First responders overcome history to ask for help

After Nashua Police Capt. Jonathan Lehto killed himself last fall, Chief Michael Carignan took the unusual step — with the permission of Lehto’s family — of issuing a public statement about suicide among those in law enforcement.

When Merrimack County Sheriff Scott Hilliard was convicted of aggravated driving while intoxicated this month, his attorney, Jared Bedrick, asked the court to take into consideration Hilliard’s struggle with alcohol and “the culture in law enforcement” where “people suffered in silence for many years.”

Miriam Heyman, a psychologist who was co-author of a 2018 study for the Ruderman Family Foundation, is quoted in a Boston Herald article as saying, “Mental health treatment is effective, but we live in a world that stigmatizes mental illness. So there is silence around the issue, and that prevents first responders from accessing the help they need. They should know they’re not alone. And their leadership needs to take a more proactive approach.”

Franklin Police Chief David Goldstein, who is a member of the Granite State Critical Incident Stress Management Team, said, “There is a definite nexus between the components of first responders’ jobs and the potential for abuse of alcohol or drugs, being depressed, or suicide.”

However, there is a growing awareness of how counseling can help, Goldstein said. “The reality is we have the capability of helping our own, and we’re seeing more acceptance of that today. I think that’s important.”

Sweeping it under the rug

Ken Norton, executive director of the National Alliance on Mental Illness (NAMI) of New Hampshire, said, “Just 10 years ago, many agencies would just move the person on” if there was a problem with alcohol.

Goldstein agreed that, at one time, there was little support for those who – experiencing the effects of job stress and traumatic stress – turned to alcohol.

“In those days,” Goldstein said, “if there was anything alcohol-related, and if the chief noted you were having problems, and coming to work drunk, you could very easily walk into the chief’s office, and there would be two pieces of paper. One would be a resignation and one would be a signup sheet for Alcoholics Anonymous. Today, we’ve evolved so far away from that, it’s incredible.”

Norton said the fear of consequences still keeps many first-responders from seeking the help they need. “The fear is how it will impact the job status, whether there would be a reprimand or loss of job. A person may have been doing great, and then suddenly there’s a problem.”

According to Norton, “There’s a pretty good body of research that says that law enforcement and first responders have higher rates of depression and PTSD and higher suicide rates than the general population.”

Stress disorders

“We’re all designed for dealing with stress on the job, and have defense mechanisms, both psychological and physical,” Goldstein said. “With critical incidents, we know they’re coming, but don’t know when, and because they come when we’re not prepared, that’s a trauma. That has its own set of difficulties, and that’s when we start to see the development of stress disorder.”

The chief offered the obvious examples of officer-involved shootings and the death or injury of a fellow officer, but he said extensive media coverage after such an event also can serve as a stressor.

“You’re living and thinking or reviewing the incident over and over again, and if the media comes and asks the same questions a number of times, it causes you to think about it more, and that can contribute to the development of disorders that can take a toll on officers,” Goldstein said.

Goldstein, who served as a state trooper for 23 years, said he met a fellow trooper who had been on the job for two years. “He had to handle a fatal accident, and for whatever reason, it hit him so hard, he was retired medically because of what that caused in his life.”

Triggers

“One of the things we know about trauma,” said Norton, “is it impacts people differently, and it impacts people over time differently. What triggers somebody, while it might be predictable, might not be predictable: It could be a smell, a sound, or a headline.

“One of best examples of this was during the first Gulf War, when the ‘shock and awe’ was covered live on TV. A number of Vietnam veterans, who had been doing well, when they’re seeing that on TV, it triggered symptoms, like sleeplessness, nightmares, and hyper-vigilence.”

Goldstein said it would be incorrect to say that alcoholism is due to the trauma one has experienced. “An alcoholic is an alcoholic,” he said. “The individual would be an alcoholic regardless of whether he is in law enforcement, a truck driver, or a U.S. senator — alcoholism doesn’t recognize any boundaries.”

However, he said, dealing with the issues that first responders face, “The bottom line is it’s a contributing factor, absolutely.”

Goldstein said there are no solid numbers to quote. “In the old days — about 40 years ago — we used to say without any validation that, at any given time, in any police department, you would find 10 percent of the officers would have an alcohol problem, but there was no way to validate that.

“The other issues that come up, we have a better idea, but we don’t have finite numbers because the research is not really there so we can make a statement with absolute surety.”

Numbers

The estimates that are available say that, of roughly 800,000 police officers across the country, 125,000-150,000 could be diagnosed with post-traumatic stress disorder. Last year, there were 228 law enforcement suicides, compared to 134 line-of-duty deaths.

“Both numbers are unacceptable and horrific, but those are the numbers,” Goldstein said.

“These issues have not really been openly dealt with until fairly recently,” Norton said. “While New Hampshire provides all cadets with 16 hours of training coming through the academy, with Wellness 101 and hearing from people about de-escalation techniques, there are also conversations about their own mental health and, since 2008, suicide of police.

“More broadly, there’s been a recognition about the challenges that law enforcement and first responders face. Law enforcement has tended to be more on top of this than the first-responder community until very recently.”

Norton added that the “D” in PTSD is currently a subject for debate, with some people objecting to it being called a “disorder.” Veterans and other groups say that, if it’s a disorder, it’s a disorder as a result of their service to the country.

“There’s an active debate going on,” Norton said.

Help

Norton said that a commission created two years ago studied the impact of trauma on first responders and made a recommendation for the definition of injury under workers’ compensation. It resulted in Senate Bill 59, which offered a presumption of injury for first responders seeking compensation.

There also are numerous resources available throughout the state, as well as access to programs outside of New Hampshire. There is a retreat in Brattleboro, Vermont, as well as an inpatient unit at McLane Hospital in Belmont, Massachusetts — the LEADER (Law Enforcement Active Duty Emergency Responder) Program, specifically for those in law enforcement.

“It’s a special program, understanding that those folks have special needs,” Norton said.

Individual police departments have established peer-to-peer groups, training officers to serve on stress management teams that can help those affected by their work. The New Hampshire State Police have their own peer-to-peer group but also will help other departments with officers experiencing stress-related problems.

The Granite State Critical Incident Stress Management Team, of which Goldstein is a member, is directed by retired Nashua lieutenant Mark Proulx, and serves all first responders.

“We will go anywhere, and that’s how we can deal with these issues and start to intervene and bring normalcy back to the individual or group,” Goldstein said. “With good, solid counseling and intervention — people who can really work with the individual — they may miss 12 weeks of work. Without the counseling, there’s about 42 weeks of work lost.”

Goldstein said, “The bottom line is, all first responders — fire, police, and EMS — have to get past ‘seek help’ — then they have a leg up on getting better. The second thing is making sure you follow through. It’s hard work, and it bothers a lot of people, it’s annoying to a lot of people. Also, finding the right therapist, because not every therapist, just because he or she has credentials, can necessarily deal with some of these issues.”

Goldstein said it has taken four decades to get to where they are today. “Now the phone doesn’t stop ringing,” he said.

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A confidential crisis hotline for those experiencing problems is available at 800-273-8255. The number also offers an option to access a veterans’ crisis line.