Sep. 13—CONCORD — Firefighters rescue people from burning buildings and crashed cars. They care for the injured, and console the families of those who don't survive. They rush toward danger when others are running away.

But the stress and trauma that first responders experience can take a cumulative toll on their mental health and well-being. Studies show that rates of depression, PTSD and suicide are higher among police officers and firefighters than in the general public.

A new program invites mental health providers to experience real-world scenarios that firefighters and EMS personnel face on the job. For the first time in the nation, the training was held last week at the New Hampshire Fire Academy in Concord, with 30 clinicians taking part.

It's all about helping the helpers.

After a day of classroom instruction, participants were led by experienced firefighters through four simulations: a car crash, a search and rescue, a building fire and a medical emergency. They donned turnout gear and breathing apparatus, hoisted heavy extrication tools to cut open a vehicle, hauled hose lines and poured water on flames. Their vision obscured under masks, they crawled through a dark building to search for someone inside.

The victims were imaginary; the flames were real.

'I'm a little bit closer'

"I felt like the world's worst seeing-eye dog," Cailyn Chisholm, a care manager at Lakes Region Mental Health Center, said as she emerged from the search and rescue exercise. "If I ever wanted to be a firefighter, this completely reminded me this is not the job for me."

Clients often tell counselors that they don't understand what they've been through, Chisholm said. After going through the first-responder training, she said, "Maybe I don't fully understand, but I'm a little bit closer than I was before."

Andrea Mitchell, program director at Forge VFR, which provides mental health services for first responders and veterans, said the training was eye-opening. "It's going to help me really understand what my clients go through" — especially female firefighters, she said.

The training was developed by the International Association of Fire Fighters, which represents more than 325,000 members in the U.S. and Canada.

It's about building "cultural competence," said John Niemiec, who runs the IAFF's behavioral health program. "We wanted mental health clinicians to have a keener understanding of what firefighters and EMS personnel go through all day, every day," he said.

Justin Cutting, the state director of fire standards and training and emergency medical services, was instrumental in bringing the program to New Hampshire. When he learned that the IAFF was looking for a place to pilot the training for mental health providers, "We told them our doors are open," he said.

The hope is that showing clinicians what first responders go through may prevent PTSD and other health issues in that population, Cutting said. "They now have a glimpse, from the perspective of that person who experienced some sort of job-related trauma, and they can help them," he said.

Matt Lamothe, Manchester's assistant fire chief, and Manchester firefighter Steve Barton led the crash-scene exercise. First they showed the participants how to use extrication tools to remove the doors and windows of a vehicle to get to the patients inside. Then they had them try it themselves; it was not an easy task.

When he started in the fire service, mental health support "wasn't a thing," said Lamothe, who is also an instructor at the fire academy.

He recalled one terrible accident on Interstate 93 near the Londonderry line, where rescuers found a little girl standing near a demolished car, her father inside. To this day, he remembers the details.

"She was wearing a red dress," he said. "The dress was blowing in the wind."

Even talking about it all these years later, he said, "I'm there right now."

"That's why you guys are here," Lamothe told the counselors. "I appreciate this more than you know."

Jake Dodge, the training lieutenant for Nashua Fire Rescue, led the fire suppression exercise. Deciding what size hose to use at a fire is a judgment call, made in seconds, he said: "The more water, the more weight."

His fellow Nashua firefighter, Corey Morin, told the group that at a fire scene, "We're pushing our bodies to the ultimate limit, both physically and mentally."

The participants got a taste of that, lugging a heavy hose into a training building and then aiming the water at intense flames.

'What people have to live with'

Robert Quinn, New Hampshire's safety commissioner, said this new program is about "taking our wellness and resilience to the next level."

"It's understanding what people have to live with for the rest of their lives," Quinn said. "What they've seen and done."

IAFF representatives who came to Concord to watch the training included Scott Robinson, who as a young firefighter in Rhode Island responded to the Station nightclub fire in 2003, in which 100 people died.

It took him three years to reach out to a clinician for help with what he had experienced, Robinson said. But when he finished telling his story for the first time, he realized that the counselor was crying. "You can't help me," he remembers thinking.

Robinson now trains firefighters to help their peers cope with the stress and trauma of the job. It's time to train the clinicians, he said.

Also observing was Will Ostinguy, who retired from the Boston Fire Department after 40 years of service and is now a consultant for IAFF.

This kind of program was unheard of when he was a young firefighter, he said. No one talked about mental health, or suicide.

"It was old school," said Ostinguy. "Suck it up and move on."

"We've come so, so far," he said.

IAFF plans to offer the program around the country and in Canada, Ostinguy said. "As more clinicians get trained, they'll know a little bit more about our members and what they experience, and be able to help them," he said.

Candice Alizio, executive clinical director of Forge VFR, said the value of the training was "beyond words."

"This is going to help us serve so many more people," she said.

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