PTSD training in works for first responders

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Posted: Wednesday, January 9, 2013 9:08 am

Targeted to prepare for encounters with post-traumatic stress disorder

It is a call that Marion Studer will never forget.

It was cold and the middle of the night when Studer, EMS captain for the Lacey’s Spring Fire Department, responded to an emotional call. When Studer arrived on the scene, it was something she had never encountered before. The man was at least 6 feet tall, weighing more than 200 pounds, and while he was physically right before her eyes, mentally, he was back on the battlefield, on the ground crawling and talking to his buddies, trying to get them help. One thought went through her mind – what do I do?

“He was reliving his incident and I didn’t know what to do,” Studer said. “Because of the way he was acting, I knew he was not here. He was back in Iraq.”

Luckily, the deputy that was with her had served as a medic in the Army, and knew exactly what to do. After 15 to 20 minutes of talking him through it, he was able to calm him down, although the man was still unresponsive. Had the deputy not been there, Studer doesn’t know what would have happened.

“We have protocol that we have to go by in this state, and my scope of practice is very limited to EMT basic,” Studer said. “We do cover emotional in our protocols, and it covers PTSD, but it’s not the same thing. It doesn’t work. If I would’ve been alone that day, I don’t know what I would’ve done.”

So Studer made the decision to make sure she and her fellow first responders in the area, are never again caught unprepared. This summer, Studer is aiming to bring a special course to the Tennessee Valley to teach first responders and law enforcement how to handle calls where an individual with PTSD is involved.

“We can’t put these patients in restraints,” Studer said. “We can’t taser them because they’re having a mental break and my responsibility to my patient is to do no harm. I don’t want to harm these people and I don’t want to make the situation worse, so I need to know what to do to start with.”

Funded through the Bureau of Justice Assistance, Department of Justice, the course, “Law Enforcement Tools for Supporting Veterans in Transition,” provides first responders and law enforcement officers with a working knowledge of what PTSD is and how to handle it when they encounter it in the field. Offered by the Florida Regional Community Policing Institute through the Center for Public Safety Innovation at St. Petersburg College, the course teaches attendees de-escalation tactics and other tools needed when encountering veterans in transition, as well as helps them understand the different stress-related disorders occurring among veterans and how to differentiate between mental health, mental health issues and mental illness, as well as post-traumatic stress reaction, post-traumatic stress disorder and post-traumatic stress emotionally disturbed persons.

“To the first responder, there may be no difference in how a person would present with these different disorders,” Dr. David Ferguson, with Fox Army Health Center’s behavioral health department, said. “A person experiencing a flashback and a person with schizophrenia/hallucinations have significant impairments in reality testing. They are not responding to realistic, external stimuli, but to internal, non-realistic stimuli. Each should be approached with extreme caution. Typically, the person with PTSD will regain accurate reality testing more rapidly than the person with schizophrenia/hallucinations. The person with schizophrenia/hallucinations may not regain accurate reality testing and a medication intervention is a fundamental approach to that person’s recovery.”

From fiscal year 2002 to the third quarter of fiscal 2012, 256,820 veterans from Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn were seen for potential PTSD at VA facilities, according to a report released in December 2012 by the VA. Data released in June indicated that the VA has seen a 35 percent increase in the number of veterans seeking mental health services since 2007. In 2011, the VA provided 1.3 million veterans with specialty mental health services.

“There are so many Soldiers coming back, it’s not just the Army or the Marines or the Navy or the armed services, it’s also anyone that serves over there that sees this,” Studer said. “It’s not just this campaign, it’s also the Vietnam veterans that are manifesting themselves in those problems, because during the Vietnam era these guys weren’t treated for anything. They were called baby killers when they came home.”

Thus far the “Law Enforcement Tools for Supporting Veterans in Transition” course has been conducted in Florida, Minnesota, Texas, South Carolina and Arizona. In 2013, Illinois, South Dakota and further locations in Texas are expected to be added to that list, with more in the works, according to Laura Heisler, with St. Petersburg College. Studer is seeking law enforcement, first responders, EMS and other personnel locally that would be interested in attending the course.

“We need to have some training, because my first job is my safety, my second job is my crew’s safety and my third job is the patient’s safety,” Studer said. “Putting him in restraints or treating him as a psychotic, even though it was a psychotic episode, we can’t treat patients that way, not with PTSD. They’re no longer in the present; they are back at the incident.”

Similar programs across the country exist to assist law enforcement and first responders in responding to veterans with PTSD with knowledge and care to prevent further escalation. The Upper Midwest Community Policing Institute is bringing its course, “Public Safety De-Escalation Tactics for Military Veterans in Crisis,” to 15 locations across the U.S., including Reno, Nev., San Diego, Calif., Havana, Fla., and Syracuse, N.Y., training made possible through funding by the Office of Community Oriented Policing Services, Department of Justice. At the VA Law Enforcement Training Center in Little Rock, Ark., all VA police officers, nationwide, are trained in how to recognize signs that someone may be acting based on PTSD-induced behavior, teaching the officers how to interact with them using what they call “verbal judo” skills.

“It’s necessary in every state. It’s necessary in every big town. I think it’s necessary everywhere in the United States to have this training,” Studer said.

Editor’s note: If you are interested in attending the summer training, email Studer at redutsm@gmail.com.

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