Suicide is an inherent risk of working in EMS, as are substance abuse, depression and post-traumatic stress disorder. NYCARESUP is a New York State government, grant-based, tax-funded program that recognizes mental health risks and works to address them.
The program is designed to accomplish the following:
- Increase awareness of mental health risks.
- Provide better services to face these problems.
- Improve resilience.
- Reduce suicide rates among not only EMS personnel, but all first responders, corrections officers, and military veterans.
The program was founded in April 2022. It is currently run through the Suicide Prevention Center of New York, a division of the New York State Office of Mental Health.
The program has a basic approach:
- Agencies apply for and, if they’re successful, receive grants.
- While grant-receiving agencies are expected to work toward stated program goals, they are also allowed to develop their own approach to meeting those goals.
Jenna Heise, MA, NCC, is division director of implementation at the Suicide Prevention Center of New York, as well as former state suicide prevention coordinator at the Texas Health and Human Services.
She acts as one of the key figures in the program. Heise initially became involved with the program as a consultant while working for a company called EDC. The parent organization of the Zero Suicide Institute, EDC previously led the Substance Abuse and Mental Health Services Administration (SAMHSA)-funded Suicide Prevention Resource Center (SPRC) and currently partners with the University of Oklahoma Health Sciences Center that now leads the SPRC.
“The program is flexible,” Heise said. Recipient agencies have a great deal of latitude in how to use their grants. For instance, the Clifton Park Halfmoon EMS, a grant recipient, created a trained peer-counseling program within the agency.
Colonie EMS, another grant recipient agency, did not. Instead, in addition to wellness training for members, Colonie EMS used part of its grant award to develop a better referral network of mental health professionals who understand EMS and can see struggling EMS providers on short notice. The time frame for such appointments is often weeks or even months in advance, which makes prompt intervention for providers deemed at risk or in need of some counseling following a critical incident extremely difficult.
When asked what sort of monitoring is in place and what metrics are used to judge the effectiveness of a grant-funded program, Heise said it varies. The exact evaluation and metrics are based on the leadership and membership of the programs developed and their goals.
“We continue to develop and grow based on the individualized plans that each site develops with their implementation specialist from SPCNY-based on their specific needs and membership, leadership capacity, and resources,” she said. “Although individual action plans are part of the program, it is important to evaluate each agency’s program as a whole.”
Outcomes are sometimes measured using an evidence-based resiliency scale, and the services of a state psychiatric epidemiologist are often used to evaluate success.
Within participating agencies, people understand the importance of increased awareness of mental health issues. The agencies take concrete preventive measures to improve resilience, mental, and emotional health.
They also work to improve the capability of individual care providers, managers, and supervisors to access resources when problems arise. In other words, the program encourages participating agencies to change their own culture to both reduce mental health problems, and to promote a better response when those problems become unavoidable.
The acronym CARESUP stands for the following:
- Changing the Conversation
- Awareness
- Resilience
- Empowering Peers
- Skills Building and Suicide Prevention
- Uniformed Personnel
CARESUP reflects the way the program is supposed to work. Here’s a more detailed look at the acronym.
Changing the Conversation
Inspiring more discussion around mental health in the hope that first responders will begin to recognize that mental health issues are an inevitable risk of this type of service and will discuss them as such. This includes EMS, as well as corrections personnel and military veterans.
Awareness
Being aware introduces the goal that having recognized these issues, first responders will develop increased awareness of them and be on the lookout for the early signs of common mental and behavioral health issues in themselves and their colleagues.
Resilience
Having resiliency inspires the goal of using awareness to take steps, both as individuals and as an agency, to prevent or reduce the likelihood of developing these problems.
Empowering Peers
Empowerment refers to the desire for uniformed personnel to not only take steps, but to develop the necessary confidence for taking those steps and reduce these issues. It also encompasses efficiently addressing these issues when they do arise.
Skills Building and Suicide Prevention
The program’s main thrust is suicide prevention. Run by the Suicide Prevention Center of the State of New York, the program was created with a focus on building the skills to support suicide prevention.
Uniformed Personnel
The final letters refer to the target audience for the program and its services.
Drew Anderson, a psychologist, university professor, active EMT, and volunteer firefighter who is involved with the program, made a statement involving the general EMS approach to rescue and other hazards in an interview.
“EMS providers,” he reminded me, “have a goal of developing an awareness of special hazards such as chemical spills, structural collapse or fire issues with buildings, crime scenes, potential violence, and other environments that are dangerous or require special concern.”
While it is impossible to make EMS providers experts in every such situation, it is important that we bring awareness to the following:
- Potential hazards EMS providers face.
- How to recognize those hazards.
- How to keep EMS providers and those around them safe.
- How to address a situation when higher and more specialized levels of training are required.
One of the overall goals of the NYCARESUP program is to encourage EMS providers and others to be able to take the same approach to mental health risks and problems within their service as they do with other hazards they may face.
According to Heise, the model was not based on any preexisting structures. “I created it based on a professional environmental scan, focus groups, research, programming, best practices, reaching out to other states, etc. and decided a toolkit and model would be a way to make it generalizable,” she said.
Interested agencies can learn about the application procedure through the NYCARESUP website, its Facebook page, or getting on the program’s mailing list. NYCARESUP is also active in tabling and outreach at EMS events and conferences,” she said.
The program’s outreach happens in a few ways, including through tabling at events and social media outreach. However, as the NYCARESUP program is intended to assist several categories of first responders, as well as corrections and military veterans, only a portion of the tabling is targeted specifically at EMS personnel.
Gregory Eves is communications manager at the Suicide Prevention Center of New York. He spoke about typical events. “For the past two years, we’ve tabled at SUNY Cortland’s Wellness Symposium to speak with law enforcement personnel, probation officers, EMS professionals, and firefighters,” he said.
Eves also mentioned mention when the Clifton Park Halfmoon EMS, an EMS agency that received a grant from the program, held their Community Wellness Day, the team from his office spoke at the event and publicized both the NYCARESUP program and the 988 Suicide and Crisis Line, as well as other programs of interest to first responders the general public.
NYCARESUP follows a two-year grant cycle. The organization is now in its second cycle, preparing for its third. The grants are available to municipal, volunteer, or for-profit EMS agencies, that are New York state agencies or agencies that serve New York State.
Heise said she was not aware of programs in other states like NYCARESUP, noting that the program was built “from the ground up.” She articulated that the organization was not copied off models from other states. She expressed interest in sharing information about the program outside of New York, “You can email CARESUP [or] use the website, and we will talk to you.”
She also noted that out-of-state people and agencies can use the resources they find on the CARESUP website, which is available to the public. This means it’s available to individuals who are between agencies, have left EMS but still suffer, or are concerned about these important issues but cannot easily access the resources on their own.
A complete list of all agencies that received NYCARESUP grants in their first two years is available on the program website, as are stories that spotlight the way the grants were used. The program is now in cohort two and planning for cohort three.
Reference
NY Cares Up, Cares Up, 2024, nycaresup.com.
