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Macro Post 4

F7. Assess population needs, assets and capacities that affect communities’ health 

 In Team Prepared, we assess the community first responders about their mental health and how it affects them personally, in their work, and what we could possibly do to help these first responders. We launched a mental health awareness in first responders campaign to hope that if someone who is a first responder and is dealing with mental health struggle would see this and believe that they are not alone. We used a hashtag that we believe would help do this and we hope it continues to destigmatize mental health.

Ms. Jordan Barham, Dual student of Public Health and Physician Assistant, was kind enough to meet with Deanna and myself about her research that she conducted for her capstone research. She created a survey in 2016 that surveyed first responders (firefighters, police, EMS, and Fire/EMS individuals) in Harnett County. According to it, 57.4% of reported occurrences of feeling at least one mental health issue, which includes anxiety, depression, and PTSD.  60% of the responders also reported that their mental health issues we’re work related. It was prevalent that in her research she found that EMS workers were 5.24 times more likely to experience poor mental health status compared to firefighters, which is the highest out the comparison to firefighters. The last thing that we talked about in our meeting with her was about stigma and when asked, she definitely was an advocate and said there was. About 43.7% reported in her survey that there is a stigma that surrounds mental health in their field. This is a ginormous issue within their field because they face experiences that typically are not seen by other fields. They are the individuals that see it first and are the ones who are going to have reactions. These experiences carry with them, the memories stick; so why is stigma so unavoidable when it comes to mental health in first responders.

David, our preceptor, was particularly effected by a traumatic experience through a EMS response call. Him and his wife we’re trying to grow their family at this time and one night they receive a call about a child unconscious. Riding to the emergency, David prepared himself for this stressful environment. After getting there, he saw that the child had overdosed on some of his parent’s pills. This truly affected him immediately and went in the assess the emergency. Thankfully, the got the child to come back to life after a few minutes. But all he could think about was this memory afterwards, feeling anxious about this child who got the access to someone else’s medication. After this event happened, David turn his back for a while from EMS; focusing his attention on his company, On Target Preparedness, LLC.

This is just one of many stories that we heard about mental health in first responders. Some stories that we heard are less fortunate, as their mental health wasn’t treated and resulted in suicide. It so happened that the two stories we heard about suicide in first responders were about chiefs of Fire/EMS departments. Even higher ranked individuals suffer from mental health issues because there is so much pressure on them as well as having to go to the bigger emergencies and respond to them. The strain it creates on individuals builds a gap between their work and their personal life, resulting in the mental health feelings and conditions that can result in harming yourself.

Our social media campaign, Mental Health Awareness in First Responders, kicked off and was a success within On Target Preparedness, LLC as well as reaching out to another contact, Dena Ali (Fire Captain of Raleigh) who started up a Firefighter Peer Support. They both want to continue to use our #FightTheStigma to increase awareness for first responders.

One thing I’ve learn throughout the years is that people who suffer from mental health are not alone. People who go through traumatic events are more likely to suffer from mental health issues. First responders do go through mental health training and depending on departments, some may debrief after major events occur. But sometimes you cannot emotionally prepare yourself to see an emergency. Their job may be to apply their training through immediate action, but sometimes that results in a decline of mental health.

If you are in need to talk to someone for mental health, please contact the National Suicide Prevention Lifeline by calling 800-273-8255 or texting START to 741741 to the Crisis Text Line. If you are in crisis and considering harming yourself, call 9-1-1 or go to the nearest hospital emergency room and ask for the psychiatrist on call.

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It was such a joy to work on this video as well as present our practicum to the class!

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As our practicum comes to an end, I want to give a shout out to the Buies Creek Volunteer Fire Department on allowing us to meet here every week, come video the wonderful facility and work closely with one of their men. Also, thank you for keeping Campbell University safe from all the burnt Mac & Cheese cups!

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Meet Rose, one Deanna’s dog. We met to practice for our presentation and I wanted to sneak a picture of this cute pup onto here. Yay for practicum, yay for presentations!

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Macro Post 3

R3. Develop strategies to prevent and respond to occupational health effects and safety risks of key industries in rural communities. 

 A preventative measure that responds to safety risk was that in our practicum we we’re able to hold a few hand-on CPR trainings throughout the semester. With the success of getting about 50 individuals trained for hands-on CPR, we saw a greater response once we handled it by giving one-on-one attention to community members. In these rural communities, it’s noted that rural individuals receive information better when they can create a relationship, so we took this to approach to ensure that people would.

Hand-on CPR training includes two steps: calling 9-1-1 and giving compressions. The American Heart Association recommends that while giving compressions, they should be in a range of 120 to 140 beats per minute. A tip that we gave participants would to sing songs (out loud or in their head) that can go to the beat of the music. Some example of songs is “Can’t Stop the Feeling” by Justin Timberlake, “Staying Alive” by Bee Gees and “Call Me Maybe” by Carley Rae Jensen. This made all of the events we did a little fun as well because by using songs that people knew would get them more involved.

Our strategy was to go out into the community and give the information out about hand-on CPR while demonstrating on the manikins that were provided through Central Carolina Community College, which we got from Mrs. Susan that let us access them at any time since it is right up the road from Campbell University. Our plans slightly changed once more information was given to us about who to contact about certain things. When we contacted Kyndal Riorden, Dual Public Health/Physician Assistant student, who had done hand-on CPR training through her practicum experience last year. She gave us information about how to give credit for individuals who are in local (Harnett County) middle and high schools who want to use their hand-on CPR as they need to have before graduation (by giving out a hand-only CPR training certification that they can bring to the school).

By this information, I was shocked that it is now required for students to have CPR training completed before graduating high school. Since I went to a North Carolina public high school just four years ago, I wondered how this took place. It’s a useful tool that can be used at any moment and suspect that the school district (Harnett County) thought it was the right choice to have this as a requirement. According to the Harnett Central High School website, they must meet the CPR requirement (GCS-N-004) that the NC State Board of Education approved as a state graduation requirement back in October 2012. The bill eventually took place in 2014-2015 school year and anyone who graduates now is required to have it. In Harnett County, they have this CPR training in the 8th grade, so for people who move into the county later has to go through it sometime when they’re in their high school career. Even though the school system will help get that for someone, going to outside sources like getting their hand-on CPR certification would be the equal to their training they would get in the classroom for Student CPR Awareness Level. Compared to the classroom aspect, ours was handled as a hand-on only demonstration and to let the individuals try for themselves. After giving them the certification for the hand-on training, they can provide it to the school so that they can have it on file and go to the next step for Community CPR, the certification program that is more extensive for CPR. All of this is free for students through the school system. Since it is no time at all taken out of our day to train individuals about hands-on CPR, it also was free to just come up and get the training whenever we were at Denim Days and at the Campus Ministry House for Halloween.

This experience was by far one of my favorites. We saw community members receive their certificate after doing the proper techniques for CPR compressions. We got to see a wide range of ages participate in this exercise: from kids who were as young as 7 to adults who were in their mid-60’s. The most exciting for me was to see older adults come up to us and ask if they can learn it because they never got the option to do it before. Each one was very proud to hold the certification that they we’re hands-on CPR trained. This experience brought joy to me and was very interesting to see that we’re one of the states that has implemented CPR training requirements before high school graduation.

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Macro Post 2

R2. Identify and distinguish the access to care barriers and the health care utilization challenges that affect the health of rural communities.

Individuals who have less access to health care is due to not having health insurance, not having the income to pay for cost-sharing thing (deductible, out-of-pocket, co-payments), and not having the access to care in predominant rural areas. This lack of access of health care providers is due to recruitment and retention rates which cause longer wait time to get the care and issues of access to providers, which result into having to travel longer distances for health care. It is shown that in rural areas, a lot of first responders are the ones to use their basic knowledge to treat individuals for primary care needs, according to our text. In our practicum, we we’re given the opportunity to see first-hand in the community and be able to give information about preparedness and how it can help the barriers be broken for health care.

Located in Erwin, North Carolina, Denim Days 2017 was an opportunity given to us to get out into the community to understand how to relate to rural community members. We also were able to communicate with them by giving pamphlets out about preparedness. In the pamphlets that were given out, there was information of what was needed for a “bug-out bag”. These bug-out bags included food, water, necessary equipment for first-aid, etc. The bags also highlighted that they should have medical records for everyone in the family as well as all medications that are needed. These bags should be located in a easily-accessed place in one’s house or car. This helps utilize health care challenges as many individuals are unaware to have their personal medical records on file with them at all times. This helps break barriers for access of health care as well because if a situation occurred, wherever you are located you will have the access to your own medical/drug records.

While in Erwin for the day, we discussed options and precautions with community members about the possibility of a situation that could occur. We made sure that they got the proper information so that they could be educated for emergencies. Even though education is not a panacea, we want the community members to be aware of what is needed and how measures can be taken; especially when health care is involved. Topics like challenges within the senior citizen community and not knowing how to get their medical records ready for an emergency was discussed. We wanted to make sure that participants who came up to our tent knew that they needed everything that pertains to health care whenever files are being created for bug-out bags. We also discussed getting to a safe area first and then assessing any health care dilemmas that they may face when an emergency occurs.

Lastly, we gave hands-on CPR training at our tent to ensure that there wouldn’t be any challenges when faced with an emergency and to create the availability of time in case the access to health care isn’t an immediate option. We paired up with some Campbell University Physical Assistant students who help train individuals one-on-one. These one-on-one connections are better received in rural areas especially because community members typically like the close-net experiences and will receive the information that is given to them more easily.

One thing that I learned through the experience of Denim Days is that in the rural community of Erwin, North Carolina, the access for health care and the challenges it faces within the community. When it comes to being prepared for an emergency, especially a disaster, majority of the individuals and families we spoke to would not be prepared for it. They didn’t know that they should have medical records and all the prescription drugs for each person in a family. Not obtaining these records for themselves would leave them not knowing decisions a primary care provider had made and how it would be applied to a medical emergency when a disaster occur. But having these records can be utilized and create easier access for health care.

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Macro Post 1

F14. Advocate for political, social or economic policies and programs that will improve health in diverse populations.

Mental health in first responders is a big epidemic that causes stress and anxiety to individuals who are struggling with it. With not many resources in North Carolina, rural areas in Harnett County (Buies Creek, Bunnlevel, etc.) might not know what is available to them within the state. There are attempts of creating policy for first responders’ mental health in the state as well as national wide, but both not being able to show their potential.

As my time continues to do research for policy development for mental health in first responders, I have been given some information about contacting individuals about implementing and giving the awareness about a program for emergency service departments. NC LEAP (North Carolina Law Enforcement Assistant Program) is a program for people who have serve or who are currently serving with law enforcement, first responders, their families and civilian staff. Working with NC LEAP will give an opportunity for education, training, and peer support through times of disasters, incidents of high risk, and/or a tragedy. This program is to assess the emotional/physical distress of individuals and groups who may have been effected by an event. This program is a non-profit organization that solely depends on donations for expenses as the program is free to use for any county in North Carolina. Most North Carolinians that serve in the area for law enforcement and first responders do not know about this program; thus, Team Prepare has been trying to contact Harnett County officials to see if know about the program and if not to give them the contact information for the program. Harnett County is our priority for the semester long project since it is local and our community; but we hope that the trend will continue and more awareness will be brought to NC LEAP. 

While searching within mental health for first responders and policies that might be implemented or have been brought to attention currently, I came across two; one from Congress and another from the North Carolina General Assembly. Unfortunately, both of these bills had been discontinued with the process of trying to make a difference. The North Carolina bill (House Bill 181) was more financial back-up for mental health treatment and tax breaks for First Responders, and unfortunately it died within the financial committee of the General Assembly. After contacting someone about the bill (who worked as an intern during the session), the problem with it was that representatives were worried that the spending for the bill would become complicated and not allow the services needed for the First Responders. The Congress bill was back in 2016 called the Mental Health Training Enhancement for First Responders Act which would increase training in all departments across the United States. This would help partners, co-workers and chiefs to understand when someone needs help with their own mental health. Their plan for the bill was to amend the Omnibus Crime Control and Safe Streets Act of 1968 so that mental health training was included. Again, unfortunately Congress let this die within session as it was not enacted.

While brain storming ideas to try to find a solution for this, I believe that Congress should try to find a solution for this problem between mental health and first responders. Working with state representatives that have an interest in protecting the mental health of individuals (hopefully individuals that have an interest in first responders), they can get together and find solutions to make the Mental Health Training Enhancement for First Responders Act a better bill to get Congress to pass it.

With the policy changes that could happen in the future, seeing it be developed and implemented in rural areas would help decrease the stigma of mental health in these first responders. Knowing that it is a staggering issue within the realm of first responders (depression and suicide rates increasing over time), something needs to be done to help individuals in rural areas with their mental health. Training and finances would help these first responders get the help they need. For example, if first responders had the training to see the warning signs of depression and they see it in their partner; they can talk to their partner and help them seek help for their mental health. The process of this would take much longer than a whole semester of classes, but finding information and contacting state representatives is something that we all can do to get the topics discussed, especially since mental health in first responders is such a pressing issue within rural communities.  

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This woman right here is the ultimate host. We went to her house before Denim Days to plan and make sure that everything went running smoothly. If we didn’t have something, she had it in her house! Having her on our team has made it fun and enjoyable and personally having her help with mental health (social campaign and policy planning) has made it a great experience. Shout out to you, D!

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Denim Days went great on October 7th! We held a trivia show about disaster planning and facts (picture with our contestants). We also held hand-on CPR training and gave out information about preparedness from FEMA!

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We have a different face in this picture: meet Alex! He is going to be interning with David with On Target Preparedness and helping us out with planning Denim Days (and other events/things that are outlined for this course). We are excited to have a spot for Denim Days which is coming up in the next short few weeks!!

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David, our preceptor, has been a big help with getting us names to get in contact with to spread the word about NC LEAP! I cannot wait to follow-up with him for the Buies Creek Fire Department and their possible implement of NC LEAP.

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Deanna and myself went to Creek Coffee on Wednesday to meet with Jordan and discuss her research that she did last year with first responders. We got a lot of information from her! Then we went to Raleigh on Friday to meet with Dena, a fire chief from the area. We discussed stigma of mental health in first responders and she gave us a lot of information for our projects we’re working on. We’re excited for Tuesday to report back to David!

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David was running a little ‘fashionably’ late, but our meeting was very productive on August 25, 2017. We talked about getting in contact with people who might help with our individual projects. Deanna and myself are both in charge of mental health of first responders (creating a social marketing strategy & creating an advocacy campaign) and are meeting with Jordan Barham (dual PH/PA) and Dena (Fire chief of Raleigh) this upcoming week!

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Team Prepared met on on Friday at the Buies Creek Fire Department and discussed the preparation of this semester! We’re super excited to continue working together!