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Responding to First Responders

Joe Coffey’s interest in mental health is personal.

As a youth, he watched his mother struggle with depression so severe that she eventually was admitted to treatment. His sister struggled with substance abuse and has long been in recovery. Two family members died from substance abuse. Others had their lives cut short from complications of alcohol abuse.

Those early experiences stuck with Coffey as he entered public safety work: three years in the Army, nine years as a corrections officer and then two decades on the Warwick, Rhode Island, police department. He lamented how officers were poorly prepared to recognize and address mental health issues, whether on the street or in the squad room.

On the street: He learned that between 7 and 10 percent of police interactions involved dealing with people facing mental health issues.

In the squad room: He saw fellow officers struggling with the stress of their jobs and the after-effects of tragedies like the Station nightclub fire in Warwick in 2003, which killed 100 people.

I recognized there was no training or very limited training in all of the academies—military, corrections and policing,” he said. “So it was a kind of quest. I wanted to change that.

Coffey partnered with the National Council for Behavioral Health to create Mental Health First Aid (MHFA), a training module that teaches public safety employees how to recognize and respond to a developing mental health problem or crisis in others and themselves.

Aetna has been involved with the MHFA program since 2013, when—in the wake of the Sandy Hook shooting—we began offering training to employees. Since then, more than 2,100 employees have been trained.

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Last May, Aetna—in collaboration with the Connecticut Police Chiefs Association—offered training to 30 officers from police departments around the state. Coffey, who retired as a captain in 2015, was there, too. The Aetna Foundation contributed a $40,000 grant to help fund the effort.

The goal was to turn those officers into instructors who could return home and teach the course at least three times a year. Program participants learn to recognize people dealing with depression, anxiety, psychosis and substance abuse, among other things. They also learn to recognize and better manage stress in themselves and their fellow officers.

Eventually, the groups hope to make MHFA a part of every officer’s training, as common as CPR or firearms training. In Rhode Island, MHFA already is required for officers, and Coffey said the idea is catching on across the country. Aetna is committed to that effort. In addition to the Connecticut training, the Aetna Foundation awarded a $50,000 grant to fund MHFA training for 200 rural law enforcement personnel across the United States. Overall, Aetna has helped train more than 1,000 community members in MHFA.

“Getting officers trained in MHFA will support first responder emotional well-being, as well as their capability to support fellow first responders,” said Dr. Hyong Un, the chief psychiatric officer for Aetna.


Between 7 and 10 percent of police interactions involved dealing with people facing mental health issues

The training also enhances the officers’ ability “to address the challenges of dealing with individuals with mental health issues,” Un said. “We know that individuals with chronic mental health illnesses often get incarcerated because their behavior is misinterpreted.“

As part of the training, police officers practiced dealing with someone who hears voices and disregards an officer’s commands. They practiced what to do when someone is suicidal. They learned to identify the most common mental health disorders. And they memorized a five-step action plan that includes assessing someone at risk of suicide or harm, listening nonjudgmentally, giving reassurance, suggesting professional help and encouraging self-help and support.

“What Mental Health First Aid does in a direct and subtle way is give people a language to talk about mental health,” Un said. “There’s role-playing, so Mental Health First Aid isn’t just a classroom where you sit passively. You actually interact with other attendees to practice. It increases confidence as well. Part of the reason why people don’t respond when someone is in distress is they don’t quite know what to do.”

Coffey offered an example from his own experience.

In 2010, he was driving by a pond while off-duty and noticed a partially submerged car. He waded into the water. Unable to open the driver’s door, he climbed in through the back to find a woman. She was crying, not panicked. She spoke. He listened. The more she talked, the more Coffey realized this was not an accident. It was a suicide attempt.

He applied his training, empathizing with her, offering her a blanket, and reassuring her. His actions were subtle, but as dramatic as an officer compressing a victim’s chest during CPR. She lived. He earned a life-saving commendation.

“The bottom line is that initial encounter with a police officer, sometimes that first 30 seconds, can have a great impact on the outcome,” Coffey said. “It starts with a police officer at the scene making observations, making decisions.”

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