Feb. 1, 2019 2:00 pm

The City of Philadelphia wants to help its frontline workers better deal with trauma

The Take Care PHL initiative will aim to alleviate secondary traumatic stress in firefighters, correctional officers, social workers and the like.

A firefighter.

(Photo by Flickr user Daniel Fleming, used via a Creative Commons license)

Correction: A PGW worker was killed in 2011, not 2016, as previously reported. (2/5, 1:57 p.m.)
A PGW worker is killed in 2011 when responding to a gas explosion and his coworkers help recover his body.

A longtime school nurse calls it quits when the school police officer who broke up fights between students has a heart attack and dies.

A parole officer tries to deal with the personal emotional toll when one of his parolees commits a rape and a murder.

These are a few of the tales of secondary traumatic stress — the stress that results from indirect exposure to firsthand accounts of a traumatic events and is severe enough to hinder a sufferer’s personal and professional performance. Because they deal daily with those in crisis, many city workers, including firefighters, paramedics, correctional officers, social workers, mental health workers and teachers, pay a high personal cost to their emotional and mental wellbeing.

The answer to this silent suffering or secondary traumatic stress, according to City Councilman Derek Green, is to make Philadelphia a trauma-informed employer with human resource practices that intentionally build resiliency into the workforce. Green, the chair of the Committee on the Disabled and Persons with Special Needs, used a hearing in early December to kickstart the public conversation on the needs of the city’s frontline workforce.

“The essential act of listening to trauma stories may take an emotional toll that compromises professional functioning and diminishes quality of life,” testified Dr. Tamra Williams, deputy chief clinical officer at the city’s Community Behavioral Health, at the hearing. “Essentially, any time someone experiences a traumatic incident or helps someone deal with a traumatic incident, that can help expose the helper to secondary traumatic stress.”

Research has well-documented that adverse childhood experiences (ACEs) can have a debilitating lifelong impact resulting in poorer adult health and emotional outcomes. The Philadelphia ACE Task Force, a network of more than 100 Philadelphians in relevant fields, was born to raise the awareness of trauma and the need for trauma-informed practices and policies throughout social service organizations the city.

Now a work and policy subgroup of that task force is looking at how caregivers and frontline responders are themselves adversely impacted by caring for traumatize people — and a subcommittee on secondary stress has created the Take Care PHL initiative to help build resiliency into the city’s workforce.

“The Take Care PHL initiative was born out of this idea that as a city, we can do more to take care of each other,” explained Children’s Hospital of Philadelphia pediatrician Dr. Sandhyaa Iyengar, a Philadelphia ACE Task Force member.

The initiative will address the impact of secondary traumatic loss.

“Councilman Green has expressed particular interest in peer support models available to police and firefighters and making similar programs more accessible to other professional caregivers,” said Leslie Lieberman, one of two Philadelphia ACE Task Force staffers. “We are eager to work with him toward that goal.”

Locally, the Philadelphia Fire Department will be partnering with the Philadelphia Department of Public Health and the University of Pennsylvania through a grant to implement resiliency training, said Crystal Yates, the fire department’s assistant deputy commissioner of EMS, during the December hearing.

There is a nascent movement in the country for a more resilient workforce. According to Lieberman, the Colorado legislature has convened a statewide commission to look at potential solutions to secondary traumatic stress among caseworkers, and New York City has created the Resilience Alliance Project to help decrease burnout and increase job satisfaction for its caseworkers.

As a next step, Green wants to push the federal Occupational Safety and Health Administration (OSHA) to add secondary traumatic stress to the list of workplace hazards thus putting mental protection of workers on par with physical protections. The Philadelphia ACE Task Force workgroup is preparing a resolution for Green to present to City Council to urge OSHA in this direction.

Lieberman said there is no specific timeline or source of funding for the recommendations, though the task force will convene by the end of the quarter to discuss implementing next steps.

“However, with regard to peer support, Behavioral Health Training and Education Network already does training in peer consultation model as part of their training on vicarious trauma [for] behavioral health providers and it’s open to other city workers,” she said.

Growing the Take Care PHL Initiative is the next focus.

“While there has been interest in [secondary traumatic stress] for some time, the #TakeCarePHL initiative only began in December 2018,” she said. “We’re looking for opportunities to engage other partners in #TakeCarePHL, like the education sector. We know that teachers are also heavily affected by secondary traumatic stress.”


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