Former firefighter and PTSD sufferer Richard Jones has opened up on his battle in a bid to increase support and awareness for first responders who experience trauma on the job. Photo / Wayne Stronach
Richard Jones still has nightmares.
"When I first started in the Fire Service, the majority of deaths were in domestic fires, but we did a huge push in fire safety education," the former firefighter recalled.
"We went into schools because we found the best way to educate adults is through the children."
But within a few years, a large part of the work involved supporting the police by retrieving bodies from car accidents, suicides, drownings and other traumatic events.
During nearly 20 years as a firefighter, working at a specialist rescue station within the South Wales Fire and Rescue Service, Jones was involved in dealing with traumatic incidents and deaths on a regular basis.
Most of his career in the emergency services was in the UK, before he moved to Auckland in 2016 to work for our fire service.
He says the pressures on crew are the same in all countries.
And so too are the mental scars endured - including tragedies during what should be the festive weeks of summer.
As the last of holidaymakers return home from holidays around the country before school starts back, Jones - who has post-traumatic stress disorder (PTSD) - explains the impact accidents can have on first responders, not just victims and their families.
Eleven people died on our roads during the official holiday period (from Christmas Eve to 6am, January 5). That's almost three times the number last summer.
'We never discussed how we were feeling'
On his first day in the job as a 23-year-old, Jones' new boss took him aside and told him he would have to "fit in" or move on.
Thus began a career of service, brotherhood – and trauma. Jones said though the brotherhood was strong, for some there was also a culture of not talking about mental health issues.
"After a particularly bad accident involving a fatality, the boys would go back to station, where a big pot of tea and possibly the brigade chaplain would be waiting. We'd sit around the mess table and discuss what we could have done better or differently. We never discussed how we were feeling."
It wasn't until he reached a particularly low point early last year that he realised that his nightmares, mood swings and outbursts of anger needed to be looked into.
In his new home in New Zealand, he was diagnosed with PTSD.
"As part of my coping mechanism, I soon learnt to lock away all emotion to allow me to operate efficiently during the traumatic times. It was an unconscious decision to lock it all away, " he said.
Since the diagnosis, Jones has discovered that not only that there is an online community of fellow PTSD sufferers, but that a number of ex-colleagues have suffered from mental health issues.
When he wrote a Facebook post about his diagnosis of PTSD, messages and support flooded in for "Bootsy".
"Even though they're on the other side of the world, you know you can pick up the phone and talk to someone anytime."
Jones has shared his story in online PTSD support groups and been warmed by the responses he has received. Some of these first responders and war veterans talked about relationship difficulties.
He believes there should be more some proactive training and support for emergency responders and their families on how to talk about the work they do.
After a particularly gruelling day, Jones would go home and say to his wife: "It's been a rough day, just don't talk to me for an hour or so."
Sometimes he couldn't eat because the smell would remind him of a particular meal he and the crew mates had eaten after a harrowing incident. Or worse, the food reminded him of the carnage he had seen.
He now knows that he was displaying classic PTSD symptoms of hyper/hypo avoidance.
"What happens is that 80 per cent of the time you can function normally, but then a memory, a smell, or something will trigger you and you either shut down and become emotionally unavailable, or become angry," he said.
As he sits at a kitchen table on the other side of the world, tears well up. When asked why he is crying, he says: "We always tried to treat people and bodies with dignity and respect.
"But sometimes you had to literally tear people out of cars. Our job was to cut the car away around them to create space for the paramedics or doctor to be able to work on the casualty.
"There is a golden hour from the time of the trauma taking place to the casualty reaching hospital care. I feel guilty about the ones who didn't make it."
When he joined the Fire Service, Jones thought he would be putting out fires and rescuing people from burning buildings.
The former head chorister and rugby player admitted there was a bit of the action man/hero about his choice of career and he was proud of the lives he saved.
But now older, wiser and a bit broken, he just wants people to know what his colleagues in the emergency services do and that they need understanding and, at times, professional support.
On relocating to New Zealand, Jones joined the Fire Service in Auckland but a subsequent move to Blenheim, which only has a volunteer service, saw a career change to working as a linesman with an electricity network company.
First responders and PTSD
In 2014, Fire and Emergency New Zealand (FENZ) reached an agreement with St John New Zealand and Wellington Free Ambulance to attend all life-threatening, cardiac or respiratory arrest emergencies as co-responders.
In 2016, there were more than10,000 medical co-response and first response call-outs.
A 2018 report commissioned by FENZ on the impact of illness, injury and death incidents on the wellbeing of firefighters interviewed more than 50 Kiwi firefighters and found that non-fire incidents such as medical calls, motor vehicle accidents and suicides largely had negative impacts on them and their families.
Though Blenheim-based clinical psychologist Jeanique Willemse acknowledges the good intent of the report, she is concerned that its recommendations don't include World Health Organisation and internationally recommended evidence-based treatments of PTSD.
"There's no expertise for PTSD in one place here because there are different agencies trying to fix mental health but they don't necessarily use science or evidence-based practice to guide their treatment or support programmes. It's very fragmented – here different traumas are treated by different agencies.
"In the Netherlands all trauma that causes PTSD falls under one system – there will be a department that specialises in PTSD and their knowledge and the treatment specialty is comprehensive –there's also much more capacity to do PTSD treatment."
PTSD is acknowledged as a risk of the profession for first responders in the Netherlands. In New Zealand, FENZ now offers staff affected by PTSD a limited number of sessions of psychological support. Willemse says people don't come into the mental health services unless their condition is more severe or suicidal.
She believes it is hard to pinpoint the number of PTSD referrals among first responders in New Zealand because people are seeking help from multiple work-related counsellors, agencies and institutions.
International studies cited in the FENZ report found that in general, firefighters have post-traumatic stress rates of 18-20 per cent compared to about 3.6 per cent in the general population.
Less than 40 per cent of these seek mental health care when experiencing distress and 32-55 per cent of those seeking care receive the recommended treatment.
The New Zealand research found that due to the strong team culture, dependence on colleagues and the image of firefighters as heroes, many were unwilling to disclose when affected by traumatic events.
Willemse worked as a clinical psychologist in the Netherlands for 10 years, before working in the area in New Zealand over the past four years.
She says due to the nature of their work, most firefighters and first responders meet a key criterion for PTSD, which is that they have been exposed to or witnessed actual or threatened death, or serious injury.
People with PTSD present with anxiety, low moods and sleep problems. Avoidance is a big problem as they are frightened to talk - or even think - about the event, or events, that have impacted them, but they can't let them go, she says.
"They don't understand why they can't get over it and they feel that they have lost control over their own minds because this trauma keeps coming back. They keep being drawn back into the situation and the whole body has to experience it again."
Generally, people have the strength to deal with exposures to trauma and death but some incidents can't be processed because they are so overwhelming.
"The problem with PTSD is people say 'this is too overwhelming' and they stay alone with it. Then they try to avoid it. But what happens in the brain is that you become fearful of the memory because when you go back there, you have to relive the whole thing. The brain can't let it go because it feels there's a danger. So you will have all these fight/flight responses in the body. It's not just a memory- it's like an unsolved problem- it keeps coming back," Willemse says.
FENZ deputy chief executive people Brendan Nally says responding to emergencies can be as psychologically demanding as it is physically.
"This is why we have a number of psychological support options available for our people and their families, and encourage them to access them when they need.
"We provide free counselling, professional psychological support, and peer support to our people whenever it's needed.
"We have dedicated safety health and wellbeing advisors, a health monitoring programme, chaplaincy, and Tikanga Māori-based services.
"Counselling is also available free to family members whenever they feel they need it.
"These services aren't just available to frontline firefighters, but can also be accessed by our communication centres, support staff and their family members.
"We are actively trying to break down the stereotype of a 'tough' firefighter who is reluctant to ask for help and we're pleased to see that the number of people accessing our available support is increasing.
"It's important that our people know it's okay not to be okay and seek the support we provide."
Holidaymakers making the most of New Zealand over the summer have been urged to stay safe on the roads.
Eleven people died on our roads during the official holiday period (from Christmas Eve to 6am, January 5). That's almost three times the number last summer.
National Road Policing Manager Acting Superintendent Gini Welch says with more cars on the road, there is naturally more risk, so it's more important than ever that people are focused when they're driving so that everybody can arrive alive.
"We all need to do the simple things to keep safe on the road," Welch says.
That includes watching following distances, speeds, resting before going off on journeys and sharing the driving load.
"Driving tired can be just as dangerous as driving drunk, neither of which we want to see on our roads this summer.
"We need drivers to be fresh and alert for the duration of their journey.
"We know at this time of year people are out socialising, and spur of the moment drinks with friends could lead to people making poor decisions.
"We ask that people are conscious of the potential consequences of each choice they make."
New Zealand Transport Agency General Manager Safety, Health and Environment Greg Lazzaro, also urges everyone to make the right decisions when behind the wheel.
"We're coming to the end of what has been a long and difficult year for many, and we all deserve a safe and relaxing holiday."
Since 2015, an average of 11 people have been killed and over 400 injured on New Zealand roads during the Christmas-New Year holiday break.
"Deaths and serious injuries on our roads are not inevitable, and we shouldn't accept that serious crashes are just another part of the holidays.
We're all human and we can all make mistakes, but every one of us also has the power to make the right decisions which will keep the roads safer for everyone."