As you enter the fire service, or strive to become a firefighter - more so seeking to get paid to do it - you find yourself in disbelief that someone who gets the job would ever jeopardize it with drugs, alcohol, or inappropriate behavior. This is a normal reaction, but as you become seasoned on the fireground, at emergency medical services calls, and at the kitchen table, you realize that there are demons everywhere, and this job can’t eliminate them - to the contrary, actually.
The fire service and the experiences that you will endure are full of wins and losses, tragedy and heartbreak, and hope and doom. This is the construct of life in general, but the consequences are enhanced in the fire service because we are the ones who are charged with managing them on a personal and professional basis. When firefighters find themselves having a hard time dealing with these consequences and the issues we all face at home, this becomes the tipping point. When we don’t get our firefighters help at this point, we begin to see the previously listed destructive behavior. But our profession makes us cynical, sarcastic, and adversarial to the programs that are designed to help people through personal tragedy or substance abuse. It is this reality that we’ve built over the history of the fire service as the original way to deal with everything we experience that often makes these programs ineffective for the alpha-minded men and women of the fire service who seek their help. And when these programs fail to help, the behavior continues to devolve and leads to career-ending decisions that become even more ruinous for the firefighter. This is where the Rosecrance-Florian Program comes in.
A Conversation with Dan DeGryse
I had the opportunity to discuss the Rosecrance Florian Program with its founder, Battalion Chief Dan DeGryse of the Chicago (IL) Fire Department, and asked him to answer a few questions about the program and its benefits to firefighters.
Erich Roden: Give an overview of the Florian program, its impetus and makeup.
Dan DeGryse: The Rosecrance Florian Program serves firefighters, paramedics, and other fire service members, offering the best opportunity for lasting recovery for co-occurring substance use and mental health disorders by incorporating occupational factors into the treatment process. Florian was the first program in the country dedicated to and specializing in helping fire service members who need substance abuse treatment and who also need care for job-related post-traumatic stress disorder (PTSD), anxiety, depression, and other behavioral health issues.
Florian is housed in a designated coed unit at the Rosecrance Harrison Campus in Rockford, Illinois, which offers a full continuum of residential and outpatient services. Florian clients benefit by having services tailored to the needs of people who experience ongoing exposure to trauma, access to chaplains and other staff with military and firefighting experience, and relationships with peer support volunteers from the Illinois Firefighters Peer Support network and a community of firefighters. When clients’ treatment on the Florian unit concludes, Rosecrance offers comprehensive, individualized discharge planning to provide a smooth transition to aftercare services in the clients’ own communities.
Rosecrance also has a well-established family program that takes place every weekend. Family members are invited and encouraged to attend two days of family education, which includes information about addiction and how substance abuse is a family disease. Scheduled family sessions that help with the transition of returning home, maintaining boundaries, and repairing relationships damaged by addiction are an integral part of treatment.
Roden: Tell us about yourself and your inspiration for establishing the Rosecrance Florian Program.
DeGryse: Florian is led by me, an active-duty battalion chief/EMT with 27 years of experience with the Chicago Fire Department. I am a certified employee assistance professional and a certified alcohol and drug abuse counselor. I spent 14 years as the coordinator of the Chicago Firefighters Union Local 2 Employee Assistance Program (EAP) and developed a working relationship with Rosecrance during that time. I studied the suicide rate within the Chicago Fire Department, which experienced 52 firefighter suicides in 25 years. Although many people who die by suicide have substance use and mental health disorders, little has been known about firefighter suicides specifically. That’s what led me to Rosecrance and its clinical team to try to better understand and address behavioral health within the fire service.
I approached Rosecrance President/CEO Phil Eaton in 2013 about tailoring a program specifically for the fire service, and Phil welcomed the challenge. Florian - named for the patron saint of firefighters - was developed with the help of Dr. Raymond Garcia, medical director at the Rosecrance Harrison Campus, who also has experience treating first responders. We gathered a 12-member panel of experienced firefighters and fire personnel from across the country to advise us and welcomed our first client in August 2014.
Roden: What are the services provided?
DeGryse: Florian clients stay an average of 35 days on the unit and receive core services including physician care; on-site detoxification with medication assistance; comprehensive psychiatric evaluations; individual, group, and family counseling; peer support groups; counseling sessions with a certified chaplain; experiential therapies that include art and recreation; and nutrition health education.
Treatment days are structured, with wakeup starting around 6:45 a.m. Balanced meals are an important part of each day, as are daily assigned times for exercise. There’s education about addiction and mental health, relapse prevention, vicarious trauma and spirituality, as well as individual sessions with primary counselors and myself, group therapy, and therapeutic recreation such as yoga and meditation. In the evenings, clients attend in-house and community 12-step meetings and participate in leisure activities that help them learn and relearn how to enjoy time without using drugs and alcohol.
To ensure that firefighters can recognize the need for behavioral health services, Florian leadership is training fire personnel across the county to recognize and act on the signs and symptoms of substance abuse and mental health struggles.
I and other Florian staff have personally visited departments across the United States. Rosecrance has hosted several successful regional “Reading Smoke” seminars attended by firefighters, fire chiefs, chaplains, and other clinicians who treat the firefighter population. Those seminars emphasize the importance of peer support and education about stress, how pain medication and other forms of self-medication can lead to increased use and abuse of substances, PTSD, and suicide prevention.
Rosecrance expanded on those trainings with an eight-hour Firefighters’ Professional Day at the Rosecrance Harrison Campus where employee assistance professionals, clinicians, and fire service personnel from many different organizations spoke about their profession and services. The response to the education led to the development of the first Rosecrance Florian Symposium, which took place in 2016 over three days near Chicago, bringing together clinical experts and fire service leaders from across the country to speak about behavioral health within the fire service. The first-of-its-kind comprehensive event attracted nearly 200 attendees from 20 states and Canada.
Roden: How does an individual enter the program, and what is the process?
DeGryse: People can enter the program several different ways. They can refer themselves; a family member can refer a loved one; or the referral could come directly from an employer (in this case, most often a fire department), an EAP, or a peer supporter.
Once an inquiry is made, a person is connected with our access department. An access staff member asks the person a series of questions to determine if he or she formally qualifies for treatment. After that, a phone assessment or in-person assessment is done with one of our master’s-level counselors. Insurance is verified, then people can be admitted to the health center for detoxification, if needed, or directly to the Florian unit.
Roden: What’s in store for the future of Rosecrance Florian?
DeGryse: We moved the Florian unit to a bigger space in 2016 in preparation for expanding the program to serve all uniformed services, including police, military, and corrections officers. Rosecrance decided to expand services to all first responders after finding success with addressing the needs of fire service personnel and identifying the often-volatile climates faced by police and other first responders. We’ll be adding law enforcement members to our Florian Advisory Committee to help lead and guide us through the transition.
What’s great about Rosecrance is the staff is also reevaluating programs to make sure they’re the most effective they can be for clients. We’re looking to add more relapse prevention education because many of our clients return to work and environments of stress and trauma.
We’re also planning the second Rosecrance Florian Symposium, which will take place in fall 2017.
Roden: How does Rosecrance Florian measure its successes, and are you able to give examples or testimonies?
DeGryse: The Rosecrance Florian Program has served 110 clients from more than 85 fire departments and 12 states since August 2014. Those clients have included active and retired firefighters, paramedics, and other fire service personnel.
About 85 percent of clients successfully completed treatment. About 70 percent of clients who can work return to work (some are unable to return to work because of injuries, some have been terminated, and others are retired).
Comprehensive, personalized discharge planning takes place at the completion of clients’ residential treatment stay to ensure they receive continued services as needed, either at Rosecrance and/or in their respective communities. I have worked hard to become a trusted ally of clients because of my extensive history in the fire service and clinical training, and I am a resource for them after they leave residential treatment.
The Florian Program’s management team (listed below) is responsible for evaluating its success:
- Dan DeGryse, program director.
- Kerry Larson, unit coordinator.
- Erica Gilmore, primary counselor.
- Craig Stallings, Rosecrance Harrison campus administrator. He oversees all residential programming for adult services, including the Rosecrance Florian Program.
- Dr. Raymond Garcia, Rosecrance Harrison Campus medical director. He is a board-certified psychiatrist and addictionologist who is trained and experienced in treating firefighters and paramedics for cooccurring disorders.
To ensure the highest level of care, all Florian staff participate in regular cultural awareness training so they can better understand the physical and emotional nature of the fire service. That training includes suiting up in full firefighter gear and doing drills under the supervision of the Rockford Fire Department, whose fire chief serves on the Florian Advisory Committee.
The fire service community engages regularly through social media, so Florian has dedicated Facebook and Twitter accounts that share program information, outreach and education opportunities, and video testimonials.
A Chicago firefighter and Rosecrance alumnus embraced the camaraderie and brotherhood in the Florian Program. Social drinking with the guys had turned into isolated drinking to numb the pain he experienced from seeing tragedy every day on the job. After addressing his alcoholism, he returned to work but was hit with a major back injury that resulted in surgery and chronic pain. He was only 33, but the simple act of playing with his children left him in agony. Doctors prescribed pain medications, but he knew use could quickly turn into abuse. He was depressed, and his sobriety was in serious danger. So, he came back to Rosecrance, and staff encouraged him to stay.
“I wasn’t there again because I was abusing alcohol,” he recalled. “I was there because the Florian Program would save my life again. The discussions, the walks around the track, the meetings, the meals outside, the brotherhood - all of these things brought me up, put my head on right, and brought me back to who I am. And no matter what happens, God has a plan for me.”
Contact Dan DeGryse at 815-387-2461, 312-833-0196, or firstname.lastname@example.org for more information.