Nearly 50 firefighters, emergency medical technicians (EMTs) and other first responders from around Washington state attended the first-of-its kind mental health crisis training Friday at South County Fire headquarters in Everett. Co-hosted by University of Washington’s Behavior Health Crisis Outreach Response and Education (BHCore) program and South County Fire, the one-day training course – called COAST: A Roadmap for Fire/EMS – helps emergency responders improve their crisis response skills.

These skills include handling opioid overdoses and suicides as well as recognizing cultural norms and body language when communicating with certain groups of people.

BHCore co-founder Kim Hendrickson said the COAST program is similar to Washington State’s Crisis Intervention Team (CIT) program for the police. She had been involved in training and development for the CIT program for many years.

“What’s different about what we’re doing here with COAST is very much based on the individual responding to the call and creating a roadmap about how to be more effective and humane, actually building skills in the moment to help people in their moment of crisis,” Hendrickson said. “I would say CIT is more interested in building empathy and having police officers understand the perspective of people that are struggling with behavioral health issues.”

Firefighter and paramedic Craig O’Neill, who has been working with BHCore at South County Fire, said that the EMTs and medics are not given crisis training as part of their basic training.

“[Crisis] was always presented as a police problem first, so we’re hoping to segue into that so we can be better prepared,” he said. “Eventually this will go out to all EMTs and medics in the state.”

Hendrickson said that having multiple professionals with various skill sets in handling a crisis is better than having only one approach. “Washington state is a leader in Mobile Integrated Health and fire departments, understanding that their job has to be beyond just emergencies and working on things to prevent emergencies or follow up from emergencies,” she said. 

Eight fire departments across Washington state are training crisis response to firefighters and EMTs, she added. “We’ll be looking to the state Legislature this coming session to provide the funding so we can spread this out beyond those eight departments and make sure all parts of the state have access to the training,” she said.

Dr. Jenn. Stuber, who is the BHCore executive director and associate professor at University of Washington’s School of Social Work, said that BHCore is working with State Reps. Osman Salahuddin and Greg Nance to pass two House bills that allow BHCore to train first responders and expand firefighters’ and emergency medical personnel’s scope of practice in behavioral health prevention and crisis work. 

While COAST is a one-day training course, Stuber said that it’s a stepping stone to getting the course into state law so that it can expand to a more in-depth training.

Stuber also co-founded BHCore after her husband’s suicide in 2011 and starting a suicide prevention program at University of Washington in 2013. She said that several first responders asked her about having a first responder support program, but there was no blueprint for it.

“You can’t be a good first responder if you yourself aren’t doing well, [and] that’s a piece of what we’re going to be weaving into the BHCore in the future,” Stuber said. “It’s not just for first responders; it’s for anyone who’s a frontline dispatcher, medical examiner, the behavioral health people. It’s a community that really needs a lot of support and deserves a lot of respect.”

Stuber also said that the timing of first responders crisis has “hit a perfect storm” because of the current rates of current overdose and suicides and the fentanyl crisis. 

“[The police] have been much more mindful about [taking] calls that could kind of get them into situations that they don’t want to be in,” she said. “[And firefighters are] increasingly being the one that’s been sent, not the police.”

O’Neill said that the police services are already stretched thin, and sending a police officer with a firearm is not always the best solution. “[The police] are given CIT training, but they’re not social workers,” he said. “That’s not their specialty. Now we’re finding that sending multiple skillsets – fire, police and social work – is sometimes better than just sending one and put [people] in handcuffs.”

One of the participants in Friday’s program was Support 7 Executive Director Shannon Sessions, who said that the COAST program is a good reminder for first responders to be active listeners and open minded and not jump to conclusions about a situation when they arrive at the scene.

“Don’t just believe [what] you hear right away on scene because different first responders have different goals on scene,” Sessions said. “Certainly the police…if there’s a threat, they need to handle that threat immediately, and then everything else can be talked about after that. If there’s a fire, firefighters aren’t going to stop to ask different questions about mental health. If there’s a fire, they’re going to put it out. That’s their first goal.”

“Our first responder chaplains are part of the teams in different agencies in South County, and as such, it’s important for us to continue our education, and this was just one of those ways to do that,” Sessions continued. “We’re there generally on all unexpected deaths, such as suicide, homicide, fires.”

Hendrickson said that the public can be more vocal about the crisis incidents in their neighborhoods to their city councils, county commissions and state legislators.

“I’m just so happy to see COAST taking off today in a roomful of firefighters and EMTS that are obviously taking this very seriously and are getting a lot out of it,” Hendrickson said. 

— Story and photos by Nick Ng