The call came in just before sunset. Lincoln County Search and Rescue needed help retrieving the body of a snowmobiler who had died in an avalanche.
With daylight fading, Teton County Search and Rescue responded, flying its helicopter down. It was a quick mission, a race against the light, and though it was successful, it didn’t sit well with volunteer Jen Reddy.
“It felt very cold and tactical to complete that mission that quickly,” she said. “I really would have liked to say how sorry I was to the surviving members, who were the son and brothers of the deceased.”
That Feb. 17 incident set off the deadliest spate of avalanche events in area history, with three deaths in six days. Rescuers flew to Togwotee Pass, Greys River Road and Grand Teton National Park on those missions.
Rescuers and emergency response professionals feel a sense of purpose in helping the public, but a week like that one in mid-February can be traumatic.
“It’s obviously a lot more emotionally draining on us when we’re coming home from a burial that’s a fatality,” search and rescue volunteer Keegan Pfeil said.
Agencies around Teton County are working to connect rescuers with counselors and other services, and to build a culture of emotional awareness that keeps people ready to respond in times of crisis.
“It’s sad for someone to fade away into the sunset, carrying baggage that we could’ve worked through together,” said Jackson Hole Fire/EMS Battalion Chief Mike Moyer, who is a longtime search and rescue volunteer.
What started as an idea for a peer resilience group a couple of years ago has transformed into a more formal collective, the Teton Interagency Peer Support group.
Known among the local first response community as TIPS, it began as a way to remove barriers that usually stand between first responders and professional therapists. It’s also a group of agencies and individuals who want to prioritize conversations about mental health for emergency responders.
TIPS aims to remove the tough-guy culture sometimes associated with emergency response organizations and normalize conversations about what seeing and experiencing tragedy up close can do to someone.
“It’s important to understand as first responders you’ll be faced with situations that cause injury to your brain,” Sheriff Matt Carr said. “We need to treat it the same as a dislocated shoulder ... or else we are not fixing anything.”
The first-of-its-kind group anonymously connects Jackson Hole’s emergency response personnel — firefighters, ski patrollers, volunteer rescuers, police officers, park rangers — to professional therapists at no cost.
The trauma-specific counselors work in several practices around town, including at St. John’s Health. They offer sessions at a reduced rate, paid for through a combination of county funds, private business contributions and donations, Carr said. A “significant” private donation helped keep the group funded this year.
“This community has really embraced it, which is nice,” he said.
Reflecting on the past year, between all the fatal backcountry accidents on top of the pandemic, Carr said he’s thankful TIPS was in place.
At least 135 therapy sessions happened in the past year because of the peer support group, said Stephanie Thomas, executive director of the Teton County Search and Rescue Foundation. Family members of first responders are also allowed to seek help through the group.
“The biggest change in that program is that we now have funds to directly provide services for people’s families,” she said. “So if you are going through a really hard time and it is affecting your spouse, we can help with funding for your spouse or your children to get help. And that’s either through our trauma therapists or we have access to a psychiatrist at the hospital who has previously specifically worked with adolescents and youth.”
For Moyer, who’s been a first responder in Jackson Hole since the 1980s, offering the mental health services to family members is critical.
“There’s impact on family, too. It’s not just the rescuers,” he said. “The team has done a lot to reach out to our families and make them feel part of the team and appreciated and supported.”
Treating stress injuries
If you sprain your ankle on a hike, you’re probably going to go home and take care of it, maybe with ice, rest and a splint or wrap. You might stay off it for a few days until the pain goes away; you might ease back into activity.
With stress, many people don’t treat it the same way. They might ignore it, telling themselves that they’ll get over it.
“Nobody wants to feel like they need help or they’re weak,” Pfeil said.
That’s a common sentiment in military, law enforcement and rescue professional circles. Not handling stress could be taken as evidence someone isn’t up to the task, so rather than address it early, people have a tendency to suppress their symptoms.
“We have a tremendous barrier around the fear that admitting that you’re stress affected means you’re not fit for duty,” said Laura McGladrey, a psychiatric nurse practitioner who works with agencies around the Mountain West.
McGladrey is part of a growing field of clinicians who are changing the way rescuers and first responders look at stress. Using the term “stress injury,” which originated in the military, they talk about the symptoms people have after repeated traumatic events.
Using a stress injury continuum, the clinicians have developed a language for rescue professionals to orient themselves and their needs. The four steps on the continuum are ready, responding, injured and critical, and the stages’ corresponding colors are green, yellow, orange and red.
This vernacular allows counselors and patients, along with agencies, to recognize that stress injuries don’t go from nonexistent to debilitating overnight.
“We didn’t have a name for what was stress impact and injury,” McGladrey said. “People had to be quote-unquote ‘fine’ all the way up until they had PTSD, and there was nothing in between.”
That language is helpful because of the way trauma affects rescue professionals. They’re always on call, and incidents create a fight-or-flight response. The changes in the body, including increased cortisol levels, help them complete missions under difficult circumstances.
Repeated stress responses can cause a bevy of physiological symptoms, including cortisol build up, irritability and insomnia, among many others.
Tania Glenn, a counselor who works solely with the military and first responders, said that can have a damaging effect over time.
“There’s this toll that it takes on you, on your resilience, because overall this is great for survival, but it’s really bad for your health,” she said.
When search and rescue teams arrived back at the hangar following each of the deadly February avalanches, they debriefed like after any other incident. Debriefings can include discussions of dangerous parts of the day and what went well, but they also include a reminder to monitor yourself.
“There’s always a mention of the TIPS program,” Pfeil said. Those running the debrief tell rescuers that “it might take a couple days for it to sink in.”
Through both the TIPS program and a heightened awareness of emotional intelligence, the team and other agencies have developed a culture of checking in well before someone might need therapeutic care. Thomas, from the Search and Rescue Foundation, said they estimate three peer interactions for every counseling session, which means at least 400 in the past year.
Following that week in February, “several people on the team reached out to me,” Pfeil said. “Just a brief text message, ‘Hey, you OK?’ Just to check in.”
Creating that culture is imperative, clinicians say. Keeping people in the yellow or orange areas of the continuum is key to maintaining both their health and preparedness.
In mid-February when the teams were handling back-to-back missions, Sheriff Carr sent his weekly internal newsletter, with a somber tone.
He said he “personally had a really difficult time” with one of the deaths, and wanted to remind deputies, dispatchers and rescuers to check on each other and reach out for needed help.
“Everyone has different triggers for how events affect them and these impacts are cumulative in their effect,” he wrote. “DO NOT hesitate to reach out through our TIPS program for any assistance.”
For Reddy, self-care meant taking a break after responding to the third avalanche fatality, a slide in Broken Thumb Couloir in Grand Teton National Park. Just a day later, a man broke both of his legs in a slide on Mount Leidy, and although he survived, Reddy knew she needed to stay home to avoid exacerbating any stress injuries she had sustained.
“I was like, ‘You know what, I can’t be in the field for that one in case this is another gruesome, very tragic accident,’ ” she said. “I didn’t think I was maxed out, but I didn’t need to get there.”
Jackson’s responder community has taken to implementing that culture, though both McGladrey and Glenn say an unwillingness to address stress head-on is still a barrier in agencies across the nation. Therapists of all kinds talk about resilience, a person’s ability to handle stress and come out the other side, and that concept is perhaps even more significant for those who are charged with keeping the public safe.
“It is definitely about teaching and educating,” Glenn said, “then counting on departments to start to look at mental health in terms of resilience versus being weak.”
That way, they’re ready the next time someone needs help in the backcountry, regardless of whether it’s a lost hiker or an avalanche fatality.