a checkup from the neck up.”
Once a year, retired 9/11 firefighters go for a medical and mental examination at one of the department’s five CSU medical monitoring sites. Thorough exams are conducted by medical and mental personnel, and the results are compared with the previous year’s exam results. The findings are discussed with the member, and an updated plan is put into motion.
When COVID-19 hit New York City, new challenges were presented to the CSU. Firehouse visits were stopped; telephone calls became the new normal. Each peer was assigned 6–8 firehouses. As one might expect, COVID stresses resulted in an increase in calls to the CSU.
EMS Capt. Gil Medina, who is a peer, knows the importance of the program for his EMTs and paramedics. He so appreciates the services of the CSU for EMS workers and their families, so they know that they aren’t alone when the stresses of the job affect them.
The bottom line is peers aren’t mental health clinicians. They share their experience to help members to take advantage of the many mental health programs that are available to help firefighters to develop their mental resilience.