August 27, 2025 • 36 mins
The IAFF Center of Excellence stands as a sanctuary for firefighters navigating the complex terrain of mental health challenges. In this revealing conversation with Hannah Elmore, Clinical Outreach Coordinator, we explore how this specialized treatment facility has become a lifeline for nearly 4,000 firefighters across North America.
Hannah takes us behind the scenes of this unique 15-acre campus in Maryland, explaining how every aspect—from the station house-style sleeping quarters to the communal kitchen tables—was designed with firefighters in mind. "The IAFF's fingerprints are all over everything we do," she explains, highlighting the unparalleled cultural competency that makes the Center so effective.
What struck me most was the Center's commitment to treating the whole person, not just a diagnosis. While many assume PTSD is the primary concern for firefighters, Hannah reveals they address everything from depression and anxiety to substance use disorders and what she calls "administrative betrayal"—that profound sense of being let down by leadership that can be more devastating than emergency calls. The facility's dual licensure for both mental health and substance use treatment ensures comprehensive care without arbitrary distinctions.
Perhaps most powerful was our discussion about the fire pit—that simple gathering place where many firefighters experience their deepest healing through connection with peers from across the country. These relationships often continue long after discharge, creating a nationwide network of behavioral health champions who support each other and bring resources back to their departments.
The message Hannah wants every firefighter to hear? "You don't have to wait until you reach crisis before reaching out for help." Whether you're struggling with job-related trauma, family stress, or simply feeling that disconnect between your feet and your mind, the Center offers a path forward with culturally competent care that understands the unique challenges of the fire service.
Ready to learn more or connect with resources? Reach Hannah directly at 727-506-9036 or contact the 24/7 admissions team at 855-441-3024. Your journey toward healing doesn't have to wait another day.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to Resilience Development in Action, where
strength meets strategy andcourage to help you move forward
.
Each week, your host, steveBisson, a therapist with over
two decades of experience in thefirst responder community,
brings you powerfulconversations about resilience,
growth and healing throughtrauma and grief.
Through authentic interviews,expert discussions and
(00:21):
real-world experiences, we divedeep into the heart of human
resilience.
We explore crucial topics liketrauma recovery, grief
processing, stress managementand emotional well-being.
This is Resilience Developmentin Action with Steve Bisson.
Speaker 2 (00:42):
Hi and welcome to episode 219.
If you haven't listened toepisode 218, well, it's the same
guest, so hopefully go tolisten to that first and then
join us for the second part withHannah Elmore, who is the
clinical outreach coordinatorfor the IAFF Center of
Excellence.
The interview has gone reallygreat.
She talked about her work asoffering support, providing
education, connecting people tobehavioral health resources.
(01:05):
She's talked about even doingwork in the community and I
think she said go Seminoles forFlorida State University fans on
here.
So here is the second part ofthe interview.
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Hi again, I'll, I'll.
I'll tell people to go toYouTube, because I smiled,
because I can tell you fromexperience.
I've had a few clients talkabout that fire pit and what I
(02:52):
mean by that is the center ofexcellence for the IFF.
It was really clinically therewas really good for them.
But they said that the lettinggo, the, the actual clinical
internalization sorry to boreyou with clinical words really
occurred around that fire pit.
And the other thing, too, thatI want to emphasize and help me
(03:14):
out a little bit too, is thatit's not.
There's two things.
These are not like a hospitalbed next to a hospital bed, all
white.
This is not how the facilitylooks, and I, you know, I want
to.
I want people to understand.
You know I don't plug thingsunless I believe them, but this
is the one thing that was aselling point for at least one
of my clients.
That was really helpful.
(03:35):
The other thing I want tomention in regards to that is
that the center itself doesn'tmake you feel like you're a
patient, and what I mean by thatis when you go to a hospital,
there's clearly this is the boss, this is the clinical person,
here's the nurse, here's thedoctor.
And the other part, too, thatmy clients have shared with me
(03:55):
was like you really felt like ahuman being in there, but other
human beings some of them hadroles.
We respected their roles, butwe understood that we're all
human beings.
And that's another great partof the IFF Center of Excellence,
my experience.
But please tell me more,because I've never been there.
Hopefully one day I'll go do atour.
Speaker 3 (04:14):
I was going to say we have to schedule a tour, steve,
I can't believe that's not beenon our.
Well, that's where we can meetup is in Maryland.
Speaker 2 (04:20):
Middle ground really between Massachusetts and
Florida, kind of Exactly.
Speaker 3 (04:24):
Perfect Quick plate for both of us.
But yes, so the IFF Center ofExcellence.
One unique aspect of it as wellis it is the only treatment
facility that has the IFF'soversight and approval over
everything that we do.
Their fingerprints are all overnot only the structure of our
programming, the way thatindividuals are trained and the
way that programming is held,but the way that the environment
(04:45):
is set up, from the kitchen tobe mirroring how it looks back
at the station house, with thatgathering tables and those
breaking bread together, to thestation houses where individuals
sleep at night, and everywherein between, has the IFF's
fingerprint on it too and hasthat complete oversight.
We can't do anything withoutthe IFF being aware of what
(05:05):
we're doing and having directreporting of everything in a
confidential manner, of course,but of our processes to make
sure that it is the highestquality of care for IFF members
and to make sure that it makessense for fire service members,
and so that's something that'sreally important too and really
separates that from maybe someother programs or facilities.
Now, the IFF Center ofExcellence is exclusively for
(05:26):
IFF members.
It is duly licensed for bothprimary mental health and
primary substance use, so that'sanother really important factor
that I hope can be beneficialand validating to members is
there's definitely not a onesize fits all that.
Reasons may come thatindividuals may come to us.
It may be from mental health,anxiety, depression, ptsd,
(05:46):
complicated grief, ocd or othermental health challenges.
It may be from substance abuse.
If they need medical detox, wehave that as well on campus with
the same clinical and medicalteam, and it may be co-occurring
, which we are seeing quitefrequently due to a high
utilization of substances out ofa you know, out of a need or an
attempt to feel better andmaybe leaning on substances in
(06:08):
the process without having othercoping skills to call upon.
But it doesn't have to be oneor the other.
We have a dual licensure so wecan treat a wide variety of
behavioral health challenges.
Now we have been open since2017.
We are just a few individualsaway from hitting that 4,000
members treated on campus since2017.
And these come from at leastone individual treated from all
(06:33):
50 states, as well as fiveprovinces in Canada.
So although it's in Maryland,it is certainly not exclusive to
individuals in that pocket orcorner of the country.
We are seeing a widerepresentation of IFF members,
which is really unique to havethat ability to connect and
network with IFF members fromall corners of the country in
Canada.
(06:53):
Now I will say everything isvery individualized, including
length of stay.
A lot of times individuals arewondering before coming in how
long can I expect to stay there?
It is individualized.
We do see an average length ofstay to be about 35 to 45 days,
but could be a little less,could be a little bit more.
It really just depends on how istheir treatment evolving, how
(07:16):
are they interacting in groups?
How are they responding tomedications, if that's
applicable, and that's kind ofhow our curriculum is set up for
the best possible outcome upondischarge.
Now let's say someone's tuningin today and they are from, you
know, the West, or they're fromthe South, or it's not a
drivable distance, although itis located in Upper Marlboro,
maryland, to be able to havethat 15 acre rural campus.
(07:38):
It is only about 45 minutesoutside of Washington DC.
So that way there are threenearby airports that individuals
can fly into and then we willhave pickups coordinated from
Center of Excellence staff tothose airports to make sure that
your members are safely andquickly transitioned into
treatment with a friendly facefrom the facility as well.
Speaker 2 (07:57):
And I can vouch for that too, for someone who went
from Massachusetts there acouple of times actually.
So I can vouch for thatpersonally.
That's true.
One of the there's so manythings that you just said that I
feel I can go on and on and oneof the I'm going to start off
with one the other benefit thatpeople don't understand about
being from all over the countrySometimes it's hard to talk to
(08:18):
your peer support in your, inyour own, you know, in your
firehouse, in your area, county,state, cities, town, village.
I just I want to try to hiteveryone, so I don't exclude
anyone.
But one of the things that oneof the one of my, the members
who have gone there, who said tome you know, sometimes I call
(08:40):
the guy in, we'll say Colorado,it's not Colorado, I don't want
to protect the innocent.
Sometimes I call the guy in,we'll say Colorado, it's not
Colorado, I want to protect theinnocent.
And sometimes it's just easierto say to someone who's not in
the firehouse, and vice versathey exchange, it's an equal
exchange.
But I think that, being allover the country, in five
provinces which, again, if youask me, those are the two best
countries in the world, but Imight be a little biased.
(09:01):
But I might be a little biased,but the point is is I think
that that's one of the things Ithink is a huge advantage of the
Center of Excellence for IAFFis having people from all,
because now you make contactsall over the country.
Speaker 3 (09:12):
I'm sure you have some stories that you can omit
the information to share, butyeah, and I was going to say too
, I think, learning from theexperiences of others in various
areas of the country, havingthat long-term relationship.
You know, once they dischargethey're added to alumni groups.
They have the opportunity tokind of keep that conversation
going, keep that networkinggoing both in, you know, virtual
(09:33):
recovery group options as wellas an alumni group and so, you
know, sharing that information,most of these individuals come
home and a lot of times theybecome kind of the behavioral
health champions for theirdepartment or for their local
and a lot of times they becomekind of the behavioral health
champions for their departmentor for their local and a lot of
times then become peers.
And so to have all of thiscontact, information and, you
know, long lasting relationshipswith individuals from all over
the country, sharing ideas,sharing SOPs, sharing, you know,
(09:57):
all these different aspects ofhow they're building their
behavioral health program andtheir peer support program can
be really cool as well.
And it is neat to see kind ofthat ongoing relationship
building and kind of what cancome from that relationship as
well.
Speaker 2 (10:10):
You talked about the dual diagnosis.
The other problem I find inMassachusetts is very good at
the healthcare system, but forfirst responders it's still
primitive, and what I mean bythat is there is no strict
mental health facility inMassachusetts for first
responders.
And I think that that'simportant too, because if you
(10:30):
have someone who's strugglingwith again, we'll go with a
stereotype PTSD.
Go see YouTube.
I'm rolling my eyes as we speak.
But let's go with PTSD, but youdon't have any substance use
per se.
Then they got to like eitherdrink or they got to be smoking,
and then then it becomescomplex to get them in.
So the fact that this center ofexcellence takes on a straight
(10:53):
as as I call in my clinicalworld, straight mental health is
such a unique perspective andthere's not many of those in the
United States that do that forfirst responders, particularly
firefighters.
Speaker 3 (11:10):
And I want to just touch on your comment about PTSD
, because I agree with you is Ithink that is, of course, the
stereotypical disorder for firstresponders and it's of course
all of them have PTSD, which isnot true.
All of them have PTSD from thejob, which is not true.
And so we get calls sometimesfrom individuals that say, hey,
I think I'm struggling withtrauma, but it is not related to
the fire service.
It's from childhood or from themilitary or from something else
in my life.
(11:31):
Would this be eligible?
Absolutely.
This is a facility that has theexpertise in working with
firefighters, but firefightersare complex human beings.
They're not just coming intothe job, as you know, robots,
and then exposed to potentiallytraumatic events and then
getting PTSD from the job.
There's a lot that comes to aperson's individual life
(11:52):
experiences, family upbringing,characteristics, personalities,
you name it and so we are seeinga lot of firefighters that are
coming in.
Perhaps they may have PTSD, butit's not always tied to the job
as well, and I think that'sreally important to validate
that, no matter what yourexperience is, it is valid and
there is help and support foryou.
We're also seeing a ton ofmarital struggles.
(12:13):
We're seeing a lot ofindividuals that maybe are
feeling like they've been kindof coping as they go, but their
stress and their compassion,fatigue and their burnout or
whatever it is is reaching apoint that makes it hard to get
out of bed in the morning, makesit hard to have motivation to
go to work.
We are having people that arecoming in struggling with
substances, but sometimes, likeyou said, it's just for that
(12:34):
mental health and we're able totreat that as well.
So certainly not a one size fitsall treatment plan and
certainly not a one size fitsall reason that individuals call
us either.
We see individuals that havebeen on the job for weeks.
We see individuals that havebeen on the job for 35 years and
everything in between.
So there's no right or wrongtime to call and ask for help.
(12:54):
I also think there's amisconception that one has to
reach crisis before they reachout and ask for help.
But we want individuals to knowthat there is so much support
before you reach crisis.
We don't want anybody everreaching the point of crisis and
just know that there is so muchout there, including the Center
of Excellence, that you don'thave to wait until the peak of
(13:15):
crisis before reaching out forhelp, and we really want that to
be something that individualsknow as well.
If you're suffering orstruggling at all, please reach
out to whatever capacity ofresource you're looking for.
There is so much out there andyou don't have to wait until
it's really really bad or reallyreally uncomfortable before
doing so.
Speaker 2 (13:32):
Took the words right out of my mouth.
I think that that's.
I was laughing.
You don't need to wait tillyou're on the verge of whatever
we call Section 12 inMassachusetts, where you're
suicidal, homicidal, lackingjudgment, in order to go and get
some support, the marital stuff.
You talk about that.
(13:53):
The other part too, thatsometimes with the mental health
part that really pushes down onfirefighters in particular,
that's not talked about.
I talk about it all the timebut it's not a fun subject.
It's called administrativebetrayal and people don't
understand how hurtful that isand how much that weighs,
because it doesn't only have animpact for the work, it has an
(14:15):
impact for the family, it has animpact for when they're in the
community and so on and so forth.
I wanted to mention thatbecause I think that you know
people are like well,administrative betrayal, that's
not really a mental health issue, not if it's fucking up your
life in four different ways.
It's absolutely an issue.
And sometimes, going to yourpeer support who maybe is
(14:35):
friends with the LT you want totalk about or what have you and
I'm making it up as I go hereWell then you know where do you
go.
Well, that's why the center ofexcellence exists.
That's why therapy exists.
That's why there's other partswhere you can get the
intervention.
I'm sure that you see that too,at the center of excellence.
Speaker 3 (14:52):
Oh, absolutely.
I'm really glad that youbrought that up because I think
administrative betrayal alsoties into why having culturally
competent providers is soimportant.
Because if you go to a generaltherapist that has no experience
working with first respondersand present the distressing
experiences of administrativebetrayal that you're
experiencing, they may not knowhow to be you know handling that
or be best equipped to do so.
(15:14):
Administrative betrayal isunfortunately common with not
only firefighters but with otherfirst responders as well, and
can be completely distressing,can be difficult to continue
finding motivation to go to workand do your job and feeling the
impacts every day and, as youmentioned, affecting family,
affecting health, affecting job.
(15:35):
All of these aspects and thatkind of makes me think of the
issue of moral injury as well, Ithink it can be kind of a
subsection of moral injury.
Moral injury is not adiagnosable condition in the
DSM-5.
It doesn't mean that it is notincredibly, you know, running
rampant within the fire serviceand first responder communities
and certainly can be verydistressing and unfortunately,
(15:56):
in the most severe ofcircumstances can also cause
increased risk of suicide andreally really challenging
situations.
And so certainly administrativebetrayal, moral injury, burnout
, compassion, fatigue none ofthese are diagnosable conditions
such as PTSD or depression.
But that does not take awayfrom the incredible impact that
(16:17):
they have on individuals andtheir families as well, and
certainly something that ourteam is very accustomed to
supporting individuals through.
Speaker 2 (16:26):
I really appreciate you talking about that because
it's so common.
It was the number one stressors, the stressor number one by and
I can't remember the exactnumber, I think it was 80% in
the survey I did.
I know it's a small sample, butit was like 57 or so people.
Speaker 3 (16:43):
I mean that's an alarming percentage.
Speaker 2 (16:45):
But I think that that's where you need to be able
to go somewhere and talk aboutit, because that's great to go,
talk to your peer support.
But again, what I hear all thetime is you know, when this
happened, it really gave me.
They don't say moral injury,but we'll say moral injury just
for an example here.
And then you're like well, you,you know, I'm friends with the
lieutenant and the lieutenant'salways right, or I'll tell him,
(17:06):
you said that, or whateverthere's.
You know, firefighters, they're, they're they're words, not
mine.
They're a chatty bunch who liketo bitch and moan to each other
.
Those are not my words, thoseare their words and I agree with
them for the record.
But sometimes you feeluncomfortable saying and when
it's been hurtful and itaffected you as a worker or
whatever, where do you go withthat?
(17:27):
Well, now we have some otheroptions we can offer.
Speaker 3 (17:32):
Absolutely and I think really.
Sorry, I don't mean tointerrupt you.
Speaker 2 (17:36):
No worries, go ahead.
Speaker 3 (17:37):
I was just going to say it.
Really, you know.
I hope that this can bevalidating for individuals that
might be struggling and knowingthat you don't have to be able
to pinpoint exactly what you'restruggling with, if you're
struggling at all, whether it isone thing that you can think of
or it's a combination, or, ingeneral, you have just felt a
decline, or felt a decline inmotivation, a decline in your
(17:57):
health, a decline in just thehappiness within your home.
You know, whatever it may be,you don't have to know exactly
what's going on, but there arepeople out here that will, that
will help you navigate and helpyou get to the other side and
help you to give you tools to beable to feel more present
within yourself.
I always say I love to feel thatmy feet and my mind are
(18:18):
grounded in the same place,because when I'm struggling, I'm
physically present but my mindis elsewhere.
I'm just feeling very blurry,very hazy.
I'm just, my mind is just.
It's not even that I'moverthinking, I just my brain is
so overwhelmed I can't evengenerate thoughts and that
really impacts my ability to bemindful and be present in my
relationships and in my home andjust within myself, and that's
(18:40):
just such a crappy feeling andsomething that I think a lot of
people are are experiencing, andperhaps experiencing for long,
extended periods of time andthen only kind of starting to
increase in severity and thereis so much freedom that comes to
reaching out and asking forhelp and just seeing the you
know impacts and kind of theshift in how that changes your
(19:03):
entire life.
Speaker 2 (19:04):
The other thing I want to mention, because that's
the other part too, is noticingall those things.
I'm going to speak from myexperience, but I'm pretty sure
you're going to concur.
So I don't have a magic wand tofix people in two weeks or
three weeks.
It's not downstairs, it's notupstairs, it's not even my house
.
I don't know where it is.
I do not have the magic wand,and I'm assuming that the center
(19:26):
of excellence, while very good,in 35 days it's not like oh my
God, I'm a new person, I'm allset.
One of the things about the IFFcenter of excellence is, I
think, that the message one ofmy firefighters really liked was
this is really good, but youstill need to continue working
on yourself.
So one of the things I want tomention you know a little bit
(19:48):
too is don't be in a rush Causeagain, if you've had a problem
for 20 years, it's not going tobe fixing itself in 35 days.
That's just not how it works.
Speaker 3 (19:56):
Absolutely.
I always say you know you're achange, you may be a changed
person, but you're coming backto an unchanged environment.
And so you are coming backexactly to the environment that
you had left, and it can be verychallenging to lean on those
lessons learned, those copingskills developed, the processing
that was done and all of thehealing that you encountered
(20:19):
while in treatment.
But it is just the kind of tipof the iceberg.
It is just the beginning ofyour healing journey, but it
does require ongoing care,ongoing support, ongoing
outpatient therapy Sometimesit's ongoing medication,
whatever that is for eachindividual, and so I think it's
really important to know that itis really the start of your
(20:40):
healing journey.
Our team works really hard toset people up with vetted,
culturally competent providersso that when they do return home
they can continue to engage inthe learning and the healing and
the processing that they did oncampus.
But it is not a quick fix, itis not a magic wand and I think
(21:00):
it can be daunting to imagine itthat way, like, oh, I really
want to go and just come backand be fixed forever.
But again, humans aremultidimensional people.
Mental health is not a blackand white type of kind of
checkbox that we went throughtreatment and we're good to go.
It's an ongoing journey, butthe benefit of that is learning
the tools, to master those tools, to put it into practice and to
(21:21):
just continue the work andcontinue to feel better and
knowing that you know if youstart to kind of fall back again
, these resources are still hereto help you get back on track
too.
Speaker 2 (21:33):
I'm going to share a little bit.
When I have first responders oranyone but first responders my
specialty they go.
Well, how long do I have to bein therapy?
So well, let me put it this wayI started off with weekly
therapy after my third death in10 days in my job and I needed
therapy way before that.
That just triggered a lot ofshit and I had to go to therapy
(21:55):
every week and then eventually Iwent to every other week and
now I go anywhere from three tofour weeks, sometimes six weeks,
depending on how good or howbad I'm doing.
And, frankly, recently I wentevery two weeks for a short walk
because I had something I hadto work out on.
This journey started in 2004.
We're recording this in 2025.
(22:15):
And I don't see myself everbeing completely done, and maybe
I'll go to six to eight weeks,and that's great.
And I've got guys who come inevery three months after seeing
me, sometimes twice a week for awhile.
At the end of the day, I want toshare that personal story, not
to make it about me per se, butto explain that the magic wand
doesn't exist.
Because I'll tell you what if Iwas a magic wand, I'd be using
(22:36):
it on myself.
I'm sorry to be selfish, butthat's how it would be.
So I think that that's thestory I share, because I think
that one of the other things too.
We're going to finish a bit ofcultural competency a little bit
here, and then I want to go alittle more about the center,
the cost, the insurance and allthat stuff.
You know, when we talk about acultural competency, you need to
(22:57):
share about yourself as a first, as a therapist with first
responders, because you're notauthentic if you're not and I
think that people know thatabout me, obviously, listening
to podcasts, but they've one ofthe other part of therapy oh, I
can't tell them this.
I'm like you're not going toconnect ever with a first
responder If you can't say thisor can't say that you don't want
(23:17):
to invite them to your barbecue.
I get that and they get thatand they get that, but that, if
you don't share a little bitabout yourself, you don't seem
authentic.
And that's very important aboutcultural competency, in my
opinion.
Speaker 3 (23:28):
I agree completely Because, as you said, there's a
part of cultural competency thatis about the discipline and the
learning about aspects of thejob and learning the culture.
But there is an entirely otherside of that, as you mentioned,
with building that rapport beinga trustworthy person, being
somebody that they want to bearound, being somebody that they
trust, that they know has theirbest intention, and a lot of
times that comes from findingways to connect in how you got
(23:52):
to where you are and why you'reso caring about your position
and all of these aspects as well, and I want to thank you for
sharing those experiences withme and on this podcast, and I'll
echo what you mentioned too.
Just personally, the reason whyI became a social worker was
from childhood and going throughtherapy and figuring out those
strategies to be able to live,to be able to work through a lot
(24:14):
of my challenges as well and,depending on the severity,
depending on the season of life,sometimes it was more
frequently, sometimes there wasmore space in between and it's
never something that's going tobe a forever closed chapter.
You know there are times, suchas new motherhood, such as new
jobs or new seasons in life,that is normal to feel, you know
(24:35):
what, maybe I need a littletune up, a little check in and
let me kind of loop back in myprovider or perhaps find a
different provider, depending onwhat the specific circumstance
is.
And so I appreciate you sharingthat and I'll certainly echo
that for myself as well and forany clinicians that are on, you
know, listening to this too,just finding ways to connect and
really connect from really thatperson perspective.
(24:57):
It's very important to be aprofessional and maintain
professional boundaries, ofcourse, but, as you said, first
responders really want to feelthat they can connect and that
this is someone that is, youknow, a friendly, familiar face
that they can really just settlein and get comfortable with for
the long haul.
Speaker 2 (25:13):
Well, you know, I appreciate you sharing that
number one.
You know, I think that me andyou have to start a group soon
Just for us therapists to talkabout this stuff together.
Uh, but, um, you know, as wewe're getting close to the hour
already, oh, I end up being too,too sad to two full episodes
here we always do this steve, wealways go after our time again.
(25:38):
I'm nowhere on the podcast here, but I'm gonna share.
Have we ever either likefinished on time or anything
else like that?
Speaker 3 (25:45):
I was going to say never.
It has always been extended.
But like mutually glad it hasbeen extended.
I mean, I can't speak for you,but I feel like we've always
been on the same page, thatwe're like ah, it's fine, let's
just keep it rolling.
Speaker 2 (25:57):
You know I'll, I'll share with the audience.
I know you're right here, butI'm going to pretend you're not
here.
The other, she could never lieto me.
And I can't lie to her because,like, my face tells the story,
or my voice, or like yeah, yeahor whatever.
I, I can't hide how I feel andit's clear that we actually
enjoy talking to each other.
(26:18):
We always go over.
So I want to share that witheveryone because that's truly
how I perceive you.
I'm pretty sure if I everpissed you off, it would.
We, we, we touched on thisright beforehand on a different
subject.
I'm just going to keep privatefor me and you and you're like,
oh no, no, don't worry, I'lltell you.
Oh yeah, don't worry.
So, and I should have neverdoubted her honestly.
(26:39):
But to finish off a little bit,tell us about how we can get
into the Center of Excellence.
You know insurance and missions.
Do I just show up at Hannah'splace or what do I do here?
Speaker 3 (26:49):
Come on down to Florida.
I'm just kidding.
Yes, so the IFF Center ofExcellence.
We do have a parent companythat is called Advanced Recovery
Systems.
Advanced Recovery Systems ownsand operates the kind of
behavioral health treatmentfacility of the IFF Center of
Excellence.
It is a partnership betweenAdvanced Recovery Systems and
the IFF.
Now, with that being said,Advanced Recovery Systems does
(27:11):
have a dozen inpatient treatmentfacilities for civilians all
over the country.
Now I bring this up to mentionthat we do have a 24-7
admissions team call center thatis operated by Advanced
Recovery Systems.
But we have specific intaketeam members on the admissions
team that works with our IFFmembers, and so there's
(27:32):
sometimes this confusion whenthey see a callback and maybe
somebody identifies as advancedrecovery systems, that is just
because that is one call centeroperated by advanced recovery
systems.
But there would never be asituation where an IFF member is
filtered elsewhere or, you know, recommended to go somewhere.
I mean, they will go to the IFFcenter of excellence if that is
what their preference and thatis the IFF's expectation as well
(27:52):
.
But I say that to share.
We do have a 24-7 admissionsteam and so no matter what time
of day, no matter what day ofthe week, no matter if it's a
holiday weekend.
Two in the morning.
If somebody wants to initiatethis conversation, you can try
to reach me, but if it's themiddle of the night, I'm a
pretty heavy sleeper, so I'llcall you back in the morning,
but I don't want you waiting onme and so in the meantime, until
you can reach me, theadmissions team is always there.
(28:15):
They are able to get theinsurance information and then
be able to provide eachindividual what their exact
deductible, co-insurance rateand out-of-pocket max for the
year looks like.
The cost of treatment iscompletely dependent on what
your insurance carrier and whatyour specific plan is.
Now I will say we are innetwork with most major
insurances, between the BlueCross, Blue Shield, the Aetnas,
the Cigna's, the United HealthCares.
(28:37):
We have a ton of directcontracts with municipalities to
eliminate any barriers toaccessing care.
To know what your specificbreakdown is, let's connect
offline care.
To know what your specificbreakdown is, let's connect
offline.
We like to be able to have thisbe available for departments and
local leadership to share withtheir members so that
individuals can see oh, this ishow much it would cost to go to
treatment, and a lot of timesit's a lot less than I think a
(28:59):
lot of individuals may think,because we are a network with
most major insurances.
So let's say somebody calls intothe admissions team, the
insurance information iscollected and delivered back to
the individual so they knowbefore coming to treatment what
that out-of-pocket would looklike.
They would then do apre-assessment over the phone
with the admissions team whichlooks at medical psychological
history, gets a little bit moreinformation as to what they are
(29:21):
struggling with.
All of that gets kind of puttogether into a clinical summary
that gets sent over to ourmedical director at the Center
of Excellence, who is apsychiatrist.
She will then review that andmake sure that before they come
to us that we have determinedthey are a good fit for
treatment, because we wouldnever want somebody to fly
across the country and arrive inMaryland and for whatever
reason, and not be a good fit.
(29:42):
So we do that on the front end.
Once that clinical approval isgiven, our admissions team will
help coordinate the logistics oftravel, whether it be car,
plane, train, whatever meansthey want to get to us.
We will schedule that so thatwhen they do either arrive at
the airport for the pickup orarrive at the facility, they can
immediately jump right intotreatment, with no waiting
(30:03):
period, no line, no bedavailability issues.
We want to get them transitionedright into treatment right when
they get there.
Now, ways that I can help tofacilitate this process, make it
go faster, make it morepersonal for you.
I'm happy to work inpartnership with the member
themselves, with their peer,with their local leadership,
(30:23):
their spouse, their clinician.
Steve, you and I have workedtogether for these purposes.
However, I can help make thisas comfortable and quick as
possible.
That's something that I do.
Our admissions team doesincredible work and I would
never, you know, replicate whatthey're doing.
But in effort to keep itfamiliar and keep it easy, you
can always call me.
I'm happy to answer anypreliminary questions a member
(30:45):
may have, help them feelcomfortable in progressing to
the next step.
If they want to stay on the line, I can call into our admissions
team and then introduce themfrom there and then kind of be
that supportive individual alongthat process.
If there's a peer involved or aclinician involved, I'll keep
them updated as to the timelineof what we're looking at and
then up to when they land at theairport, to make sure that
(31:06):
everyone knows that everyone issafe and progressing towards
their care, and so I'm available, however I can be, whether it
be questions or to initiate theadmissions process, to connect
to an outpatient therapist inyour area, to host a behavioral
health training or anything inbetween.
I would love to be able toconnect with any of you guys,
whether you are a clinician or afire service professional.
(31:28):
However, I can be of supportand kind of compliment the work
that your peer team is doing, bean extension of support or kind
of jump in.
If maybe behavioral health is anewer part of your local.
Would love to share ideas andresources as well.
Speaker 2 (31:43):
Well, this is all true, by the way, I can tell you
, and I absolutely we've beenthrough this a couple of times,
me and you at least, but I wantto make sure that I also I mean,
I like confirming stuff this isabsolutely true.
So I want to make sure everyoneheard me say that, and you
again, you've listened to 219episodes, or whatever my number
is at.
(32:03):
You know that I don't lie andthat's absolutely all true.
So I hope people hear me saythat.
So now, finally, how do wereach you or the Center of
Excellence, or anything else?
Speaker 3 (32:16):
Thank you.
So my direct cell phone numberI would love all of you all to
save it and, you know, save itfor a rainy day, if ever needed.
My direct cell phone number is727-506-9036, 727-506-9036,
which is 727-506-9036.
And then to reach our 24-7admissions team, at any time,
(32:36):
you can call 855-441-3024.
My email address is helmoreH-E-L-M-O-R-E at
advancedrecoverysystemscom.
Advanced with a D, I will sayRecoverysystems with an Scom,
and then the website for the IFFCenter of Excellence is
(32:57):
wwwiaffrecoverycentercom.
I will shout out the websitehas a ton of resources that you
can go in and print out for peerteams.
A lot of them have bookletswith these resources and kind of
pull them as needed Supportiveresources for learning how to
talk to kiddos about some ofthese issues, how to support
crew members returning fromtreatment, and a lot of
(33:18):
additional information on theIFF Center of Excellence.
And then our webinar library isalso on the website.
So, although we have two livewebinars a month that we would
love you to join us on and beable to ask live questions and
network with each other in thechat box, there's also a library
of recorded webinars that havebeen going on for the last five
years to kind of view on demandas well.
Speaker 2 (33:40):
I can vouch for the website, so go ahead and it'll
be all on the show notes.
I'll put all the phone numberstoo the other part too before we
go, other than saying thank you, absolutely, adore working with
you, can't wait to meet inMaryland.
Apparently, that's our nexttrip.
Speaker 3 (33:54):
Yes, I can't wait.
Speaker 2 (33:57):
We'll figure it out when out offline.
The other part too.
I want to hear it, I wanteveryone to hear.
I call Hannah.
Hannah set up everything for myclient and then she was offline
because she has a life outsideof work, go figure and she had
(34:17):
two people call me to confirmpicking them up and landing and
being in the center ofexcellence for the IFF.
So this is all true.
Again, I have my personalexperience with that and I vouch
for them a hundred percent.
So I want to thank you for yourtime.
This was, again too long and yetfelt like and not only that, I
mean like I literally feel likeit was like 20 minutes.
Speaker 3 (34:37):
Me too.
No, it is always such a joy anda pleasure to talk to you,
steve, and I'm so thankful forthe opportunity to join today
and to share this resource andreally just continue to just
talk about behavioral health andthe fire service and really
shine a light to it and thankyou for all that you do each and
every day and I'm just sothankful for each and every
interaction with you.
So it was a joy and a pleasureto be here with you today and
(35:00):
for everyone out there listening.
I look forward to theopportunity to work with you and
serve your members if anyquestions or needs come up, and
let's keep on shining a lightand ending the stigma and really
doing our proactive steps toworking towards a better
behavioral health wellness forall.
So thank you, steve.
Speaker 2 (35:18):
I could not have said it better myself.
Thank you so much.
Speaker 3 (35:21):
Thank you, Steve.
Speaker 2 (35:22):
Hi.
Well, this completes episode219.
Hannah Elmore, I cannot thankyou enough and, yes, I'm looking
forward to go to Maryland justto see the IFF Center of
Excellence.
All the show notes will showthe connection with phone
numbers and everything else youneed.
They'll be included on thereand I hope you join us for
episode 220 with Bill Dwanell, acolleague of mine who we work
(35:45):
on.
He's a co-owner of a companywe're working on, so I hope you
join us then.
Colleague of mine who we workon.
Speaker 1 (35:49):
He's a co-owner of a company we're working on, so I
hope you join us.
Then Please like, subscribe andfollow this podcast on your
favorite platform.
A glowing review is alwayshelpful and, as a reminder, this
podcast is for informational,educational and entertainment
purposes only.
If you're struggling with amental health or substance abuse
issue, please reach out to aprofessional counselor for
(36:09):
consultation.
If you are in a mental healthcrisis, call 988 for assistance.
This number is available in theUnited States and Canada.
Welcome to Resilience Development in Action, where
strength meets strategy andcourage to help you move forward
.
Each week, your host, steveBisson, a therapist with over
two decades of experience in thefirst responder community,
brings you powerfulconversations about resilience,
growth and healing throughtrauma and grief.
Through authentic interviews,expert discussions and
(00:21):
real-world experiences, we divedeep into the heart of human
resilience.
We explore crucial topics liketrauma recovery, grief
processing, stress managementand emotional well-being.
This is Resilience Developmentin Action with Steve Bisson.
Speaker 2 (00:42):
Hi and welcome to episode 219.
If you haven't listened toepisode 218, well, it's the same
guest, so hopefully go tolisten to that first and then
join us for the second part withHannah Elmore, who is the
clinical outreach coordinatorfor the IAFF Center of
Excellence.
The interview has gone reallygreat.
She talked about her work asoffering support, providing
education, connecting people tobehavioral health resources.
(01:05):
She's talked about even doingwork in the community and I
think she said go Seminoles forFlorida State University fans on
here.
So here is the second part ofthe interview.
Get freeai you heard me talkabout it.
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It does a subjective and anobjective, with a letter if
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Hi again, I'll, I'll.
I'll tell people to go toYouTube, because I smiled,
because I can tell you fromexperience.
I've had a few clients talkabout that fire pit and what I
(02:52):
mean by that is the center ofexcellence for the IFF.
It was really clinically therewas really good for them.
But they said that the lettinggo, the, the actual clinical
internalization sorry to boreyou with clinical words really
occurred around that fire pit.
And the other thing, too, thatI want to emphasize and help me
(03:14):
out a little bit too, is thatit's not.
There's two things.
These are not like a hospitalbed next to a hospital bed, all
white.
This is not how the facilitylooks, and I, you know, I want
to.
I want people to understand.
You know I don't plug thingsunless I believe them, but this
is the one thing that was aselling point for at least one
of my clients.
That was really helpful.
(03:35):
The other thing I want tomention in regards to that is
that the center itself doesn'tmake you feel like you're a
patient, and what I mean by thatis when you go to a hospital,
there's clearly this is the boss, this is the clinical person,
here's the nurse, here's thedoctor.
And the other part, too, thatmy clients have shared with me
(03:55):
was like you really felt like ahuman being in there, but other
human beings some of them hadroles.
We respected their roles, butwe understood that we're all
human beings.
And that's another great partof the IFF Center of Excellence,
my experience.
But please tell me more,because I've never been there.
Hopefully one day I'll go do atour.
Speaker 3 (04:14):
I was going to say we have to schedule a tour, steve,
I can't believe that's not beenon our.
Well, that's where we can meetup is in Maryland.
Speaker 2 (04:20):
Middle ground really between Massachusetts and
Florida, kind of Exactly.
Speaker 3 (04:24):
Perfect Quick plate for both of us.
But yes, so the IFF Center ofExcellence.
One unique aspect of it as wellis it is the only treatment
facility that has the IFF'soversight and approval over
everything that we do.
Their fingerprints are all overnot only the structure of our
programming, the way thatindividuals are trained and the
way that programming is held,but the way that the environment
(04:45):
is set up, from the kitchen tobe mirroring how it looks back
at the station house, with thatgathering tables and those
breaking bread together, to thestation houses where individuals
sleep at night, and everywherein between, has the IFF's
fingerprint on it too and hasthat complete oversight.
We can't do anything withoutthe IFF being aware of what
(05:05):
we're doing and having directreporting of everything in a
confidential manner, of course,but of our processes to make
sure that it is the highestquality of care for IFF members
and to make sure that it makessense for fire service members,
and so that's something that'sreally important too and really
separates that from maybe someother programs or facilities.
Now, the IFF Center ofExcellence is exclusively for
(05:26):
IFF members.
It is duly licensed for bothprimary mental health and
primary substance use, so that'sanother really important factor
that I hope can be beneficialand validating to members is
there's definitely not a onesize fits all that.
Reasons may come thatindividuals may come to us.
It may be from mental health,anxiety, depression, ptsd,
(05:46):
complicated grief, ocd or othermental health challenges.
It may be from substance abuse.
If they need medical detox, wehave that as well on campus with
the same clinical and medicalteam, and it may be co-occurring
, which we are seeing quitefrequently due to a high
utilization of substances out ofa you know, out of a need or an
attempt to feel better andmaybe leaning on substances in
(06:08):
the process without having othercoping skills to call upon.
But it doesn't have to be oneor the other.
We have a dual licensure so wecan treat a wide variety of
behavioral health challenges.
Now we have been open since2017.
We are just a few individualsaway from hitting that 4,000
members treated on campus since2017.
And these come from at leastone individual treated from all
(06:33):
50 states, as well as fiveprovinces in Canada.
So although it's in Maryland,it is certainly not exclusive to
individuals in that pocket orcorner of the country.
We are seeing a widerepresentation of IFF members,
which is really unique to havethat ability to connect and
network with IFF members fromall corners of the country in
Canada.
(06:53):
Now I will say everything isvery individualized, including
length of stay.
A lot of times individuals arewondering before coming in how
long can I expect to stay there?
It is individualized.
We do see an average length ofstay to be about 35 to 45 days,
but could be a little less,could be a little bit more.
It really just depends on how istheir treatment evolving, how
(07:16):
are they interacting in groups?
How are they responding tomedications, if that's
applicable, and that's kind ofhow our curriculum is set up for
the best possible outcome upondischarge.
Now let's say someone's tuningin today and they are from, you
know, the West, or they're fromthe South, or it's not a
drivable distance, although itis located in Upper Marlboro,
maryland, to be able to havethat 15 acre rural campus.
(07:38):
It is only about 45 minutesoutside of Washington DC.
So that way there are threenearby airports that individuals
can fly into and then we willhave pickups coordinated from
Center of Excellence staff tothose airports to make sure that
your members are safely andquickly transitioned into
treatment with a friendly facefrom the facility as well.
Speaker 2 (07:57):
And I can vouch for that too, for someone who went
from Massachusetts there acouple of times actually.
So I can vouch for thatpersonally.
That's true.
One of the there's so manythings that you just said that I
feel I can go on and on and oneof the I'm going to start off
with one the other benefit thatpeople don't understand about
being from all over the countrySometimes it's hard to talk to
(08:18):
your peer support in your, inyour own, you know, in your
firehouse, in your area, county,state, cities, town, village.
I just I want to try to hiteveryone, so I don't exclude
anyone.
But one of the things that oneof the one of my, the members
who have gone there, who said tome you know, sometimes I call
(08:40):
the guy in, we'll say Colorado,it's not Colorado, I don't want
to protect the innocent.
Sometimes I call the guy in,we'll say Colorado, it's not
Colorado, I want to protect theinnocent.
And sometimes it's just easierto say to someone who's not in
the firehouse, and vice versathey exchange, it's an equal
exchange.
But I think that, being allover the country, in five
provinces which, again, if youask me, those are the two best
countries in the world, but Imight be a little biased.
(09:01):
But I might be a little biased,but the point is is I think
that that's one of the things Ithink is a huge advantage of the
Center of Excellence for IAFFis having people from all,
because now you make contactsall over the country.
Speaker 3 (09:12):
I'm sure you have some stories that you can omit
the information to share, butyeah, and I was going to say too
, I think, learning from theexperiences of others in various
areas of the country, havingthat long-term relationship.
You know, once they dischargethey're added to alumni groups.
They have the opportunity tokind of keep that conversation
going, keep that networkinggoing both in, you know, virtual
(09:33):
recovery group options as wellas an alumni group and so, you
know, sharing that information,most of these individuals come
home and a lot of times theybecome kind of the behavioral
health champions for theirdepartment or for their local
and a lot of times they becomekind of the behavioral health
champions for their departmentor for their local and a lot of
times then become peers.
And so to have all of thiscontact, information and, you
know, long lasting relationshipswith individuals from all over
the country, sharing ideas,sharing SOPs, sharing, you know,
(09:57):
all these different aspects ofhow they're building their
behavioral health program andtheir peer support program can
be really cool as well.
And it is neat to see kind ofthat ongoing relationship
building and kind of what cancome from that relationship as
well.
Speaker 2 (10:10):
You talked about the dual diagnosis.
The other problem I find inMassachusetts is very good at
the healthcare system, but forfirst responders it's still
primitive, and what I mean bythat is there is no strict
mental health facility inMassachusetts for first
responders.
And I think that that'simportant too, because if you
(10:30):
have someone who's strugglingwith again, we'll go with a
stereotype PTSD.
Go see YouTube.
I'm rolling my eyes as we speak.
But let's go with PTSD, but youdon't have any substance use
per se.
Then they got to like eitherdrink or they got to be smoking,
and then then it becomescomplex to get them in.
So the fact that this center ofexcellence takes on a straight
(10:53):
as as I call in my clinicalworld, straight mental health is
such a unique perspective andthere's not many of those in the
United States that do that forfirst responders, particularly
firefighters.
Speaker 3 (11:10):
And I want to just touch on your comment about PTSD
, because I agree with you is Ithink that is, of course, the
stereotypical disorder for firstresponders and it's of course
all of them have PTSD, which isnot true.
All of them have PTSD from thejob, which is not true.
And so we get calls sometimesfrom individuals that say, hey,
I think I'm struggling withtrauma, but it is not related to
the fire service.
It's from childhood or from themilitary or from something else
in my life.
(11:31):
Would this be eligible?
Absolutely.
This is a facility that has theexpertise in working with
firefighters, but firefightersare complex human beings.
They're not just coming intothe job, as you know, robots,
and then exposed to potentiallytraumatic events and then
getting PTSD from the job.
There's a lot that comes to aperson's individual life
(11:52):
experiences, family upbringing,characteristics, personalities,
you name it and so we are seeinga lot of firefighters that are
coming in.
Perhaps they may have PTSD, butit's not always tied to the job
as well, and I think that'sreally important to validate
that, no matter what yourexperience is, it is valid and
there is help and support foryou.
We're also seeing a ton ofmarital struggles.
(12:13):
We're seeing a lot ofindividuals that maybe are
feeling like they've been kindof coping as they go, but their
stress and their compassion,fatigue and their burnout or
whatever it is is reaching apoint that makes it hard to get
out of bed in the morning, makesit hard to have motivation to
go to work.
We are having people that arecoming in struggling with
substances, but sometimes, likeyou said, it's just for that
(12:34):
mental health and we're able totreat that as well.
So certainly not a one size fitsall treatment plan and
certainly not a one size fitsall reason that individuals call
us either.
We see individuals that havebeen on the job for weeks.
We see individuals that havebeen on the job for 35 years and
everything in between.
So there's no right or wrongtime to call and ask for help.
(12:54):
I also think there's amisconception that one has to
reach crisis before they reachout and ask for help.
But we want individuals to knowthat there is so much support
before you reach crisis.
We don't want anybody everreaching the point of crisis and
just know that there is so muchout there, including the Center
of Excellence, that you don'thave to wait until the peak of
(13:15):
crisis before reaching out forhelp, and we really want that to
be something that individualsknow as well.
If you're suffering orstruggling at all, please reach
out to whatever capacity ofresource you're looking for.
There is so much out there andyou don't have to wait until
it's really really bad or reallyreally uncomfortable before
doing so.
Speaker 2 (13:32):
Took the words right out of my mouth.
I think that that's.
I was laughing.
You don't need to wait tillyou're on the verge of whatever
we call Section 12 inMassachusetts, where you're
suicidal, homicidal, lackingjudgment, in order to go and get
some support, the marital stuff.
You talk about that.
(13:53):
The other part too, thatsometimes with the mental health
part that really pushes down onfirefighters in particular,
that's not talked about.
I talk about it all the timebut it's not a fun subject.
It's called administrativebetrayal and people don't
understand how hurtful that isand how much that weighs,
because it doesn't only have animpact for the work, it has an
(14:15):
impact for the family, it has animpact for when they're in the
community and so on and so forth.
I wanted to mention thatbecause I think that you know
people are like well,administrative betrayal, that's
not really a mental health issue, not if it's fucking up your
life in four different ways.
It's absolutely an issue.
And sometimes, going to yourpeer support who maybe is
(14:35):
friends with the LT you want totalk about or what have you and
I'm making it up as I go hereWell then you know where do you
go.
Well, that's why the center ofexcellence exists.
That's why therapy exists.
That's why there's other partswhere you can get the
intervention.
I'm sure that you see that too,at the center of excellence.
Speaker 3 (14:52):
Oh, absolutely.
I'm really glad that youbrought that up because I think
administrative betrayal alsoties into why having culturally
competent providers is soimportant.
Because if you go to a generaltherapist that has no experience
working with first respondersand present the distressing
experiences of administrativebetrayal that you're
experiencing, they may not knowhow to be you know handling that
or be best equipped to do so.
(15:14):
Administrative betrayal isunfortunately common with not
only firefighters but with otherfirst responders as well, and
can be completely distressing,can be difficult to continue
finding motivation to go to workand do your job and feeling the
impacts every day and, as youmentioned, affecting family,
affecting health, affecting job.
(15:35):
All of these aspects and thatkind of makes me think of the
issue of moral injury as well, Ithink it can be kind of a
subsection of moral injury.
Moral injury is not adiagnosable condition in the
DSM-5.
It doesn't mean that it is notincredibly, you know, running
rampant within the fire serviceand first responder communities
and certainly can be verydistressing and unfortunately,
(15:56):
in the most severe ofcircumstances can also cause
increased risk of suicide andreally really challenging
situations.
And so certainly administrativebetrayal, moral injury, burnout
, compassion, fatigue none ofthese are diagnosable conditions
such as PTSD or depression.
But that does not take awayfrom the incredible impact that
(16:17):
they have on individuals andtheir families as well, and
certainly something that ourteam is very accustomed to
supporting individuals through.
Speaker 2 (16:26):
I really appreciate you talking about that because
it's so common.
It was the number one stressors, the stressor number one by and
I can't remember the exactnumber, I think it was 80% in
the survey I did.
I know it's a small sample, butit was like 57 or so people.
Speaker 3 (16:43):
I mean that's an alarming percentage.
Speaker 2 (16:45):
But I think that that's where you need to be able
to go somewhere and talk aboutit, because that's great to go,
talk to your peer support.
But again, what I hear all thetime is you know, when this
happened, it really gave me.
They don't say moral injury,but we'll say moral injury just
for an example here.
And then you're like well, you,you know, I'm friends with the
lieutenant and the lieutenant'salways right, or I'll tell him,
(17:06):
you said that, or whateverthere's.
You know, firefighters, they're, they're they're words, not
mine.
They're a chatty bunch who liketo bitch and moan to each other
.
Those are not my words, thoseare their words and I agree with
them for the record.
But sometimes you feeluncomfortable saying and when
it's been hurtful and itaffected you as a worker or
whatever, where do you go withthat?
(17:27):
Well, now we have some otheroptions we can offer.
Speaker 3 (17:32):
Absolutely and I think really.
Sorry, I don't mean tointerrupt you.
Speaker 2 (17:36):
No worries, go ahead.
Speaker 3 (17:37):
I was just going to say it.
Really, you know.
I hope that this can bevalidating for individuals that
might be struggling and knowingthat you don't have to be able
to pinpoint exactly what you'restruggling with, if you're
struggling at all, whether it isone thing that you can think of
or it's a combination, or, ingeneral, you have just felt a
decline, or felt a decline inmotivation, a decline in your
(17:57):
health, a decline in just thehappiness within your home.
You know, whatever it may be,you don't have to know exactly
what's going on, but there arepeople out here that will, that
will help you navigate and helpyou get to the other side and
help you to give you tools to beable to feel more present
within yourself.
I always say I love to feel thatmy feet and my mind are
(18:18):
grounded in the same place,because when I'm struggling, I'm
physically present but my mindis elsewhere.
I'm just feeling very blurry,very hazy.
I'm just, my mind is just.
It's not even that I'moverthinking, I just my brain is
so overwhelmed I can't evengenerate thoughts and that
really impacts my ability to bemindful and be present in my
relationships and in my home andjust within myself, and that's
(18:40):
just such a crappy feeling andsomething that I think a lot of
people are are experiencing, andperhaps experiencing for long,
extended periods of time andthen only kind of starting to
increase in severity and thereis so much freedom that comes to
reaching out and asking forhelp and just seeing the you
know impacts and kind of theshift in how that changes your
(19:03):
entire life.
Speaker 2 (19:04):
The other thing I want to mention, because that's
the other part too, is noticingall those things.
I'm going to speak from myexperience, but I'm pretty sure
you're going to concur.
So I don't have a magic wand tofix people in two weeks or
three weeks.
It's not downstairs, it's notupstairs, it's not even my house
.
I don't know where it is.
I do not have the magic wand,and I'm assuming that the center
(19:26):
of excellence, while very good,in 35 days it's not like oh my
God, I'm a new person, I'm allset.
One of the things about the IFFcenter of excellence is, I
think, that the message one ofmy firefighters really liked was
this is really good, but youstill need to continue working
on yourself.
So one of the things I want tomention you know a little bit
(19:48):
too is don't be in a rush Causeagain, if you've had a problem
for 20 years, it's not going tobe fixing itself in 35 days.
That's just not how it works.
Speaker 3 (19:56):
Absolutely.
I always say you know you're achange, you may be a changed
person, but you're coming backto an unchanged environment.
And so you are coming backexactly to the environment that
you had left, and it can be verychallenging to lean on those
lessons learned, those copingskills developed, the processing
that was done and all of thehealing that you encountered
(20:19):
while in treatment.
But it is just the kind of tipof the iceberg.
It is just the beginning ofyour healing journey, but it
does require ongoing care,ongoing support, ongoing
outpatient therapy Sometimesit's ongoing medication,
whatever that is for eachindividual, and so I think it's
really important to know that itis really the start of your
(20:40):
healing journey.
Our team works really hard toset people up with vetted,
culturally competent providersso that when they do return home
they can continue to engage inthe learning and the healing and
the processing that they did oncampus.
But it is not a quick fix, itis not a magic wand and I think
(21:00):
it can be daunting to imagine itthat way, like, oh, I really
want to go and just come backand be fixed forever.
But again, humans aremultidimensional people.
Mental health is not a blackand white type of kind of
checkbox that we went throughtreatment and we're good to go.
It's an ongoing journey, butthe benefit of that is learning
the tools, to master those tools, to put it into practice and to
(21:21):
just continue the work andcontinue to feel better and
knowing that you know if youstart to kind of fall back again
, these resources are still hereto help you get back on track
too.
Speaker 2 (21:33):
I'm going to share a little bit.
When I have first responders oranyone but first responders my
specialty they go.
Well, how long do I have to bein therapy?
So well, let me put it this wayI started off with weekly
therapy after my third death in10 days in my job and I needed
therapy way before that.
That just triggered a lot ofshit and I had to go to therapy
(21:55):
every week and then eventually Iwent to every other week and
now I go anywhere from three tofour weeks, sometimes six weeks,
depending on how good or howbad I'm doing.
And, frankly, recently I wentevery two weeks for a short walk
because I had something I hadto work out on.
This journey started in 2004.
We're recording this in 2025.
(22:15):
And I don't see myself everbeing completely done, and maybe
I'll go to six to eight weeks,and that's great.
And I've got guys who come inevery three months after seeing
me, sometimes twice a week for awhile.
At the end of the day, I want toshare that personal story, not
to make it about me per se, butto explain that the magic wand
doesn't exist.
Because I'll tell you what if Iwas a magic wand, I'd be using
(22:36):
it on myself.
I'm sorry to be selfish, butthat's how it would be.
So I think that that's thestory I share, because I think
that one of the other things too.
We're going to finish a bit ofcultural competency a little bit
here, and then I want to go alittle more about the center,
the cost, the insurance and allthat stuff.
You know, when we talk about acultural competency, you need to
(22:57):
share about yourself as a first, as a therapist with first
responders, because you're notauthentic if you're not and I
think that people know thatabout me, obviously, listening
to podcasts, but they've one ofthe other part of therapy oh, I
can't tell them this.
I'm like you're not going toconnect ever with a first
responder If you can't say thisor can't say that you don't want
(23:17):
to invite them to your barbecue.
I get that and they get thatand they get that, but that, if
you don't share a little bitabout yourself, you don't seem
authentic.
And that's very important aboutcultural competency, in my
opinion.
Speaker 3 (23:28):
I agree completely Because, as you said, there's a
part of cultural competency thatis about the discipline and the
learning about aspects of thejob and learning the culture.
But there is an entirely otherside of that, as you mentioned,
with building that rapport beinga trustworthy person, being
somebody that they want to bearound, being somebody that they
trust, that they know has theirbest intention, and a lot of
times that comes from findingways to connect in how you got
(23:52):
to where you are and why you'reso caring about your position
and all of these aspects as well, and I want to thank you for
sharing those experiences withme and on this podcast, and I'll
echo what you mentioned too.
Just personally, the reason whyI became a social worker was
from childhood and going throughtherapy and figuring out those
strategies to be able to live,to be able to work through a lot
(24:14):
of my challenges as well and,depending on the severity,
depending on the season of life,sometimes it was more
frequently, sometimes there wasmore space in between and it's
never something that's going tobe a forever closed chapter.
You know there are times, suchas new motherhood, such as new
jobs or new seasons in life,that is normal to feel, you know
(24:35):
what, maybe I need a littletune up, a little check in and
let me kind of loop back in myprovider or perhaps find a
different provider, depending onwhat the specific circumstance
is.
And so I appreciate you sharingthat and I'll certainly echo
that for myself as well and forany clinicians that are on, you
know, listening to this too,just finding ways to connect and
really connect from really thatperson perspective.
(24:57):
It's very important to be aprofessional and maintain
professional boundaries, ofcourse, but, as you said, first
responders really want to feelthat they can connect and that
this is someone that is, youknow, a friendly, familiar face
that they can really just settlein and get comfortable with for
the long haul.
Speaker 2 (25:13):
Well, you know, I appreciate you sharing that
number one.
You know, I think that me andyou have to start a group soon
Just for us therapists to talkabout this stuff together.
Uh, but, um, you know, as wewe're getting close to the hour
already, oh, I end up being too,too sad to two full episodes
here we always do this steve, wealways go after our time again.
(25:38):
I'm nowhere on the podcast here, but I'm gonna share.
Have we ever either likefinished on time or anything
else like that?
Speaker 3 (25:45):
I was going to say never.
It has always been extended.
But like mutually glad it hasbeen extended.
I mean, I can't speak for you,but I feel like we've always
been on the same page, thatwe're like ah, it's fine, let's
just keep it rolling.
Speaker 2 (25:57):
You know I'll, I'll share with the audience.
I know you're right here, butI'm going to pretend you're not
here.
The other, she could never lieto me.
And I can't lie to her because,like, my face tells the story,
or my voice, or like yeah, yeahor whatever.
I, I can't hide how I feel andit's clear that we actually
enjoy talking to each other.
(26:18):
We always go over.
So I want to share that witheveryone because that's truly
how I perceive you.
I'm pretty sure if I everpissed you off, it would.
We, we, we touched on thisright beforehand on a different
subject.
I'm just going to keep privatefor me and you and you're like,
oh no, no, don't worry, I'lltell you.
Oh yeah, don't worry.
So, and I should have neverdoubted her honestly.
(26:39):
But to finish off a little bit,tell us about how we can get
into the Center of Excellence.
You know insurance and missions.
Do I just show up at Hannah'splace or what do I do here?
Speaker 3 (26:49):
Come on down to Florida.
I'm just kidding.
Yes, so the IFF Center ofExcellence.
We do have a parent companythat is called Advanced Recovery
Systems.
Advanced Recovery Systems ownsand operates the kind of
behavioral health treatmentfacility of the IFF Center of
Excellence.
It is a partnership betweenAdvanced Recovery Systems and
the IFF.
Now, with that being said,Advanced Recovery Systems does
(27:11):
have a dozen inpatient treatmentfacilities for civilians all
over the country.
Now I bring this up to mentionthat we do have a 24-7
admissions team call center thatis operated by Advanced
Recovery Systems.
But we have specific intaketeam members on the admissions
team that works with our IFFmembers, and so there's
(27:32):
sometimes this confusion whenthey see a callback and maybe
somebody identifies as advancedrecovery systems, that is just
because that is one call centeroperated by advanced recovery
systems.
But there would never be asituation where an IFF member is
filtered elsewhere or, you know, recommended to go somewhere.
I mean, they will go to the IFFcenter of excellence if that is
what their preference and thatis the IFF's expectation as well
(27:52):
.
But I say that to share.
We do have a 24-7 admissionsteam and so no matter what time
of day, no matter what day ofthe week, no matter if it's a
holiday weekend.
Two in the morning.
If somebody wants to initiatethis conversation, you can try
to reach me, but if it's themiddle of the night, I'm a
pretty heavy sleeper, so I'llcall you back in the morning,
but I don't want you waiting onme and so in the meantime, until
you can reach me, theadmissions team is always there.
(28:15):
They are able to get theinsurance information and then
be able to provide eachindividual what their exact
deductible, co-insurance rateand out-of-pocket max for the
year looks like.
The cost of treatment iscompletely dependent on what
your insurance carrier and whatyour specific plan is.
Now I will say we are innetwork with most major
insurances, between the BlueCross, Blue Shield, the Aetnas,
the Cigna's, the United HealthCares.
(28:37):
We have a ton of directcontracts with municipalities to
eliminate any barriers toaccessing care.
To know what your specificbreakdown is, let's connect
offline care.
To know what your specificbreakdown is, let's connect
offline.
We like to be able to have thisbe available for departments and
local leadership to share withtheir members so that
individuals can see oh, this ishow much it would cost to go to
treatment, and a lot of timesit's a lot less than I think a
(28:59):
lot of individuals may think,because we are a network with
most major insurances.
So let's say somebody calls intothe admissions team, the
insurance information iscollected and delivered back to
the individual so they knowbefore coming to treatment what
that out-of-pocket would looklike.
They would then do apre-assessment over the phone
with the admissions team whichlooks at medical psychological
history, gets a little bit moreinformation as to what they are
(29:21):
struggling with.
All of that gets kind of puttogether into a clinical summary
that gets sent over to ourmedical director at the Center
of Excellence, who is apsychiatrist.
She will then review that andmake sure that before they come
to us that we have determinedthey are a good fit for
treatment, because we wouldnever want somebody to fly
across the country and arrive inMaryland and for whatever
reason, and not be a good fit.
(29:42):
So we do that on the front end.
Once that clinical approval isgiven, our admissions team will
help coordinate the logistics oftravel, whether it be car,
plane, train, whatever meansthey want to get to us.
We will schedule that so thatwhen they do either arrive at
the airport for the pickup orarrive at the facility, they can
immediately jump right intotreatment, with no waiting
(30:03):
period, no line, no bedavailability issues.
We want to get them transitionedright into treatment right when
they get there.
Now, ways that I can help tofacilitate this process, make it
go faster, make it morepersonal for you.
I'm happy to work inpartnership with the member
themselves, with their peer,with their local leadership,
(30:23):
their spouse, their clinician.
Steve, you and I have workedtogether for these purposes.
However, I can help make thisas comfortable and quick as
possible.
That's something that I do.
Our admissions team doesincredible work and I would
never, you know, replicate whatthey're doing.
But in effort to keep itfamiliar and keep it easy, you
can always call me.
I'm happy to answer anypreliminary questions a member
(30:45):
may have, help them feelcomfortable in progressing to
the next step.
If they want to stay on the line, I can call into our admissions
team and then introduce themfrom there and then kind of be
that supportive individual alongthat process.
If there's a peer involved or aclinician involved, I'll keep
them updated as to the timelineof what we're looking at and
then up to when they land at theairport, to make sure that
(31:06):
everyone knows that everyone issafe and progressing towards
their care, and so I'm available, however I can be, whether it
be questions or to initiate theadmissions process, to connect
to an outpatient therapist inyour area, to host a behavioral
health training or anything inbetween.
I would love to be able toconnect with any of you guys,
whether you are a clinician or afire service professional.
(31:28):
However, I can be of supportand kind of compliment the work
that your peer team is doing, bean extension of support or kind
of jump in.
If maybe behavioral health is anewer part of your local.
Would love to share ideas andresources as well.
Speaker 2 (31:43):
Well, this is all true, by the way, I can tell you
, and I absolutely we've beenthrough this a couple of times,
me and you at least, but I wantto make sure that I also I mean,
I like confirming stuff this isabsolutely true.
So I want to make sure everyoneheard me say that, and you
again, you've listened to 219episodes, or whatever my number
is at.
(32:03):
You know that I don't lie andthat's absolutely all true.
So I hope people hear me saythat.
So now, finally, how do wereach you or the Center of
Excellence, or anything else?
Speaker 3 (32:16):
Thank you.
So my direct cell phone numberI would love all of you all to
save it and, you know, save itfor a rainy day, if ever needed.
My direct cell phone number is727-506-9036, 727-506-9036,
which is 727-506-9036.
And then to reach our 24-7admissions team, at any time,
(32:36):
you can call 855-441-3024.
My email address is helmoreH-E-L-M-O-R-E at
advancedrecoverysystemscom.
Advanced with a D, I will sayRecoverysystems with an Scom,
and then the website for the IFFCenter of Excellence is
(32:57):
wwwiaffrecoverycentercom.
I will shout out the websitehas a ton of resources that you
can go in and print out for peerteams.
A lot of them have bookletswith these resources and kind of
pull them as needed Supportiveresources for learning how to
talk to kiddos about some ofthese issues, how to support
crew members returning fromtreatment, and a lot of
(33:18):
additional information on theIFF Center of Excellence.
And then our webinar library isalso on the website.
So, although we have two livewebinars a month that we would
love you to join us on and beable to ask live questions and
network with each other in thechat box, there's also a library
of recorded webinars that havebeen going on for the last five
years to kind of view on demandas well.
Speaker 2 (33:40):
I can vouch for the website, so go ahead and it'll
be all on the show notes.
I'll put all the phone numberstoo the other part too before we
go, other than saying thank you, absolutely, adore working with
you, can't wait to meet inMaryland.
Apparently, that's our nexttrip.
Speaker 3 (33:54):
Yes, I can't wait.
Speaker 2 (33:57):
We'll figure it out when out offline.
The other part too.
I want to hear it, I wanteveryone to hear.
I call Hannah.
Hannah set up everything for myclient and then she was offline
because she has a life outsideof work, go figure and she had
(34:17):
two people call me to confirmpicking them up and landing and
being in the center ofexcellence for the IFF.
So this is all true.
Again, I have my personalexperience with that and I vouch
for them a hundred percent.
So I want to thank you for yourtime.
This was, again too long and yetfelt like and not only that, I
mean like I literally feel likeit was like 20 minutes.
Speaker 3 (34:37):
Me too.
No, it is always such a joy anda pleasure to talk to you,
steve, and I'm so thankful forthe opportunity to join today
and to share this resource andreally just continue to just
talk about behavioral health andthe fire service and really
shine a light to it and thankyou for all that you do each and
every day and I'm just sothankful for each and every
interaction with you.
So it was a joy and a pleasureto be here with you today and
(35:00):
for everyone out there listening.
I look forward to theopportunity to work with you and
serve your members if anyquestions or needs come up, and
let's keep on shining a lightand ending the stigma and really
doing our proactive steps toworking towards a better
behavioral health wellness forall.
So thank you, steve.
Speaker 2 (35:18):
I could not have said it better myself.
Thank you so much.
Speaker 3 (35:21):
Thank you, Steve.
Speaker 2 (35:22):
Hi.
Well, this completes episode219.
Hannah Elmore, I cannot thankyou enough and, yes, I'm looking
forward to go to Maryland justto see the IFF Center of
Excellence.
All the show notes will showthe connection with phone
numbers and everything else youneed.
They'll be included on thereand I hope you join us for
episode 220 with Bill Dwanell, acolleague of mine who we work
(35:45):
on.
He's a co-owner of a companywe're working on, so I hope you
join us then.
Colleague of mine who we workon.
Speaker 1 (35:49):
He's a co-owner of a company we're working on, so I
hope you join us.
Then Please like, subscribe andfollow this podcast on your
favorite platform.
A glowing review is alwayshelpful and, as a reminder, this
podcast is for informational,educational and entertainment
purposes only.
If you're struggling with amental health or substance abuse
issue, please reach out to aprofessional counselor for
(36:09):
consultation.
If you are in a mental healthcrisis, call 988 for assistance.
This number is available in theUnited States and Canada.
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