Mary Anne Cody is one of about 20 Rock Township paramedics or EMTs who take part in the ambulance district’s new Yoga For First Responders program.
“In this job, you’re always thinking about what might happen next,” said Cody, 61, a longtime paramedic. “You’re always in a state of anticipation. This helps me relax, helps me be in the moment and pay attention to what my body is doing.”
Fellow paramedic and yoga instructor Jessie Sutton leads the yoga sessions at House 1 in Arnold during duty hours, as part of the district’s health and wellness initiative. The High Ridge Fire District also has a YFFR program.
Rock officials hope the program provides staff members with a stress relief outlet and improves their mental health resiliency both on and off duty.
“When you go through school, they tell you, ‘Don’t smoke; don’t drink; eat right,’ but in this job, that is just not always possible,” district Deputy Chief Josh Hemmelman said. “And the mental health aspect is even worse. There are all kinds of statistics showing first responders are something like 10 times more likely to experience depression, three times more likely to attempt suicide. This is an avenue to help provide resilience.”
Yoga classes are held monthly, but employees are encouraged to use the techniques at other times as well.
“It doesn’t always have to be done in a group setting,” Hemmelman said. “It’s something you can do after a stressful call or in the middle of a long shift.”
‘Always on edge’
According to the National Institutes of Health, police, fire and EMT/paramedic personnel see injuries, death and violence at significantly higher rates than most people, sometimes leading to post-traumatic stress disorder, depression and even suicidal ideation.
“You get asked in (paramedic) training, ‘How much of your job is mental rather than physical?’ People answer between 50 and 90 percent,” Sutton said. “Then you ask them, ‘How much of your training is about mental preparedness?’ They say maybe 10 percent, if that.”
Some of the stressors include:
■ Scheduling. First responders work around-the-clock shifts, which can interrupt sleep cycles and interfere with family life. Meals are eaten at odd hours and are often interrupted for calls.
■ Unpredictability. “At home you can truly relax, but here you’re always on edge,” said Paramedic Adam Passer, 31, of Festus. “You’re always thinking, ‘What’s going to happen in the next few hours?’ It affects you physically. Even if you’re resting, you hear (dispatch alarm) tones and your heart rate and blood pressure go shooting up. You can never really get into a state of relaxation.”
■ Physicality. The physical demands on the body can be considerable for paramedics and EMTs. In addition to regularly lifting patients and equipment, they sometimes encounter situations that involve contorting the body to fit in small spaces.
“Flexibility is something we need to develop to prevent injury,” Passer said. “You see a lot of people in the medical field with back injuries.”
■ Responsibility. When firefighters and paramedics go on a call, they never know whether they will face a minor health crisis or a situation where they hold a life in their hands.
“Burnout is a real thing,” Sutton said. “People can start to desensitize to the really awful things they see. I mean, you need to do that a bit to be able to do your job, but constantly pushing it down is not good for you. You have to find ways of handling it.”
Yoga is one answer.
“I’ve been doing yoga for seven years,” she said. “I know what it’s done for me and I wanted to bring that to other first responders. We rely on our partners a lot; you can talk about your feelings with them if you’re close, and that helps – but they are dealing with their own trauma. You need other tools, and this is a good one to have.”
Changing the culture
Sutton said programs like YFFR also offer the chance to bring the subject of mental health into the forefront for first responders.
“Mental health is talked about more than it was 20 years ago, but most people in this field are still in the mindset of, ‘It’s my job; I need to hide my feelings,’” she said. “The culture has never been, ‘Let’s talk about how that call made you feel.’ You just put on a brave face and tough it out. But now I think first responder communities are starting to see where they’re lacking in that area.”
Sutton said the type of yoga in YFFR is different from what you might see in a typical YMCA or yoga studio.
It’s more “job-specific,” she said. “We don’t use the term ‘relaxation’ but rather ‘regulation.’ You can’t really relax in this job; you are constantly in a fight-or-flight state. So, since we can’t get rid of the stress, we can learn to regulate it.
“The classes emphasize breathing techniques that help you regulate those fight-or-flight responses and get from there into a rest-and-digest mode. We use breathing, humming, things that calm the body. We always start and end with breathing exercises.”
Sutton said the sessions also help first responders increase flexibility, build strength and increase mobility.
“Kneeling, reaching – the mobility aspect is so important,” she said. “That’s why I like to do classes in the morning, to get loosened up and get yourself going.”
Once learned, the techniques can be applied in other areas.
“Once they have these tools, they can do it on their own,” Sutton said. “Kid has a tantrum, you start feeling road rage – you can always bring those tools into your everyday life to get your mind right.”
Sutton said the district plans to continue the program for at least a year.
“There are other agencies that have been doing it a long time,” she said.
A tool that works
The Yoga For First Responders program is a nonprofit organization formed in 2013 in California. Yoga sessions are free to participants; the district pays a fee for each class.
“If Jessie is on duty at the time of a class, the district pays nothing; if she comes in and does it on her own time, the district pays $150,” said Jessica Gannon, director of instructor success with YFFR. “The district pays the cost of training the instructor and buys the yoga mats from us at wholesale price.”
Gannon said instructor training costs $1,375 for a five-day session, and first responders get a 10 percent discount. YFFR also helps first responder agencies with fundraising, grants and other assistance with costs.
Gannon heard about the program through her own job.
“I used to work for SSM Executive Health, where a lot of firefighters get their annual physicals,” she said. “I found out about YFFR, thought it was a great idea, and went and got trained myself. I went to some local agencies and offered a free trial, and it has just grown.”
Gannon has been teaching classes at the High Ridge Fire District for about three years.
“I’d love to have more people do the training,” she said. “It would be great to see police departments and more fire and ambulance districts take advantage of this tool.”
But does it work?
A recent study in Australia, published in the Lancet medical journal, looked at the results of mental health training among firefighters in New South Wales, one of the world’s largest fire departments, Gannon said.
“It showed that, in addition to reducing absences, the training had a return of something like $13 in benefits for every dollar spent,” she said. “And, that doesn’t take into account the things you can’t really measure – like people feeling better about themselves, being more relaxed with their families, better able to do their jobs.”
To date, YFFR has trained more than 600 instructors and introduced the program to more than 12,000 first responders and military personnel in the U.S., Canada, Australia and the Netherlands.
For more information, visit the Yoga For First Responders website or its Facebook page. Or, email info@yogaforfirstresponders.org.