The Innerbloom team, including Libby, Cindy, Eli, and I, recently attended a two-day conference at the Madonna Inn Expo Center, hosted by 1st Responder Conferences. This organization is largely staffed by volunteers and individuals who have profound personal experiences and losses stemming from the high-risk, high-stress first responder professions. The company organizes conferences nationwide to raise awareness of the mental health challenges faced by first responders, including firefighters, law enforcement officers, and EMTs. Providing a platform for educational presentations paired with resource partners (such as Innerbloom) who can provide culturally competent mental healthcare to first responders, the organization promotes discussions that aim to reduce the stigma associated with seeking mental health treatment—a significant hurdle for many in these professions. This troubling issue was highlighted by a survey involving over eight thousand officers, with more than 90% indicating that shame prevents them from seeking help with their mental health. With many alarming statistics, such as firefighters and EMTs being twice as likely to die by suicide as in the line of duty, the discussions during the conference emphasized the importance of addressing issues such as post-traumatic stress disorder (PTSD), substance abuse, and the high risk of suicide.
As we arrived on Thursday morning, Chief Neil Gang of the Pinnacle Police Department had just begun his presentation on creating wellness, starting with a heart-wrenching story about a fellow officer and friend who had shot himself in the chest. I quickly realized that this conference was unlike any I had experienced before, either during my medical training or even last year at the Psychedelic Science Conference in Denver. There was no filter on these folks; in fact, it was their well-placed four-letter words that kept my attention razor-sharp and at times had me giggling with their frank jokes and compelling narratives. I enjoyed the quick-witted, raw, and real nature of this crowd. No frills, just real life &*@#.
Let's dive into the heart of this conference, exploring key presentations which struck a personal chord with me as someone familiar with the stress and burnout of working on the front lines as a former trauma surgeon.
Firefighter Egan De Los Cobos, with over twenty five years at the Santa Barbara Fire Department, shared his personal battle with PTSD stemming from a traumatic off-duty incident in 2013. De Los Cobos vividly recalled a visit to his local coffee shop with his son when tragedy struck—a moment he described as "when my whole life changed." An elderly driver lost control and crashed into the area where they were seated, knocking his son beneath the car. De Los Cobos managed to free his son from the wreckage, who was incredibly relatively physically unharmed. The sound of his son's cries was a reassuring sign of life. Remarkably, both left the incident with only mild injuries, which he deemed as nothing short of a miracle.
However, about four weeks later, De Los Cobos began experiencing a myriad of disturbing and odd symptoms, including eczema-like rashes on his head and persistent foot, hip, and back pain, which gradually worsened, causing huge upset in his life. These physical symptoms were accompanied by sudden anger outbursts and debilitating insomnia, indicating deeper mental health issues. After seeing doctor after doctor, it was years later that he was diagnosed with an autoimmune disease and PTSD. Although surgery was recommended for his hip, he chose to pursue professional mental health care instead, including Eye Movement Desensitization and Reprocessing (EMDR) therapy, counseling and working out. Remarkably, this conservative approach alleviated all physical manifestations of his trauma. De Los Cobos's experience underscores the profound connection between mental and physical health, illustrating how addressing mental trauma can lead to physical healing.
His journey of struggle and resilience transformed into a mission of empowerment. He became a certified health coach and founded First Wellness Health, using his experiences to help others achieve wellness. As silver lining and sweet twist of fate, he revealed that he later married the news reporter who interviewed him at the scene car crash. De Los Cobos is a profound believer that through pain and heartache, beauty can prevail.
Chief Alex Hamilton of the Oxnard Fire Department delivered a presentation titled "Sleep Health and Wellness" from the Sleep Matters Initiative (SMI) Team. His talk highlighted the sleep deficiency epidemic, particularly prevalent among firefighters, and addressed common sleep disorders such as insomnia, obstructive sleep apnea, and restless leg syndrome. Chief Hamilton emphasized the critical importance of sleep for maintaining both physical and mental health, noting that chronic sleep deprivation can lead to severe health issues like cardiovascular disease, diabetes, and mental health disorders such as depression and anxiety. He stressed that inadequate sleep is also linked to a shortened lifespan. Firefighters and other first responders routinely suffer from sleep deprivation when working 24 to 48 hour long shifts.
Being awake for 24 hours can result in impairments that are equivalent to having a blood alcohol concentration (BAC) of 0.10%. To put that into perspective, the legal limit for driving in most states in the U.S. is 0.08% BAC, which means that staying awake for such an extended period can make someone more impaired than is legally permissible for driving.
During his presentation, Chief Hamilton offered practical strategies for improving sleep health. He recommended maintaining a consistent sleep schedule and creating a bedroom environment conducive to rest. This includes minimizing exposure to screens and avoiding stimulants such as caffeine and alcohol before bedtime. He also highlighted the benefits of regular physical activity and proper dietary habits in promoting better sleep. Additionally, Chief Hamilton suggested incorporating relaxation techniques into evening routines to help the body wind down effectively. He is a huge proponent to improving the quality of the sleeping quarters provided for First Responders to help them get the best sleep possible.
Speaker Stephanie Kiesow, who is deeply rooted in law enforcement as a former police officer, the wife of an officer, and the daughter of two retired officers, began her presentation with a personal story about a past boyfriend, Ricky. Tragically, Ricky struggled with his mental health, turning to unhealthy coping mechanisms, ultimately resulting in suicide, which became a pivotal event that profoundly influenced Stephanie's life journey and purpose. She shares this story to provide a real-life example of how things can tragically go wrong, often unexpectedly and without obvious warning signs. She mentioned that in high-stress professions, including those of first responders, individuals often develop the skill of compartmentalizing as a means to cope and fulfill their work duties. However, burying down the trauma takes a toll, and if not dealt with in a healthy manner, can greatly affect one's own health. After a 16-year career in law enforcement, Stephanie left her position in 2022 to fully dedicate herself to pursuing a Ph.D. in Psychology. Her research focuses on work-related factors contributing to suicide within the first responder community.
Stephenie shared the Interpersonal Theory of Suicide, which provides a framework for understanding how isolation, perceived burdensomeness, and desensitization contribute to suicidal behavior. According to this theory, the desire to die by suicide typically emerges from two main interpersonal beliefs. The first, perceived burdensomeness, involves the belief that one is a burden to others, causing more harm than good. Individuals who feel that their existence negatively impacts their family, friends, or society are at increased risk of developing suicidal thoughts. The second factor, thwarted belongingness or isolation, relates to a profound sense of alienation or a lack of meaningful connections, leading individuals to feel fundamentally alone and disconnected. I've discussed this before in a previous post, explaining how studies have demonstrated that prolonged social isolation can have deleterious effects on mental health. Additionally, desensitization to pain and self-harm plays a critical role, particularly in those regularly exposed to trauma, such as first responders or military personnel who are exposed to extreme stress and danger on a daily basis. This exposure can reduce their natural aversion to self-harm, lowering the psychological barriers to suicide. When these factors—perceived burdensomeness, isolation, and desensitization—coalesce, the risk of suicidal behavior significantly increases, underscoring the need for targeted preventive measures and supportive interventions.
Stephanie Kiesow has developed a concept called WARRIOR, an acronym that encapsulates Wellness, Awareness, Resilience, Resources, Identity, Openness, and Routine. These elements, when integrated into their lives, empower first responders to address the factors contributing to mental health issues and suicide, thereby enhancing their capacity to manage the demands of their professional and personal lives. Learn more about this in her Amazon Best Seller, "Workicide."
Ryan Dedmon, a former 911 dispatcher, delivered a presentation that blended his personal struggles along with his experience behind the console. His talk aimed to help first responders recover and grow from post-traumatic stress. He shared a story about Kathy Johnson, a fellow officer and dear friend who tragically took her own life. Having been close, in both a professional and personal way, he was completely caught off guard. He highlighted the absence of mental health resources in the department, stating that after news of his friend’s suicide, the department's "debrief" session consisted of thirty minutes sitting silently around a table with a few other coworkers. Life kept moving, and Dedmon threw himself into his job, becoming a key member of his department, working more than ever.
Years later, during a particularly harrowing 911 suicide call where a father reported his daughter had shot herself, Dedmon vividly recalled hearing her last breaths over the phone. The call was remarkably similar to the way his friend had taken her life and even after handling many, many difficult calls, it shook him to the core. Three days later, he realized had neither eaten nor slept, and holding a master's degree in psychology, he recognized he needed help. At 33, he was offered short-term disability, but chose to voluntarily resign instead.
Four months after resigning, he became an alcoholic, using alcohol to cope and “shut off” his mind. He was eventually put in touch with a trauma-informed therapist and underwent intensive therapy, including cognitive-behavioral therapy (CBT) and EMDR. Slowly, he began healing and returned to more his former self. Now, his life mission is to provide resources and training for those suffering as he did.
As an engaging presenter, Dedmon then instructed the entire conference (roughly 220 attendees) to form a large, kumbaya-like circle for a group exercise. We were asked to turn to the person next to us and rate ourselves how we were doing on a scale from 1 to 10. Openness and honestly was expected. As he moved around the circle, he put several people on the spot, asking why they felt the way we did. As you might expect, it was uncomfortable for some, especially those who gave lower numbers. The group discussed the appropriate response when someone is "not okay." Essentially, the takeaway message was to avoid offering solutions, threatening to get help for them against their will, or making them feel worse. Instead, his approach focused on three points: validation, affirmation, and availability. Here’s an example of this:
“Jim, how are you doing today?”
“Not well, I’m having a hard time at work and finding it more difficult to enjoy activities that once brought me joy, like surfing and hiking.”
"I'm really glad you felt comfortable sharing that with me, Jim. It sounds like things have been really tough for you lately. I want you to know that I'm here for you, and we can talk about what you're going through whenever you need. You're not alone in this."
The conference concluded with a presentation by Joe Willis, a US Army First Sergeant. This a big, burly fellow sported one of the most quintessentially manly beards you could imagine—a stereotypical military tough guy, exactly who you’d want on our side. However, appearances can be misleading. While he’s undoubtedly a hardened soldier, (and has the experience to prove it) it was a delightful surprise to hear him advocate for the crowd to "man up and do some downward dogs." Yoga, meditation, and self-care—now that's where it’s at! He shattered all stereotypes, emphasizing the importance of breathwork and various meditation practices such as metta, where the focus of meditation is on the betterment of others, starting with those close to you and extending peace and love to the community and humanity at large. This guy knew his stuff, and it was evident in how poised his presentation was. In the moment? Absolutely—Willis was there, making it the place to be.
This first responder conference surpassed all my expectations, and it certainly won't be my last. These heroes, who risk their lives daily, often face traumas that would likely send most people home in a puddle. Here's some food for thought: law enforcement officers witness an average of 188 major traumatic events during their careers, compared to just 4 for the average civilian. And one in three people who experience a single severely traumatic event will develop PTSD. It was enlightening, shocking and heartening to participate in this conference, meet our local first responders, shake hands, and gain insight into their complex and fascinating lives. What an excellent opportunity to tackle the stigma surrounding mental health, be among peers, and normalize the reality that life is tough—it's okay to ask for help, and it's okay to not be okay. However, it's not okay to do nothing about it. It's crucial discussions like these that we need to continue to support our community protectors, ensuring our collective well-being and the freedoms we enjoy as civilians.
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