Movember, EMS, Firefighters, Resilience With Frank Leeb
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): The Good Men Project
Publication Date (yyyy/mm/dd): 2024/10/28
The Enhanced Stress First Aid program, funded by Movember, provides tailored mental health support for firefighters and EMS, improving accessibility through online training and flexibility. Frank Leeb is the Managing Director for the First Responder Center for Excellence and a Retired FDNY Chief Officer.
Scott Douglas Jacobsen: Today, we are here with Frank Leeb, who will discuss advancements in mental health support for firefighter and EMS organizations. The First Responder Center for Excellence has developed an enhanced Stress First Aid (SFA) program. This new program is designed to help firefighters and EMS personnel manage stress in their high-pressure roles.
How does building mental well-being and resilience benefit professionals? This is a softball question.
Frank Leeb: Yes, it is. Building mental resilience is crucial. It helps prepare responders for the challenges and situations they may face as firefighters, EMTs, or paramedics.
By introducing resilience-building mechanisms early, our first responders are better equipped to manage the stress of their jobs. They can recover more quickly if they experience increased stress due to their work. In the fields of homeland security, fire, and EMS, we often refer to the concept of being “left or right of the boom”—meaning before or after an incident occurs. Our focus is on preparing responders before an incident, in the “left of the boom” stage, to build their mental resilience. This is the primary goal of the program.
Jacobsen: Many classes are now offered online, which is especially helpful for those juggling responsibilities like family or caregiving. This format allows more people to access and attend these courses, making it easier for them to gain valuable information. How extensive are the online services for this education?
Leeb: The class we offer takes about 40 minutes to complete one module. It’s free for firefighters or EMS personnel who want to take it. Initially, the program was delivered in person as part of a three-year project with Movember. However, due to COVID-19, we transitioned to an online format.
The long-term benefit of offering this online is substantial. In-person classes could only reach a limited number of people. Still, online courses allow us to “force multiply” the message, reaching many more responders, especially in remote areas where gathering enough people for in-person training can be challenging. Smaller or rural departments often need more funding for in-person training, so this online option enables them to train all their members without the need to travel to a single location. They can complete the course from the comfort of their homes or firehouses.
This model, which we implemented during our work with Movember, has proven successful. The First Responder Center for Excellence plans to create more modules in this format.
Jacobsen: How was stress managed for firefighters and EMS personnel in the past, and how is it viewed now? How is this newer understanding integrated into the education?
Leeb: That’s a great question. Often, we have peer support groups and people who come in after a firefighter is struggling. But again, let’s switch to preloading the mechanisms to deal with it. Let’s teach different strategies, such as breathing exercises or mindfulness, and equip responders with the tools to recover quickly. In addition, bringing those trainings online, as I mentioned, has broadened the audience we can reach.
Jacobsen: When I was in basic training for the Canadian military this year for 7 of the 8 weeks/8 of the 9 weeks, they introduced tactical breathing. So, they practice something similar to pranayama. It’s essentially the same when it comes to calming the nervous system and reducing anxiety. This kind of direct physiological practice is very helpful in stressful situations.
Leeb: Well, those techniques would have been useful for you in Ukraine, right? It’s all about calming and getting your body into the right state.
Jacobsen: That’s right.
Leeb: It’s about understanding the sympathetic and parasympathetic systems and how we can influence them. That’s what these classes aim to do—they provide the tools first responders need to survive, thrive, and continue. We know that first responders encounter situations that many people will never see. They do things and go places that most people won’t experience on a normal day. We want our first responders to be resilient and ready for the next call.
Jacobsen: Their work conditions are often unpredictable. For example, when I was in Ukraine, a couple of instances caused genuine fear due to the circumstances. However, I won’t go into detail. That’s a reality for first responders. In extreme work environments, whether domestic or international, they witness emergencies, tragedies, and death firsthand. It doesn’t have to be like a high-speed car chase in a movie with Harrison Ford or Mel Gibson. Simply witnessing traumatic situations in others is physiologically triggering.
Leeb: Exactly. You’re right. It could be as simple as responding to a medical run and encountering a case of child abuse or a young child who didn’t survive. You might also be performing CPR on someone or attending to a horrific car accident. It doesn’t have to be a major disaster like 9/11, where I was a responder in the afternoon in lower Manhattan. We know there are significant mental health impacts from those situations. And just a month later, in October of the same year, a plane crashed in Queens, and I responded to that as well. Programs for mental health back then were either lacking or inadequate.
In many cases, the necessary mental health support systems were not in place to prepare you for the psychological impact of those experiences. When I was with the FDNY, where I recently retired, this led to a drastic shift in how we handle peer counselling and our counselling unit. There has been significant evolution in this area. Similarly, at the First Responder Center for Excellence, transitioning from in-person to online training while ensuring we preload these mental health mechanisms into first responders represents a dramatic shift in preparing for these inevitable events. Firefighters will face these challenges, and it doesn’t matter whether you work in a busy city like New York or Toronto or in a suburb anywhere—emergencies happen everywhere.
Online training is important because we can reach responders everywhere, which is crucial.
Jacobsen: Not every responder will get the same attention or recognition that 9/11 first responders received, like when Jon Stewart advocated for their health issues. His focus was primarily on cancer and other related conditions. But when it comes to mental health, it’s rare to see long-term, intensive advocacy from someone that prominent. How do you balance short-term initiatives, like month-long awareness campaigns like Movember, with the long-term commitment required for mental health support?
Leeb: For us, working with Movember was part of a three-year project. So, regardless of the month, our class was available year-round because emergencies happen all year, and preparing for mental wellness is a constant task. Movember was the perfect partner for us because of their recognition and because when people see the Movember logo, particularly men—and firefighters are predominantly men—they pay attention. While we’re working to shift the demographics a bit, Movember’s appeal and global reach were crucial in helping us get our message out to the right people.
Let’s face it: who still shaves their mustache in November? Some firefighters keep their mustaches in November without knowing the backstory behind Movember or why it started. When we can leverage organizations like Movember for good, it’s a win for men everywhere, especially for firefighters. That’s why the program was successful.
When we shifted to the online class, we immediately saw positive results. Based on feedback, we adjusted the content slightly in years two and three and ended up with an astonishing completion rate of 76%. If you have a program where nearly 80% of participants complete it, that’s a significant achievement.
Jacobsen: That’s a great final note. What do you think?
Leeb: I agree, that’s good. Thank you for your work, too—whether it’s about this or your reporting from Ukraine, it’s important for people to hear those stories.
Jacobsen: Thanks. I’m just a holler-back girl!
Leeb: [Laughing] All right. Take care of yourself.
Jacobsen: You too. Take care. Bye.
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