The Wayne State University Department of Psychiatry and Behavioral Health Sciences has teamed with the State of Michigan to develop a comprehensive behavioral and mental health training and support program for the state’s first responders and their families to address the stress they face in their duties protecting residents.

The program, Frontline Strong Together, will be available electronically and in-person to first responders and their families in nearly all of Michigan’s 83 counties this year. The program is being developed and implemented with representatives of the Michigan Professional Firefighters Union, the Fraternal Order of Police, the Department of Corrections, paramedics and dispatchers.

Mental health experts from Wayne State University and Wayne Health have teamed with Kenneth Wolf, Ph.D., director of the Incident Management Team, and the 211 crisis and referral network, to develop the program. A $2 million grant from the Michigan Department of Health and Human Services will fund the development of education, training, support and behavioral health treatment services by experts of the Wayne State University Department of Psychiatry and Behavioral Neurosciences. The programs will assist police, firefighters, emergency medical technicians, dispatchers and corrections personnel and their families in addressing and reducing sources of stress from both acute and chronic stressors.

“Frontline Strong Together distinguishes Wayne State University in that the research we do is not in some ivory tower. This is right in the trenches with the community, in real time, to develop evidence-based approaches to help as many people as possible,” said David Rosenberg, M.D., chair of the WSU Department of Psychiatry and Behavioral Neurosciences. “We go where the data is and implement the best practices.”

Dr. Rosenberg said the program is fortunate to partner with Dr. Wolf, who has extensive experience as a psychological consultant to the Detroit Police Department, the Police Officers Association of Michigan and the Wayne County Sherriff’s Department. The Incident Management Team is a nationally recognized consulting and training organization that specializes in pre-incident prevention, crisis management and post-incident recovery.

The 211 system is a free service that connects Michigan residents with help and answers from thousands of health and human services agencies and resources in their communities—quickly, easily, and confidentially.

The training and resources made available throughout the state under Frontline Strong Together will provide support via academic-backed medical research in a state with a critical lack of support services, especially for first responders and their families.

Dr. Rosenberg said statistics indicate that more first responders die of suicide than from injuries sustained in the line of duty. A 2020 study conducted by BLUE HELP, a national organization working to bring awareness of suicide and mental health issues among police officers, showed that in 2019 228 American police officers died by suicide, an increase over the numbers reported in 2018 and 2017. Another study, conducted by the Ruderman Foundation, indicated that police officers are at a higher risk for suicide than any other profession. The number of officers taking their own lives is more than triple the number fatally injured in the line of duty. With the increased stress brought about by the COVID-19 pandemic, Dr. Rosenberg said he would not be surprised if the numbers increase.

Researchers attribute the higher rates of suicide to the intense stress that accompanies the occupation, the toll of witnessing the strife and harm caused by and to those the officers are serving, and post-traumatic stress disorder.

Frontline Strong Together will see WSU psychiatrists develop and manage a statewide clearinghouse of materials that include training videos and manuals, and train-the-trainer curriculums for use in police and firefighter training. A website will be developed that will include videos by mental health experts that provide explanations and positive techniques, and training videos for families and peers. The topics will focus on effective language family members can use to deescalate situations; recognizing self-harm, including alcohol and substance use; psychiatric symptoms; non-violent communication; when and where to get help, resources for mental health treatment; and coping mechanisms for stress and trauma.

Frontline Strong Together will be developed with a steering committee that includes representatives of the Michigan Professional Firefighters Union, the Fraternal Order of Police, the Department of Corrections, paramedics and dispatchers.

The program, Dr. Rosenberg said, grew out of a recent collaboration with the city of Sterling Heights to develop post-traumatic stress disorder treatment efforts for police and firefighters.
Peer support and training will be a vital component of Frontline Strong Together, said Alireza Amirsadri, M.D., associate professor of WSU Psychiatry and Behavioral Neurosciences and the main developer of the project. Trainees will be trained in-person and through virtual platforms, and will receive ongoing training to maintain their status. There will be a three-hour training program for police and firefighter cadets, as well as an eight-hour program for academies, departments and field training officers. This will include training to identify daily stressors, anger and depression.

“The goal of peer training is not to ‘fix’ all of the problems, but rather to know how to handle and communicate about certain situations,” Dr. Amirsadri said.

Another critical component of the intervention program is tele-health services. A registry of mental health providers will be maintained for referrals if a first responder prefers in-person assistance. Services will include assessments, cognitive behavior therapy, medication management and outpatient therapy for mental health.

Frontline Strong Together also came about through the WSU Department of Psychiatry and Behavioral Neurosciences’ tele-health program launched in the early days of the COVID-19 pandemic. Recognizing the strain the pandemic was placing on the nation, Dr. Rosenberg and his colleagues launched Warriors Strong Together, an innovative program offering free assistance for members of the WSU campus community who required help coping with the new demands of the pandemic. The program provides free mental health intervention to all faculty, staff and students at Wayne State University by telephone or videoconferencing. The program received “a lot of traffic,” Dr. Rosenberg said, and allowed the department to leverage tele-medicine to provide support. Callers were able to speak with a mental health expert the day they called, and received referrals, if needed, by the next day.