Four years ago, Cumberland County, Pa. recognized a need to support 911 dispatchers in the county. Facing growing levels of “compassion fatigue,” the county decided to create a peer support network that could ease the burden of a difficult job. Although peer support and Critical Incident Stress Management (CISM) teams they already had in place were effective, there was a gap in what their services could provide. It was clear the county needed access to trained clinicians with experience in caring for first responders.

Mike Snyder, a county 911 dispatcher and leader of the CISM team, ran into a problem almost immediately in trying to bridge the gap in service. Snyder found mental health clinicians could not respond quickly, with wait times as long as five to six months for an appointment. In the first responder community especially, it can be difficult to convince someone to seek help, and to be met with such a drastic wait time, meant that some were less likely to, Snyder said. The county continued to look for a solution.

They found it by teaming up with former firefighter Ali Rothrock, who now heads up a program that helps first responders with the stresses of the job. The roots of the program years ago, on her first call working with a volunteer fire department at age 16. She knew that something was missing in how communities care for first responders, after responding to a fatal car crash involving children. She quickly realized there was “absolutely nobody” to help first responders recover from such a scene.

“I moved forward from that call realizing that our training really stops at a certain point,” she said. “We’re never taught how to deal with the constant sleep disruptions, the horrible things that we see, the burnout, how that affects our ability to, you know, be a spouse or a parent.”

Through her volunteer work as a firefighter, Rothrock identified a need for care and dedicated herself to raising awareness. She wrote a book called “Where Hope Lives,” began speaking at events, became a Certified Trauma Responder and toured the country teaching mental health awareness and support for first responders.

In 2018, she founded On the Job and Off, bringing her in-person training online. Rothrock moved to Cumberland County, Pa. and began working on the CISM team under Snyder and quickly made the same realization, waiting six months for an appointment with a specialist who has no experience with first responders is “almost not even worth it,” she noted.

With the help of a trusted clinician and also a former firefighter, Lisa Zoll, Rothrock launched the “Gearing Up” training, began vetting clinicians and sending first responders for care to someone with experience in the field. “Gearing Up” is a one-day training course for clinicians to receive the experience needed to understand the duties and difficulties of a first responder.

In partnership with Cumberland County, On the Job and Off launched the First Responder Assistance Program (FRAP) designed to provide care quickly, when it is most needed. The program provides a hotline for first responders to receive care in a timely manner. The program has the full support of the county commissioners who understand the need for such services.

“Cumberland County is leading the state by implementing this access of care to our first responders,” said Cumberland County Commissioner Gary Eichelberger.

“First responders experience the worst of the worst — they absorb the sights, sounds and smells of the horrific details,” said Commissioner Vince DiFilippo. “These men and women are dedicated to helping people, and Cumberland County is proving that we are dedicated to supporting their lives, so they can continue to respond to our county’s needs.”

Snyder said the scope of the program is not only for those traditionally considered first responders. The county has identified others who could be in critical need of mental health support like coroners, human services and children and youth caseworkers. “We need to make sure as employers and as supervisors, that we’re taking care of those folks.”

One of the ways the county is working to fight back against the stigma of mental health treatment is through making mental health treatment more routine. Snyder said even if the team returns from a call that is not a “critical incident” they will conduct the briefing anyway. This helps encourage participation when things are difficult as the process becomes more normal. Another way the county is encouraging participation is by appealing to the team dynamic. Snyder said there is a “culture of teamwork” within the EMS community and by encouraging people to support their team, they have been more receptive to mental health discussions.

“This program is available for all our dedicated first responder agencies in the county, including the Cumberland County Department of Public Safety, prison, probation, sheriff and coroner offices, and all of the fire department, law enforcement, and EMS agencies in the county,” said Commissioner Jean Foschi.

Rothrock said On the Job and Off is rapidly growing and is talking with other counties in the state to expand the service.

Her program provides Cumberland County with an assessment tool in the form of a survey to help the county gauge the mental health of their employees and understand when someone might need extra support. Rothrock said she hopes to continually expand the scope of programming, including creating courses for coroners and other lesser recognized first responders.

She has heard from many first responders about how the program has impacted their careers and lives, and shared a testimonial from an anonymous first responder: “I was connected with a counselor from On The Job and Off’s First Responder Assistance Program at a time when I really needed help. My grief included anger, irritability, breakdowns and sleeplessness. I wasn’t able to run fire calls or spend time at the firehouse. I know now, that reaching out for help does not make you weak. It takes a lot of courage to tell someone you don’t know how to handle what you’re going through. I want other first responders to know they can ask for help and that the help I got was exactly what I needed.”