By Abigail Ham
The Keene Sentinel
MARLBOROUGH, N.H. — As the sun slid behind the mountains on Wednesday, Route 12 in Walpole was lit by the red and blue lights of emergency vehicles. Police, fire and EMS personnel spent several hours there, responding to a crash that left an Alstead woman seriously injured and a Marlborough resident dead.
At the scene, Walpole Police Chief Justin Sanctuary was calm, cool and collected; that’s his job. But Sanctuary says having feelings is part of the job, too.
“If it doesn’t bother you, you shouldn’t be doing this job,” he said on a phone call a little less than 24 hours after the crash, in which a 22-year-old died. “You should feel something … It’s human to feel something.”
The night before, Sanctuary debriefed with his staff. The debrief was partly professional — getting things together for the official investigation into the crash — and partly personal — making sure each officer who worked the scene had a chance to talk about what they’d experienced.
This openness is the norm in the Walpole department and some other police and fire departments in the Monadnock Region, but in others “feelings” is still a taboo word. First responders and mental health experts said the profession has come a long way in opening up to conversations about mental health, although work remains.
‘Elephant in the room’
A 2021 study based on more than 4 million death certificates in the United States found law enforcement personnel are 54 percent more likely to die by suicide than the general population.
The Monadnock Region lost at least three current or former members of law enforcement to suicide in the past year.
First responders said the stigma around mental health has weakened in many departments but remains a problem in the profession.
Brattleboro Police Sgt. Tyler Law said some first responders still have an “old-school mentality” that associates emotions with weakness.
Similarly, Chesterfield Police Chief Lance Rouse said officers sometimes fear that admitting they’re having a hard time could result in having their badge and gun taken away.
“As a profession, we’re trying to move away from that,” Rouse said. In Chesterfield, the recently promoted chief tries to lead by example by being transparent about his own feelings.
Epping Fire Deputy Chief Mark Proulx, who has led debriefs for departments across the state with the Granite State Critical Incident Stress Management Team for about 40 years, likes to compare mental injuries to physical ones to encourage first responders who are hesitant about participating in debriefs or are skeptical of seeking other forms of support.
“If you fell off a ladder and broke your arm, you’re going to go get that fixed,” he said. “If you go to a call, and you have a serious stress reaction, you should go get that fixed.”
In Brattleboro, a psychologist helps first responders debrief after difficult calls. Those conversations often start quiet, Sgt. Law said, but one person opening up can start a domino effect.
That’s a change from when Law first started on the Brattleboro force about seven years ago. Back then, he said, “You’d get back from a call, get back in your car, and go to the next one.”
Still, Marlborough Fire Chief John Manning said talking about mental health remains taboo in the profession. “The taboo starts with the macho attitude of first responders. ‘We can handle anything and nothing bothers us,’ ” he said. “I’ve been doing this a long time, and there’s been a lot of incidents over the years where people don’t want to talk about it, where people don’t think they need to talk about it.”
In reality, though, Manning said, “You need to deal with the elephant in the room.”
Pamela Goss-Power, a Concord-based psychologist who specializes in helping first responders cope with the cumulative stress of their careers, said suicide prevention is a goal for her and others who are working to break down the stigma around mental health. “We all recognize that one suicide is way too much,” she said, and early identification and treatment are essential to prevention.
‘A daily grind’
For most people, a day that involves interacting with police, fire services or EMS is a bad day. Maybe even the worst day of their life. But for the men and women who don the badge, that’s daily life.
The public often doesn’t realize just how stressful and difficult those jobs can be, Goss-Power said.
Rouse said first responders “see things we’re not supposed to see. We smell things we’re not supposed to smell. We hear things we’re not supposed to hear.”
Rouse’s department has responded to several serious car crashes over the past year, including one in which two people died. He said first responders tend to be good at compartmentalizing their reactions during incidents to respond professionally and efficiently — it’s after that the emotions tend to hit.
“The first night, you don’t sleep well.”
Part of the challenge for first responders is that these aren’t one-offs. Over the course of a career, a person might witness many traumatic incidents.
Law said the repetitiveness of calls can be “a daily grind” that “definitely wears on” people.
Individual calls like car crashes can be challenging, but smaller incidents add up, too, Manning, the Marlborough fire chief, said. “You start to say, ‘Why is this always happening? Why can’t we do anything to stop this from happening?’ ”
Many people become first responders because they want to be heroes — they want to be able to do what needs to be done in a tough moment and save people, Sanctuary said. When they’re able to do that, it’s incredibly fulfilling. But when they do everything they can and aren’t successful, it can be difficult.
Sanctuary said he and others he knows have had experiences of performing CPR, giving a shock with an AED, and having things look like they’re going to turn around only to ultimately lose the person.
“Every fiber of their being is, ‘I want to do this, I want to save this person’, ” Sanctuary said. When someone can’t be saved, “Suddenly you’re analyzing yourself. ‘What could I have done differently?’ … That can cause people to be depressed.”
Manning said first responders can easily fall into feeling that bad outcomes are their fault. He said he reminds his staff that “whatever the problem is, we didn’t create that problem … This is not our fault. We are doing what we can do to help people, but it is not our fault. And I think that’s an important thing to recognize.”
For law enforcement in particular, additional stressors are added by staffing struggles and public scrutiny, Goss-Power said. “Some of the prominent police officer cases that have gained national attention have placed police departments under a tremendous amount of scrutiny,” she said. “Many people would agree there are places where we really need to do police reform and have police departments be better educated … at the same time, the outcome of some of this national attention is it has been very, very difficult for police departments to recruit new people and good people … People are spread very thin.”
In the Monadnock Region , struggles to fill vacancies in police departments has forced some staff to work more overtime and nights, which department leaders say can contribute to burnout.
Fire and EMS services in Keene and other local communities are looking to hire, too, per postings through the N.H. Fire Academy .
Someone to talk to
Even in fully staffed departments beloved by their communities, the stress and trauma of a career as a first responder can have serious consequences for people and their families.
Manning said those consequences can include first responders dying by suicide, struggling with substance use disorders, and facing problems with family life.
Manning’s family is full of first responders, and he said he feels lucky to have been able to discuss calls freely over the years with his wife, Phylis, an EMT, and sons, who have both served as EMTs and firefighters.
“We would be able to come home and talk about it with our family, but for the majority of folks who are in this business and may have a difficult call, their family isn’t available to them — they don’t understand it, they don’t want to hear it, you get into confidentiality issues,” he said.
But having someone to talk to is essential. Law said he would advise younger officers to find a supervisor or someone else in their department they trust to talk to when they’re processing difficult calls. “Don’t take it home and put it on others in your life,” he said.
In Walpole , Sanctuary encourages his staff to share their experiences at scenes with each other. “One of our biggest things is just having an open dialogue … Go ahead and discuss if something really bothered you,” he said. “We don’t just go home … we come back, we sit down, usually over coffee or water or something, and we just hash it out.”
When someone needs more help than peer support can offer, Sanctuary said the department pays for them to see a local therapist. He has sometimes even mandated they do so.
Breaking the stigma
In Manning’s fire station and Law and Sanctuary’s police stations, talking through difficult experiences is normal. But that’s not the case in every department.
Where leadership is less open to those conversations, Manning said it can be “really, really difficult for individual members.”
In debriefs, Proulx’s Critical Incident Stress Management Team offers departments space to talk about their experience and provides information about the types of responses people may have to trauma. It’s that informational aspect that struck Proulx personally when he was first getting involved with mental health work.
In a call he remembers vividly, Proulx said he started seeing his stepdaughter’s face on the body of a young girl in cardiac arrest. He said experiences like that can make first responders start to second-guess themselves. “People think, ‘It’s only me, maybe I can’t do this job, maybe I’m not cut out for it,’ ” he said. Learning that a range of reactions can be normal, both during and after difficult calls, helped Proulx. And he said it helps others, too, to realize they’re not abnormal or alone.
Goss-Power said she’s one of several providers offering specialty services for first responders in the Granite State. She believes the stigma about mental health has been lessening and that access to services is improving.
“In the past I think there was always a worry that if a fire department or the chief of a police department found out that somebody might need services, officers would be concerned that their job might be in jeopardy or that their coworkers might not have confidence in them anymore,” she said. Helping leadership in departments better understand mental health conditions can ease that.
For departments where stigma still reigns, Manning said he would encourage leaders to “look at the consequences of not doing anything. It’s out there. People understand what’s happening to first responders. You can read articles about it. You see it in your own departments.”
Manning’s own department in Marlborough has lost members to suicide — losses he said “hit home to us exactly how much it can affect people.”
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