Rod Ammon: Welcome to the CFITrainer.net podcast. Today, we'll be talking about fire investigator behavioral health. What can fire investigators do to help themselves and each other stay mentally healthy given the difficult and sometimes emotionally challenging work they do? We're looking forward to an open, honest, and supportive conversation with Captain Michael Brewer of the IAAI Health and Safety Committee. Michael Brewer began his firefighting career in 1995 as a volunteer firefighter for the Mackenzie Valley Rural Volunteer Fire Protection District outside of Eugene, Oregon. An Arizona native, he moved back home after six years to move into the career service as a firefighter EMT Basic for the Heber- Overguard Fire District in Northern Arizona. He now works for the Mesa Arizona Fire Department. He began conducting fire investigations in 2010 and was promoted to fire captain in 2016. Managing the fire investigations program until March of 2020, captain Brewer has been an IAAI CFI since January of 2018. He served concurrently as the Heber-Overguard Fire District Deputy Fire Chief of Operations and Fire Marshal from 2010 to 2012. His responsibilities ranged from responding battalion chief to managing Fire and EMS training and ambulance transport operations, and assisting in preparing the annual budget. Michael is certified as an incident safety officer and incident support officer by the Fire Department Safety Officers Association. He served the Mesa Fire Department as a battalion safety officer from 2020 until 2022. Brewer is currently assigned as a captain paramedic on Engine 212. Captain Brewer describes himself as having a heart of a teacher and a passion for the health and safety of the fire service members around the world. He has been serving on the IAAI Health and Safety Committee since 2016 and he became the co-chair of the Health and Safety Committee in January of 2024. Captain Brewer, welcome to the podcast.

Captain Michael Brewer: Good morning, Rod. I'm happy to be here.

Rod Ammon: Well, we're so glad you are. When I read the notes for our interview, of course, something always has to stick out. It made me laugh. You said something, "We're going to talk about the F-word, feelings." A lot of emergency responder professionals are hesitant to open up about that conversation. Why don't you tell me why?

Captain Michael Brewer: Well, Rod, I think there's a lot of stigma throughout the fire service and in the last, let's say, 200 years of history where firefighters and fire investigators did not want to talk about the F-word, which is their feelings. And that has started to change in the last 10 to 15 years and definitely more so even in the last five years. And, unfortunately, what we typically do in the fire service is we have a knee-jerk reaction to something horrible that's happened. And unfortunately, we're not super proactive for the future, and that's one of my passions with this particular project and the mental health world for the fire service is to have those tough conversations ahead of time and get people the help that they need. As you know, we've seen an increase in fire service suicides and we want to help curb those. Our members are from all walks of life and all different backgrounds, and that's even growing more so now. And so, the fire service of the future, I think, is going to be drastically different than what we've seen in the past. And, all of those different folks are going to need some mental and behavioral health assistance to be successful in a very long career.

Rod Ammon: Well, it sounds like we're moving in the right direction. I'm sorry if I missed this, but I saw in my notes that we're not just talking about how things made us feel and what we dealt with. We're also talking about PTSD an investigator might carry from a previous situation.

Captain Michael Brewer: Yeah, Rod. So that's true. So as I stated before, we come from all walks of life and as fire investigators we're not all just firefighters or past firefighters. So we have folks in the investigation world that are police officers, former military, on both sides, fire and police. And those investigators are going into scenes where there may be lots of burnt bodies, there could be horrific losses of life, and they're having to navigate through those. And, I'll be honest, one of my least favorite is folks that fires are fatality, because the body is also evidence. And so, there's a process that gets done processing a burned body and those incidences can be very traumatic for the investigator as well. But, those folks that come into this job that have some previous experiences in either fire, police, or military that maybe never addressed any post-traumatic stress issues that they've experienced in the past, those things can compound. It's not one of those things that usually one event that does happen, but a lot of times, it's multiple events over multiple years or even decades that start to build up and bother somebody towards the middle or the end of their career.

Rod Ammon: Yeah, makes sense. So, tell me, how did you get started working in behavioral health? How did you end up making this a priority?

Captain Michael Brewer: Well, so ironically enough, I started the health and safety committee with a passion to fight cancer. And, that comes on the tail end of losing some family members to cancer, losing some brothers and sisters in the fire service to cancer. And so, I had passion for that. And, it just snowballed into... They needed somebody to head up the mental health side of things. And I happened to be married to a licensed professional counselor. And, I'm one of the few people that was willing to step up and have that tough conversation when someone's going through something terrible. And so, with the assistance of my wife just got snowballed into this. And, it is a passion of mine because I have lost co-workers to suicide in my organization as well as multiple suicides across the greater Phoenix metro area. So, it's one of those things where I never imagined in a million years that this would be what I would be doing and fighting for, but I don't want anyone else to experience what I've had to go through with losing those people that are close to you. We need somebody to rescue the rescuers, if that makes sense. The stigma that I grew up in the fire service was, "Don't talk about it. Suck it up buttercup." And thank God that that is starting to change and we're starting to embrace the needs of our own folks and that they're starting to get the assistance and services that they need. And we talked about PTSD. So, that's one small piece of the mental health and wellness world. And, our folks are not just going through a PTS, post-traumatic stress, incident, they're also dealing with life, and divorces, and marriages, and kids that are hooked on whatever drug that are going through rehab. So, when we look at the grand scheme and scope of someone's life, the fire service can be a small snippet of what someone's going through and our goal is to provide good resources that are helpful, because if it's not helpful, then people have a tendency to try it and then say, "Man, that just didn't work for me." And then not try anything else. So, we want to provide a large array of resources and different types of therapy to our members in the fire service. Please understand when I say fire service, I'm talking about all those other folks that are involved in fire investigations from all walks of life. Because we do have private sector, we have public sector, there are military, there's federal with the ATF. So we have a wide scope of people that we're dealing with and we just want to help provide them the best services possible.

Rod Ammon: It's a great thing. It's nice also to have a supportive wife. I know about that. I've got a wife who's got many years as a social worker. She's not clinical, she's more administrative these days. But, I've always been around it being very normal for folks to reach out, get help, and also been exposed to the value of that. I'm guessing you've seen it in your own life with your friends, and family, and all the things that you've gone through.

Captain Michael Brewer: 100% Rod. And, my wife's my rock, there's no question. We'll call each other... We call it our five-minute pep talk when one of us needs to vent and just reset for the day. And, having that ability to call somebody that understands that holding a dead baby that was just burned in a fire isn't a normal experience for most people and she can help walk me through something like that. Not to mention just the other traumas of life when you're losing family members, and loved ones, and friends, and all of those different things that happen to all of us as we progress through our careers. So, no question, having a good support system at home is huge, and unfortunately not all of our members across the world have that. So that does compound their mental health and wellness struggles, and that's why we want to just make sure that we're getting the word out and letting everybody know that it's okay not to be okay.

Rod Ammon: Yeah, and it also sounds like there's a great message there about if you don't have somebody to lean on, it's the right thing to do to reach out to have somebody or to find somebody. And we'll talk maybe about that a little bit later. What approach have you seen work in getting fire investigators to be more receptive to behavioral health resources and help to process emotions that they carry?

Captain Michael Brewer: So, getting the word out amongst our own individual organizations is truly key. And, that's where breaking that stigma and having somebody know that it's okay to reach out to somebody to talk to. And that person's going to be your trusted advisor within your organization and they may not be a mental health professional, and that's okay, but that might be the person that helps you navigate to get connected with somebody officially that can help you. I think, unofficially, we've all been doing mental health counseling for each other, whether that be on the fire truck after a bad call or back at the office after a bad investigation. And we all have that firehouse humor, if you will. Sometimes that's a little dark, but that's the way that we've processed those events. When that type of processing doesn't 100% take care of those events, that's when we start diving into maybe alcohol, or drugs, or something else to take the edge off. And then, that has a tendency of snowballing out of control. So, it's okay not to be okay. And, we just want to make sure that we get somebody the services that they need. And people hopefully understand and we're trying to get the message out there that not all therapy is... I'm going to date myself here, but it's not like the Bob Newhart Show where you lay on a couch and you spill your guts to somebody and you have to talk about all these things. There's therapy modalities out there that you don't even have to talk about what's bugging you, and the therapist will navigate you through your thoughts, and you will experience a benefit from doing that. One of those is accelerated resolution therapy. I have actually done that. And, I didn't have to say a word. I won't lie, I bawled like a baby, because I was processing what I thought was bothering me. And then, your brain's like a spiderweb. So there's things that you don't even realize you're holding onto that are bothering you, that are attached to everything else maybe that is bothering you. And, it was very beneficial for me. I did it as an experiment. My wife got trained in it, and then she said, "Hey, I think you should try this." It helped me process some things. And I said, "Well, yeah, sure, if you did it, I'll do it." After several sessions of that, I processed some things that were 20-years-old that I didn't even realize I was hanging on to. So, that's just one particular type of therapy that's available. And I liked it because I didn't have to spill my guts to a total stranger laying on a couch. But, there's 30 to 60 different types of mental health therapy available out there, and I just want to make sure everybody knows that it's not all just sitting on a couch talking to a stranger.

Rod Ammon: You started out talking a little bit about family, and I totally get when you talk about the team, or the unit, or the men and women you work around with a sense of humor, is that being a kind of therapy. And then, you talked about family being there for you, but I think in a lot of situations people may or may not have family around, or they may not feel comfortable to have these conversations with family. And I think it happens especially in leadership. I know with myself, there were times in my life where I didn't want to be going to a family member, because part of my job was being a leader in the family and I'm thinking that there are people in the fire service, especially in leadership or there's so many different roles of leadership in the fire service that would really benefit by having somebody, as you've said, that may have dealt with people in the fire service or EMS in the past. I hope we motivate people to do that. You certainly seem to be doing the work.

Captain Michael Brewer: Thank you, Rod.

Rod Ammon: Tell us about the work that's going on with the IAAI Health and Safety Committee's Mental Health Working Group. What are you guys doing?

Captain Michael Brewer: So, Rod, we started out in 2020 with a survey to our membership. The survey had about a 20% response rate, which is pretty good throughout our organization. And at the time, we had 85 chapters across the world with about 8,800 members. Overall, what was really eye-opening for us was 73% of the folks that responded said that there was a need for increased mental health therapy education and awareness in the fire investigation community. So, that was a very eye-opening experience for us to run that survey, run those numbers, and get that response. And then, approximately 50% of all those people responded that said that there was some type of an organizational stigma involved as to maybe why they hadn't reached out to get services for mental health and wellness. So, that was also eye-opening, where we know we've got a lot of work to do, and we just want to get the word out. I'm not a licensed therapist. I don't have a degree in psychology. I just have a passion to help my brothers and sisters in the fire service and fire investigation community. I don't want those folks to experience what I've had to go through, losing post loved ones and friends and family to suicide. And, it was pretty eye-opening for me. I was the guest speaker at our ITC convention in Jacksonville, Florida a few years ago, and I asked the crowd how many members in this crowd have experienced suicide in their families or in their fire service careers with somebody close, and almost every person in the room raised their hand.

Rod Ammon: Wow.

Captain Michael Brewer: So, that really hit. I think everybody in the room looked around and we all went, "Wow." So, that's one of those things where we're on the right track, we're breaking that stigma, we're doing the good work, and the goal for the IAAI Health and Safety Committee and our mental health work group is break the ice, have the conversations, let everybody know it's okay to have the conversations, and then provide a solid list of resources that's helpful that they can reach out to. And there's free resources out there that you don't even have to use insurance for, because there's a lot of nonprofit groups across the country now that have recognized that there's a need in the fire investigation and fire service world for mental health and wellness services. And so, those are available online for free with just reaching out and scheduling an appointment.

Rod Ammon: Great. And that's good to hear. And I think we're going to have some links on the podcast page at CFI Trainer to some of those resources. You also talked about how your survey got picked up by somebody, a doctor.

Captain Michael Brewer: Yes, Rod. So, Dr. Alberto, Caban Martinez from University of Miami picked up the results of our survey and made an attempt to submit that to be published. And unfortunately, even though it was developed with the assistance of licensed professional counselors, there was a couple of things about some of the demographics that we captured that the journal didn't like. So he went ahead and created his own survey and we worked together on that project, and that was published just September of this year. So, that spanned November of 2023 to January of 2024. And, that also had a very eye-opening result. So, it was one of those things where another 53% of the people that responded to his survey also said that there's an organizational stigma about mental health disorders in their organization. So, we're still batting about 50% on breaking that stigma, but we just want to make sure that we're getting that information out there. And, the Journal of Occupational and Environmental Medicine is who published that, and it is available, we'll put a link on the podcast site. So, it's interesting because out of everybody that responded to his survey, there's a thing called GAD, which is generalized anxiety disorder, and about 18% of the respondents had that, 22.8% had depression, and then 18.2% identified a post-traumatic stress disorder. So, you can go through a post-traumatic stress event and not develop a disorder. So, PTS or PTSD, they're not one and the same, but they definitely are related. And so, just making sure that we're getting the appropriate type of therapy. And once again, back to the family, right? So, if unfortunately your loved ones are going through something, whether it be a family member that's dying of cancer, or a son, or a daughter, or a family member that's going through some type of mental health therapy, or drug rehab, or whatever it may be, there's different things that you're going to go through as far as therapeutic modalities to help process a post-traumatic stress event, versus some of those other things that happen to us just in general with life.

Rod Ammon: God, there's so much good information. I had here another note about you had done some work or are working in the second Alarm project.

Captain Michael Brewer: Yes. So the second Alarm project is based out of Florida. And, it's another nonprofit organization that does just amazing, amazing work across the country. And they have what they call a behavioral health access plan. What we're doing is, is with them, we're compiling a list of resources that are helpful. And when I say helpful, I want to clarify that, because if someone goes to their EAP program with their organization, or their city, or whoever they work for and they get assigned a random therapist, there's a probability that that random therapist might not be educated or helpful, because they don't deal with public safety, fire, police, fire investigators. We want to make sure that we're connecting our members with appropriate types of therapy and the appropriate therapists that are helpful on the first session. We don't want to have someone go to five or 10 sessions and be like, "This isn't helping me." And get frustrated. We'd rather hook you up with somebody... It's a lot if you have a traumatic brain injury, we want to send you to a trauma hospital. We don't want to send you to two or three other hospitals first before you get there. So, that's an analogy of what we're trying to do is do a good triage and give you access to good information, so that you can get connected with the right therapist and the right type of therapy right off the bat.

Rod Ammon: Yeah, it makes a lot of sense. I mean, therapists are just another type of professional. Like firefighters, they're just somebody else who's there to serve your mind, I guess. And, knowing that somebody's not learning on the job about what you do, especially when it can be as sensitive as it can be in law enforcement or first responders, fire investigation.

Captain Michael Brewer: And the second Alarm project is a non-profit. It's with Dr. Kelly O'Dare who has a fire service family. She's out of the Florida A&M University. And, like I said, they're doing great work. We have a huge list of people that we're partnering up with across the country, because the magnitude of what we're trying to do, we're trying to reach out to not only the 50 states, we have 50 chapters of the IAAI, and then obviously multiple across the world. So, that in and of itself is a huge task. And trying to get our membership across the world to be able to either look on our website or make a phone call and get a good list of resources that are going to be applicable to them is a huge task. And so, we partner up with different organizations like the second Alarm project. Jeff Dill with the Firefighter Behavioral Health Alliance spoke at our last ITC in Las Vegas, and he's a tremendous resource. He's based out of Las Vegas. And so, that was very convenient for us and for him. And he's been actually tracking suicides in the fire service for many, many years with the Firefighter Behavioral Health Alliance. And, to my knowledge, he's the only one in the country that's doing that. And his numbers, he'll admit, are probably skewed because not all of those are reported. I think, collectively, many hands make light work, so we have to partner up with people from all over the country to try to get people in every different region, and every different state, and every different country. Outside the country is going to be a bigger challenge, but you never know. Maybe that'll lead to some road trips.

Rod Ammon: Well, yeah, it might also lead to some progress. I'm sure in different countries it's looked at differently.

Captain Michael Brewer: 100%.

Rod Ammon: Their own stigmas. We're working on our country right now and just going through a normal day. These days can be incredibly stressful. Even just coming out, I know with the children and with all the things that affected us going through COVID, I think it's still affecting us. And, I hope people are reaching out to get support in any way they can. Good to hear this is going on, and I love to hear about that partnership, and I love the way you're talking about these are professionals who have dealt with somebody that might be tied to the fire service, or a fire investigator, or somebody who's at least aware of the issues and situations that you deal with. How can listeners keep up with what's going on with IAAI Health and Safety Committee?

Captain Michael Brewer: We're launching a new website. We're actually going to have two websites on the IAAI homepage that's going to be launched by the end of the year hopefully, at the very latest in January. And so, I would ask everyone to stay tuned to that. We're working on our next edition of our white paper for the Health and Safety Committee Best Practices, and that's related more to PPE and Health and Safety as a fire investigator on a fire scene and what you can do to protect yourself from all the different toxicants that are out there in a fire scene. So it talks about respiratory protection, cold, warm, and hot zones. And then, on the mental health side, we're going to have a mental health and wellness page also, and that's where you're going to be able to go and get all these resources that we're talking about that we're going to be listing on there. And, the National Suicide Prevention line is very easy. That's 988. All you have to do is hit that, and that may not get somebody specific to fire service or public safety, but that will get you to a crisis counselor immediately if someone's in an emergency right now and is having suicidal thoughts and needs help. So that's a national hotline.

Rod Ammon: And just to repeat that again, there's nothing just except 988, send?

Captain Michael Brewer: That is correct.

Rod Ammon: Okay. Just want to make sure people who are stressed and are going through these things, 988 sounds easy, but we hear so many different things to text to. So, 988, if you need some help. What's your advice? You already gave some, but to someone who might be listening right now who has an idea that they may need some behavioral health assistance but hasn't yet been able to ask or to find somebody.

Captain Michael Brewer: So if you're uncomfortable going through your insurance, and some people are because they feel like they're going to have a mental health issue tied to their record on their physical protected health information, reach out to the 988, reach out to the other anonymous resources that are out there. There's firestrong.org for the Fire Service. For union members, there's the Center for Excellence for the IAFF. Whatever you do, please don't do nothing. You're loved. There's people out there that love you. They want you to be here for their weddings, and bar mitzvahs, and all the different things that are going to... High school graduations, all the things that go on in life that are good things for all of us. Just please remember that there's people out there that love you, that care about you, and you cannot be replaced. So, don't do nothing and reach out to a trusted advisor, somebody that you trust, whether it's in your organization that could be a family member, whatever that is, and just get the help that you need. Don't sit at home and cry over your beer. Just reach out and find some help to help you navigate the troubles of life, because nothing in life's permanent. Everything changes, right? So, whether you're going through some tough times, we just want to make sure that all of our members know that it's okay not to be okay and just reach out and get some help.

Rod Ammon: Well, we love you and we appreciate you for what you're doing. Thank you very much, Michael.

Captain Michael Brewer: Thank you, Rod. It's been a pleasure to be here today.

Rod Ammon: You've opened up a nice door here and a conversation that we really don't give enough attention to. I know that it's out there, it's building on the fire service, but we appreciate your time and thoughtfulness, especially specific to the fire investigation world. Again, there's going to be resources that are listed on this podcast page, so please check that out. And, again, Michael, thank you very much.

Captain Michael Brewer: Have a great day, Rod. Thanks.

Rod Ammon: You too, sir. This podcast and CFITrainer.net are made possible by funding from the Fire Prevention and Safety Grant from the Assistance to Firefighters grant program administered by FEMA and the U.S. Department of Homeland Security. We also have support from the Bureau of Alcohol, Tobacco, Firearms and Explosives, and voluntary online donations from CFITrainer.net users and podcast listeners. Thanks for joining us today on the podcast. Stay safe. We'll see you next month. For the IAAI and CFITrainer.net, I'm Rod Ammon.

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