While driving back to the Central Station firehouse in Concord, Michael Kelley propped his feet up on the gurney in the back of the ambulance and closed his eyes.

Being a paramedic is physically and emotionally draining, and they’ll get a wink of rest whenever they can. They respond to all kinds of trauma, like an elderly man who had a seizure, a little girl who fell and hit her head – car accidents, overdoses, fires. They don’t panic. They fall back on their training.

“Nothing really triggers me. I’ve been doing this long enough that I can put aside the emotions until after,” Kelley said. “We expect people to be sick. It’s only bothersome when it’s something unexpected, like kids, but the older folks are more manageable.”

It wasn’t always like that for Kelley, especially when he began his career in the military in 2006. With several tours in the Middle East under his belt as a flight medic, the trauma of war and senseless death caused him to struggle with anxiety, sleep and PTSD, he said. Before leaving for Iraq and Afghanistan, Kelley had worked as a nurse and an EMT and thought he was prepared for what he might see while serving overseas.

“I did not seek help until 2017, after my wife and I got married,” he said. “It was a friend of mine who told me he was seeing someone to deal with similar issues with anxiety and sleep deprivation. It took him telling me that he was going to think about going.”

Through counseling, Kelley learned to talk about his anxieties and experiences, which inspired him to volunteer for the Concord Fire Department’s peer support group that he co-chairs alongside Beth Davin, a paramedic and firefighter whose generalized anxiety is often triggered due to the demands of the job.

“I have always managed it pretty well, but I do feel like the job does add to it,” Davin said. “I have seen an increase (in anxiety) but recently, through reading books and therapy, I can recognize triggers and come up with new ways to help dissipate it, whether on shift or at home.”

The purpose of the peer support group, which is run by eight volunteer members, including Kelley and Davin, is to support first responders, give them a space to talk and decompress and provide resources for counseling.

In addition to the peer support group, the Concord Fire Department is working to implement policies that would allow supervisors to put a station out of service and call in the peer support group after a critical call and make judgment calls to send someone home if they’re triggered by a call.

“I’ve been part of calls where I needed that break after a call and I didn’t have it,” Davin said. “I hope to support someone better in the future so they don’t have to experience that.”

From conversations and encounters with her peers, Davin believes the root of their stress and anxiety is from the steady increase of calls for service the department has seen over the last several years, especially during the pandemic, and the lack of time they’ve had to process what they’ve seen between calls, she said.

“We see people that are in bad places in their lives and not able to pull themselves out of it,” said Concord fire chief Jonathan Chisholm. “That does take a toll.”

Over the last 10 years, the conversation surrounding mental health has shifted, Kelley said, and the stigma around speaking up and asking for help has all but vanished.

“When I enlisted in 2006, I needed to go there with a strong mindset to complete the mission, but the problem was coming home,” he said. “I had the sign that I was developing PTSD but no one recognized it, and I wasn’t getting treated.”

It wasn’t until a decade later that Kelley opened up about his struggles and sought help.

“With the military and fire and EMS, we kind of have to push things down because you have to keep moving forward,” Davin said. “Unless you go back and readdress it, a lot of the times you’re just burying it.”

Now, counselors are better equipped and trained to help first responders with their mental health. Meanwhile, first responders are better trained to recognize the signs and symptoms of mental illness in their peers.

Not all professional therapists understand the demands and culture of emergency responders, which can make finding help more difficult.

That’s why the peer group is so important, Davin and Kelly said.

“That’s a big piece of the support team and why we try to get the support team together,” Kelley said.

“They understand what we go through. If your spouse or your support system isn’t in the field, it’s very challenging to explain how your bad day went and you don’t want to put that burden on them.”

Through continued efforts, Chisholm, Kelley and Davin are working to bolster peer support with additional involvement from other firehouses in the Concord area, implement mental health trainings in first responders and create policies for fire personnel to address mental health.

If someone you know is a first responder struggling with mental health, reach out to Kelley at mkelley@concord.nh.gov or Davin at edavin@concord.nh.gov for help with finding resources in your area.

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