The CARES UP Model

What Is The CARES UP Model?

CARES UP is a wellness and resiliency program for uniformed personnel organizations. This model is intended for leaders at New York State uniformed personnel organizations and serves as a how-to-guide that includes helpful templates and resources to implement the program.  

A purple pyramid highlighting the seven CARES UP steps.

Why Is It Called CARES UP?

CARES UP stands for:

  • Changing the Conversation
  • Awareness
  • Resilience
  • Empowering Peers
  • Skills Building and Suicide Prevention for
  • Uniformed Personnel

It was created in 2021 based on national expertise in suicide prevention and best practices for uniformed personnel organizations to address and combat the stress and trauma that are a day-to-day reality in these professions.

Why Do Organizations Need CARES UP?

Cumulative stress and trauma are very common in uniformed personnel professions. A survey found that more than 37% of first responders had contemplated suicide and roughly 7% had attempted.1  

Another found that first responders are more likely to die by suicide than in the line of duty.2 A 2018 study by Heyman showed 103 firefighters and 140 police officers died by suicide in 2017. In 2019, the Firefighter Behavioral Health Alliance (FBHA) reported that nationally, 119 firefighters and 20 EMT paramedics died by suicide. 

Uniformed personnel are also at increased risk for developing mental health problems, including:

  • Anxiety3
  • Poor sleep4
  • Depression4
  • Post-Traumatic Stress Disorder (PTSD)5

These concerns can be attributed at least in part to the reoccurring, risky, and often traumatic situations they experience at the workplace. They can also lead to additional physical health problems and/or burnout. This combination can result in long-term work performance issues (ex: decreased productivity, absenteeism, early retirement, etc.) and higher rates of thoughts of suicide and attempts compared to the general public.6 Partners and other family members of first responders also experience trauma and distress and face unique challenges due to taking on supportive roles for their loved ones.7

It’s important to get the right support, resources, and tools to uniformed personnel organizations to proactively address mental health and well-being. That’s where the CARES UP initiative can help. In 2022, the New York State Office of Mental Health’s Suicide Prevention Center (OMH’s SPCNY) provided funding to 12 first responder agencies to implement the CARES UP Model. This guide contains their lessons learned. In addition to improving mental health and well-being initiatives in participating agencies, CARES UP goals include:

  • Create organizational and cultural change to support and improve mental health at work.
  • Reduce the impact of workplace trauma and stress, and provide opportunities to learn about resilience, life skills, and healthy coping strategies. 
  • Promote acceptance of mental health care broadly defined and wellness at work.
  • Increase access to peer programs and other social supports.
  • Introduce access and decrease barriers to wellness options at work. 

How To Use This Guide:

This toolkit contains resources that uniformed personnel organizations can use to develop or grow their infrastructure to support mental wellness and resilience for their teams by implementing the CARES UP Model. The steps of the model provide a pathway for departments to get started and build a comprehensive approach to mental health. Each step contains links to no cost resources and tools that were developed during the initial CARES UP pilot and have been tested by organizations like yours. Whether you’re starting from step one or have some building blocks already in place, there are valuable materials that you can use to improve the well-being of your staff.  Lessons learned from the original grant sites have been built in!  

Move on to the first step of the CARES UP Model:

Step One - Step UP

References:

1. Barber, E., Newland, C., Young, A. & Rose, M. (2015). Survey reveals alarming rates of EMS provider stress and thoughts of suicide. Journal of Emergency Medical Services. Retrieved from https://www.jems.com/special-topics/survey-reveals-alarming-rates-of-ems-provider-stress-and-thoughts-of-suicide/  

2. Heyman, M., Dill, D. & Douglas, R. (2018). The Ruderman White Paper on Mental Health and First Responders. Retrieved from: https://rudermanfoundation.org/white_papers/police-officers-and-firefighters-are-more-likely-to-die-by-suicide-than-in-line-of-duty/ 

3. Bentley, M. A., Crawford, J. M., Wilkins, J. R., Fernandez, A. R., & Studnek, J. R. (2013). An assessment of depression, anxiety, and stress among nationally certified EMS professionals. Prehospital Emergency Care, 17(3), 330-338. 

4. Berger, W., Coutinho, E. S. F., Figueira, I., Marques-Portella, C., Luz, M. P., Neylan, T. C., … & Mendlowicz, M. V. (2012). Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Social psychiatry and psychiatric epidemiology, 47(6), 1001-1011. 

5. Charles, L. E., Slaven, J. E., Mnatsakanova, A., Ma, C., Violanti, J. M., Fekedulegn, D., … & Burchfiel, C. M. (2011). Association of perceived stress with sleep duration and sleep quality in police officers. International journal of emergency mental health, 13(4), 229. 

6. Stanley, I. H., Hom, M. A., & Joiner, T. E. (2016). A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and paramedics. Clinical psychology review, 44, 25-44. 

7. Casas, Jena B., and Lorraine T. Benuto. “Work-related traumatic stress spillover in first responder families: A systematic review of the literature.” Psychological trauma: theory, research, practice, and policy 14.2 (2022): 209.