Palm Coast - Firefighters work 24-hour shifts several days a week. They miss birthdays, holidays and important family events. Those long days are spent answering calls for help - where seconds can mean the difference between life and death. Sometimes, they see the unimaginable and they are expected to perform their duties perfectly and professionally - staying strong during intense moments.

"Nobody teaches you how to deal with those sights, sounds, and smells," said Palm Coast Fire Department Driver Engineer Chris Cottle, who's served as the department's Chaplain since last year. Cottle's role is to provide spiritual guidance and mental health wellness for fire department personnel following traumatic service calls and personal matters.

Over the course of a firefighter's career, they can develop invisible wounds from the psychological effects of responding to incidents involving the death and critical injury, house fires, car crashes or children's illnesses. These experiences challenge the core of a firefighter and could contribute to mental health issues such as post-traumatic stress disorder, anxiety, depression and suicidal thoughts.

According to the American Foundation for Suicide Prevention, suicide is the 10th leading cause of death in the U.S. The rates among first responders are heightened, as they face a greater risk for depression, PTSD and suicide compared to the general population. Studies have also found there were barriers for first responders in accessing help for mental health including shame and stigma. 

In Palm Coast, the fire department is being proactive in taking steps to raise awareness to the effects of PTSD by participating in its first department-wide mental health training. Cottle and PCFD Peer Support Team Leader Eric Robinson brought expertise from the Florida State Fire College back to Palm Coast to share with local first responders.

"It is okay to not be okay," Robinson said recently to a group of firefighters during a training event. He often meets with crews after traumatic incidents and works with fellow firefighters to remove that stigma.

"It's very important that our firefighters understand that they are not alone when they experience the negative effects after responding to critical calls," Robinson said. "This training was important because it was designed to bring everyone back to the realization that we are humans and the emotions we experience are normal reactions to abnormal situations."

Last week, they hosted a four-hour class for three days to 57 first responders from Palm Coast and eight Flagler Beach Fire Department personnel that included some group exercises and presentations from both Cottle and Robinson, Palm Coast Safety Coordinator Ben Caoili, Dr. Sandra Neer of UCF Restores and Nationally Certified Counselor Dwight Bain, who has worked to help rebuild stability after national disasters like the Sandy Hook school shooting, Hurricane Katrina, the Pulse nightclub shooting and 9/11.

"This specific training is important because the firefighters need to understand how the worker's compensation bill works so if they need to take advantage of it, they can make that decision for themselves and have the information to use it," Cottle said. "The bill is set up with workers comp - if you sprain your ankle you go to the doctor for treatment. With mental health, first responders believe they can handle it themselves. If you break your arm, you don't deal with it by yourself. We want them to take advantage of this resource and treat it like it needs more than handling with an ice pack. We want them to be able to understand everything so they make their own choice."

The training is a requirement of Senate Bill 376, which was spearheaded by Florida's Chief Financial Officer and State Fire Marshal Jimmy Patronis, and signed into law on Oct. 1, 2018 by then Gov. Rick Scott. The law requires employing agencies to provide educational training related to mental health awareness, prevention, mitigation and treatment. As part of the training, firefighters were educated on the importance of recognizing the signs of a fellow first responder in despair.

"The overall message to this training was to let our fire personnel know that we have made a strong push to remove the stigma associated with reaching out for assistance," Robinson said. "This is evident as during the past year we have had 10 department members receive peer support training at UCF Restores and our department has afforded Chaplain Cottle and I the opportunity to attend numerous conferences on this important issue."

"Their walk is never alone," said Palm Coast Fire Chief Jerry Forte. "We have asked our firefighters to come here to build a career. It's our job to return them back to their families, fit to retire."

Since becoming chief last year, it's been a staple of Forte's agenda to be proactive in preserving the mind, body and soul of the firefighters through programs like the Chaplaincy, continuance of clean-cab initiatives and health scans, plus training for aspects such as that of mental health.

"The firefighters were glad we were doing something in the realm of mental health and post-traumatic stress," Cottle said. "Everybody was appreciative. I think it went well."