CRANBERRY TWP — For more than 27 years, Jeff Kelly has taken care of others.

The executive director of Cranberry Township EMS, Kelly has spent his days and nights strapping in and speeding to calls, often not knowing what to expect once he arrives. Regardless, his goal is simple — to help people.

It wasn't until 2016 that Kelly realized he wasn't helping the person who perhaps mattered most: himself.

Following a series of trying events, a co-worker approached Kelly and asked if he was feeling OK. Confused, Kelly said he was, but his co-worker wasn't convinced.

“He said, 'Depression is not just about being sad; you're just going through the motions,'” Kelly recalled.

The co-worker said if Kelly didn't reach out for help, he would do so for him.

Kelly's story isn't unique, as first responders from all agencies must deal with traumatic incidents each day, which can compound over years of service. Because of that, agencies, including those in Butler County, are placing an emphasis on mental health for first responders, making sure resources are available when the call of duty gets to be too much.

Thrust into mental health

The details of July 5, 2016, are clear as day for Kelly, who shared his story this week during an event hosted by the Cranberry Area Diversity Network.

He had been on vacation with his family, and was returning to work in anticipation of Cranberry Community Days. He received a phone call late that night that shook him: a co-worker he had known for more than 10 years had committed suicide in the EMS parking lot.

The questioning began. Why did he do it? Had Kelly and the staff not noticed something was wrong? Did they not do enough to get the man the help he needed?

The next few days, Kelly said, were a blur. For more than a week, he doesn't remember much, and once his co-worker was buried, attention again returned to helping others.

“We had to bury one of our own, and we have to think about getting back out there,” he said.

Kelly powered through, only for the department to experience another suicide by a younger member a few months later. It capped a year in which Kelly was seemingly surrounded by bad news.

Not taking time to process what had happened eventually lead to a conversation with another co-worker, who pointed out that Kelly may not have been coping with the loss. It was compounded by years of calls for suicides, overdoses and other tragedies that he experienced.

“I've been fortunate in my career — the things that I've seen and the things that I've had to experience that took such a toll on me — that I have a great support network and I have people around me that said, 'Hey, something is wrong,'” he said. “When you're just going through the motions, and you're just getting up and you're in a wash-rinse-repeat kind of thing, or you're lashing out at people for no reason, there's a problem.”

Alarming statistics

Not being able to deal with those problems has lead to an increase in suicides for first responders. Kelly said regardless of background or the role served, suicide ”is not something that discriminates.”

He said data shows that more first responders take their lives than die in the line of duty. Nationally, in 2017, 93 fire personnel died in the line of duty, compared to 103 who committed suicide. Similarly, 140 law enforcement officers committed suicide during that same period, compared to 129 killed while on duty.

Additionally, he said the number of individuals who are committing suicide while on duty is increasing, leaving many questions to be answered. He said as those careers become safer due to a focus on better practices and equipment, the “paradigm shifts.”

“We don't really know the 'whys,'” he said.

Part of that, he said, can be associated with those individuals who serve with a department for decades before retiring, and feel as though they've lost their identity.

“They had their families in law enforcement and the fire department, and now they don't have that anymore because they're retired — and retirement is not so great and now they've lost that identity, and they take their own life,” he said. “It's a permanent solution to a temporary problem.”

Kelly said that while the data indicates suicides are increasing, there is no way of knowing how the resources being made available are helping.

“What we don't know is how many we have staved off,” he said.

Seeking help

Those resources available to help mitigate mental health issues are many and more readily available than ever.

Cranberry EMS offers an employee assistance program that can help with everything from learning to manage money to finding help to become more organized. It also offers assistance for those needing help for their mental well-being.

Kelly and his staff are educated on how to notice if someone is acting differently or appears to need help, and the environment within the building is one eliminating stigma. It can be as simple as sitting down and talking or giving a person a few days off to get away from the stress. Kelly said that the job is still there when they come back.

The key, however, is often for the person to recognize they have a problem. After years of dealing with stress and pushing through to make sure the next call is just as important as the last, even the most traumatic of incidents can take a while to resonate.

“From an emotional perspective, because you get so caught up in the adrenaline of everything, you're not in that moment until it's done,” he said.

Eliminating the stigma associated with mental health is important, and Kelly is quick to point out that it is OK to be sad or overwhelmed by the things he and his co-workers see on a daily basis. He also preaches the idea of work-life balance, and making sure there is time to get away.

Other programs include Eye Movement Desensitization and Reprocessing Therapy, a method that while intense has proved to be helpful, Kelly said. First responders can also take advantage of 911 buddy checks, yoga tailored to their career and the Code Green Campaign, an awareness and education program focused on mental health, PTSD and suicide in first responders.

Locally, the Butler County Critical Incident Stress Management Team is available at a moment's notice.

The primary role of the group is to support first responders during and after traumatic incidents, and prevent long-term effects from occurring, according to Tim Birge, Butler County CISM Team president.

A crisis worker by trade, Birge said the teams comprised of mental health professionals, law enforcement personnel, chaplains and community members attempt to create a space for those responders dealing with a traumatic incident.

“We're there for you to come back and be able to talk,” he said. “We are there to help folks to perform their duties and get back to work.”

Often, that can be as simple as being at the station with a pizza and drinks for when responders return and offering a sounding board for what may have just occurred. The team also holds a formal debriefing a few days after an incident, which he said allows for people to process and work through their feelings and emotions after the initial shock.

During Tuesday's presentation, Birge noted that a team was in Butler doing a debriefing session with fire, police and EMS workers who on Monday responded to an incident in which three children were struck by a vehicle while waiting at a bus stop. One of the children, Mark Fike, 11, died at Butler Memorial Hospital as a result of the accident.

Incidents like that, he said, can lead to a wide range of emotions.

“You're going to feel like crap, and that's OK,” he said. “Maybe you're not going to feel like crap today, but six months down the road you're going to start having nightmares possibly. That's OK. You're going to be confused, you're going to be angry, you're not going to want to talk to anyone. That's OK. We normalize things for folks.”

He said that he has noticed that informal discussions, with a room full of people sharing a common experience, tend to be the most cathartic and grow in openness as the meeting progresses. He said seeing that other people are feeling the same way can do wonders.

In Cranberry, Teak Baker, EMS deputy chief of operations, said he's taken advantage of various programs at different times based on his needs, and has found them to be helpful.

“Our programs are really forgiving,” he said. “They have to be.”

He said he doesn't hesitate to approach his co-workers, including Kelly, to talk when he or they need to do so.

For Kelly, it's easy to ask why someone would voluntarily put themselves in a position to deal with the stress and demands that the job can have mentally. However, he said for him, his co-workers and friends, the answer is relatively simple.

“There is no greater feeling … than knowing there are people in this world who are walking, talking, living breathing more life today because of something you did for them,” he said.