The sound of sirens and the sight of smoke from a distant building are common aspects of the daily lives of firefighters, police officers, EMTs, and other first responders. These dedicated individuals regularly face challenging situations to assist others, but the emotional impact of these experiences can accumulate over time, leading to lasting effects.
These effects can include post-traumatic stress disorder (PTSD), a mental health condition that can develop after a person is exposed to a traumatic event. It could be a near-death experience, witnessing a traumatic event, being a victim of violence, or other distressing occurrences.
The symptoms of PTSD vary widely but may include flashbacks or nightmares related to the traumatic event, severe anxiety, and difficulty coping with everyday life.
Studies show a disturbing trend: first responders are far more likely to develop PTSD compared to the general population. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), it is estimated that 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and PTSD, as compared with 20 percent in the general population.
First responders are the cornerstone of our communities, putting their lives on the line to ensure our safety. It's our collective duty to ensure their well-being.
First responders are on the front lines of emergencies and tragedies. Firefighters witness the devastation of burning buildings and the loss of life. Police officers confront violent crime and its aftermath. EMTs grapple with critical medical situations and the emotional toll of loss. These are just a few examples of the traumatic events that first responders encounter on a regular basis.
This repetitive exposure to such experiences can take a significant emotional toll. First responders face these challenges day in and day out. There's no clear demarcation between work and personal life, and the potential for encountering another traumatic event is always present.
Beyond the immediate trauma of critical incidents, the work environment of first responders contributes to chronic stress and burnout. Their jobs often involve long hours, unpredictable schedules, and shift work that disrupts sleep patterns. The pressure to perform under time constraints and make critical decisions on the spot further compounds the stress.
Additionally, first responders may feel isolated and misunderstood by those outside their profession. The graphic nature of their experiences can be difficult to share with family and friends, leading to feelings of loneliness and a sense of carrying the burden alone.
This combination of factors – constant exposure to trauma, a high-stress work environment, and social isolation – creates a perfect storm that significantly increases the risk of developing PTSD in first responders.
PTSD doesn't just stay confined to the workplace. It significantly impacts the personal lives of first responders and their loved ones.
Reliving a traumatic event in vivid detail, as if it's happening again.
Being constantly on edge and easily startled, anticipating danger.
Avoiding people, places, or situations that trigger memories of the trauma.
Turning to drugs or alcohol to cope with symptoms
Difficulty experiencing positive emotions, feeling detached or emotionally withdrawn.
These symptoms can wreak havoc on a first responder's personal life. Relationships with family and friends can suffer due to emotional withdrawal, irritability, and difficulty communicating the emotional turmoil. Sleep disturbances lead to fatigue and hinder daily functioning. The constant state of hypervigilance can be emotionally draining and make it difficult to relax.
In severe cases, PTSD can lead to depression, anxiety, substance abuse, and suicidal ideation. Nearly 37 percent of EMS personnel and firefighters in the US have contemplated suicide at some point in their lives – nearly 10 times the rate in average Americans, according to The Institutes of Health's website.
Fortunately, there are several evidence-based treatments available that have proven effective for PTSD in first responders. According to the American Psychological Association's clinical practice guideline, the most well-supported psychotherapies for PTSD are:
This cognitive behavioral therapy involves gradually exposing the patient to trauma memories and reminders in a safe environment. It helps reduce avoidance and anxiety associated with the traumatic event.
CPT focuses on modifying maladaptive beliefs related to the trauma through cognitive restructuring techniques. It helps patients gain a new understanding of the traumatic event.
These CBT approaches directly address memories, thoughts, and feelings related to the trauma through exposure and cognitive restructuring components.
EMDR uses bilateral eye movements while recalling traumatic memories, which is thought to help the brain reprocess and desensitize to the memories.
The guidelines and strong research evidence suggest that PE, CPT and trauma-focused CBT should be the first line of treatment for PTSD whenever possible. A study found 90% of police officers with varying trauma histories responded positively to these evidence-based PTSD treatments.
Medication can also play a role, with selective serotonin reuptake inhibitors (SSRIs) like sertraline often prescribed to help manage PTSD symptoms like intrusive thoughts, avoidance, and hyperarousal.
In addition to therapy and medication, there are several organizations providing PTSD treatment resources tailored for first responders:
The National Alliance on Mental Illness (NAMI) has a helpline, support groups, and educational programs to support first responders' mental health.
The International Association of Fire Fighters (IAFF) Center of Excellence offers confidential, specialized PTSD treatment for firefighters.
Employers and organizations overseeing first responders play a crucial role in promoting mental health support and reducing stigma. Here are some key recommendations:
While addressing PTSD is crucial, prevention and resilience-building strategies can also play a vital role in supporting first responders' mental health. Here are some key strategies:
By addressing PTSD and taking proactive measures to prevent or minimize it, we can better support the mental health of our first responders – the heroes who selflessly serve our communities every day.
When you partner with Ulliance, our Life Advisor Consultants are always just a phone call away to teach ways to enhance your work/life balance and increase your happiness. The Ulliance Life Advisor Employee Assistance Program can help employees and employers come closer to a state of total well-being.
Investing in the right EAP or Wellness Program to support your employees will help them and help you. Visit https://ulliance.com/ or call 866-648-8326.
The Ulliance Employee Assistance Program can address the
following issues:
• Stress about work or job performance
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References:
First Responders: Behavioral Health Concerns, Emergency Response, and Trauma; Substance Abuse and Mental Health Services Administration https://www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdf
First Responders and Mental Health: When Heroes Need Rescuing; Psychiatric Times; Rodney Luster
https://www.psychiatrictimes.com/view/first-responders-and-mental-health-when-heroes-need-rescuing
First Responders First; National Alliance on Mental Illness; Gregory Beyer
https://www.nami.org/frontline-wellness/as-a-first-responder-your-health-and-well-being-are-key/
PTSD in First Responders; Institutes of Health, https://institutesofhealth.org/ptsd-in-first-responders/