The People, Process, & Progress Podcast - How Rhonda Kelley and the All Clear Foundation are Building More Resilient Emergency Responders | KEV Talks #13

Episode Date: December 20, 2022

On this episode of the KEV Talks Podcast (  @kevtalks ), Host Kevin Pannell and Rhonda Kelly, Executive Director of the All Clear Foundation ( @allclearfdn ), talk about how Emergency Responders can succeed, thrive, and matter using tools provided by the All Clear Foundation. Viewers and listeners will also learn about Rhonda's transition from providing emergency medicine aboard an icebreaker ship through her time on shift as a Firefighter and becoming the Executive Director of the All Clear Foundation.- Connect with Rhonda on LinkedIn at https://www.linkedin.com/in/rhonda-kelly-99244610b/- Follow the All Clear Foundation on Instagram and YouTube at  @allclearfdn  - Learn more about the programs All Clear has to offer at https://allclearfoundation.org/resources/Thank you for watching this video, subscribing, and listening to the KEV Talks podcast. Follow KEV Talks on Instagram and Twitter @pannellkg, and look for the KEV Talks Podcast on Facebook.Remember...- Have a plan- Stay informed- Get involvedGodspeed,KevinKevin Pannell, PMP | Founder of KPannell Productions, LLC | Creator & Host of the KEV Talks and You-Jitsu Podcasts | Principal on the @Pannell5Fit and KEV Talks YouTube Channels

The risk of cancer for firefighters is 250% higher than for non-firefighters. Emergency medical service personnel report suicidal thoughts at a rate 10 times greater than the national average. The average life expectancy for law enforcement officers is 57 compared to 79 years of age for civilians. And 70% of the U.S. fire service is volunteer. We're fortunate today to have Rhonda Kelly, who is the founder and CEO, or was the founder and CEO of Responder Strong, and now the executive director of the All Clear Foundation, who we're going to learn more about Rhonda. We're going to learn about how to address and of the All Clear Foundation, who we're going to learn more about Rhonda.

We're going to learn about how to address and how the All Clear Foundation is already addressing many of these issues. And as you say on the website, how we can help folks succeed, thrive, and matter through All Clear. So Rhonda, thanks so much. It's good to see you in person and meet you in person. Virtually, I guess. Yeah, there we go. Virtually in person. Thank yeah there we go virtually in person thank you it's a pleasure to be here awesome cool yeah we touched base i was just looking a month or two ago which is awesome really appreciate you responding when it reached out that's you know kind of the the shift in the podcast we were people process progress very kind of process program management incident management focus um still are still have some of that but really wanting to give back in the areas i know

i spent time and you spent a lot of time in which we'll hear about um because it's critically still are still have some of that, but really wanting to give back in the areas. I know I spent time and you spent a lot of time in which we'll hear about, because it's critically important, kind of discussion, I had a discussion with a good buddy of mine about substance abuse. And we talked about that, I think a little bit before, I'm sure we'll touch on that today. But Rhonda, let's let the folks know about you, your your background from our call is very interesting, even before the fire service and before public safety. So let us know where you grew up and what led you to, let's get to the kind of start the, you know, get to the Responder Strong. Oh, fantastic. Grew up in Michigan and Virginia,

got an undergraduate in physics, was working on a master's degree in physical oceanography when I got some opportunities that just I couldn't pass up to travel. So I spent the better part of my 20s living out of a backpack traveling around the world working on research ships. The last four years I spent working on icebreakers for the U.S. Antarctic program. Loved it. Those were research platforms and everybody was obligated to wear many hats. Two of the additional hats I picked up were expanded practice EMT and hazardous materials technician. So I really developed a taste for emergency response work.

And as I was closing in on 30 and thinking it was time to get my adult job, I landed in Colorado, was volunteering for a rural ambulance service, working for an urban ambulance service, and shadowing PAs and RNs in the ER, thinking that I wanted to be a PA or a nurse. I continued to see firefighter paramedics come in and just thought that looks like too much fun. I like the teamwork. I like the unusual schedules, the camaraderie, the wearing multiple hats again, and service to the teamwork. I like the unusual schedules, the camaraderie, the wearing multiple hats again, and service to the community. So I jumped ship again, became a firefighter paramedic in Aurora, Colorado for 17 years, picked up my RN on the side. So I was working part-time as an ER and psych ER nurse in Denver. And about 10 or 11 years into my career, really began to notice

the changes in myself, the changes in my co-workers, not just on the fire department, but in EMS, dispatch, law enforcement, and really started to recognize that our professions really didn't prepare us for what's arguably the single greatest exposure over any of our careers. And that's the exposure to the intense trauma and suffering of others in the complete absence of any preparation, how to deal with that and being embedded in the culture that tells us any mental or emotional impact from the job is a sign of weakness. And really realizing we were setting ourselves up for the catastrophic statistics, the ones you just

mentioned. But back in 2011, 2012, we were aware that suicide was one of our leading occupational killers. We just weren't doing anything effective about it. And in 2016, I was given the option to create an organization called Responder Strong, a mental health initiative that is targeting emergency responders and their family members to improve their access to appropriate culturally competent trauma informed mental health resources was given the opportunity to found that. And my response was, we need to stop working in isolation. Not only the silos of our agencies, whether it's career or volunteer, but the isolation of our branches, that it's not usually people think of police, fire, EMS as first responders. Right. Missing the first of the first responders, the dispatchers and missing all of the other professionals and career dedicated servants who are trained to respond to their community in times of crisis, disaster, emergency. So healthcare workers, I know that I saw the same types of personalities, the same types of motivations, the same types of occupational exposures, and the same types of human impact on the other side of the yard or when I was nursing that I did out in the field. And it's not just the four main branches. We've got corrections, coroner's personnel, search and rescue, disaster workers, ski patrol. And I mean, the list just goes on and on. And yeah, it's been kind of a wild ride. And back to that, you know, founded Responder Strong in 2016. It really took off. We were working across branch boundaries, which is really, I think, essential to address that culture piece. And we were working with our allies. We found a lot of clinicians, educators, researchers who really wanted to help us. They just didn't speak the right language. They didn't have the right keys to open the door. So we've always been a very collaborative organization. In 2020, we were invited to join All Clear Foundation as their mental health initiative. And I was invited to join All Clear as the executive director. We focus on what's my true passion, integrating mental and emotional wellness in the entirety

of our wellness. So we also focus on cardiac, metabolic, relational, social, spiritual. And that's kind of where we're at. Cool. That's it. It's just so simple. Yeah. I know, which one, your story is unique. And then like you talked about, I think it's great because a lot of folks focus on, oh, I can go squat 300 pounds, but I never take time for my noggin, right. Or to deal with the things I see. And it's easy to do.

And I've done that before. Cause you're like, oh, I feel better, but you don't. And then you start to, you know, we can talk about some of that. Can I ask you a question though, when you were, so when you were doing the EMT stuff, it sounded like you got some austere medicine type work out there being on a ship and out there doing EMT work. Cause you don't have, you're not going back and, you know, each shift, you know, restocking and do it, you know, it's, it's a bit different. So did some of that troubleshooting you had to do kind of in a steer environment carry over pretty well to when you were in a kind of a more traditional, um, not first responder, what's,

what's the emergency responder? Is that an accurate role? You know, nobody's ever asked me that. And yeah, that's a very insightful podcast. Breaking, breaking new ground. I love it. So, yes, absolutely. When I was based on the ship, we only had one medical person on board, and that was an expanded practice EMT. So we also had a very deeply ingrained culture of safety. We were usually two weeks out from a medevac point. So two weeks off the coast of any country that could send us a helicopter to medevac point. So two weeks off the coast of any country that could send us a

helicopter to medevac somebody. So we all understood a serious injury out here is likely going to be fatal. We carried a very well-stocked pharmacy. We had a lot of medical equipment. And when we were at the right latitude, we had satellite radio so we could connect to a physician group we worked with remotely. So I think this is one of the best things. Yeah. For my later skill set that came out of that was I had to think on my feet. I had to do a really good assessment, a really good set of differential diagnoses. And I never knew when the connection was going to drop with the doctor. So I had to be really concise in my report. This is our Latin lawn. This is our call sign. This is who we are. This is the patient age situation. This is what I've seen. This is

what I've done. What do you recommend? And that really carried over into reports on both sides of the ER doors when I was a medic coming into the hospital, giving a report to the staff and when I was in the hospital, turning over patients to other staff members. So yeah, great question. That's awesome. Yeah. It made me think of so many things. One, kind of the military nylon report, you know, bottom line up front in business, even, you know, I just need to get leaders or whoever I need to get the message to, like, here's what you need to know right now, here's the action you do need to take, or, you know, it just, that to me carries over beyond or in addition to like you mentioned, other jobs where your gloves and, you know, scrubs,

or you're in, you know, scrubs or your, you know, cargo pants, all that kind of stuff. And then thought of, I was on an incident management team for a while where we traveled around, you know, missing persons and disasters and special events and things. And there was a medical unit leader position, which I did a bit. And some of the folks that did that in big wildfires and things more akin to what you did. The lesson they learned was not good communication, not good equipment, really staffing. And there was one case we learned about a wildland firefighter, a young guy who died because a tree fell on his leg and he bled out and they couldn't talk to the people they needed to talk to less because of a communication kind of window gap.

But it just stressed to me and what you just said, reinforce that, you know, if you're going to be deployed somewhere, because you could be deployed if you're working the streets as a firefighter or police officer as a task force, just something happens. And, you know, kind of that planning, but yeah, that that mindset just seemed seemed invaluable, even if you're in a place where you have all the stuff you need, typically. And you brought up so many good points as you do. Before I founded Responder Strong, I had just started a master's program in clinical mental health counseling, thinking that, hey, I really want to help our own.

And that was why I had transitioned the last couple of years of my career. I was the health and safety officer as I'd realized most of us get into this work to help others. And that's where a lot of our injury stems from is realizing we can't. The cards are already dealt when we get there. Many times we can't change the outcome. We hold ourselves to a high standard. And when we can't change the outcome, we think we failed.

I mean, it's this vicious kind of cycle. And I got to the point where I realized there's only so much I can do for the community at large. Right. But what I really want to do is help our own, help the personnel I work with, my people. And so I was in the first year of the program. And that's when the opportunity to found Responder Strong came up. And I realized my passion is really what you just spoke to is, I really, really appreciate the people who sit in the chair and counsel one-on-one. We need them desperately, but I want to work at the systems level. I want to find those communication flaws. I want to find the networking flaws. And that's really informed a lot of our development as Responder Strong and later as All Clear Foundation is realizing there are a lot of

really good resources out there that are difficult to find. So we've really been focused on developing strategic partnerships, finding people who are doing good work in these various domains, and building a more easily accessible and navigable network. Because none of us reach out until we're in crisis. And at that point, Siri and Google aren't really going to point us in the right direction. It's like, how can we empower people to take proactive action constructively? And then also when they are in crisis, how can we get them to what they need

when they don't really have the cognitive bandwidth to go search it out on their own? Yeah, that's such a challenge. One, not your website, because it's awesome, All Clear Foundation, but there's so much, but to have it all in one space is super helpful to grab it, but to have someone that can guide you and say, oh, this is probably the better, because not every resource is the same, provides the same positive or negative, I guess, effect for each person. And one thing we touched on before, like the employee assistance program. Some folks, it's awesome. Some folks, it's awful. And that's just the ground truth of it. And it's, you know, those folks do great work, hard work, you know, from when you ask for help through you get in the chair, you're able to talk to somebody.

But there's a lot of other outside your employer kind of resources, I guess, right, that are available as well that you all have connected with? Absolutely. And one of the tenets of our development has been that we recognize there's usually three main barriers to emergency responders reaching out for effective help. One is stigma, the cultural and the internal. So we do a lot to normalize what are stress reactions. And you mentioned the military earlier. We know that roughly 30% of emergency responders are current or former military. And many times they're bringing in pre-existing stress injuries. Now they're living and working in an environment that they can't escape. So that's a whole other situation.

But we've been borrowing from the military stress injury model to really destigmatize mental and emotional health challenges and showing responders that these are driven by the same mechanisms that drive our hypertension, our obesity, our diabetes, our cancer issue. This is all the way that we are responding to stress. It's the physiologic change in our minds and in our bodies. Two other barriers. One is geographic. Many of us work in cities that are rich with resources. That's fantastic. Even more of us work in small and rural communities that are not rich in resources and don't have a lot in the community. So we're working to resolve that. And then the third one is the financial barrier, which sooner or later gets all of us. And it's always been a personal point of pain for me when

I see responders prevented from accessing particularly the mental and emotional help that they need, the support they need when they're struggling from exposures they encountered on the job. I don't think it's right that they should have to pay out of pocket. And I don't think it's right that that should be a barrier. They've sacrificed their wellbeing and their longevity to serve the community. And that's just not right. So to that end, everything all clear foundation offers is free to agencies, to participants or to their families. And we, yeah, we're able to do this through generous donations, whether it's federal philanthropic or individual donations. And we're, we're very happy about that.

That's great. Yeah, the insurance, navigating that, whether it's for yourself, your kid, you know, it's just a, it's a beast, or can be. So it's nice, like you said, to remove those barriers and help streamline where folks can find things and get the help that they need. Absolutely. And one of the things that we don't do, but we really seek those strategic partners, is pay for services. That's not part of our mission. But we've been noticing across the country there are more and more nonprofits who are raising the funds to pay for care. Sometimes in the EAP model, we'll pay for six visits, ten visits. We'll provide a travel scholarship or will provide a care scholarship to a residential facility. And so it's heartening to see that too. And again,

you and I both know this problem is so pervasive and so deep. There's no one entity, no one organization, no one person who can effectively make a dent in it. So it really does require collaborative partnership. Yeah, absolutely. And is there, you know, to that point, is there, are there kind of partner organizations that also gather info, like a network nationally or internationally where you all kind of share, share the secret sauce, so to speak of like, Hey, here's a, here's a bunch of good resources. And I know you will provide training and we can talk about that, but is there, is there potential for kind of a network or do you all network as foundations, I guess I'll say?

You know, it's been more on an individual organization to organization basis. I do see a lot more openness towards collaboration. In the past, there was a little bit of territorialism. And I think now the really good organizations are realizing there is so much work we need to partner so that we don't drown in it. And one of the things we're working towards developing is an emergency responder resource network, where it's a community, virtual, of course, of organizations who are doing really good work sharing resources, because ultimately, at the end, we don't care who gets the credit. We just want people to find what they need in the moment.

Yeah, that's, that's huge. And follow up on a couple of things that you mentioned, you know, not being ready for what you see, what you hear, what you, what happens. And again, a good buddy of mine, and he's been on fire department for quite some time. We were together in the Navy and, you know, when you're 19 and they're like like, hey, you're gonna work in the critical care area, you're like, that's awesome. And then you go, oh, that's what a really sick patient looks like, or a dead person, or, you know, and whatever you see, or you're going to be the EMS for this base, and who knows, you know, what can happen. And there's, you know, tons of domestic stuff that happened, you know, just bad stuff, right? And, and the and that was, you know, I went stuff. Right. And, and the, and that was, you know, I went into the nineties, it was a while ago, but I'd be curious between military folks that you

see, right. That are then first responders and then first responders over the years that you've been both responder and a nurse and with all clear, have you seen an improvement in that pre kind of prep as much as you can, I guess, in academies or, you know, where they've integrated more of the more of the mental health preparedness aspect? Definitely. And definitely seeing a move in the positive direction there. Back to our responder strong days, one of the first things we did is we created a mental health curriculum. It's designed to be three and a half hours of content or so. and it is targeting the normalization the destigmatization and the empowerment through education for emergency responders

we open it with the discussion about the physiology of stress how it impacts our bodies and our brains we talk about what stress actually is we talk about the stress injury model the performance continuum we talk about the statistics among our ranks of not only suicidality and post-traumatic stress, but the earlier pieces, the earlier segments on the stress injury continuum, anxiety, depression, substance misuse, anger issues. And we contextualize those as a response to the overwhelm of our coping mechanisms. Then we talk about suicide and awareness and prevention in ourselves and in our coworkers, because many times we've had blinders on that for the past for, yeah, good

reasons, but poor outcomes. And then we wrap it up with a segment on resiliency with the overall messaging being, it is rarely the single headline grabbing event or incident that gets us. It's the accumulation of the smaller T traumas, the smaller S stressors that we just don't deal with in the moment that we compartmentalize, that we suck it up buttercup. And that's typically what gets to us. But the good news around that is if that accumulates a drop at a time, resiliency practices, even though they seem so small as to maybe be inconsequential, if we make those habitual and we practice them on a regular basis, those accumulate a drop by drop. So those can balance out the stressors and traumas

in our lives and prevent that cumulative damage and injury that we've seen so many sustain. But to your point about the openness to this, absolutely. When we first created the curriculum, we wanted to target the community colleges in Colorado, knowing that they train more than half of our emergency responders in the state, which is true in many states. And that they have a particularly strong presence in the rural communities, which are underserved, and that their adjunct instructors are almost always current or former responders. Get them at the source. Yeah, that's great. Yeah, exactly. So we rolled that out. It's in almost every public safety program and community colleges in Colorado. We started to be incorporated in, in services, in academies for agencies, in family nights, in peer support training. We're part of the curriculum for a lot of colleges and universities across the country. We work with

groups like Warriors Rest Foundation. We are incorporated in their peer support training, and then they in turn got us incorporated into the state of Oklahoma's public safety peer support training. Oh, wow. Yeah, we've been involved in some nursing programs. And when we originally created it, we thought we have to catch the people when they're coming into the profession, because that's the biggest bang for our buck. Teach them that the most likely injury you're going to sustain is a stress injury. And this is what it is. And this is how to prevent it. That's fantastic. But we found that the seasoned responders, especially those with military backgrounds, were just grabbing onto it. Like, I wish somebody taught me this. And, you know, this is empowering me now that I understand. And I don't feel like I'm in a shame spiral, because this is just alcoholism or just anxiety. This is an outcome for my coping mechanisms being overwhelmed. And now I know what to do about it. So what we've seen over the past three years in particular is I think collectively COVID, the social unrest, the financial upset, inflation, the things that are happening on the global level have pushed us all to the point where we've realized everything's crazy. You're not feeling it.

You're not paying attention. And that there's no shame in this. This is something we can prevent. So I'm seeing that there's a lot more receptivity and openness to this, both proactively and reactively to help people heal. Good. Yeah. It's almost like the after action of anything bad that happens or war, right? Medicine we have lessons learned um and you know from honestly from your time and as an incident manager we read after action reports right so from like reading about the aurora right shooting and reading about other things there's always

lessons learned and so from covid uh hey we're disconnected and that's a problem for a lot of people and all this stuff's happening that hasn't happened for a while at the same time or ever. And it just bombards you constantly, especially if you're always checking the news and your feeds and likes and all this kind of stuff. And yeah, it's great that the change happened. It just stinks, right? Because that's another thing you learn if you're in healthcare or public safety or public health is the mental health system has been a mess for quite some time. It just took this global pandemic and this global disagreements from all different sides and political barrages and all the other stressors of life to bubble it up again. But

hopefully it sticks a little bit more because there's more exposure, it seems. That's, I guess, a plus with the internet and news being everywhere, or information sharing instantly. Well, and one of the things that we're seeing at the organizational level, the agency level, is that leaders in the past have acknowledged, yeah, resiliency is important. We need to take better care of our people. But it wasn't one of the top operational priorities. And now it is, is we're seeing an exodus of personnel out of law enforcement, EMS, and healthcare in particular. Are recognizing, wow, this is now a recruiting and retention issue. And this is service provision. This has got to be an operational priority for us. And we're starting to see a lot more buy-in from leaders about, yeah, let's bring this content in. Let's reduce

the suffering among our personnel. Let's empower them to live healthy lives. Let's uproot this whole martyrdom ideal in our culture and recognize we check our batteries. We check our radios. We check our equipment, multiple times shift. Why are we not doing an internal scene size up? Why are we not taking care of our people? Because nothing else matters if our most precious resource is burning themselves out. Yeah, that's a great point. So it is great to hear of the change that we're front-loading, kind of preparing folks more and more in the academies or in the community colleges. And you mentioned folks that are in retirement or had experience or have been on the job for a while embracing it. And retirement is another, I think, area, another timeline where folks face a lot of crisis, right?

And even suicide rates, right? Because what they know, their identity or substance abuse maybe can go up. How do you prepare folks for retirement? Are there workshops that you do focused on that as well to help get people kind of transitioning out of, for a lot of folks, the life they've known for decades, really? Great question. And yes, you're absolutely right. We do see a spike in reported suicides after retirement. We know that we're missing a lot of them. And we think this happens for several reasons. In fact, you touched on several of them is one responders tend to really identify with what they do is who they are.

And when we throughout the course of our career, don't expand upon that identity, it can be a really abrupt termination after we leave the department. And I remember when I left Aurora, I still had the opportunity to teach at a couple of our academies afterward. We were talking about this very topic. And I asked the group of recruits, when people ask me what I do, what do you think I say now? And a guy who was probably 26, 27 in the back raised his hand. And he said, I used to be a firefighter. Said exactly. How did you know that? And he said, because I used to be a Marine. And it is a really difficult transition for us. It can be mitigated. We prepare by, well, so many different ways before we retire. But some of the other things we see happening

when someone retires from a career or a volunteer role in emergency response, they lose the identity. They lose the sense of mission and purpose unless they've created another one. They oftentimes lose the social status that they're not, they feel like now I'm not contributing to the community. I'm not held in as high a regard. They oftentimes lose the camaraderie, the shared sense of humor, the shared experience, the access to resources, whether they use them or not. And now they often find that in the absence of all of these things, that compartment door that they had been shunting all of this, the stress and trauma into starts to creep back open. And it can be just catastrophic at that point. So one of the responder populations that we really focus on

are the retirees, letting them know that, hey, there's still plenty of ways to contribute, to still be a member of the team, and to use your lessons, your life experience to the benefit of others, perpetuating that mission of taking care of our own, helping other people. So retirees are definitely an area that we've been focused on. Right now, The mental health curriculum has been something that's really been resonating among retirees so they can understand why they're feeling the way they're feeling, why they've experienced what they've experienced, whether it's depression, anxiety, multiple divorces, financial troubles, drinking issues, and see them through a lens that doesn't put shame or blame out there. No, this was a response. And now that you understand it better, we can help you build out coping skills so you don't need those things and you can heal and recover. So we also, through our resource directory, have been pointing towards resources. One we just posted is how to prepare for retirement so you don't experience

these. So again, you know, we're balancing out when we're looking at the stress injury model, the green, yellow, orange, and red zone. We have a lot of responders in the orange and red zone, and they need to be our priority. But the biggest thing for our buck is teaching people in the green zone, how to stay in the green zone, that if you transition to yellow, where you're starting to react, how do you recover and bring yourself back? Yeah, that's tough when you're kind of pegged the needle. It's hard to, you know, unrev it than it is to just not have to hit the gas so much, you

know, when you're in your burnout stage. And yeah, it's good to hear about retirees because just like, you know, burnout EMS, we heard that, you know, EMS thoughts about suicide are way higher where I used to work that they just lost some money to that. Hear about folks are way higher where I used to work. They just lost some money to that. Hear about folks that left the job recently, same thing. And so it's great to give them a new mission that you hear, whether it's military first responders to refocus and realize, hey, you're not done. You still have a use, even though somewhere in there, they probably feel like, man, to your point,

I'm not part of the community anymore. I'm not the senior person on shift. I'm not whatever role they played, but they have a new role to play. So that's great to hear. And with that, one of the kind of big three things we've touched on a little bit is success that came from Responder and is the model to help folks even get ready financially to get ready, you know, with themselves professionally. Can you talk about or touch on kind of the three areas of success, thrive and matter? And really, I guess, we'll kind of start with success there, which does give folks tools, whether you're brand new on the job or you're on your way after 25 years. Absolutely. So some of the strategic partners that we have

connected with, one is Grit Digital Health. They created a wellness tool. It's called the U platform. Our version is the U Responder Strong Wellness Tool. It's available free 24-7 to emergency responders and their family members. And it is in recognition that it is the human behind the badge, the uniform, the scrubs that often suffers and pays the price. We experience very normal human reactions to the abnormal situations we encounter on the job. And then we fall into shame thinking, oh, I'm weak. I'm not as good as everybody else. I don't belong. And what we recognize is to help prevent that is to really focus on our basic human needs. We all have them. We're all responsible for meeting our own needs. But it's oftentimes, especially in a job that glamorizes the signs of stress injury as badges

of honor and a job, a culture that glamorizes martyrdom, take care of everybody else. You're just going to have to make this work. And that's not the healthiest way to do things. So we borrowed from grit, their model succeed, thrive and matter succeed are yeah. Is the basic human needs around academic and professional success, around leadership development, around financial success, retirement, those sorts of things. Thrive is what we typically think of as wellness. So cardiac cancer, diabetes, anxiety, depression, health, fitness, nutrition, all of those things. And then the matter piece is that existential stuff that we talked about a little bit with the retirees, a sense of identity, sense of meaning and purpose, positive social connection, spiritual wellness.

We just did a great session, an educational session with a chaplain I really respect who really opened my eyes to the benefits that chaplaincy, when it's well done, can provide us on spiritual wellness, what it looks like and how to attain it. That's available in our you tool. And yeah, so that's kind of more of the existential stuff. We draw a lot out of existentialism and Viktor Frankl's work in particular, with the message being life doesn't have inherent meaning and purpose, it's up to you to create your own. And what you experience, whether it's on the job or in your personal life, challenges that belief, that meaning and purpose, and sometimes destroys it. It's up to us to recreate it based on our new vision of the world, our new view or perspective.

How can I still continue to find fulfillment in what I'm doing and who I am? And there's a lot around the who I am versus what I'm doing. And that reaches back to the identity piece. Yeah. So I read just this year, which I wish I would have read it earlier, but Mancers for Meaning, which is when anyone's like, what's the book that impacted you? That's always it. And it used to be The Killer Angels, which is about the Battle of Gettysburg because it was a pre-read and it's got like great leadership lessons, but yeah, there's so much. And I should read more of his books.

That one just stuck so much because both the quote that you said, and then just getting in your own wellness, particularly mental and spiritual is realizing like some of these thoughts that you might have, whether you're new and you had a bad call or you're getting ready to retire and you think, Oh, I'm out of the loop. They're just thoughts, right? They're fleeting. They're not the truth. These physical feelings you might have. And this is for me, having some anxiety and having some panic sometimes and then working through it and feeling like I'm in the lowest point possible. But the other key that you said is that you have to meaning I and anyone listening, you have to put the work in like there's no getting around it. So you can seek help, you can go sit on the chair on

the couch to talk to somebody you can, you know, whatever you need, but you have to find and I think it was Frankl quoting Nietzsche, who was like, you know, if you if you have your why you can get your how I totally truncated that. But the gist of that is you have to. Another great person that, and you mentioned faith, and I did an episode, a short one on that, between religion, spirituality, faith. They're not the same, but they're intertwined.

And believe something, right? It doesn't matter what you believe. But it's Joyce Meyer. So she's a pastor, a Christian pastor. But to me, she's more of a no-nonsense like speaker where, you know, you can believe in whatever you want to believe, but at the end of the day, you have to put your shoes on and go do it. And if you have that anxiety, if you have that nervousness, if you're not sure, then why can't you just do it afraid?

Which, you know, when you can kind of keep those things and build them up as part of that thrive, that, that who I am, that yes, I can get through this. It makes a huge difference. And all those things together with regular physical fitness, right. I think, you know, folks have realized particularly in police and fire, you know, there was the old, I'm going to lift as much weight as I can, because that's what I needed to do. And then realize you last two minutes with it with an air tank on because you're huge, but you have no cardio, and then it got better. And so it seems like that's also more round rounded is that the physical training itself is, you know, it's much more functional focus and has been probably for a little bit. Is that accurate? Yeah, absolutely. I think this has been one of the big messages that we push out

through our Clear Foundation is relational health, social health, spiritual health, mental and emotional, physical, cardiac, metabolic, it is all intertwined. If yeah, and that it is all susceptible to the same challenges that we experience on the job. And that's the unmitigated exposure to the stress and trauma. But when we understand that we can do something about it. And it's really a message of hope. And back to your point about suicidality, the last thing somebody loses before making the choice to end their own life is often hope. They feel like this is the way it is. It's always going to hurt this bad. It's never going to change. And in that deeply stressed state of mind, they can't see potential.

And we do a lot around that in the mental health curriculum, talking about so many people who are well-intentioned and see red flags. Responders feel like, I need to know the right thing to say. I need to have all the resources. I can't just ask a question. And really in that moment of suicidal ideation, just being present, you don't have to have the answers, but you know, don't be afraid to reach out to somebody because that isolation, that perceived shunning, um, robs them of that hope. It just, it takes just a tiny glimmer of connection to rekindle hope. That's a great point because even first responder or not, I think a lot of folks are, you pause when you see, you could see someone

standing there crying outside the grocery store and most folks pause to say, Hey, do you need some help? Are you okay? Right. Let alone someone that's, you know, Oh, they're, they're fine. They'll just tough it out. They always, you know, get through it or something like that, which is, which is unfortunate. Cause yeah, you, you know, that one word, one, one just checking could be like, Oh, someone did check. You know, for, cause you know, in that, that darkest of times like you say, they're not thinking about how do I get out of this? I'm going to go ask this person. And I think that's what you see too afterwards is why didn't they ask for help? But I think we know the answer cause they, they weren't in a place to ask this person. And I think that's what you see too afterwards is why didn't they ask for help? But I think we know the answer because they weren't in a place to ask for it.

Exactly. Whether it's because of shame or loss of hope or just feeling, I love the work of Thomas Joyner. He's a suicidologist out of Southern Florida. And he talks about the interpersonal theory of suicide as applied to responders. And he said, you know, to think about ending your own life takes the intersection of two things. One is a perceived sense of burdensomeness and the other is a thwarted sense of belonging. So somebody is, they're getting more and more stressed and feeling less and less worthy starts to spiral down. But to get to the point where you can actually take action, where you can overcome your personal sense of self-preservation requires acquired capacity. And many times our job inadvertently does that. It teaches us to put ourselves last. It teaches us to run towards the danger,

into the fire, towards the bullets, whatever. And to keep going, whether we're tired, we're hungry, we're thirsty. And it also exposes us to people, to violence, to people who have attempted suicide, completed suicide, and in a highly stressed state of mind, it can seem like a reasonable solution. And most people who take their own lives don't really want to die. They just don't want to live in the pain that they're living in. But in a stressed state of mind, it's black or white, very rigid. There's not a whole lot of room for compassion, empathy, outreach, sense of belonging, sense of worthiness. So this looks like a reasonable outcome. And especially if you're in that state and contemplating, should I end my life? And you believe, oh, I'm a burden. No,

this is going to be better for my family. It's going to be better for other people. They don't have to worry about me or deal with me. And a sense that I don't belong. Nobody will even notice. And that's, I hear so many people in the wake, the aftermath of completed suicide saying it was selfish. Like, no, it was desperate. And yeah. Which is hard. Cause it's, it's, it's hard not to be mad at the person, right. Because of what's left in the wake. And I think that's a consideration or hopefully is, you know, it's not just, it's desperate book, Mindfulness for Warriors, and the author's Kim Corbett, her husband committed suicide and talking about the ripple effect. And in other things, where one person can do that, and of course, the ripple effect that happens to the whole family, the guilt, all that, but then other folks that then are affected and think, oh, maybe that's

my solution. So not just the impact that I lost somebody I love, but that somebody else may think, oh, that's a viable solution for me now. Oh, exactly. But to your point, the individual at that state, and this is one of the best descriptions I've heard of that state is that a healthy mind doesn't contemplate self-destruction. By the time somebody is thinking about and has a plan and has the means to take their own life, they are suffering so deeply

that oftentimes they can't project, they can't see the repercussions of their action. They're suffering, they think they're a burden, they think they don't belong. And that does seem like a reasonable choice. They're not seeing all of those sequelae that come out of it. It's out there. Well, yeah, for folks that are watching or listening, if you're having tough, you're not a burden. There's help. And in fact, for the All Clear Foundation on your website, and we have national ones now, but there's a crisis text line as well, right? If folks need someone now, if they're having problems that they can find on the website as well, correct? Absolutely. So back in 2016, we were looking for a partnership that would help us extend culturally competent crisis supports to emergency responders. You know, we recognize suicidality isn't the only crisis. There are lots of crises that come before

that and are definitely worthy of the call. But we also recognize that many responders, we're used to responding to the call. It's really tough to pick up the phone and vocalize that you're having challenges to ask for help. So we search for partners. Crisis Text Line was already well established. They've got an incredible training program, which we really liked. They have a robust cadre of really well-trained volunteers across the country. They're available 24-7 and it's free. We partnered with them, any responder in the country, healthcare worker, field responder, disaster worker, volunteer, can text the word badge to 741-741-247. Someone will come up on the channel within five minutes. You can text.

What we're finding is we're all accustomed to texting. We tend to not beat around the bush. We know we got that 140 characters. Let's get right to the point. You don't hem and haw like you would when you were speaking. You can yell, scream, cry, throw things, and nobody on the other end of the text knows. So you get a lot more anonymity, confidentiality, and privacy. And we're just really impressed with the system. We've gotten so many reports from responders who utilized it saying, wow, that I texted in seven different times before I was convinced that I was really worthy of seeking help for these. It wasn't that I was being convinced that I was really worthy of seeking help for these.

It wasn't that I was being weak. I was really struggling and it was normal. So yeah, we're really proud of that connection. That's good. I love the work they do. That's amazing too to get, it stinks to get the response, but it's great to get the response. You know what I mean? That good that it made the difference.

But before we get to that point, before someone gets to that point, you mentioned the mindfulness and things like that. What kind of practices do you all help facilitate or align people to, to help folks kind of self-regulate, to learn how to kind of calm themselves or deal with thoughts or get them out? What are the kind of modalities that you all advocate for and connect people with? Great question. So I talked about our mental health curriculum. We are just revamping the whole presentation that goes with that. And we've had a lot of requests in the past. We only wanted our mental health curriculum delivered in a live format so that whether it's remote or in person, that there was an opportunity to engage and really empower the participants. We're recognizing now,

if we want to have the reach that we want to have, we have to move beyond the train the trainer to provide the content itself through learning management systems and other platforms, including our strong wellness tool. So that content has a resiliency module at the end that can is also going to be available next month on its own, that talks about all of the different things that the resiliency umbrella encompasses. So we talk about time in nature, which has been proven to help rebalance the nervous system. We know one of the big challenges responders face is that their sympathetic nervous system is in overdrive and they're having a stress hormone response. Cortisol in particular is elevated chronically, and that causes a lot of challenges in the body and in the brain. So in order to better regulate that time in nature, 20 minutes a day has been shown to be very restorative. A variety of breathing practices, particularly breath work in which the exhale is prolonged,

trigger the vagus nerve and the parasympathetic nervous system. So to bring us back in balance, there's tons of other researchers out there. Andrew Huberman is a big one. His physiologic side, which you and I were probably taught in fire academy as skip breathing. So it's an inhale through the nose, a second inhale through the nose on top of it,

and then a slow exhale through your mouth to conserve air when you're trapped in your SCBA is low. Right. Well, it burns out with that. It really brings your sympathetic nervous system down and brings your parasympathetic nervous system into dominance, decreasing your metabolic demand for oxygen. So that's an amazing way to balance. Other things we talk about, mindfulness practices like yoga and meditation. There's a reason those have been recommended for thousands of years.

They help center us, they help calm us, and they help give us perspective. There are journals. Journaling is fantastic. Bullet point journaling is a great thing. And even just writing a to-do list before we go to bed for those of us like me, whose mind spinning and keeps waking me up in the middle of the night with all the things I forgot to do. Just writing those down before bed is a mindfulness practice in its own and can help us relax and fall into a deep sleep, sleep hygiene, physical fitness, positive social connection. There are so many different things that fall under the umbrella of resilience that it's easy, easy to integrate them into our day

when we make a practice of them. And then the big question we get from a lot of participants in that program is, well, what's the best resilience? Right. What's going to work now and fast? Right. Exactly. The best is the one that you'll do. Right. It's a good point. Because it really is a practice, a habit.

Yeah. To your point, human lab, no association, but I'll plug him here all day. And he's done a series, right? Sleep, mindfulness, all that kind of stuff. And, you know, sometimes it gets heavy in the science, but to your point, and you'll also, when you start to take, I think I like that. I really like the thought of you have to put a veteran's vested interest in yourself. Right. And when you start to look at that, and I did that the summer, big time, you find the

patterns, just like you talked about. Um, the yoga is everywhere. Um, the body keeps the score, which is a book about trauma, right? Yoga is all over it. Um, and, and it's amazing. Plus for, you know, if you're, if you're doing that functional exercise, we talked about earlier through a yoga day in there, you also feel a lot better because you're less sore and stuff. What were you going to say? Oh, I was going to say, and one of the great things about it is you don't have to put on the stretchy pants and do a full hour. One of the things we see with that chronic activation of the sympathetic nervous system and the elevation of stress hormones is that the body's trying to go to fight or flight.

So muscle tension increases. And we know we all have our area, whether it's the neck, the shoulders, the hips, the low back, whatever, where we tend to store that tension. So the body keeps the score. Many times responders have this tight muscle tension and they don't understand where it's coming from. So stretching, just stretching the areas on a regular basis to keep that tension from accumulating cannot only help decrease the stress response, but it can help increase and improve sleep because we've got this constant feedback cycle going where if our muscles are tight, they're sending a signal to our brain that there must be danger. So our brain's ramping up the nervous system to respond to this danger or to find this danger. And when we relax those

muscles, it sends calming signals to the brain to say, hey, everything's okay. And then the brain can start to ramp down. So again, it goes back to that. Everything's connected messaging. Yeah. Yeah. Which is another, if folks can get massages, massages are also awesome. And that, you know, there's, gosh, there's so much about this where we're talking about

just that, right, for hours. But the benefits of massage, and particularly there's some much about this where we're talking about just that, right. For, for hours, but, but the, the benefits of massage and particularly there's, there's some folks that specialize in kind of post-traumatic massage, right. Cause if you're say you were in a collapse and you were stuck, you know, you don't want to be touched, but it's, it's both in relaxing your muscles and this feeling of safety, um, is a huge, huge benefit. And I think the combination to is a great statement, you know, it's, it's the stuff that you the combination is a great statement. It's the stuff that you're going to do that's going to make the difference. And it could be like all of those things, right? So you get your morning exercise, you do some mindfulness, you walk

outside, right? Because nature can be a challenge, right? Depending on if you're in New York City or out in a rural area, but there's nature somewhere, right? Exactly. And maybe nature's not everyone's thing. If you live in the heart of New York City and you can't get to a park, maybe there's something else that's good for you. And mindfulness doesn't have to require a special outfit or a special dedication of time. Just injecting mindfulness into the things we do every day can be really restorative, like grabbing our cup of coffee. And instead of rushing off to work or to shift or wherever, just taking a few sips and really tasting it, smelling it, feeling the warmth, that's mindfulness. Yeah, taking opportunities throughout the day to just notice, even if it's only five seconds or 10, the way the sun's filtering through the tree or to notice a cute baby or just to notice something that we appreciate.

That is a form of mindfulness. There are just so many ways to engage, even in the checkout line at a grocery store or a fast food place to instead of just being transactional, take the few seconds to look the cashier in the eye and ask, hey, how you doing? Or have a conversation, see them, be seen by them. That fills a basic human need, yeah. Yeah, which most of society seems to be challenged with not looking at your phone when you're waiting, right? Like on purpose, don't look at your phone,

put it in your back pocket and just look around, which is good situational awareness anyway which first responders emergency responders should appreciate like you know what i mean looking around uh to connect not to be on guard and hyper vigilant yeah that's a good point and that's hard to do right of scene safety survey the scene right if you take any certification test you fail if you don't say that scene safety bsi magic things and so you're taught oh there's no danger here and then to shut that off is is very hard to do um i remember going on a hike and i had like a tourniquet and a k-bar with me and it was a picture of my friend so he's like dude where are you going and i was like i was just in you know my' neighborhood at the lake.

I wasn't like in the woods and a hike in the mountains, like where I live, which would make more sense. But it was like, yeah, I probably don't need all this gear. It's just, you know, and I wasn't, you know, the super tactical guy either. It's just knowing like, hey, these things are important generally, but maybe not when you're just walking in the neighborhood. But exactly. Yeah.

Yeah. Well, and, you know, that's one of the neighborhood, but. Exactly. Yeah. Yeah. Well, and you know, that's one of the big things is we're taught all of these great skills and rewarded for them on the job, but we're never taught to turn them off when we go home and to recognize that these skills don't necessarily translate so well into the rest of life. And yeah. Yeah. For another big,

big area to touch on that you mentioned, it is huge for all first responders, particularly for the fire service. And well, I guess whoever's doing shift work, right, is sleep, right? It's hard to get when you're on on duty, of course, because you get woken up in the middle of the standard of that cognitive behavioral therapy for insomnia to be helpful? Or do you scale kind of just a basic sleep hygiene? Or what have you found to be the most helpful for getting first responders to improve their sleep, I guess, is kind of a long way to get to that? Well, I think that's an individual answer. It goes back to the resiliency practices. It's whether people will do it. So CBTI, cognitive behavioral therapy for insomnia is covered by a lot of insurance companies. There's a ton of data that backs it. So I think that's fantastic for somebody who has the access and who likes that structure. But for responders who don't prefer either one of those things and or want to do it on their own, there are a ton of things that we can do. And we talk about that in the resiliency module in the curriculum, things like making sure you have

a good sleeping environment, that it's cool between 65 and 68 degrees is ideal. Making sure that room is dark, whether you need room darkening blinds, you're sleeping in a basement, or you got the fancy little eye mask. We are all trained, however we operate in the emergency response world to look for two signals to tell us that we need to react. One is audible and one is visual. So any light during the night, our eyelids aren't blackening. They're not room darkening. You know, if somebody flips on the light switch in the room you're in, you can see the light, even though your eyes are closed. So our brains are watching for light.

So take any light stimuli away and that'll help us calm down. Same thing with the noise, whether it's a white noise machine, just a super quiet place, earplugs, whatever, making sure we're in a quiet environment. And so many responders will tell me, well, I don't wanna wear earplugs

because I need to hear my alarm. There's so many watches that have haptics now that'll vibrate so you'll feel it. Yeah, so to take that have haptics now that'll vibrate. So you'll feel it. Yeah. So to take that worry away. So you've created an environment that's cool. That's dark. That is quiet. That's huge. But the prep work before bed, you know, alcohol within about two, three hours going to bed, it's going to disrupt your sleep. It's really going to hit the recovery portion of the REM sleep. Try to not, not testifying or a testimonial for day drinking, but try to not drink right up until you go back.

Same thing with eating. And what happens with food and with alcohol is your liver's processing the sugars and you will get a sudden plummet in your blood sugar several hours after you finish eating or drinking. That's usually around one or two in the morning if you're on a regular sleep schedule and you wake up and you're not sure why, but your nervous system is fired up because it knows there's a threat, your blood sugar dropped, what's wrong? So having some control around that is really good. Also stretching for the forebed, like we talked about, getting the muscles relaxed can really calm your brain down. Jotting down anything that's on your mind, that can calm your brain down.

We've seen all the work and Huberman's lab talks about it a lot with blue light suppresses our melatonin production. So eliminating bright light from anything, but especially bright light from TV screens or phone screens for at least an hour before bed can be tremendously beneficial. So there are a lot of things we can do. Going to bed at the same time and getting up at the same time as much as possible when we're off duty is really important. Naps, if we can't get enough sleep at night, naps can be tremendously restorative, as long as we don't sleep too close to when we're trying to go to bed. The other thing is non sleep deep rest, there's tons of Yeah, tons of videos on YouTube about that. It's a form of meditation. And it has been shown that 20 minutes of non sleep deep rest activity can have the restorative equivalent of two hours of good sleep. So there are a ton of things we can do out there. It's amazing how folks figured this

stuff out, right? Someone power nap for 20 and they're like, wait a minute, I wasn't quite asleep, but I feel fantastic. Let's, you know, repeat that experiment or something like that and then extrapolate it to, um, Huber talks about that as what yoga ninja, I think he does. Yeah. I think we have the same, uh, podcast playlist, maybe including KevTalks podcast right here. Um, awesome. So there's so many solutions to that y'all provide to address so many problems because there just are some, and we just touched on some of those.

Um, but how can folks learn more about what you all are working on get the tools they need to help work through those or just get in touch with you and the folks with the all clear foundation oh so all clear foundation.org is our website that is the best place to find out about us if you're interested in the tools and resources we provide, click on the solutions tab. That'll drop down. We've got respond online, which is relationship and education, relationship and communication content. We've got you responder strong tool. We have the mental health curriculum and a whole host of other things.

On our resource page is our resource directory that's divided into succeed, thrive and matter. If you are looking for us, we're on Facebook. We are on Instagram. If you would like to email with us, team at allclearfoundation.org. If you'd like to reach out to me, Rhonda with an H at allclearfoundation.org. And again, really encourage responders

and their family members to reach out and connect. Our resources are free. They are private. They are confidential. We respect your privacy. And we are really working to provide proven solutions that cross geographic, financial, and stigma barriers across the country. Our mental health curriculum, we do 20 to 25. Actually, this coming year, I think we have 30 scheduled across the country where people can attend in person or remotely. Again, removing that geographic and that financial barrier.

And everybody who attends it, we've had more than 800 facilitators attend it. They're certified to reteach our content. We give them all the content. We update it annually. And yeah, we're really just looking to empower not only individual responders, but the local wellness champions and ambassadors so that we can continue to have that positive ripple effect. Awesome. And that's all this content. We'll share those in both the comments here on the video and then the show notes. If someone wants a class that

they can email and say, Hey, we'd like to get, you know, some of the responder on the mental health classes and for their department. Absolutely. And if they just go to our website solutions, responder strong mental health curriculum, we have a full calendar of all of our events across the country. Great. Cool. Rhonda, thank you so much. This has been a fun conversation, hopefully informative.

I think it was for the folks listening and helpful to address all those crappy statistics, honestly, that we talked about in the beginning, but that there is hope. There are resources like All Clear Foundation and you. So thank you so much for continuing to be an emergency responder, but at a large scale and help all the folks in for being on the Kepp Talks podcast. And everybody listening or watching, or watching go to kept talks pod.com. There's more resources. This episode will be there. We'll link to all the stuff that Rhonda talked about. And, uh, thank you so much. I appreciate your time. Appreciate you being here. Oh my gosh, Kevin. Thank you. I really enjoyed it. And, uh, thanks for all you're doing. You're spreading the good word. I love it.

Trying to, it's kind of that, you know, you find a new mission, you think, Oh, I'm going to pivot and focus on these kinds of things and definitely want to focus on the things that really matter right to me and to others and to folks that I care about and have served time with. So yeah, part of the pivot of Cali Talks podcast. So I appreciate it. Hopefully it's making an impact. Fantastic. Let's stay in contact. Yeah, absolutely. Thanks everybody.