Justin Jensen felt stunned when he was named Firefighter of Year by the Professional Fire Fighters of Idaho after spending the past year clashing with demons brought to life by post-traumatic stress disorder.
“It’s our most prestigious award that recognizes one of our own,” Rob Shoplock, a firefighter with the Eagle Fire Department and vice president of the firefighters’ union. As vice president, Shoplock lobbies for industry changes with state lawmakers.
The organization presented the award to Jensen on Feb. 22 during a virtual conference.
The award left the 44-year-old Burley man feeling emotional, overwhelmed and without words, something he said he hopes to remedy with a speech during next year’s conference.
An advanced emergency medical technician, Jensen was diagnosed with PTSD after his symptoms escalated, leaving him isolated, sleepless, short-tempered, emotionally exhausted and feeling suicidal.
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Firefighters, police and emergency medical personnel are exposed daily to some of the worst experiences life has to offer. They routinely witness horrific accidents, natural disasters and people committing heinous acts on one another. While the first responders are there to help those involved, the images they witness during those calls can affect their mental health and lead to a type of PTSD similar to what war-scarred soldiers experience.
Post-traumatic stress disorder carries a huge stigma for emergency services workers, Shoplock said. Many won’t acknowledge that they are struggling with it for fear of losing the respect and trust of their colleagues and bosses.
PTSD became a recognized psychiatric disorder in the 1980s and is listed in the Diagnostic and Statistical Manual of Mental Disorders, but Jensen prefers to use the term post-traumatic stress “injury,” he said, because an injury can be treated and the term signals hope of recovery.
Numerous groups are advocating to have the PTSD name changed to post-traumatic stress injury because PTSI would carry less stigma and offer a more accurate representation of the biological injury that causes the symptoms, they say.
Unrelenting images
Jensen first began suffering nightmares and flashbacks in 2011 after responding to a fiery airplane crash that killed a family of four in Burley.
The crash occurred after the plane left the runway at the Burley Municipal Airport and crossed U.S. Highway 30. The plane went down just south of the highway and burst into flames.
What Jensen saw that day as he helped extinguish the fire would continue to haunt him for years.
The unresolved feelings he had after the plane crash were compounded when he responded to the calls for help when his father died of a heart attack and again when a vehicle crash killed his girlfriend.
Jensen had participated in a peer group and was trained to watch for signs of PTSD, but he ignored the early warning signs that something was wrong.
“It crept up on me,” he said.
He said his adrenalin levels remained elevated after calls. He became short-tempered with people and he didn’t want to socialize. When the COVID-19 pandemic hit, all the symptoms were magnified.
“My attitude changed,” he said. “I didn’t want to talk with anyone.”
The events he looked forward to during his downtime — music concerts and the annual stair-climbing competition in which he raced against other firefighters for charity — were canceled because of the virus.
His thoughts turned dark and, during his off-duty hours, he began to take personal risks — not really caring about the outcome.
After callouts at work, he perpetually felt like he hadn’t done enough during the call and he tormented himself with questions: “What if I would have done this?” or “What if I would have done that?”
But when one of his friends at another fire department committed suicide, he started talking about his own struggles.
“I started opening up,” he said.
The effects of witnessing trauma
A very real stigma exists for people who reach out for help when they are dealing with the trauma that comes with the job, Jensen said.
The rates of PTSD and suicide for emergency services workers are alarmingly high, Shoplock said, but many of them don’t talk about their difficulties with it for fear of appearing weak.
“There used to be an attitude of ‘Suck it up, Buttercup,’” he said. But, that attitude is slowly starting to change.
Firefighters routinely work in environments known to contribute to mental health conditions such as anxiety, depression and PTSD. The job’s calling cards are high stress, sleep deprivation, low control, personal risk and exposure to trauma and suffering.
“Idaho firefighters are exposed to suffering and high stress on almost every shift worked,” Shoplock said.
A survey of emergency services personnel published in the Journal of Emergency Medical Services in 2015 found that EMS workers are roughly 10 times more likely to commit suicide than other adults. The survey was conducted by a group called Reviving Responders as a research assignment for Fitch & Associates Ambulance Service Manager Program.
More than 4,000 of the EMS workers who responded to the survey across the country showed 1,383 of them had contemplated suicide and 225 had tried to take their own life, according to a 2012 study done by the Centers for Disease Control and Prevention.
‘I was having flashbacks from then on’
The origins of Jensen’s PTSD were traced to the fiery 2011 plane crash and it intensified when another plane crashed near the same location in 2019.
“I wasn’t even supposed to be working that night,” Jensen said about the 2019 crash. Later at a barbecue, flashback images began appearing in his mind of the incident in 2011.
On the same night, he responded to a man who had caught himself on fire.
“I was having flashbacks from then on,” he said.
He felt like a ticking time bomb with a short fuse that had been lit and relit.
“I was on edge and it wasn’t me,” Jensen said.
Jensen sought counseling after the first plane crash, but he felt like the counselor didn’t take the issue seriously. His first three sessions were paid for by insurance, but payment for additional sessions would have come out of his own pocket.
He never went back.
It may take time for a person to open up to a counselor, he said, but when a person seeks counseling and they don’t feel like the counselor is a good match, they should keep looking for another one.
After doing some research, he wanted to admit himself to a 30-day treatment program at a Maryland center known for its success rate in treating PTSD, but his insurance company turned him down.
“I was really disappointed,” Jensen said.
He now has a counselor that he likes and he’s also used hypnotism and is implementing yoga, meditation and breathing exercises in his life to help relieve stress.
Right after being hypnotized, he said, he slept eight hours straight, which was the first time he’d done that in months. A full night’s sleep brought overwhelming relief. From April through September, he averaged about three hours a night.
He didn’t think any of it would work at first.
“I didn’t want to talk about what I was seeing and feeling,” he said. “But I also didn’t want to lose the battle, give up and end it.”
It was also therapeutic to talk with friends about his experiences, and after he talked about it, many people started sending him messages saying they were experiencing PTSD too.
“When I started talking about it to friends, people were shocked,” he said. “I’m this big guy, rock-solid. But deep down I believe my opening up about it helped them as well.”
At the station, they are also implementing new strategies to help the crew process their feelings after rough callouts.
“We used to come back from a bad call and the guys wouldn’t want to talk about it and we’d just go back out on another call,” Jensen said. “We are trying to change that now.”
Overall, he’s found some peace.
“I’m not blaming myself anymore for what happened and I’m not blaming others,” he said. “I chose this profession to help others and I try to focus on that.”
Andy Smithson, a licensed clinical social worker who has a private therapy practice in Burley, said a person who experiences PTSD after traumatic events may feel anxious and have increased respiratory and heart rates along with nightmares and flashbacks of the trauma events.
“They will re-experience the events a lot and may have fear day to day caused by triggers from the trauma,” Smithson said.
PTSD can be caused by one event — considered less complex — or by many events, which is more complex.
People who choose this type of work tend to be resilient and they often suffer for long periods of time before they seek help, he said.
Smithson said PTSD is a “very treatable” disorder and can be helped with various methods like cognitive behavioral therapy and exposure therapy along with the use of Eye Movement Desensitizing and Reprocessing therapy.
When using this therapy, there is a preparation period where the therapist teaches the patient mindfulness and body-calming techniques, he said. The therapist will then address the specific events causing the PTSD coupled with eye movements or the use of a buzzer held in the patient’s hand.
The therapist moves their fingers side to side and has patients track their fingers with their eyes. Smithson also uses a buzzer the patient places in their hand to provide tactile stimulation while they talk about the traumatic events.
“It helps desensitize the traumatic material and they’ll feel like it is less upsetting,” Smithson said.
Success rates can reach up to 80%, he said. But it’s estimated that only one in five will end up getting treatment.
“The research on the techniques is good,” Smithson said. “It does work and is used with a lot of veterans with war trauma.”
Overcoming barriers to treatment
Firefighters seeking help with PTSD are often left carrying the costs of the treatment, even after state legislation changed more than two years ago that allows them to receive mental health counseling under workers’ compensation laws.
“There is about a 55-60% rejection rate of the claims after they file for workman’s comp,” Shoplock said.
The organization has started training firefighters with PTSD to fill out the claims, which usually ask for a specific date of the injury, which can be difficult to pin down. But with PTSD a series of events can trigger the disorder or make the symptoms more severe, so it’s not as cut and dried.
Smithson said some insurance companies will cover PTSD treatments but the person will have copays. His office has worked successfully with PTSD patients.
Jensen took about six months off from his job and is now back on the job full time.
“The city and my chief didn’t push me to go back,” he said. “And I’ll never forget that.”
Shoplock said the Firefighter of the Year honor comes from Jensen’s peers.
“It shows how many of them love and respect him,” Shoplock said. “He is Mr. Reliable. You can always call on him for help. If one-tenth of our organization had the drive Justin has, it would be amazing.”
His story shows that these types of mental injuries can be successfully treated and people can get back to work.
“He has the ability to talk about mental health and that is needed. There’s really a strong divide on it in the field,” Shoplock said. “I think we’re just starting to peel the onion. I hope this starts the conversations statewide.”
Meanwhile, Jensen continues to reach out to others who are feeling the effects of PTSD or are having suicidal thoughts.
“Don’t be afraid to ask for help,” he reminds them. “Pick up the phone regardless of what time it is.”
The Idaho Suicide Prevention Hotline can be reached at 208-398-4357.