Editor’s note: This story was originally published by Mountain State Spotlight. Get stories like this delivered to your email inbox once a week; sign up for the free newsletter at mountainstatespotlight.org/newsletter.

By Henry Culvyhouse, Mountain State Spotlight

HUNTINGTON — After 27 years, Steve McCormick still remembers the last night he worked on an ambulance. 

It was a routine medical call, a transport to the hospital. They didn’t even run the lights and sirens. 

But when McCormick and his partner got there, it turned into a full blown emergency. The elderly patient  wasn’t breathing — they ran a tube down her throat, and McCormick pumped a bag to keep her alive. 

“I felt her last breath in my hands,” McCormick said. “I came home and I told my dad, who worked in an ambulance all his life, that I couldn’t do it anymore.” 

Today, McCormick is a captain at the Huntington Fire Department. For two decades, he’s fought fires, responded to overdoses, worked car wrecks and more. 

“I’ve seen, smelt and heard stuff I wouldn’t wish on my worst enemy,” he said. 

All those calls take a toll. When McCormick was screened for Post Traumatic Stress Disorder and showed many of the symptoms, he said it was like a kick in the gut.

PTSD among the men and women in fire, police, EMS and at 911 call centers is a nationwide issue: studies have estimated around 35% of police officers, up to 22% of firefighters and almost a quarter of 911 dispatchers suffer from PTSD. In another study, EMS personnel were found to be 10 times more likely to contemplate or attempt suicide than the average American. 

From 2018 to 2021, more police officers and firefighters died by suicide than in the line of duty. 

While there have been no numbers tabulated specific to West Virginia, state lawmakers have repeatedly said over the past couple of years that mental health among first responders needs to be a top priority — it’s one of the many issues, along with dedicated funding and pay raises, that fire and EMS have been requesting help with for years.

Del. Joe Statler, R-Monongalia, is part of an informal working group looking at mental health in first responders. He said the issues are complex.  

“It’s like hitting a yellow jacket’s nest while you’re weed eating — you don’t know which bee to swat at first,” he said. 

 Challenges in accessing mental health care

Dr. Kari Mika-Lude, a West Virginia therapist who specializes in treating PTSD in first responders, said addressing and processing a traumatic event quickly is the key to reduce the likelihood it doesn’t become full-blown PTSD. 

“Think of it like a laundry pile,” Mika-Lude said. “You might have a laundry pile and for every new piece of clothing you put into the pile, you take a little bit  away. But if you don’t take anything from the pile, it gets bigger and bigger until one day, it feels unmanageable.” 

For McCormick, he likens it to sponge under a dripping faucet — eventually, that sponge overflows. It could be a routine lift-assist call, it could be a bit of internal department politicking, but eventually, it overflows. 

And his sponge was overflowing for a while. McCormick described sleepless nights, being in a constant state of high alert, jumpiness, quick to anger, all signs of PTSD.

“I never thought I had a problem,” he said. “When you’re living like that for so long, you just think it’s normal — but you find out, it isn’t.” 

The drive to stay strong in order to help others further complicates issues. Mika-Lude said while the public’s tendency to put first responders on a pedestal might be well-intended, it can push them to keep performing to the point of burnout. 

“Helpers are people too,” she said. “When we’re talking about this, I think that’s something the public needs to remember.” 

McCormick said turning the switch off can be tough; he’s seen guys turn their whole identity into being a first responder. 

“People see my mustache, I might just be wearing street clothes, and they know I’m a fireman,” he said. “It’s hard to make that separation, but look, I’m sitting on my back deck smoking a cigar and drinking a beer, just like anyone else that gets off of work.” 

Suffering alone can cause unhealthy coping techniques, like compulsive gambling, excessive drinking and infidelity, according to Vanessa Stapleton, president of Armor Up WV, an organization that raises PTSD awareness and puts first responders in touch with resources for treatment. 

But she said there are few places in the state for first responders to seek help.

The state already lacks mental health providers — one estimate at a conference last year for EMS and mental health providers said there’s one mental health provider for every 500 people in the state. 

Finding therapists who specialize in first responders is even tougher. And in-patient care — after a suicide attempt or when getting clean from drugs and alcohol — presents its own sets of issues. 

Stapleton said getting inpatient treatment out of state is better for first responders because they’re not in rehab with people they may have arrested or may have saved from an overdose. But the Public Employee Insurance Agency has to preauthorize an out-of-state admission — sometimes taking up to two weeks to give the green light. 

Healing through meditation and trauma therapy

For the past four years, Huntington-area first responders have had another option: Compass, a program established specifically to deal with trauma among the group. 

Located on the top floor of the Huntington Police Department, the office doesn’t have the typical beige walls and harsh fluorescent lights common in most government buildings. Instead, the tones are soft. The lighting is largely natural. There’s no hustle and bustle of keyboards tapping away or a scanner blaring out a call. 

It’s quiet.

Manning the fort on a recent weekday are the tag-team duo of Amy Jefferson, a social worker, and Amy Hanshaw, a personal trainer. With roughly 79% of the city’s police and fire ranks at least popping into Compass — it might be for a coffee, it might be a high intensity training workout — the Amys said the key to the program’s success lies in how it started. 

At first, they didn’t have this office, so the two had to take the program on the road, hanging out at city fire stations and in police cruisers. Over time, they got to know the firefighters and the officers. 

Putting mental health and wellness in the training program for each department also helped. About a quarter of the department’s ranks are made up of firefighters who underwent this training. 

McCormick, who uses the services for meditation and some specialized PTSD therapy, said if this program had started earlier, it could’ve saved even more lives and careers. 

“We’ve had a suicide and we’ve a few quit because of mental health issues,” he said. “I think if this was around, that wouldn’t have happened.” 

State lawmakers work to improve first responder mental health

But outside of Huntington and Cabell County, the support for PTSD among first responders is much more limited. 

Over the past few years, lawmakers have taken some steps toward trying to address the growing crisis. In 2021, they passed a bill to carve out an exception in workers’ compensation law to allow first responders to file claims for PTSD. By and large, worker’s comp claims do not include mental illness caused by the mental stress of the job. But the law included a huge loophole: employers can elect to skip the coverage. 

“This bill was a good old-fashioned compromise — if you’re hungry, it’s better to have half a loaf of bread than to say you don’t want any at all unless it’s a whole loaf of bread,” said former Cabell County delegate Chad Lovejoy, who said giving employers the choice was the only way to get the bill across the finish line. 

Earlier this year, lawmakers set aside more money for EMS systems around the state, which included a provision to implement “critical response teams” to debrief EMS personnel after a traumatic event. Office of Emergency Medical Services Director Jody Ratliff told lawmakers at least one team was in place and more would come. He also said he’s been working with 988, the suicide hotline, to have call takers ride along with first responders so they better help them when they call. 

Statler said he visited the Compass Program and was impressed. During the September Interim session, he recommended his fellow lawmakers do the same. 

“The day I spent my time there, the two directors there answered all my questions and I saw several people come in and out to use that facility,” he said. “It is something.”

McCormick says the program is starting to move the needle at the firehouse, if only just by encouraging conversation. He says he now hears chats over dinners at the station about how guys are doing, checking in with one another. 

“People didn’t talk about this shit 10 years ago,” he said. 

While McCormick is a self-admitted “old hippy at heart” who has been quicker to embrace practices like meditation than others in his department, even he had a tough time accepting help. 

When he screened positive for PTSD, he asked his wife, a licensed therapist, what she thought. 

“It would be foolish to think someone in your job wouldn’t have symptoms of PTSD,” he recalled her saying.  

Even then, McCormick said he had a tough time accepting he had PTSD. It took a nudge from a buddy in the fire service to go see a therapist about it. 

“If he hadn’t vouched for the therapist I’m seeing, I’ll be honest, I don’t think I would’ve gone,” he said. “The things we see, the things we remember, the smelling, the hearing, none of that is going away. But maybe we can get some tools to process it better.”  

If you are facing a mental health crisis, the National Suicide Prevention Lifeline is open 24/7, at 988. 

Reach reporter Henry Culvyhouse at henry@mountainstatespotlight.org

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PITTSBURGH (KDKA) — The trial of the Pittsburgh synagogue gunman is coming to a close, and in its final hours the two sides are focused on the central issue of Robert Bowers’ mental health and whether he should face the death penalty. 

The prosecution says he was driven by pure hate and should face the ultimate punishment. The defense maintains his life should be spared because he was in the throes of mental illness and delusion when he attacked the synagogue in 2018. 

The gunman has shown no remorse for his actions. In fact, he told others he wished he had killed more people, believing he is a saint and a martyr who did the work of God by killing Jews whom he believed were possessed by Satan. 

“He has no remorse and is unable to express remorse, because the delusions are still there, that he is saving lives, that he is living the life of a saint or a martyr and what he did wasn’t wrong,” said Dr. George Corvin, a defense psychiatrist.

That was the testimony Friday of Corvin, who said the gunman acted out of bizarre and delusional beliefs that Satan-controlled Jews were bringing immigrant invaders into the U.S. and other countries to kill white Christians. 

He said the gunman told him the attack on the synagogue was “an unfortunate but unavoidable act” in a war predicted in the end times in the Book of Revelation and he was trying to stave off the destruction of humanity.

“He said, ‘If there was a non-violent way, he would have used non-violence, but the end days must happen. The tribulation must happen. He didn’t want to do this. He had to do this. How can I turn my back on God?'”

Corvin’s testimony is at the heart of the defense case that the gunman is schizophrenic and driven by insane delusions when he planned and executed the attack, and remains delusional to this day. 

United States Attorney Eric Olshan quoted other prosecution witnesses who challenged this, saying delusions must be generated from a person’s own brain and that the gunman simply latched on to beliefs, which though disgusting, are held by other white supremacists on the web platform Gab.

“Did you know that everything he believes was on Gab?” Olshan asked. 

“There are things that are in scripture, and there are things that are on that awful website. The way he puts them together is schizophrenic,” Corvin said.  

Olshan continued to pick holes in the diagnosis of schizophrenia, pressing the government’s case that the gunman is an intelligent person driven by hate who knowingly and methodically planned and executed the attack. 

Corvin pointed to the jury and said: “It doesn’t matter what I think. It matters what they think. It may not have to do with schizophrenia, but you don’t want that brain. I don’t want that brain.” 

The prosecution rested its case last week and the defense began calling witnesses to the stand. So far, they’ve focused on the family of the convicted gunman. Dr. Katherine Porterfield, an expert who is testifying about mental health issues, was on the stand Monday detailing the convicted gunman’s troubled childhood.

The defense is trying to show why his life should be spared with the jury soon to decide whether he will spend the rest of his life in prison or if he will be sentenced to death.  

Last month, Bowers was found guilty of all 63 federal charges in the attack when he shot and killed 11 worshippers from three different congregations, Tree of Life, Dor Hadash and New Light on Oct. 27, 2018. It was the deadliest antisemitic attack in U.S. history.  

Recapping the defense’s arguments

In their final push in the penalty phase, the defense is trying to convince the jury that the convicted gunman should be spared the death penalty because of mental illness.

They have called Dr. Katherine Porterfield, a psychologist and trauma expert, to the stand. She testified that the convicted gunman’s actions stem from a family history of mental illness and abuse at the hands of his parents. 

The suspect’s father, she said, was violent and committed suicide. And she called the suspect’s mother, Barbara Bolt, a lifelong depressive who physically and mentally abused the suspect as a child. Porterfield interviewed Bolt, who bizarrely admitted to showing the child how to sexually pleasure himself and cutting herself in front of him. 

“I was a terrible mom. I did horrible things,” Porterfield quoted Bolt as saying. “I should do half the sentence. He was provoked into things.” 

Porterfield said the suspect’s childhood environment, combined with a long family history of depression, resulted in him being suicidal at the age of 10 and repeated suicide attempts throughout his teen years. As an adult, she said he became a loner without true friends. 

“He’s had a very impoverished social life, a very damaged sense of self and suicidality stemming from self-hatred,” she said. 

But under cross-examination, Porterfield — who never personally interviewed the suspect — conceded she did not include the defendant’s own statements denying the suicide attempts and that he has not been suicidal as an adult. 

Prosecutors also brought to light that the suspect had reconciled with his mother, had been a responsible employee at a local bakery and kept a tidy apartment as signs that he had adjusted.

The jury also heard from witnesses who knew the suspect as a child. 

Dennis Kavanaugh, the suspect’s fifth-grade teacher, said during a timed math quiz, the suspect “became anxious, shaking and shouting. I was surprised because he was pretty good at math, but I had to stop the class.” 

Later, Kavanaugh heard the suspect had tried to harm himself and maybe tried to kill himself, but when he put his hand on his shoulder and tried to counsel him, he said the suspect “made like he was spraying an aerosol can, getting the teacher cooties off his shoulder. I didn’t know how to break through to him.” 

The convicted gunman’s family member, Naomi Grimm, a first cousin to his mother, also took the stand.

Recapping victim impact statements

Last week, the prosecution called family members of the victims to the stand to give victim impact statements. The wife and son of victim Dan Stein took the stand; and then, Michele Rosenthal, the sister of victims David and Cecil Rosenthal, talked about her two younger brothers.

Andrea Wedner summed up the loss she feels as a pain in all the small moments when talking about her mother, Rose Mallinger. “I’m haunted by what happened to me and by what I saw and what I heard that day,” she told the jury. 

The jury also heard victim impact statements from Dan Leger, who dropped from 145 pounds on the day of the shooting down to 110 pounds in the hospital. He couldn’t even speak, and said he wrote to his wife on a piece of paper “let me go” because he thought he’d never recover from his injuries. 

The brother-in-law of Dr. Jerry Rabinowitz took the stand on Tuesday, stating how his brother-in-law just wanted to help people, which is why he got into family medicine, saying that he would even make house calls after hours. 

He added that many people in the family have changed their professions since the deadly shooting took place to do things to more directly help people, like Dr. Rabinowitz did. 

Michelle Weiss, the daughter of the slain couple Sylvan and Bernice Simon, said she spoke with her mother every day and was asked what life is like without her. 

“I lost my best friend, my confidant, lost my most important people in my life in one day,” she said. “It’s very hard for me to go on. We don’t have holidays anymore, nothing is the same.” 

Anthony Feinberg, the son of Joyce Feinberg, called his mother “the central cog” in his family who has left such a void.

In earlier testimony, Margaret Durachko, the wife of Richard Gottfried, was the first of more than 20 family members to take the stand during this phase of the trial and testified of how her whole life was turned upside down following the mass shooting at the synagogue.

Diane Rosenthal, the sister of Cecil and David Rosenthal, testified that when they were diagnosed early with fragile X syndrome, her parents insisted they be raised at home with her and her sister Michelle rather than be put in an institution. The boys, she said, were a gift with an infectious joy for life which they spread throughout the neighborhood. 

Testifying on videotape, Cecil and David Rosenthal’s mother said she thanks God for her sons and couldn’t be more proud to be their mother but now they are gone. 

Support is available for those in need during the trial

If you or someone you know is experiencing mental health effects from the trial, go to 1027healingpartnership.org to find help resources. As always, call 911 to report threats. 

Phone: 412-697-3534
Email: info@1027HealingPartnership.org
Website: 1027healingpartnership.org

More resources can be found here.

Andy Sheehan

KDKA-TV Investigator Andy Sheehan began his broadcast journalism career in September 1992, when he joined KDKA after reporting for the Pittsburgh Post-Gazette for nine years. Andy’s forte is the in-depth investigative story, exposing corruption and government waste.

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By Liz Carey
The Daily Yonder

For the first time in 20 years, mental health and addiction are more pressing health concerns than getting access to basic healthcare, according to a survey of rural stakeholders.

Rural Healthy People 2030, released by the Southwest Rural Health Resource Center, surveyed a national sample of people “working to improve the lives and health of rural Americans,” to determine the most important issues facing rural residents. Participants included people working in health care, public administration, education, human services, and other fields.

In 2010 and 2020, the biggest issue in the survey was access to health care.

While access to health care remained one of the top five issues according to survey respondents, researchers said, the growing impact of mental health and addiction took the number one and two spots on the list regardless of age, race, region or occupation.

“For the past two decades, health-care access has been, far and away, the most important topic no matter how we cut the data,” said Timothy Callaghan, one of the survey authors. “The fact that mental health and addiction came out ahead of health-care access this time… certainly surprised us, but when you start thinking about the context of the past decade and the context of the pandemic in which you launched the survey, the findings are a bit less surprising.”

Callaghan said the rise of the opioid epidemic prior to the COVID-19 pandemic, and the growing recognition of the lack of mental health resources in rural America since the pandemic may be part of the reason. But changes in health care through the Affordable Care Act may have improved health-care access, bringing other issues to the top of the list, Callaghan said.

According to the U.S. Department of Health and Human Services, nearly 20 million people signed up for insurance as part of the Affordable Care Act during open enrollment this past year. During 2022, 35 million people signed up for insurance during the open enrollment period, 21 million of whom were part of Medicaid expansions.
 
Still the fact that mental health and addiction rose to the top across all categories was striking, he said.

“You’re going to see small changes in characteristics over the course of decades,” he said. “But the extent to which mental health and addiction have risen and were so consistently selected by stakeholders, demonstrates how big those issues really are.”

Stakeholders may have been focusing on what were the most pressing needs given the moment, Callaghan said. The survey was presented to stakeholders 2021. Partnering with rural health organizations like the National Rural Health Association, the Centers for Disease Control and Prevention, the American Hospital Association, and the National Association of Rural Health Clinics, the research center sent out links to the survey and asked stakeholders to comment. In addition, the center sent the survey to people who had filled out the survey in previous decades and asked stakeholders to identify others they felt may be able to provide insight.

According to the Pew Research Center, an estimated 40% of American adults suffered from increased mental health issues during the pandemic. A survey done by the Kaiser Family Foundation and CNN found that 90% of the American public felt the country was facing a mental health crisis. Adults across the country during the pandemic reported increased symptoms of anxiety, depression, hopelessness and sadness and suicidal ideation, as well as increased drug and alcohol use.
 
In all, 1,291 respondents answered at least one of the questions between July 2021 and February 14, 2022.

“I think part of (the rankings) could be that a lot of the rural stakeholders participating understood that we’re looking at 10-year trends,” he said. “Our data didn’t allow us to identify specifically why, for example, vaccination isn’t in the top 20 even though we might have expected it to be, due to the pandemic.”

Major concerns besides health-care access in previous surveys included heart disease and stroke, diabetes, and nutrition.

Callaghan said as a country we’ve made significant strides in those areas. A report by the research center to the Federal Office of Rural Health Policy found that rural America has made progress on some leading causes of death.

“We’ve seen some pretty considerable gains in heart disease deaths,” Callaghan said. “We still do have a gap between urban and rural America, but there have been some pretty considerable gains.”

Callaghan said it’s not clear if that is because rural health-care providers are better at managing the disease, or educating patients about the diseases, or if other topics have just become more important.
For now, Callaghan said, the study reveals where the focus of rural health systems should be, according to rural health stakeholders.

“We now have a better sense of the areas that are particularly in need of rural health investment,” he said.

“We now know that addressing addiction and addressing mental health issues have become increasingly important to rural experts over the past decade and while health-care access remains important… we nonetheless have to start prioritizing the issues that are most important which are addiction and mental health.”

The Daily Yonder

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