Code Green Campaign Honored for Raising Awareness of EMS Mental Health

On March 12th, 2014, a paramedic in the Eastern Washington city of Spokane died of suicide. Co-worker and fellow field paramedic Ann Marie Farina didn’t know him well, but was still shaken by his death. Two weeks after he died she started The Code Green Campaign to help bring awareness and education about the high rates of mental health conditions and suicide among first responders.

Less than two years later The Code Green Campaign received the 2016 Nicholas Rosecrans Award for Excellence in Injury Prevention at the 2016 EMS Today Conference as a result of their work in preventing mental health conditions and suicide in first responders. The award is named in honor of 2-year-old Nicholas Rosecrans, who drowned in a pool in 1996. One of the paramedics who responded that day was Paul Maxwell. He went on to found EPIC Medics, a group dedicated to injury prevention.

Code Green Campaign for first responder mental health

As for how The Code Green Campaign was founded, Farina explained, “After [my co-worker] died I spoke with some friends who all worked for different agencies in different parts of the country and, despite us being spread out, we all knew a first responder who had died of suicide. I felt like that couldn’t be a coincidence so I started looking into it.”

During her research she stumbled upon the Firefighter Behavioral Health Alliance. “They had the only real numbers I could find, but they also acknowledged their numbers aren’t complete because of how suicides are reported. The information I found on depression and PTSD [post-traumatic stress disorder] all seemed to indicate that first responders have a really high risk for developing mental health issues. It was absolutely an ‘oh, duh’ moment for me. It made perfect sense we’d have higher rates of mental health issues, I just hadn’t thought about it before.”

As a result of her findings, Farina and her friends came up with the idea for an anonymous storytelling project; by allowing first responders to submit their stories about their experiences dealing with mental health issues, they hoped to break down the stigma and get people talking. “We all know if there’s one thing first responders like to do, it’s tell stories. How many times have we gone to a class only to have it be 70% ‘war stories’?” Farina remarked. “I figured it wouldn’t be hard to get people to put their stories in writing.”

With that, The Code Green Campaign was born. The campaign, often known simply as “Code Green,” takes its name from the color of the mental health awareness ribbon. Farina says, “The idea is that we’re calling a code alert on our mental health, just like we’d call a code stroke or a code blue on a critical patient.”

Farina’s hunch about the stories was right, and in the two years since Code Green was founded they’ve collected over 400 stories from first responders around the world. Code Green normally publishes the stories every Monday, Wednesday and Friday on their website and social media with occasional breaks for holidays and special events.

Social media has been Code Green’s biggest asset. “When we first started the page we went from 0 to over 2,000 likes in 48 hours. That was when we started to think we might have something bigger on our hands than just a Facebook page. It didn’t take long for us to decide to organize to become a nonprofit.”

Farina put together a board of directors from the organization’s volunteers, which includes Vice-President Kyle Norris, Secretary Fiona Campbell, and officers Kelly Grayson; Lau Morrison, PsyD; and Sarah Mielke-all of whom are current or former first responders. Together, Campbell and Farina manage the day-to-day operations of the organization, with help and input from the others.

It turned out that “something bigger” was an understatement. The team’s activities quickly grew to include helping the Firefighter Behavioral Health Alliance track and record suicides, maintaining a database of first responder-friendly mental health resources, and providing a two-hour continuing education course. Code Green is scheduled to lecture at several conferences this year. The team also does a lot of peer support, referrals, advocacy, outreach and general education at conferences and on social media

The campaign is also preparing to launch a peer-led support group program this year. The program will be overseen by Code Green but each individual group will be run by a leader who’s applied for the position and been thoroughly vetted. The groups will be an outlet for people who want to gather and speak about their experiences as a first responder. Group meetings can also include retirees and family members. “We’re really excited to get this off the ground. Many people will not use services offered through their employer due to the stigma and fear of retribution. This program will be 100% through Code Green and we hope that will encourage people to participate.”

An additional program in the works provides treatment scholarships for people unable to afford mental healthcare. Depending on the type of mental health professional, treatment costs range from $100-$300 per hour. Even if a portion of this is covered by insurance, the costs of weekly or bi-weekly visits add up fast. The scholarships will also be able to be used for inpatient treatment. Farina expects the average scholarship to be $1,000-$2,000 and would like to have at least $20,000 raised before the scholarships start.

Farina hopes the treatment scholarships will offer a way for agencies, friends and family members to remember someone who has died of suicide. “We have a lot of people who approach us and say ‘My brother was a firefighter who died of suicide, we’d like to have a fundraiser and do something to help the community but we’re not sure what to do.’ In those cases, we will be able to set up a scholarship with the money raised and earmark it for someone in that area or someone who is also a firefighter.”

Making sure all responders, along with friends and family members can get involved is important to Code Green. The campaign is very active on social media and regularly has a Talk Tuesday feature to encourage discussions. Farina states, “There are many ways people can get involved with Code Green. Social media and our website are big ones. We’re also looking forward to working with people to fundraise for the treatment scholarships. We have a list on our website in the Frequently Asked Questions with a number of other suggestions.”

To support the campaign or get involved, go to

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