By Cali Torell
“Rub a little dirt on it, brush yourself off, and get back to work” was the attitude toward mental health challenges when John Swenson first started his career as a police officer more than 28 years ago. Today, as co-chair of the Public Safety Duty Disability Stakeholder Group, Swenson is leading a conversation about mental health within the public safety profession that would’ve been unheard of early in his career.
“Simply having these conversations will be a positive step in normalizing the conversation around mental health and public safety,” says Swenson, director of public safety for the City of Lino Lakes. “We are growing as a profession to recognize that the old way doesn’t work. We have to create avenues for our first responders to step forward and say when they are having problems.”
In response to rising concerns about mental health conditions taking experienced and skilled employees out of the profession, the League of Minnesota Cities convened the Public Safety Duty Disability Stakeholder Group. It is comprised of employer and employee representatives, as well as representatives from the state Department of Public Safety and the Minnesota Public Employees Retirement Association (PERA).
This group is tasked with developing strategies to prevent and treat physical and mental injuries in the line of duty. Members have identified several priorities for the upcoming legislative session that would create a culture of wellness and support first responders and public safety personnel grappling with mental health issues and post-traumatic stress disorder (PTSD).
Advocating for state partnership
First up on the agenda: Create support systems for public safety officers before issues escalate into PTSD, and normalize the return to work for people who have sought treatment for any mental health condition.
The group’s approach is centered on prevention, education, and funding for treatment and peer support, says Anne Finn, assistant intergovernmental relations director for the League. The League’s new legislative policy on public safety duty disability asks the state to become a partner with local governments in:
- Fully funding the Public Safety Benefit Account that reimburses employers for providing continued health insurance to police officers and firefighters injured in the line of duty and dependents of those killed.
- Funding to reimburse local governments for providing paid time off to public safety employees who experience work-related trauma and/or are seeking treatment for a mental injury.
- Funding for initiatives and programs that provide peer support, emotional trauma training, early intervention, and mental health treatment.
- Requiring public safety college programs to include mental health and specifically PTSD education as part of their curriculum, focusing on prevention and coping.
- Funding for emotional trauma training for pre-service and in-service public safety officers.
- Advancing wellness for public safety employees as a component of law enforcement reform.
A compounding problem
Cities are growing concerned about the human and financial toll of PTSD within public safety departments. In recent years, the number of public safety employees seeking duty disability determinations through PERA and making workers’ compensation claims for line-of-duty injuries has accelerated. This is particularly true in the wake of a 2019 legislative change that made PTSD a presumptive condition for workers’ compensation purposes.
A record number of public safety personnel have been awarded or are in the review process for duty disability retirements due to a diagnosis of PTSD — a scenario in which officers receive both workers’ compensation benefits and disability payments — which, in turn, has created a fiscally unsustainable situation for public employers and taxpayers.
PERA, which administers benefits for all police and fire employees throughout the state, received 119 disability benefit applications in 2019; 236 in 2020; and 256 in 2021 (through October).
The League of Minnesota Cities Insurance Trust (LMCIT) provides workers’ compensation coverage for most cities in Minnesota, which collectively employ nearly 4,250 police officers and 16,000 firefighters. Four years ago, the Trust faced approximately $2 million in incurred PTSD costs. Today, that number is above $35 million. The Trust increased workers’ compensation rates by 10% per year for both 2021 and 2022.
The trend is troubling for many reasons, but to longtime Moorhead Fire Captain Rick Loveland, it’s about much more than the financial picture.
“We are looking at this from the perspective of health. This is not about payroll,” says Loveland, who serves on the stakeholder group as co-chair. “We are looking at treatment and not separating people from service and the job they were doing.”
Support before it’s too late
Rather than seeking relief through changes to the workers’ compensation benefits, the Public Safety Duty Disability Stakeholder Group is focused on early intervention efforts to help more employees come forward earlier when they are struggling. This maintains current resources needed for people who can’t return to work due to their injuries.
In 2020, the League launched an online PTSD and Mental Health Toolkit at www.lmc.org/mhtoolkit. It contains information covering different types of programs that are available to cities, resources they can tap into, and best practices for dealing with mental health challenges and creating a mentally healthy work culture.
Legislative efforts in 2022 will focus on training for public safety professionals and funding for initiatives that provide early intervention and mental health treatment. Members of the stakeholder group believe this is a critical first step toward seeing PTSD as a treatable mental health condition that doesn’t have to be career-ending. The Duty Disability Stakeholder Group is also closely following recent changes to Wisconsin’s workers’ compensation law that focuses on treatment for work-related mental injuries.
The current claims process is an “all-or-nothing” situation for people who are struggling, Finn says. “When they’re making this decision, they’re in crisis mode,” she says. “They think, ‘If I don’t file the claim and leave, I might end up stuck without any help.’”
The process needs to provide a realistic timeline and support for someone to get treatment and work their way back into service, Finn says. This aligns with recent research that shows returning to work can be beneficial for people healing from trauma.
Early intervention also has benefits for the community at-large because PTSD and other mental health issues don’t go away at the end of a shift.
“As employers, we need to give our employees the help they need to be healthy, not only for their professional role, but for their families and personal lives,” Swenson says.
Peer support success
Peer support is another area where the stakeholder group hopes to see future investment. LMCIT has instituted a Public Safety Peer Support Standards and Training Advisory Board, comprised of law enforcement and fire representatives and a mental health professional. The advisory board makes recommendations and helps prioritize LMCIT initiatives for public safety peer support. It also provides quarterly training to peer support personnel across the state.
There’s a blueprint for peer support through the Minnesota Firefighter Initiative (MnFIRE). Since 2016, MnFIRE has provided the state’s firefighters with the tools, training, and support they need to prioritize and protect their health. They directly address the three health problems most commonly experienced by those in the fire service: cardiac, emotional trauma, and cancer. They’ve seen success with a 24-hour confidential peer support hotline, Loveland says.
Many municipal employers offer counseling and support through employee assistance programs (EAPs), but it may not be enough for the types of trauma public safety officers witness in the line of duty.
“What we are finding is that the counselors that work within EAPs aren’t really trained or suited for dealing with the trauma that police and firefighters might be bringing to them,” Loveland says.
Nationwide, peer support is a best practice for professionals in the public safety field, and it can take many forms. Public safety professionals can process events with peers in the industry who have been through similar situations and are equipped to handle tough calls.
Other peer support models allow employees to discuss their trauma in groups with trained mental health professionals who specialize in the field. It also helps normalize the conversation around mental health in these professions, Loveland says.
Although peer support doesn’t replace professional services, it is often a starting point along the continuum of mental health care, according to the International Association of Chiefs of Police.
Improved service for communities
Advocates are hopeful that lawmakers will see the value in investing in these resources to deliver better public safety services throughout Minnesota.
“It’s important for them to understand that our first responders are out in everyone’s community performing essential, stressful duties that do affect them over time,” Swenson says. “It’s in everyone’s best interest to make sure we take steps to give them the tools and resources they need to remain healthy.”
Beyond the financial toll, there are other losses associated with duty disability retirements, like the increased pressure on already short-staffed departments. They will need to backfill the position or cover shifts through overtime, risking burnout.
Providing funding to reimburse local governments for giving time off to employees experiencing work-related trauma or mental injuries can prevent public safety departments from shifting burdens to other employees.
The stakeholder group also agrees that treatment for PTSD and other mental health conditions is an important part of the public safety accountability discussion. As lawmakers consider reforms around law enforcement and policing, the League will ask them to invest in some of its proposals.
“We believe that mental wellness is an important component of accountability for public safety employees,” the League’s Finn says. “Healthier employees have better interactions with the public.”
For Loveland, it’s very simple: Anything less is dangerous to first responders and the public.
“When someone calls 911 — whether it be for police, fire, or ambulance — we want to make sure that we are bringing the best,” he says. “If we have people out there dealing with an emotional crisis or mental health issue in their life, are they giving their best?”
Cali Torell is a senior account executive/lead writer with Goff Public.